Background Metabolic syndrome (MetS) represents a significant public health burden due to its association with increased risk of chronic diseases and individual lifestyle factors. Physical activity (PA), as a potential effect modifier, has gained considerable attention in public health, with many health organizations promoting behavioural change. Numerous studies have reported inverse associations between PA and incident MetS; however, emerging evidence is rarely incorporated into health strategies worldwide due to inconsistencies in diagnostic criteria and persistent methodological challenges. Given these considerations, the present study aims to: (1) investigate the association between step-based PA, objectively measured by a wearable device, and each component of MetS in Japanese workers over a 5-year study period, and (2) evaluate the current reference value of 8,000 steps/day recommended by the Ministry of Health, Labour and Welfare (MHLW) in Japan. Methods This prospective longitudinal observational study examined average daily step count as the main exposure and key components of MetS as the main outcomes among 1,084 eligible participants aged 40–74 years who underwent annual health check-ups. Multivariable random-effects regression models were used to estimate pooled associations, incorporating both between-individual differences and within-individual changes over the study period. Results Each 1,000-step/day increment was significantly and inversely associated with MetS components in the adjusted model as follows, including waist circumference (WC): β = −0.23 cm (95% confidence interval [CI] -0.34 to −0.12 cm); triglycerides (TG): β = −2.54 mg/dl (95% CI −4.56 to −0.51 mg/dl), systolic blood pressure (SBP): β = −0.38 mmHg (95% CI −0.62 to −0.14), and diastolic blood pressure (DBP): β = −0.39 mmHg (95% CI −0.57 to −0.21 mmHg), and was positively associated with high-density lipoprotein cholesterol (HDL): β = 0.47 mg/dl (95% CI 0.25 to 0.68 mg/dl), but not with glucose markers. The current reference value of 8,000 steps/day was significantly and inversely associated with MetS components: WC: β = −1.52 cm (95% CI −2.24 to −0.80 cm); TG: β = −20.69 mg/dl (95% CI −32.71 to −8.68 mg/dl); SBP: β = −2.51 mmHg (95% CI −4.55 to −0.48 mmHg); DBP: β = −2.74 mmHg (95% CI −4.22 to −1.26 mmHg); and HDL: β = 4.57 mg/dl (95% CI 2.93 to 6.21 mg/dl) but not with glucose markers. Conclusions Step-based PA and the current reference value of 8,000 steps/day were significantly and inversely associated with waist circumference, triglycerides, and blood pressure, and positively associated with high-density lipoprotein cholesterol, while no significant associations were observed for glucose markers in generally healthy Japanese working population. Approximately linear dose–response relationship was observed, except for glucose markers.

Step by step: associations between physical activity and metabolic syndrome components in a Japanese working population

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2026年6月14日

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Yukako Yamaga,
Thomas Svensson,
Ung-il Chung,
Akiko Kishi Svensson

摘要

Background

Metabolic syndrome (MetS) represents a significant public health burden due to its association with increased risk of chronic diseases and individual lifestyle factors. Physical activity (PA), as a potential effect modifier, has gained considerable attention in public health, with many health organizations promoting behavioural change. Numerous studies have reported inverse associations between PA and incident MetS; however, emerging evidence is rarely incorporated into health strategies worldwide due to inconsistencies in diagnostic criteria and persistent methodological challenges. Given these considerations, the present study aims to: (1) investigate the association between step-based PA, objectively measured by a wearable device, and each component of MetS in Japanese workers over a 5-year study period, and (2) evaluate the current reference value of 8,000 steps/day recommended by the Ministry of Health, Labour and Welfare (MHLW) in Japan.

Methods

This prospective longitudinal observational study examined average daily step count as the main exposure and key components of MetS as the main outcomes among 1,084 eligible participants aged 40–74 years who underwent annual health check-ups. Multivariable random-effects regression models were used to estimate pooled associations, incorporating both between-individual differences and within-individual changes over the study period.

Results

Each 1,000-step/day increment was significantly and inversely associated with MetS components in the adjusted model as follows, including waist circumference (WC): β = −0.23 cm (95% confidence interval [CI] -0.34 to −0.12 cm); triglycerides (TG): β = −2.54 mg/dl (95% CI −4.56 to −0.51 mg/dl), systolic blood pressure (SBP): β = −0.38 mmHg (95% CI −0.62 to −0.14), and diastolic blood pressure (DBP): β = −0.39 mmHg (95% CI −0.57 to −0.21 mmHg), and was positively associated with high-density lipoprotein cholesterol (HDL): β = 0.47 mg/dl (95% CI 0.25 to 0.68 mg/dl), but not with glucose markers. The current reference value of 8,000 steps/day was significantly and inversely associated with MetS components: WC: β = −1.52 cm (95% CI −2.24 to −0.80 cm); TG: β = −20.69 mg/dl (95% CI −32.71 to −8.68 mg/dl); SBP: β = −2.51 mmHg (95% CI −4.55 to −0.48 mmHg); DBP: β = −2.74 mmHg (95% CI −4.22 to −1.26 mmHg); and HDL: β = 4.57 mg/dl (95% CI 2.93 to 6.21 mg/dl) but not with glucose markers.

Conclusions

Step-based PA and the current reference value of 8,000 steps/day were significantly and inversely associated with waist circumference, triglycerides, and blood pressure, and positively associated with high-density lipoprotein cholesterol, while no significant associations were observed for glucose markers in generally healthy Japanese working population. Approximately linear dose–response relationship was observed, except for glucose markers.