{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T19:35:15Z","timestamp":1778009715091,"version":"3.51.4"},"reference-count":49,"publisher":"Elsevier BV","issue":"2","license":[{"start":{"date-parts":[[2022,2,1]],"date-time":"2022-02-01T00:00:00Z","timestamp":1643673600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2022,2,1]],"date-time":"2022-02-01T00:00:00Z","timestamp":1643673600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"funder":[{"DOI":"10.13039\/100006108","name":"NCATS","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","nmcd-journal.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Nutrition, Metabolism and Cardiovascular Diseases"],"published-print":{"date-parts":[[2022,2]]},"DOI":"10.1016\/j.numecd.2021.10.021","type":"journal-article","created":{"date-parts":[[2021,11,6]],"date-time":"2021-11-06T19:35:25Z","timestamp":1636227325000},"page":"346-354","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":20,"title":["Association of diet quality, physical activity, and abdominal obesity with metabolic syndrome z-score in black and white adolescents in the US"],"prefix":"10.1016","volume":"32","author":[{"given":"Suzanne S.","family":"Summer","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Todd","family":"Jenkins","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Inge","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ranjan","family":"Deka","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jane C.","family":"Khoury","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"78","reference":[{"key":"10.1016\/j.numecd.2021.10.021_bib1","doi-asserted-by":"crossref","first-page":"1113","DOI":"10.1016\/j.jacc.2010.05.034","article-title":"The metabolic syndrome and cardiovascular risk a systematic review and meta-analysis","volume":"56","author":"Mottillo","year":"2010","journal-title":"J Am Coll Cardiol"},{"key":"10.1016\/j.numecd.2021.10.021_bib2","doi-asserted-by":"crossref","first-page":"1898","DOI":"10.2337\/dc08-0423","article-title":"Metabolic syndrome and incident diabetes: current state of the evidence","volume":"31","author":"Ford","year":"2008","journal-title":"Diabetes Care"},{"key":"10.1016\/j.numecd.2021.10.021_bib3","doi-asserted-by":"crossref","first-page":"1640","DOI":"10.1161\/CIRCULATIONAHA.109.192644","article-title":"Harmonizing the metabolic syndrome","volume":"120","author":"Alberti","year":"2009","journal-title":"Circulation"},{"key":"10.1016\/j.numecd.2021.10.021_bib4","doi-asserted-by":"crossref","first-page":"E24","DOI":"10.5888\/pcd14.160287","article-title":"Metabolic syndrome prevalence by race\/ethnicity and sex in the United States, National Health and Nutrition Examination Survey, 1988-2012","volume":"14","author":"Moore","year":"2017","journal-title":"Prev Chronic Dis"},{"key":"10.1016\/j.numecd.2021.10.021_bib5","doi-asserted-by":"crossref","first-page":"2494","DOI":"10.1161\/01.CIR.0000145117.40114.C7","article-title":"Prevalence of the metabolic syndrome in American adolescents: findings from the third national health and nutrition examination survey","volume":"110","author":"de Ferranti","year":"2004","journal-title":"Circulation"},{"key":"10.1016\/j.numecd.2021.10.021_bib6","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1186\/1475-2840-11-128","article-title":"A confirmatory factor analysis of the metabolic syndrome in adolescents: an examination of sex and racial\/ethnic differences","volume":"11","author":"Gurka","year":"2012","journal-title":"Cardiovasc Diabetol"},{"key":"10.1016\/j.numecd.2021.10.021_bib7","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1016\/j.metabol.2013.10.006","article-title":"An examination of sex and racial\/ethnic differences in the metabolic syndrome among adults: a confirmatory factor analysis and a resulting continuous severity score","volume":"63","author":"Gurka","year":"2014","journal-title":"Metab Clin Exp"},{"key":"10.1016\/j.numecd.2021.10.021_bib8","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1016\/j.metabol.2017.01.008","article-title":"Correlation of metabolic syndrome severity with cardiovascular health markers in adolescents","volume":"69","author":"Lee","year":"2017","journal-title":"Metab Clin