OBJECTIVE

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).

METHODS

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.

RESULTS

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).

CONCLUSIONS

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.