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Kim, Kim, Choi, Won, and Kim: Relationship between Physical Activity Level, Amount of Alcohol Consumption and Metabolic Syndrome in Korean Male Drinkers
Clinical Article

Korean J Sports Med 2014;32(2):97-104.

Published online: 17 January 2014

DOI: https://doi.org/10.5763/KJSM.2014.32.2.97

Relationship between Physical Activity Level, Amount of Alcohol Consumption and Metabolic Syndrome in Korean Male Drinkers

Byung-Sung Kim, Myeong-Jin Kim, Hyun-Rim Choi, Cahng-Won Won, Sun-Young Kim

Department of Family Medicine, Kyung Hee University Medical College, Seoul, Korea

Correspondence: Byung-Sung Kim Department of Family Medicine, Kyung Hee University Medical College, 23 Kyungheedae-ro, Dongdaemun-gu, Seoul 130-872, Korea Tel: +82-2-958-8696, Fax: +82-2-958-8699, E-mail: byungskim@naver.com

Received 16 April 2014       Revised 12 November 2014       Accepted 17 November 2014

Copyright © 2014 The Korean Society of Sports Medicine

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Studies on the effect of drinking and exercise on metabolic syndrome (MetS) are lacking despite the high prevalence of the disease and the high drinking rate among Korean men. This study sought to elucidate the association of MetS with alcohol consumption and physical activity. Data on male drinkers aged 19 to 65 years were obtained from the Korea National Health and Nutrition Examination Survey conducted from 2007 to 2009. Participants were divided into mild to moderate and heavy drinkers according to daily alcohol consumption. By the intensity of physical activity expressed as metabolic equivalents (METs), participants were categorized into inactive, moderate active, and health enhancing groups. Logistic regression models were used for analyses. Prevalence of MetS was significantly higher in heavy drinkers compared to mild to moderate drinkers. In heavy drinkers, low high density lipoprotein (HDL) was significantly less frequent while the remaining four components were more frequent. Compared to inactive group, health promoting group showed a 35% decrease in MetS after adjusting for confounding factors. Higher physical activity level was associated with less low HDL and high triglyceride (TG) in mild to moderate drinkers and smaller waist in heavy drinkers. In Korean men, higher level of physical activity was associated with less low HDL and high TG, and physical activity achieving more than 3,000 METㆍ min/wk decreased the risk for MetS. Higher physical activity level was also associated with less large waist circumference in heavy drinkers, while there was no significant association with development of MetS.

Keywords: Alcohol, Physical activity, Metabolic syndrome

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Table 1.
Baseline characteristics of the subjects according to alcohol consumption (n=4,009)
Characteristic Mild to moderate drinker (1−29.9 g/day) Heavy drinker (≥30 g/day) p-value
Total number 3,056 953 -
Age (y) 40.3±0.2 42.3±0.4 <0.001
Height (cm) 171.2±0.1 171.3±0.2 0.613
Weight (kg) 70.5±0.2 72.3±0.4 <0.001
BMI (kg/m2) 24.0±0.1 24.6±0.1 <0.001
WC (cm) 83.7±0.2 86.1±0.3 <0.001
SBP (mm Hg) 117.9±0.3 122.4±0.5 <0.001
DBP (mm Hg) 79.5±0.2 83.2±0.3 <0.001
FBS (mg/dL) 96.3±0.4 100.1±0.7 <0.001
Cholesterol (mg/dL) 187.3±0.6 190.5±1.1 0.013
TG (mg/dL) 155.7±2.4 199.4±5.7 <0.001
HDL (mg/dL) 47.7±0.2 50.6±0.4 <0.001
LDL (mg/dL) 109.2±0.6 101.7±1.1 <0.001
Energy intake (kcal/day) 2,295.6±17.7 2,580.6±37.4 <0.001
Smoking status <0.001
　 Never smoker (n=670) 19.3 8.3
　 Former smoker (n=1,231) 31.8 27.1
　 Current smoker (n=2,108) 48.9 64.6
Rural area (n=830) 19.7 23.8 0.007
Education (≤9 y) (n=687) 14.7 24.9 <0.001
First quartile of income (n=353) 8.4 10.0 0.017
Prevalent Mets (n=977) 21.6 33.1 <0.001

Data are expressed as mean±standard error or %.

