Abstract
OBJECTIVE: Japan allocates approximately 21.15 billion yen annually for specific health guidance targeting metabolic syndrome (MetS), yet the prevalence of this condition remains unchanged. This study involved identifying lifestyle factors that lower the risk of developing MetS through a comprehensive cohort study encompassing the adult population (i.e., Japanese people aged ≥18 years with no preexisting MetS). METHODS: Data were collected at the St. Luke's International Hospital Clinic Preventive Medical Center in Japan between January 2012 and December 2022. A retrospective cohort study was conducted on the adult population aged 18 years or older who did not develop MetS and underwent health checkups during the study period. Lifestyle factors that were preventively associated with MetS were investigated by using a Cox proportional hazards regression model. RESULTS: Among the 52,516 included subjects, 5482 (10.4 %) developed MetS. The Cox proportional hazards analysis revealed that a lower risk of developing MetS was associated with walking for >one hour/day (HR = 0.74, 95 % CI = 0.66, 0.83), skipping breakfast