Increased physical activity may be more protective for metabolic syndrome than reduced caloric intake. An analysis of estimated energy balance in U.S. adults: 2007–2010 NHANES

Abstract Background and aim The purpose of this study was to examine the association between physical activity (PA), caloric intake, and Metabolic Syndrome (MetS) in a representative sample of the United States population. Methods and results Data for 4327 adults from 2007 to 2010 NHANES were analyzed. MetS was defined using both ATPIII and AHA/NHLBI criteria. Weekly moderate and vigorous physical activity (PA) minutes from work, leisure-time, and transportation PA were used to estimate Total Energy Expenditure (TEE) from Basal Metabolic Rate (BMR) using the Harris-Benedict equation. Average total calories (KCAL) from two 24-h dietary recalls were used to compare energy intake and expenditure between subjects with and without MetS. An alpha of 0.05 was used to determine statistical differences. The age adjusted prevalence of MetS was 21.9% (95% CI 20.1–23.6) and 36.8% (34.7–39.0) using ATPIII and AHA/NHLBI criteria, respectively. The estimated population mean for KCAL/TEE was 0.83 (95% CI 0.82–0.84), and the mean for KCAL/BMR was 1.25 (95% CI 1.23–1.27). Subjects without MetS (MetS−) reported 36 ± 13 (ATPIII) and 45 ± 18 (AHA/NHLBI) more daily moderate PA minutes than subjects with MetS (MetS+). At each level of PA, MetS− consumed more calories relative to BMR and TEE than MetS+. For both normal and overweight adults, KCAL/BMR was higher for MetS− than MetS+. For all BMI groups, there were no differences between MetS− and MetS+ with respect to KCAL/TEE. Though MetS+ adults in either MetS criteria were generally less physically active, MetS− adults maintained a higher caloric intake relative to estimated energy needs. Conclusions These results suggest energy needs may be distorted in Metabolic Syndrome and increased physical activity may be more protective than reduced caloric intake.