Sociodemographic information
The study included 500 morning walking adults, 59.4% of whom were male and 40.6% of whom were female. The mean ages of the males and females were 44.97 ± 9.31 and 43.33 ± 9.02 years, respectively. Most hailed from Rajshahi city (54.6% male, 45.3% female), which was a statistically significant difference (P<0.05). Education levels varied significantly between genders (P<0.05), with proportions ranging from 28.9% to 79.2% for males and 20.8% to 71.1% for females across different levels. Professional categories also showed significant gender disparities (P<0.05), with varying proportions across service holders, unemployed individuals, laborers, homemakers, business owners, and others for both males and females (Table 1).
Table 1Socio-demographic characteristics of study participants
Variables
|
Male
|
Female
|
P value
|
n (%)
|
|
297 (59.4)
|
203 (40.6)
|
|
Age (years)
|
|
44.97 ± 9.31
|
43.33 ± 9.02
|
0.299
|
Area, n (%)
|
Kushtia (sadar)
|
57 (57.0)
|
43 (43.0)
|
0.001*
|
Pabna (sadar)
|
76 (76)
|
24 (24)
|
Rajshahi (city)
|
164 (54.6)
|
136 (45.3)
|
Education, n (%)
|
No formal education
|
13 (28.9)
|
32 (71.1)
|
0.000*
|
Primary
|
50 (41.7)
|
70 (58.3)
|
Secondary
|
44 (57.1)
|
33 (42.9)
|
Higher Secondary
|
49 (61.3)
|
31 (38.8)
|
Graduation
|
141 (79.2)
|
37 (20.8)
|
Occupation, n (%)
|
Employed
|
175 (86.6)
|
27 (13.4
|
0.000*
|
Unemployed
|
12 (85.7)
|
2 (14.3)
|
Homemakers
|
0 (0.0)
|
160 (100)
|
Laborer
|
17 (73.9)
|
6 (26.1)
|
Business
|
81 (93.1)
|
6 (6.9)
|
Others
|
12 (85.7)
|
2 (14.3)
|
*Significant at P<0.05. The data are presented as the means ± SDs. The values are presented as the number of participants (percentages). Differences were analyzed by independent samples ttests for continuous variables and chi-square tests for categorical variables.
Prevalence and age-stratified distribution of MetS and Non-MetS in both sexes
This research revealed that the overall prevalence of MetS was 59.6% in males and 59.1% in females. Among male participants, the third age group (50-59 years) had the highest MetS rate at 35.5%, while the fourth age group (60-69 years) had the lowest at 6.2%. Among females, 45.8% of those in the second age group (40-49 years) had the highest MetS percentage,and 5.8% of those in the fourth age group had the lowest percentage(Fig. 2).
Comparison of nutritional knowledge between MetS and non-MetS participants
There was a significant difference (P<0.05) in nutritional knowledge regarding MetS and fats (good/bad) between the MetS and non-MetS groups, whereas in males, no significant difference (P>0.05) was observed. In males, similar proportions had knowledge about MetS (10.7% MetS, 15.0% non-MetS), while in females, the percentages were 6.7% for MetS and 22.9% for non-MetS. This trend persisted for knowledge about fats. Overall, approximately 80% of both male and female participants lacked knowledge about MetS and fats (Table 2).
Table 2 Comparison of nutritional knowledge between MetS and non-MetS participants
Variables
|
|
Male
|
Female
|
|
Answer
|
MetS
|
Non-MetS
|
P value
|
MetS
|
Non-MetS
|
P value
|
MetS Knowledge
|
Yes
|
19 (10.7%)
|
18 (15.0%)
|
0.275
|
8 (6.7%)
|
19 (22.9%)
|
0.001*
|
No
|
158 (89.3%)
|
102 (85.0%)
|
112 (93.3%)
|
64 (77.1%)
|
Knowledge about Fat
|
Yes
|
34 (19.2%)
|
17 (14.2%)
|
0.258
|
16 (13.3%)
|
24 (28.9%)
|
0.006*
|
No
|
143 (80.8%)
|
103 (85.8%)
|
104 (86.7%)
|
59 (71.1%)
|
*Significant at P<0.05. Percentages were analyzed by the chi-square test.
Intervention
Baseline characteristics of the intervention subjects
Both genders were included in the intervention, with 52.9% male and 47.1% female in the in-depth intervention group and 45.2% male and 54.8% female in the single intervention group. The mean age in the in-depth intervention group was 45.35 ± 8.03 years, which was slightly greater than that in the single intervention group (mean age of 40.96 ± 7.18 years). Higher secondary education was more prevalent in the in-depth intervention group (35.3%) than in the single intervention group (19.3%), while a greater proportion of subjects in the single intervention group held graduate degrees (32.2% vs. 17.6% in the in-depth intervention group). The distribution of occupations was mostly similar between the two intervention groups, except for the business category, which was greater in the single intervention group (23.5%) than in the in-depth intervention group (9.6%) (Table 3).