BMI: body mass index, WC: waist circumference, SBP: systolic blood pressure, DBP: diastolic blood pressure, FBS: fasting blood glucose, TG: triglyceride, HDL: high density lipoprotein, LDL: low density lipoprotein, Mets: metabolic syndrome.

Table 2.
Prevalence of the five components of metabolic syndrome according to alcohol consumption (n=4,009)
Value Mild to moderate drinker (1–29.9 g/day) Heavy drinker (≥30 g/day) p-value
Large WC (n=1,032) 23.3 (0.9) 33.3 (1.5) <0.001
High BP (n=1,528) 35.0 (0.9) 48.1 (1.6) <0.001
High glucose (n=1,147) 26.2 (0.8) 36.2 (1.6) <0.001
Low HDL (n=930) 24.2 (0.8) 20.1 (1.3) 0.009
High TG (n=1594) 36.6 (0.9) 50.0 (1.6) <0.001

Data are expressed as % (standard error), p-value<0.05 by chi-square test.

WC: waist circumference, BP: blood pressure, HDL: high density lipoprotein, TG: triglyceride.

Table 3.
Odds ratio of metabolic syndrome according to PA level and alcohol drinking amount (n=4,009)
Value OR (95% CI)∗ of metabolic syndrome
Model 1 Model 2 Model 3
PA level (METㆍ min/wk)
　 0–600 (n=869) 1 1 1
　 600–3,000 (n=1,622) 1.026 (0.849−1.240) 1.006 (0.826−1.226) 0.957 (0.745−1.230)
　 ≥3,000 (n=1,518) 0.802 (0.659−0.976) 0.726 (0.592−0.891) 0.654 (0.506−0.847)
Alcohol amount
　 Mild to moderate 1 1 1
　 Heavy 1.814 (1.544−2.130) 1.751 (1.480−2.072) 1.470 (1.180−1.830)
Age 1.054 (1.046−1.063) 1.071 (1.060−1.082)
Education 1.132 (0.913−1.403) 1.096 (0.840−1.431)
Family income 0.976 (0.900−1.059) 0.958 (0.863−1.063)
Smoking 1.447 (1.086−1.927)
BMI 1.502 (1.445−1.561)
Energy intake 0.852 (0.698−1.040)

PA: physical activity, OR: odds ratio, CI: confidence interval, Model 1: not adjusted, Model 2: adjusted for age, education, and income, Model 3: adjusted for smoking status, BMI, energy intake plus all variables in Model 2, MET: metabolic equivalent, Education: ≥9 years vs. <9 years, Smoking: smoker vs nonsmoker/past smoker, BMI: body mass index, Energy intake: ≥2,400 kcal vs. <2,400 kcal.

∗ OR (95% CI) by logistic regression analysis.

Table 4.
Odds ratio of the five components of metabolic syndrome according to PA level
PA level (METㆍ min/wk Mild to moderate drinkers (n=3,057) Heavy drinkers (n=952)
0−600 600−3000 ≥3000 p for trend 0−600 600−3000 ≥3000 p for trend
Large WC 1 0.718 0.502 0.001 1 0.903 0.986 0.965
(reference) (0.492−1.049) (0.338−0.743) (reference) (0.464−1.757) (0.519−1.872)
High BP 1 1.153 1.164 0.231 1 1.320 1.071 0.742
(0.903−1.474) (0.908−1.492) (0.870−2.004) (0.712−1.611)
High glucose 1 1.007 1.008 0.954 1 1.109 0.953 0.823
(0.774−1.309) (0.773−1.315) (0.720−1.708) (0.622−1.458)
Low HDL 1 1.067 0.721 0.015 1 0.546 0.539 0.010
(0.831−1.370) (0.553−0.939) (0.339−0.880) (0.338−0.861)
High TG 1 0.752 0.568 <0.001 1 0.872 0.812 0.310
(0.596−0.948) (0.447−0.723) (0.578−1.314) (0.544−1.214)

Values are presented as odds ratio (95% confidence interval). Logistic regression test was done.

Adjusted for age, education, income, smoking status, body mass index, and energy intake.

PA: physical activity, MET: metabolic equivalent, WC: waist circumference, BP: blood pressure, HDL: high density lipoprotein, TG: triglyceride.

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