The Role of Genetic, Dietary and Lifestyle Factors in Pediatric Metabolic Syndrome: A Review of the Literature from Prenatal to Adolescence

Abstract

The metabolic syndrome (MetS) is described as a cluster of health conditions that are associated with an increased risk of cardiovascular disease. The clinical diagnosis of MetS in pediatrics is challenging due to differing criteria, although the estimated prevalence continues to rise. The increased prevalence of childhood obesity and insulin resistance, in both developed and developing countries, is believed to be a major contributor to MetS diagnosis in children. We review the current literature surrounding genetic predisposition, maternal influence, epigenetics, environmental and lifestyle factors pertaining to pediatric MetS with a specific emphasis on obesity and insulin resistance. We highlight and discuss recent, key studies in prenatal through to adolescent populations and review evidence suggesting that children may be pre-disposed to obesity and insulin resistance, prenatally. We also discuss several key lifestyle drivers of these conditions including poor nutrition and dietary habits, insufficient physical activity, use of electronic devices, over-consumption of caffeinated and/or sugar-sweetened beverages, as well as the importance of sleep during childhood and adolescence in relation to metabolic health. We conclude with recommendations for preventable methods to tackle this growing pediatric public health issue, which, if current trends continue, will undoubtedly compromise the health and longevity of the next adult generation.

Gender and age differences in the prevalence and associated factors of metabolic syndrome among children and adolescents in South Korea

“…First, the KNHANES dataset was mainly composed of questionnaire items focusing on adulthood diseases, so the variables required to assess MetS-related physical, psychological, and lifestyle characteristics (e.g., data on pubertal stages) were limited or missing altogether. Second, as mentioned in previous studies [18,19], the explanatory power of BMI for the prevalence of MetS was so powerful that it made other factors meaningless. For these reasons, the authors decided to use univariate logistic regression analysis to identify the influence of each variable reflecting physical, psychological, and lifestyle characteristics on the prevalence of MetS in children and adolescents.…”