Abstract P415: Association of Baseline Physical Activity by Pedometer Counts and Nutritional Behavior on Metabolic Syndrome in the NAVIGATOR Study
Metabolic syndrome (MS) is the cardiometabolic risk cluster comprised of elevated fasting glucose, hypertension, elevated triglycerides, reduced HDL-cholesterol and enlarged waist circumference. While three or more of these components defines the presence of MS, the corresponding continuous measures may be aggregated to create a more refined, quantitative MS score (MSSc). Few clinical pharmacologic trials of diabetes or cardiovascular disease (CVD) have investigated the effects of lifestyle elements (physical activity and nutrition) on a quantitative measure of MS. In the Nateglinide and Valsartan in Impaired Glucose Tolerance Outcomes Research (NAVIGATOR) study, 9306 participants with impaired glucose tolerance and either CVD or CVD risk factors, were assigned, in a double-blind, randomized fashion to receive nateglinide, valsartan, both or placebo, in a 2-by-2 factorial design, with all participants being provided a lifestyle modification program. Here, we report the effect of baseline physical activity as measured by 7-d pedometer records and nutritional behavior as self-reported on a six-item survey on overall average MSSc. From baseline to Year 5, triglycerides, fasting glucose, waist circumference, and mean arterial pressure assessments were assessed yearly; HDL-cholesterol was assessed at baseline and Year 3. MSSc were calculated as the sum of each continuous component, centered around the gender-specific, ATP III threshold and standardized according the gender-specific sample standard deviation. Consequently, each variable contributes to the score in a common unit of standard deviations. Relations were assessed for baseline ambulatory activity, baseline nutritional behavior score, and average concurrent and subsequent MSSc. Relations were performed irrespective of study arm and were adjusted for age, gender, race, geographic region, smoking, family history of diabetes, aspirin, anti-hypertensive, and lipid lowering agent use. Median daily steps (IQR) by quartiles were 2006 (2000), 4659 (411); 7093 (1372), and 10569 (2852). Participants endorsed a median (IQR) of 5 (3) prudent nutritional behaviors. At baseline, 6716/9306 (72.2%) of individuals met criteria for MS, with IQR = 3.53 and 5th and 95th percentiles -3.43 and 5.38, respectively. For every 2,000 average daily steps, up to an average of 10,000 daily steps, there was an associated reduction in average MSSc of 0.27 (-0.31- -0.24; 95% CI). Each additional nutritional behavior endorsed was associated with an average MSSc reduction of 0.05 (-0.08- -0.02; 95% CI). Associations for daily pedometer steps and nutrition behavior were independently associated with reductions in MSSc, with no significant interaction. In summary, increased pedometer steps and more prudent nutritional behavior at baseline were independently related to reduced cardiometabolic risk as assessed by a continuous MSSc.
- © 2013 by American Heart Association, Inc.