title: Association between physical activity and metabolic syndrome in middle-aged Japanese: a cross-sectional study.
abstract: BACKGROUND
  Although many studies have reported an association between self-reported physical activity and metabolic syndrome (MetS), there is limited information on the optimal level of physical activity required to prevent MetS. This study aimed to determine the association between objectively measured physical activity and MetS in middle-aged Japanese individuals. We also determined the optimal cutoff value for physical activity required to decrease the risk of developing MetS.
  
  
  METHODS
  A total of 179 men and 304 women, aged between 30 and 64 years, participated in this study. Participants were divided into two groups using the Japanese criteria for MetS as those with MetS or pre-MetS, and those without MetS. Participants were considered to be physically active if they achieved a physical activity level of 23 metabolic equivalents (METs) h/week, measured using a triaxial accelerometer. The association between physical activity and MetS was analyzed using logistic regression with the following covariates: sex, age, sedentary time, low intensity activity, calorie intake, smoking, menopause and body mass index. We also evaluated the factors that determined the association between the prevalence of MetS and pre-MetS and the physical activity cutoff value using classification and regression tree (CART) analysis.
  
  
  RESULTS
  The odds ratio for MetS and pre-MetS was 2.20 for physically inactive participants (< 23 METs h/week), compared with physically active participants (≥ 23 METs h/week). The corresponding odds ratios for men and women were 2.27 (P < 0.01) and 1.95 (not significant), respectively. CART analyses revealed that moderate-vigorous physical activity of > 26.5 METs h/week was sufficient to decrease the prevalence of MetS and pre-MetS in middle-aged Japanese men and women.
  
  
  CONCLUSIONS
  The results of this cross-sectional study indicate that the Exercise and Physical Activity Reference for Health Promotion 2006 is inversely associated with the prevalence of MetS in men. Our results also suggest that moderate physical activity of > 26.5 METs h/week may decrease the risk of developing MetS and pre-MetS in middle-aged Japanese individuals.
authors.affiliation: Department of Sports Medicine, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan.
authors.forename: Junghoon
authors.initials: J
authors.lastname: Kim
authors.forename: Kai
authors.initials: K
authors.lastname: Tanabe
authors.forename: Noriko
authors.initials: N
authors.lastname: Yokoyama
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Zempo
authors.forename: Shinya
authors.initials: S
authors.lastname: Kuno
mesh_terms: D056044:Actigraphy / Q000295:instrumentation; D000328:Adult; D000886:Anthropometry; D003430:Cross-Sectional Studies; D015444:Exercise; D005260:Female; D006801:Humans; D007564:Japan; D008019:Life Style; D016015:Logistic Models; D008297:Male; D024821:Metabolic Syndrome; D008875:Middle Aged; D016017:Odds Ratio; D057566:Self Report