Eating behavior and metabolic syndrome over time

Purpose: We evaluated the longitudinal associations between eating behaviors (EB) and risk of metabolic syndrome (MetS). Methods: We obtained complete data on EB, assessed using the Dutch Eating Behavior Questionnaire, and MetS components at baseline and follow-up. Participants included 1876 individuals (704 men, 1172 women; mean age, 45.0 ± 12.8 years) from those participating in the Korean Healthy Twin study. A generalized estimating equation model was applied, with sociodemographic factors, health-related factors, follow-up interval, and EB (baseline and changes over time) as independent factors. Results: MetS at baseline was 21.5%, while incident MetS and persistent MetS were 12.0% and 66.6%, respectively, at the 3.13 ± 1.38 years follow-up period. In men, baseline restrained EB had positive associations with concurrent MetS (odds ratio [95% confidence interval] per 1 point increase in the score, 1.55 [1.33–1.81]) and persistent MetS (1.53 [1.16–2.01]); baseline external EB and change in external EB had positive associations with persistent MetS (1.56 [1.04–2.33], 1.37 [1.01–2.22], respectively). In women, baseline restrained EB had a positive association with concurrent MetS (1.14 [1.01–1.30]); baseline external EB had an inverse association with persistent MetS (0.71[0.52–0.98]); baseline emotional EB had positive associations with concurrent, incident, and persistent MetS (1.23 [1.01–1.50], 2.14 [1.50–3.06], and 1.92 [1.40–2.64], respectively); and change in emotional EB had positive associations with incident and persistent MetS (1.50 [1.05–2.15], 1.62 [1.14–2.29], respectively). Conclusion: Higher restrained and external EB, and an increase in external EB in men; and higher restrained and emotional EB, and an increase in emotional EB in women may be associated with increased risk of concurrent, incident, or persistent MetS. Level of evidence: III, cohort study.