Objectives:
This study aimed to investigate the association between adherence to 24-h movement guidelines and metabolic syndrome (MetS) before and during the COVID-19 pandemic.
Study design: Repeated cross-sectional design.
Methods:
We selected 10,882 adults (2019: N=5,710; 2020: N=5,172) aged ≥20 years from the Korea National Health and Nutrition Examination Survey. Domain-specific physical activity and sedentary behavior were assessed using a global physical activity questionnaire. We also measured the typical sleep duration (h/day) on weekdays and weekends. MetS was defined as the presence of more than three risk factors.
Results:
During the COVID-19 pandemic, transportation-related physical activity decreased during the pandemic, while the prevalence of abdominal obesity (+3.3%) and low HDL-C levels (+3.1%) increased significantly. An elevated risk of MetS was observed in the lower aerobic (OR=1.28, P=0.019) and muscular exercise (OR=1.31, P=0.023) groups, and in the high sedentary behavior (OR=1.23, P=0.049) during the pandemic. Sensitivity analysis stratified by sex showed similar patterns with more pronounced changes in MetS components in male. The models also showed significant associations between aerobic physical activity, strength exercises, and sedentary behavior with MetS in males and females.
Conclusions:
Although sedentary behavior and sleep time remained unchanged, a significant decrease in transportation-related physical activity was observed during the pandemic. Moreover, our findings revealed that aerobic physical activity, strength exercise, and sedentary time during the pandemic were associated with an increased MetS risk. These results highlight the importance of promoting physical activity, particularly during periods of social restriction, to mitigate the pandemic’s negative effects on metabolic health.

Keywords: COVID-19, physical activity, sedentary behavior, sleep time, metabolic syndrome