Modifiable lifestyle factors and the metabolic syndrome in older men: Effects of lifestyle changes

OBJECTIVES: To examine the influence of lifestyle factors and changes in these factors on risk of the metabolic syndrome in elderly men. DESIGN: Cross-sectional and longitudinal analyses of cohort study. SETTING: General practices in 24 British towns. PARTICIPANTS: Three thousand fifty-one men aged 60 to 79 with no diabetes mellitus or diagnosis of coronary heart disease. MEASUREMENTS: Lifestyle factors (smoking, physical activity, alcohol intake, body weight, dietary fat and carbohydrate intake) including recent changes in the previous 3 years (physical activity and body weight); metabolic syndrome. RESULTS: After adjustment for each of the other modifiable lifestyle factors, overweight/obesity and physical inactivity were associated with a significantly higher risk of the metabolic syndrome, as were cigarette smoking and a high-carbohydrate diet (> 57% of energy). Alcohol intake and dietary fat intake were not related to the metabolic syndrome. Long-term ex-smokers showed similar risk to never smokers. Taking up physical activity and losing weight in the previous 3 years were associated with a reduction in risk of the metabolic syndrome. CONCLUSION: Overweight/obesity, physical inactivity, a high-carbohydrate diet, and cigarette smoking are associated with higher risk of the metabolic syndrome in elderly men. Modification of lifestyle factors, even later in life, has considerable potential for primary prevention of the metabolic syndrome.