Exp"},{"key":"10.1016\/j.numecd.2021.10.021_bib9","doi-asserted-by":"crossref","first-page":"2735","DOI":"10.1161\/CIRCULATIONAHA.105.169404","article-title":"Diagnosis and management of the metabolic syndrome: an American Heart Association\/National Heart, Lung, and Blood Institute Scientific Statement","volume":"112","author":"Grundy","year":"2005","journal-title":"Circulation"},{"key":"10.1016\/j.numecd.2021.10.021_bib10","doi-asserted-by":"crossref","first-page":"881","DOI":"10.1038\/nature05488","article-title":"Abdominal obesity and metabolic syndrome","volume":"444","author":"Despres","year":"2006","journal-title":"Nature"},{"key":"10.1016\/j.numecd.2021.10.021_bib11","first-page":"628","article-title":"Progress and challenges in metabolic syndrome in children and adolescents","volume":"119","author":"Steinberger","year":"2009"},{"key":"10.1016\/j.numecd.2021.10.021_bib12","doi-asserted-by":"crossref","first-page":"1351","DOI":"10.1093\/ajcn\/48.6.1351","article-title":"Total and visceral adipose-tissue volumes derived from measurements with computed tomography in adult men and women: predictive equations","volume":"48","author":"Kvist","year":"1988","journal-title":"Am J Clin Nutr"},{"key":"10.1016\/j.numecd.2021.10.021_bib13","doi-asserted-by":"crossref","first-page":"2665","DOI":"10.2337\/dc10-0606","article-title":"Sagittal abdominal diameter is a strong anthropometric measure of visceral adipose tissue in the Asian general population","volume":"33","author":"Yim","year":"2010","journal-title":"Diabetes Care"},{"key":"10.1016\/j.numecd.2021.10.021_bib14","doi-asserted-by":"crossref","first-page":"874","DOI":"10.1007\/s11695-013-0874-6","article-title":"Sagittal abdominal diameter and visceral adiposity: correlates of beta-cell function and dysglycemia in severely obese women","volume":"23","author":"Gletsu-Miller","year":"2013","journal-title":"Obes Surg"},{"key":"10.1016\/j.numecd.2021.10.021_bib15","first-page":"e334","article-title":"Trends in abdominal obesity among US Children and Adolescents","volume":"134","author":"Xi","year":"2014"},{"key":"10.1016\/j.numecd.2021.10.021_bib16","doi-asserted-by":"crossref","first-page":"664","DOI":"10.1111\/obr.12406","article-title":"A systematic review and meta-analysis on the effects of exercise training versus hypocaloric diet: distinct effects on body weight and visceral adipose tissue","volume":"17","author":"Verheggen","year":"2016","journal-title":"Obes Rev"},{"key":"10.1016\/j.numecd.2021.10.021_bib17","doi-asserted-by":"crossref","first-page":"619","DOI":"10.1038\/sj.ijo.0803761","article-title":"Factors associated with percent change in visceral versus subcutaneous abdominal fat during weight loss: findings from a systematic review","volume":"32","author":"Chaston","year":"2005","journal-title":"Int J Obes"},{"key":"10.1016\/j.numecd.2021.10.021_bib18","doi-asserted-by":"crossref","first-page":"1415","DOI":"10.1249\/MSS.0000000000000888","article-title":"The effect of diet or exercise on visceral adipose tissue in overweight youth","volume":"48","author":"Vissers","year":"2016","journal-title":"Med Sci Sports Exerc"},{"key":"10.1016\/j.numecd.2021.10.021_bib19","doi-asserted-by":"crossref","first-page":"2020","DOI":"10.1001\/jama.2018.14854","article-title":"The physical activity guidelines for Americans","volume":"320","author":"Piercy","year":"2018","journal-title":"J Am Med Assoc"},{"key":"10.1016\/j.numecd.2021.10.021_bib20","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1093\/ajcn\/nqy284","article-title":"Diet quality in a nationally representative sample of American children by sociodemographic characteristics","volume":"109","author":"Thomson","year":"2019","journal-title":"Am J Clin Nutr"},{"key":"10.1016\/j.numecd.2021.10.021_bib21","doi-asserted-by":"crossref","first-page":"1","DOI":"10.15585\/mmwr.ss6708a1","article-title":"Youth risk behavior surveillance \u2013 United States, 2017","volume":"67","author":"Kann","year":"2018","journal-title":"MMWR Surveill Summ"},{"key":"10.1016\/j.numecd.2021.10.021_bib22","series-title":"2015\u20132020 dietary guidelines for Americans","year":"2015"},{"key":"10.1016\/j.numecd.2021.10.021_bib23","doi-asserted-by":"crossref","first-page":"1591","DOI":"10.1016\/j.jand.2018.05.021","article-title":"Update