Joint Association of Dietary Quality and Physical Activity with Metabolic Syndrome: A Population-Based Cross-Sectional Study in Western China
Authors: Hamulati Xieyire , Zhao Qian , Wang Ying , Mutalifu Munire , Deng Lei , Adili Niyaziaili , Liu Fen , Yang Yining , Li Xiaomei 
Published: August 2024

Background
Recent rapid economic development has resulted in many changes in life, such as a higher intake of calories and decreased physical activity (PA), imbalances in energy, obesity, and disorders in glucose and lipid metabolism. These modifications have played a part in the increase of metabolic syndrome (MetS) prevalence in Chinese people from 24.2–31.1% within the last ten years. This has become a serious public health issue. The present research aims at estimating the prevalence of MetS and exploring the interaction of diet quality (DQ) and PA in relation to metabolic syndrome in the urban areas of Xinjiang.
Methods
Participants This cross-sectional study recruited 10,192 participants between 30 to 74 years old in Urumqi and Korla from July 1, 2019 to September 30, 2021. The study adopt standardised questionnaire to determine the DQ and physical activity (PA) of the study population. Recommended techniques of clinical examination and laboratory tests were used in the study. JIS 2009 was used to screen for MetS. Dietary intake frequencies were recorded via the Food Frequency Questionnaire (FFQ) and categorized into three levels of diet quality. The participants’ DQ was categorized into three groups: poor, intermediate, and good based on their dietary scores. PA levels were determined using the International Physical Activity Questionnaire (IPAQ) calculations and classified into three groups. Three levels of analysis are identified in this regard, namely the low, moderate, and high levels. Thus, to assess the risks connected with MetS and the total impact of DQ and PA, multivariate logistic regression models were used to estimate odds ratios (ORs).
Results
The gender distribution showed that 5,251 of the 10,192 participants, 51.5% were men, and the overall mean age of the participants was 47.53 years with a standard deviation of 8.98. The prevalence of MetS in this cohort was noted to be 30.9% with a higher prevalence observed among the male than females (77.1% as compared to 22.9%, P < 0.001). The rates of waist circumference (WC) > 90 cm, blood pressure (BP) > 140/90mmHg, fasting plasma glucose (FPG) > 26.2 mg/dL, triglycerides (TG) > 1.7mmol/L, and high-density-lipoprotein-cholesterol (HDL-c) < 1mmol/L were 59.5%, 46.8%, 22.1%, 35.0%, and 18.4% respectively. Males exhibited a greater frequency of these MetS markers compared to females (P < 0.001). While 22.0% of the subjects had none of the metabolic factors, with men at 7.7% and women at 25.2%, a significant 18.7% (27.0% of males and 13.6% of females) possessed three or more metabolic components, meeting the criteria for MetS. A significant multiplicative interaction was identified between DQ and PA in relation to metabolic syndrome MetS (P for interaction < 0.05). Among those with high PA, poor DQ was linked to a higher probability of MetS. Conversely, in the context of good diet quality, insufficient physical activity also led to increased MetS risk.
Conclusion
The rate of MetS in urban Xinjiang has been identified to be very high. To reduce the effects of this metabolic disorder, emphasis should be given on the improvement of DQ as well as the levels of PA. This way interventions are crucial not only to prevent the number of premature deaths but also to relieve the burden of cardiovascular disease (CVD).