Table 3 Baseline characteristics of the intervention subjects
Characteristics
|
In-depth intervention (n=34) (n%)
|
Single intervention (n=31) (n%)
|
Gender
|
Male
|
18 (52.9)
|
14 (45.2)
|
Female
|
16 (47.1)
|
17 (54.8)
|
Age
|
45.35 ± 8.03
|
40.96 ± 7.18
|
Marital Status
|
Married
|
31 (92.2)
|
31 (100)
|
Widower
|
3 (8.8)
|
|
Education Level
|
Graduation
|
6 (17.6)
|
10 (32.2)
|
Higher Secondary
|
12 (35.3)
|
6 (19.3)
|
Secondary
|
4 (11.8)
|
6 (19.3)
|
Primary
|
9 (26.5)
|
5 (9.6)
|
No formal Education
|
3 (8.8)
|
4 (12.9)
|
Occupation
|
Employed
|
12 (35.5)
|
13 (41.9)
|
Housewife
|
12 (35.5)
|
14 (45.1)
|
Business
|
8 (23.5)
|
3 (9.6)
|
Laborer
|
2 (5.9)
|
1 (3.2)
|
Percentages were analyzed by the chi-square test.
Comparison of clinical indices at baseline and after 4 months of intervention
A significant difference (P<0.05) in systolic blood pressure was detected between baseline and after both the in-depth and single interventions. However, for diastolic blood pressure, a significant difference (P<0.05) was found only between baseline and the in-depth intervention group (Table 4).
Table 4 Comparison of clinical indices at baseline and after 4 months of intervention
Parameters
|
In-depth Intervention
|
P value
|
Single Intervention
|
P
value
|
Baseline
|
In-depth Intervention
|
Baseline
|
Single Intervention
|
SBP (mmHg)
|
127.35 ±14.71
|
120.88 ± 8.11
|
0.004*
|
122.09 ± 16.10
|
130.96 ± 15.07
|
0.000*
|
DBP (mmHg)
|
84.23 ± 7.18
|
78.11 ± 5.89
|
0.000*
|
80.48 ± 8.12
|
82.90 ± 7.61
|
0.226
|
*The statistical significance level was set at P<0.05. The data are presented as the means ± SDs, and differences were analyzed using paired samples t tests.
Comparison of biochemical indices at baseline and after 4 months of intervention
Significant differences (P<0.05) were observed in both fasting blood glucose (FBG) and triglyceride (TG) levels between baseline and after 4 months of intervention. Conversely, no significant differences (P>0.05) were noted between baseline and the single intervention group for these biochemical indices (Fig. 3).
Comparison of gender-stratified HDL-C at baseline and after 4 months of intervention
For males, no significant difference (P>0.05) was observed in either the in-depth or single intervention. However, in females, a significant difference (P<0.05) was found in the in-depth intervention study, while no significant difference was noted in the single intervention (Fig. 4).
Comparison of gender-stratified WC at baseline and after 4 months of intervention
In the first group, baseline scores were 93.25% for males and 88.25% for females, which decreased to 90.61% and 85.56%, respectively, after an in-depth intervention. On the other hand, in the second group, the baseline scores were higher, with 96.85% for males and 94.29% for females. Following a single intervention, the male score increased to 98.42%, while the female score slightly decreased to 94.05%. For females, a significant difference (p<0.05) was observed in the in-depth intervention group. Conversely, in the case of males, no significant difference (p>0.05) was found between the in-depth and single intervention studies(Fig. 5).
Changes in MetS components at baseline and after 4 months of in-depth and single intervention
At baseline, the prevalence of MetS was 0%, 0%, 44.1%, 47.1%, and 3.8% for categories 1, 2, 3, 4, and 5 (load of MetS), respectively. After completing the in-depth intervention period, these values changed to 14.7%, 44.1%, 23.5%, 11.8%, and 5.9%, respectively. In the single intervention group, the baseline prevalence of MetS was 0%, 0%, 48.4%, 41.9%, and 9.7% for categories 1, 2, 3, 4, and 5, respectively. Upon completion of the single intervention period, the prevalence shifted to 0%, 9.7%, 32.3%, 35.5%, and 22.6% for categories 1, 2, 3, 4, and 5, respectively (Table 5).
Table 5 Changes in MetS components at baseline and after 4 months of intervention
No of MetS components
|
In-depth intervention
|
p value
|
Single intervention
|
p value
|
Baseline
|
In-depth
|
|
Baseline
|
Single
|
|
1
|
0 (0)
|
5 (14.7%)
|
0.004
|
0 (0)
|
0 (0)
|
0.241
|
2
|
0 (0)
|
15 (44.1%)
|
0 (0)
|
3 (9.7%)
|
3
|
15 (44.1%)
|
8 (23.5%)
|
15 (48.4%)
|
10 (32.2%)
|
4
|
16 (47.1%)
|
4 (11.8%)
|
13 (41.9%)
|
11 (35.5%)
|
5
|
3 (8.8%)
|
2 (5.9%
|
3 (9.7%)
|
7 (22.6%)
|
The P value was ascertained by the chi-square test.