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Prevalence and correlates of the metabolic syndrome in a population-based sample of European youth^1,2,3

¹ From the Medical Research Council Epidemiology Unit, Cambridge, United Kingdom (UE, JL, and SB); the School of Health and Medical Sciences, Örebro University, Örebro, Sweden (UE); the Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway (SA and LBA); the Institute of Sport Science & Clinical Biomechanics, University of Southern Denmark, Odense, Denmark (LBA and KF); the School for Health, University of Bath, Bath, United Kingdom (CJR); and the Faculty of Human Movement, Technical University of Lisbon, Lisbon, Portugal (LBS).

² Supported by the Danish Heart Foundation, the Danish Medical Research Council Health Foundation, the Danish Council for Sports Research, the Foundation in Memory of Asta Florida Bolding Renée Andersen, the Faculty of Health Sciences, University of Southern Denmark, Estonian Science Foundation grant numbers 3277 and 5209, and the Medical Research Council, United Kingdom.

³ Reprints not available. Address correspondence to U Ekelund, MRC Epidemiology Unit, Institute of Metabolic Science, Box 285, Addenbrooke's Hospital, Cambridge CB2 0QQ, United Kingdom. E-mail: ue202{at}medschl.cam.ac.uk.

Background: Until recently, there has been no unified definition of the metabolic syndrome (MetS) in the youth. Therefore, the prevalence of MetS and its association with potential correlates are largely unknown.

Objective: The objective was to quantify the prevalence, identify the correlates, and examine the independent associations between potential correlates with MetS.

Design: A population-based cohort study was conducted in 10- and 15-y-old youth from Estonia, Denmark, and Portugal (n = 3193). MetS was defined according to the International Diabetes Federation. Correlates included maternal socioeconomic status, body mass index (BMI), hypertension, and prevalent diabetes and maternally reported child's birth weight and duration of breastfeeding. Data on sexual maturity, objectively measured physical activity, cardiorespiratory fitness, self-reported sports participation, television viewing, and regular play were collected for the children.

Results: The prevalence of MetS was 0.2% and 1.4% in 10- and 15-y-olds, respectively. Cardiorespiratory fitness (standardized odds ratio: 0.33; 95% CI: 0.15, 0.75), physical activity (standardized odds ratio: 0.40; 95% CI: 0.18, 0.88), and maternal BMI (standardized odds ratio: 1.61; 95% CI: 1.11, 2.34) were all independently associated with MetS after adjustment for sex, age group, study location, birth weight, and sexual maturity. An increase in daily moderate-intensity physical activity by 10–20% was associated with a 33% lower risk of being categorized with MetS.

Conclusions: High maternal BMI and low levels of cardiorespiratory fitness and physical activity independently contribute to the MetS and may be targets for future interventions. Relatively small increases in physical activity may significantly reduce the risk of MetS in healthy children.

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