Lifestyle habits and perceived wellbeing of adults presenting with metabolic syndrome at a diabetic clinic in Ghana: A case-control study

Heightened by the epidemiological transition associated with excess energy intake, sedentary lifestyle and urbanisation, metabolic syndrome (MetS), previously uncommon in sub-Sahara Africa, is increasingly becoming a public health concern. We retrospectively assessed the association of diet and socio-demographic indicators as exposure factors to the development of MetS in typical peri-urban and rural settings in Ghana and examined the effect of MetS on the perceived quality of life of patients. One-on-one age- and sex-matched case-control study involving 152 adults aged 45–65 years were recruited from a diabetic clinic. Controls were recruited from communities where cases resided. Case definition was concurrent adiposity, hypertension, diabetes and dyslipidaemia. Lifestyle was assessed using a lifestyle and habits questionnaire, whereas diet history was assessed using a food frequency questionnaire. Differences were tested using McNemar and paired t-tests. To determine which exposure variables significantly predicted the development of MetS, we conducted a conditional logistic regression and reported the Mantel Haenszel crude and adjusted odds ratio (OR). Markers for MetS among the cases and controls were abdominal obesity (98.7% vs 36.8%), hypertension (90.8% vs 2.6%) and diabetes (72.4% vs 1.3%). Controls (77.6%) consumed more diversified diets compared to the cases (10.5%) (p = 0.001). Lower risk for MetS was linked to secondary education (COR = 0.17) and long duration of residence (COR = 0.30) in a peri-urban setting (COR = 0.22) whereas being unemployed (COR = 9.00) increased the risk. Abdominal obesity (COR = 28.51) was a stronger predictor of MetS compared to BMI ≥30 kg/m2 (COR = 14.80). Comparatively, the controls had a better self-perception of their physical wellbeing (73.7% vs 2.6%), fitness (88.2% vs 13.2%), nutrition and weight control (14.5% vs 1.3%) and psychological health (19.7% vs 0%). Considering that socio-demographic indicators were key exposures to MetS, we recommend interventions that promote the holistic wellbeing of the individual and should be integrated into existing health, social and community-based support services. •Unlike developed countries, the rate of metabolic syndrome in transition countries and the effect on the quality of life is not well known.•Lack of formal education and dwelling in a rural area were exposures.•It affected the patients' physical health, fitness, weight control regime and psychological wellbeing.•Li