# Relationships between metabolic syndrome and lifestyle factors: a retrospective cohort study in Japan

## TL;DR

This study found that walking over an hour daily, eating breakfast regularly, and avoiding late-night meals can help prevent metabolic syndrome in Japanese adults.

## Contribution

The study identifies specific lifestyle factors associated with a reduced risk of metabolic syndrome in a large Japanese cohort.

## Key findings

- Walking for more than one hour per day was linked to a 26% lower risk of developing metabolic syndrome.
- Skipping breakfast less than three days a week was associated with a 14% lower risk.
- Eating within two hours before bedtime less than three days a week reduced risk by 12%.

## Abstract

Japan allocates approximately 21.15 billion yen annually for specific health guidance targeting metabolic syndrome (MetS), yet the prevalence of this condition remains unchanged. This study involved identifying lifestyle factors that lower the risk of developing MetS through a comprehensive cohort study encompassing the adult population (i.e., Japanese people aged ≥18 years with no preexisting MetS).

Data were collected at the St. Luke's International Hospital Clinic Preventive Medical Center in Japan between January 2012 and December 2022. A retrospective cohort study was conducted on the adult population aged 18 years or older who did not develop MetS and underwent health checkups during the study period. Lifestyle factors that were preventively associated with MetS were investigated by using a Cox proportional hazards regression model.

Among the 52,516 included subjects, 5482 (10.4 %) developed MetS. The Cox proportional hazards analysis revealed that a lower risk of developing MetS was associated with walking for >one hour/day (HR = 0.74, 95 % CI = 0.66, 0.83), skipping breakfast <three days/week (HR = 0.86, 95 % CI = 0.76, 0.98), and eating within two hours before bedtime <three days/week (HR = 0.88, 95 % CI = 0.78, 0.99).

In a large-scale cohort study of the adult population in Japan, lifestyle factors associated with a lower risk of MetS were walking more than one hour daily, eating breakfast, and not eating before bedtime. Incorporating metabolic indicators in current health guidance may enhance prevention strategies. Further multicenter studies are warranted to support the implementation of national health guidance in Japan.

•This study investigated lifestyle factors that prevent metabolic syndrome.•This is a large retrospective cohort study involving 52,516 Japanese adults.•Walking for over an hour daily is the most effective lifestyle factor to prevent metabolic syndrome.•Eating breakfast is a preventive effect for metabolic syndrome.•Health guidance to increase metabolism may help prevent metabolic syndrome.

This study investigated lifestyle factors that prevent metabolic syndrome.

This is a large retrospective cohort study involving 52,516 Japanese adults.

Walking for over an hour daily is the most effective lifestyle factor to prevent metabolic syndrome.

Eating breakfast is a preventive effect for metabolic syndrome.

Health guidance to increase metabolism may help prevent metabolic syndrome.