Multilevel analysis of habitual physical activity and metabolic syndrome in Northern Taiwan

ObjectiveThis study examines the relationship between the availability of public facilities for habitual physical activity in the community and metabolic syndrome in northern Taiwan, one of most densely populated countries in the world.MethodsSubjects consisted of 14,658 participants (43.3% men and 56.7% women) ≥ 40 years old (mean = 59.5) from 10 districts of Taoyuan County in a health check-up program in 2004–2005. Public facilities for habitual physical activity included school campuses and parks, and the density of such facilities was categorized into four levels. Multilevel logistic regression models were created to examine the effect on metabolic syndrome at both the individual and the contextual level using MLwiN software.ResultsThe addition of the contextual variable to the model that included individual characteristics led to a further reduction of 7.2% in the variance. Using the facility density level I as the reference, the odds ratios (95% confidence interval) of metabolic syndrome for levels II, III, and IV were 0.87 (0.71–1.07), 0.87 (0.68–1.12), and 0.78 (0.61–0.99), respectively, with the trend test reaching significance.ConclusionGreater availability of free facilities for habitual physical activity in a district was associated with a lower risk of metabolic syndrome among its residents.

Research highlights
► There was a district-level effect on the risk of metabolic syndrome (MS).
► Lower educational level, smoking, and physical inactivity increases the risk of MS.
► The influence of aging on MS was more obvious for women than men.
► Public facility for habitual physical activity was negatively associated with MS.