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Obesity, Physical Activity, Diet / Diabetes, Cardiovascular Risks, and Lipoproteins · Journal article
Diabetology & Metabolic Syndrome · August 14, 2026
Well-designed and adequately powered for the question it asks.
This umbrella review synthesizes 72 meta-analyses of observational studies to identify 101 risk and protective factors for metabolic syndrome across five domains. Overweight/obesity, parental MetS history, gestational diabetes, high screen time, and shift work show the strongest positive associations, while high-fiber diet, nut intake, and Mediterranean diet adherence show protective associations. The evidence supports multiple modifiable targets—particularly unhealthy diet, sedentary behavior, and occupational patterns—for MetS prevention, although the authors acknowledge heterogeneous underlying evidence quality.
Systematic umbrella review of meta-analyses. Observational studies (from 72 meta-analyses) evaluating risk factors for metabolic syndrome development in adult populations globally.. Intervention: Exposure to 101 distinct risk factors across five domains: lifestyle behaviors, pre-existing diseases, individual characteristics, environmental exposures, and occupational factors.. Compared with: Absence of or lower exposure to the identified risk factors; protective factors contrasted with non-adherence.. Global; specific geographical distribution of included meta-analyses not stated..
Metabolic syndrome affects 20–30% of adults globally and elevates risks for type 2 diabetes and cardiovascular disease 76 positively correlated factors and 25 negatively correlated factors identified across lifestyle behaviors, pre-existing diseases, individual characteristics, environmental exposures, and occupational factors Overweight and obesity showed the most significantly positive correlation with MetS development
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Clinicians should prioritize modifiable factors—unhealthy dietary patterns, sedentary behavior, and adverse occupational conditions—when counseling patients on MetS prevention. The evidence identifies high-risk groups (parental history, gestational diabetes, shift workers) who may benefit from targeted interventions, though individual effect sizes and confidence intervals for specific factors are not detailed here.
A systematic umbrella review of 72 meta-analyses synthesizing evidence from 7,367 articles on 101 risk factors for metabolic syndrome, providing comprehensive pooled estimates with confidence intervals and heterogeneity assessment.
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Clinicians should prioritize modifiable factors—unhealthy dietary patterns, sedentary behavior, and adverse occupational conditions—when counseling patients on MetS prevention. The evidence identifies high-risk groups (parental history, gestational diabetes, shift workers) who may benefit from targeted interventions, though individual effect sizes and confidence intervals for specific factors are not detailed here.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
Metabolic syndrome (MetS) - a cluster of conditions including hypertension, dyslipidemia, insulin resistance, and central obesity - affects 20–30% of adults globally and elevates risks for type 2 diabetes mellitus and cardiovascular disease. Although extensive research has been conducted on individual risk factors, a comprehensive synthesis of existing evidence is urgently required to guide the development of targeted, multi-component prevention strategies. To identify observational studies which assessed the association between MetS development and risk factors, PubMed, Embase, Web of Science, and Cochrane Database were searched from inception to May 2025. A random or fix-effects model was utilized to estimate pooled odds ratios (ORs), relative risk (RR) and 95% confidence intervals (95% CIs). Statistical heterogeneity across included studies was quantified using the I² index, where values > 50% were considered indicative of substantial heterogeneity. The Egger’s test or funnel graph was used to assess the methodological quality. This umbrella review systematically analyzed 72 meta-analyses from 7,367 unique articles to evaluate associations between 101 factors and MetS development. 76 positively correlated factors and 25 negatively correlated factors were identified from the included studies and categorized into five distinct domains: lifestyle behaviors, pre-existing diseases, individual characteristics, environmental exposures, and occupational factors. From the selected studies, the most significantly positive correlation with MetS was overweight and obesity. Parental history of MetS, gestational diabetes mellitus, high screen time, and shift work were also exhibited high degrees of correlation with MetS. In our study, we also identified several modifiable dietary factors exhibited negative correlations with MetS. High-fiber diet consumption, regular nut intake, and adherence to a Mediterranean diet had higher association with MetS. MetS pathophysiology is multifactorial. Comprehensive evidence shows that multiple distinct factors performed significantly associations with MetS. Unhealthy dietary patterns, sedentary behavioral patterns, and adverse occupational patterns are the primary modifiable associated factors for MetS. Despite the limited quality of current supporting evidence, targeted intervention strategies for these factors should be prioritized in public health policies to mitigate MetS at the population level. This review provides comprehensive prevention suggestions for high-risk groups.
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