The Behavioral Determinants of Metabolic Syndrome Risk Development in Young Adults

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PROJECT SUMMARY / ABSTRACT As few as 23.3% of U.S. young adults 20 years and up are considered metabolically healthy, based on the absence of all traditional metabolic syndrome (MetS) risk factors. Such risk factors are often asymptomatic and go undetected, clustering with other risk factors to increase future disease risk. Thus, early intervention to prevent MetS risk accrual is crucial and it is critical that behavioral interventions are tailored to specific populations. Accordingly, longitudinal research is needed to better understand the behavioral changes that lead to initial MetS risk development (behavioral determinants) and the motivating factors behind these behavioral changes in young adults. The long-term goal of the proposed research is to develop a theoretically driven intervention for the primordial prevention of MetS risk development in college students. The overall objectives are to (i) identify the optimal behavioral targets for the prevention of MetS risk development and (ii) to identify the motivations behind such behaviors and develop a theoretical framework that will guide intervention design. The rationale for this project is that the identification of the behaviors that precede MetS risk development and a population-specific framework to explain such changes will enable the design of interventions in the early college years to reduce the future burden of cardiovascular disease by helping young adults to adopt positive behaviors that will likely track throughout life. To achieve these objectives, two specific aims will be pursued: 1) Identify the behavioral determinants of MetS risk development in young adults; and 2) Explore changes in psychosocial and environmental antecedents of observed behavioral change. Using a longitudinal observational design, 150 high school seniors will be observed over 15 months as they transition from local high schools to behavioral independence at colleges across the US. For the first aim, behavioral outcomes (physical activity, sedentary behavior, sleep, diet, and risk-related behaviors) will be assessed and MetS risk scores will be calculated using baseline traditional risk factor data. Change in risk scores and novel cardiovascular risk markers (e.g. aortic arterial stiffness) will be assessed immediately following year one of college, upon return to the local community. The second aim will be addressed at multiple levels of the ecological framework by assessing constructs such as the perceived environment, perceived stress, social determinants of health, and aspects of motivational theory such as behavioral self-regulation and self-efficacy. The approach is innovative as, in a population at-risk of initial MetS risk factor development or risk factor clustering, we propose the first comprehensive, longitudinal assessment of the relationship between behavior change and MetS risk, including both traditional and novel methodologies. Moreover, we propose to do so in an ecologically valid manner that assesses actual behavior change from the home environment to campuses across the country. The proposed research is significant as it will promote prevention of subsequent clinical disease, strengthen the institutional research environment by increasing future chances of grant funding, and provide multifaceted training experiences to student researchers.