Metabolic Syndrome
Julia Smith
April16th , 2016
Mrs. Holiday
METABOLIC SYNDROME 2
Outline
I. Introduction
a. Definition of MetS
IV. Participants
V. Analysis of Data
X. Conclusion
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Metabolic Syndrome
It is estimated that around 21% to 25% of the adult population from USA, Europe, Korea,
China and Taiwan have metabolic syndrome (MetS). Also experts have pointed to an increased
risk of developing MetS among adult population worldwide (Kuei-Man et al., 2015). Metabolic
low serum high-density lipoprotein (HDL) level. People with MetS have a higher risk for
developing other diseases such as: coronary heart disease or type 2 diabetes mellitus (Xi et al., as
This paper will discuss about the increased risk of developing MetS in adult Taiwanese
population due to the interaction of several unhealthy modifiable lifestyle behaviors with each
other and with other non modifiable risk factors (Kuei-Man et al., 2015).
Data Collection
Other studies done in the past were focusing mostly on the association between MetS and
one single unhealthy behavior (Katano, as cited in Kuei-Man et al., 2015).This study focused on
lifestyle behaviors and several non modifiable factors (age and gender). The data was collected
from a Taiwanese population database survey called Nutrition and Health Survey in Taiwan
The data was collected from standard questionnaires obtained by face–to-face interviews
and physical examinations: (circumference of the waist, blood pressure, fasting blood glucose,
triglycerides and HDL levels). The survey sample of NAHSIT was obtained from 6,144 people
of all ages from 358 townships and city districts. This study used a smaller sample of data
because children younger than 6 years old were not taken into consideration.
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MetS criteria
guidelines and modified criteria, MetS is characterized by the existence of any three from a
group of five conditions: triglycerides levels more or equal 150 mg/dl, HDL cholesterol levels
less or equal 40mg/dl for men and less or equal 50 mg/dl for women; waist circumference
more or equal 90 cm for men and 80 cm for women; systolic blood pressure more or equal 130
mmHg, diastolic blood pressure more or equal 85 mmHg, or using blood pressure medication;
and fasting blood glucose more or equal 100 mg/dl or using of medication for diabetes.
Healthy lifestyle behaviors such as a healthy diet, not smoking, less alcohol consumption,
regular physical exercise, have been linked with low risk of MetS in Japan. (Katano, as cited in
behavior, nine or more hours of sleep per night, have been linked with developing of MetS in
China (Yu et al., as cited in Kuei-Man et al., 2015). In Taiwan, the most common unhealthy
behaviors associated with MetS are the combination of chewing betel quid (a nut) with smoking
behavior and a low level of physical activity (less than 75 min per week).Chewing betel quid is
an important social ritual used in Taiwan due to its effect: euphoria, increased alertness and
According to Campbell (as cited in Kuei-Man et al., 2015) these unhealthy behaviors
affect the human body by decreasing HDL cholesterol levels and by increasing the risk of
atherosclerosis and adipocytes dysfunction. Also, there are some non modifiable factors that in
combination with the unhealthy behaviors previously mentioned increase even more the risk of
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developing MetS. This study used age as a non modifiable risk factor and several social-
economic risk factors, such living with family or married, and the education level (Lim, Nguyen,
Participants
This study has included 1132 men and 1205 women. More than half of the participants
(55.1%) were between 20 and 45 years old, 71.6% were living with family or were married , and
38.4% were college educated. The participants of this study were grouped as: never, former or
current smokers; never, former, or current betel quid chewing; never, moderate, or heavy
drinking behavior, and more or less of 75 min physical activity per week within the last past year
Participants were 29.3% former or current smokers, 43.6% drinkers, 10% chewed betel quid and
60.9% with reported physical activity of less than 75 min per week.
Analysis of Data
In order to establish the association between the variables and the risk of developing
MetS, this study used descriptive statistics, univariate, and multivariate logistic regression
analysis. Data were analyzed with the program Stata version 11.0. The variables used in this
study are several health-related behaviors such as smoking, betel quid chewing, drinking,
physical activity, waist circumference, blood pressure, HDL cholesterol level, fasting blood
glucose level and triglycerides level. Other variables used in this study are some demographic
characteristics such as age, living with family or married, gender and education. (Kuei-Man Lin,
2015).The study used also the modifiable lifestyle behaviors index that took into consideration
both the healthy and unhealthy modifiable behaviors. This index was ranging from 0 to 4, one
The study’s results show that 25% of participants had MetS. The study’s findings were
similar for various ethnic groups (Beltran-Sanchez et al, 2013). Also, the study shows that the
risk for developing MetS was higher for participants older than 65 years, individuals married or
living with family, smokers, heavy drinkers, betel nut chewing, individuals with less than
elementary education, and participants with physical activity less than 75 min per week.Results
also show that the most important risk factor for MetS among Taiwanese adults was the
combination of betel quid chewing and smoking behaviors. Former smokers and current betel
quid chewers had the highest risk of developing MetS, followed by current betel chewers and
current smokers.
Another conclusion of the study was that individuals with higher modifiable lifestyle
behavior index have a decreased risk of having MetS. Higher education of participants decreases
the risk of developing MetS because they have adopted a healthier lifestyle .Also, participants
married or living with family have an increased risk of developing MetS because of sharing of a
similar lifestyle. For that reason, another conclusion of the study was that it is important to assess
the family as a group. According to this study, physical activity less than 75 min per week has a
high risk of developing of MetS. Other studies had conflicting results regarding physical activity
and MetS prevention. The relation between the intensity of physical activity and MetS requires
additional study.The risk of MetS is higher in heavy drinkers than nondrinkers. Other studies
regarding alcohol consumption had controversy results. The difference was because of different
types of alcohol drinks. The exception was the moderate drink of wine that lowers the risk of
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MetS. Smoking and betel quid chewers have the highest risk for developing MetS due to
It is important for the Taiwanese population to be informed that about the fact that the
risk of developing MetS is three to five times higher for those who smoke or chew betel quid.
The population should be educated also, that by decreasing alcohol consumption and increasing
Study’s Limitations
This study had some limitations. The data were obtained from face-to-face interviews, the
fact that it might have been affected the objectivity of some answers. Another limitation was that
this study excluded the sleep quality factor. Also, this study did not assess family as a group; the
study and did not take into consideration the influence of the intensity of physical exercise and
the types of alcohol drinks consumed. Because of all these limitations of this study, additional
studies are required to understand the impact of all these factors on MetS.
Conclusion
The results of this study show that MetS is an important public health problem in Taiwan
and that the factors associated with increased risk of MetS are the combination of smoking and
betel quid chewing, alcohol consumption, the lack of healthy lifestyle of the elderly, being
married or living with family, and the lack of physical activity. It is imperative to inform the
Taiwanese population about these unhealthy life style behaviors associated with MetS and also,
to implement strategies to educate Taiwanese population about the ways to prevent MetS by
changing the unhealthy life style behaviors and promoting healthy life style behaviors.
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References
Kuei-Man, L., Jeng-Yuan, C., Shu-Hua, K., Jung-Ying, T., Chien-Ning, H., & Weng-Chun, L.