A sample of 6,011 adults (age 18–65 years) from the Third National Health and Nutrition Examination Survey (NHANES III) Public Access Mortality Linkage was used. Age, sex, income, ethnicity, smoking status, exercise frequency, dietary fat (>30%), alcohol intake, intentions to lose weight over the last year (yes/no), and self-reported body weight 10 years prior were assessed by questionnaire. BMI cutoffs for normal weight (18.5–25 kg/m2), overweight (25–29.9 kg/m2), and obese (≥30 kg/m2) were used. To increase the sample size (n = 6,011 vs. 3,320), participants with fasting data (≥6 vs. ≥8 h) for at least three of the four MetSyn criteria were included.
Metabolic abnormalities were defined as follows (6 (link),7 (link)): 1) triglycerides ≥1.69 mmol/l or medications; 2) systolic blood pressure ≥130 mmHg, diastolic blood pressure ≥85 mmHg, or medications; 3) glucose ≥5.6 mmol/l or medications; 4) HDL cholesterol <1.04 mmol/l for men and <1.29 mmol/l for women; and 5) homeostasis model assessment (HOMA) ≥2.5 (n = 4,602).
Metabolically normal was defined using three separate definitions: 1) insulin sensitive by HOMA; 2) one or fewer MetSyn criteria; or 3) absence of all MetSyn criteria and IR.
Metabolic abnormalities were defined as follows (6 (link),7 (link)): 1) triglycerides ≥1.69 mmol/l or medications; 2) systolic blood pressure ≥130 mmHg, diastolic blood pressure ≥85 mmHg, or medications; 3) glucose ≥5.6 mmol/l or medications; 4) HDL cholesterol <1.04 mmol/l for men and <1.29 mmol/l for women; and 5) homeostasis model assessment (HOMA) ≥2.5 (n = 4,602).
Metabolically normal was defined using three separate definitions: 1) insulin sensitive by HOMA; 2) one or fewer MetSyn criteria; or 3) absence of all MetSyn criteria and IR.