of the healthy eating index: HEI-2015","volume":"118","author":"Krebs-Smith","year":"2018","journal-title":"J Acad Nutr Diet"},{"key":"10.1016\/j.numecd.2021.10.021_bib24","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1016\/j.jpeds.2018.01.080","article-title":"Modified healthy eating index and incidence of metabolic syndrome in children and adolescents: tehran lipid and glucose study","volume":"197","author":"Hooshmand","year":"2018","journal-title":"J Pediatr"},{"key":"10.1016\/j.numecd.2021.10.021_bib25","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1016\/j.jada.2007.10.049","article-title":"Metabolic syndrome and its association with diet and physical activity in US adolescents","volume":"108","author":"Pan","year":"2008","journal-title":"J Am Diet Assoc"},{"key":"10.1016\/j.numecd.2021.10.021_bib26","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1186\/s12887-019-1855-2","article-title":"Active children are less adipose and insulin resistant in early adolescence; evidence from the Mysore Parthenon Cohort","volume":"19","author":"Kehoe","year":"2019","journal-title":"BMC Pediatr"},{"key":"10.1016\/j.numecd.2021.10.021_bib27","series-title":"National health and nutrition examination survey","year":"2011"},{"key":"10.1016\/j.numecd.2021.10.021_bib28","series-title":"National Health and Nutrition Examination Survey: Sample Design, 2011\u20132014","author":"Johnson","year":"2014"},{"key":"10.1016\/j.numecd.2021.10.021_bib29","series-title":"National Health and Nutrition Examination Survey (NHANES) Anthropometry Procedures Manual","year":"2016"},{"key":"10.1016\/j.numecd.2021.10.021_bib30","series-title":"National Health and Nutrition Examination Survey (NHANES) MEC Laboratory Procedures Manual","year":"2016"},{"key":"10.1016\/j.numecd.2021.10.021_bib31","series-title":"National Health and Nutrition Examination Survey (NHANES) Interviewer Procedures Manual","year":"2016"},{"key":"10.1016\/j.numecd.2021.10.021_bib32","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1111\/j.1475-097X.2007.00728.x","article-title":"Practical approach for estimation of subcutaneous and visceral adipose tissue","volume":"27","author":"Kullberg","year":"2007","journal-title":"Clin Physiol Funct Imag"},{"issue":"3\u20134","key":"10.1016\/j.numecd.2021.10.021_bib33","first-page":"545","article-title":"An overview of USDA's dietary intake data system","volume":"17","author":"Raper","year":"2004","journal-title":"Subtrop Plant Sci"},{"key":"10.1016\/j.numecd.2021.10.021_bib34","doi-asserted-by":"crossref","first-page":"324","DOI":"10.1093\/ajcn\/88.2.324","article-title":"The US Department of Agriculture Automated Multiple-Pass Method reduces bias in the collection of energy intakes","volume":"88","author":"Moshfegh","year":"2008","journal-title":"Am J Clin Nutr"},{"key":"10.1016\/j.numecd.2021.10.021_bib35","unstructured":"US Department of Agriculture ARS USDA. Food and nutrient Database for dietary studies. Food Surveys Research Group Home Page."},{"key":"10.1016\/j.numecd.2021.10.021_bib36","series-title":"National health and nutrition examination survey (NHANES) MEC in-person dietary interviewer procedures manual","year":"2016"},{"key":"10.1016\/j.numecd.2021.10.021_bib37","series-title":"National Health and Nutrition Examination Survey (NHANES) phone follow-up dietary interviewer procedures manual","year":"2016"},{"key":"10.1016\/j.numecd.2021.10.021_bib38","doi-asserted-by":"crossref","first-page":"1603","DOI":"10.1016\/j.jand.2018.05.020","article-title":"Applications of the healthy eating index for surveillance, epidemiology, and intervention research: considerations and caveats","volume":"118","author":"Kirkpatrick","year":"2018","journal-title":"J Acad Nutr Diet"},{"key":"10.1016\/j.numecd.2021.10.021_bib40","series-title":"Global physical activity questionnaire (GPAQ) analysis guide","year":"2012"},{"key":"10.1016\/j.numecd.2021.10.021_bib42","doi-asserted-by":"crossref","first-page":"e14","DOI":"10.1016\/j.diabres.2013.12.050","article-title":"Anthropometric measures of abdominal adiposity for the identification of cardiometabolic risk factors in adolescents","volume":"103","author":"Weber","year":"2014","journal-title":"Diabetes Res Clin Pract"},{"key":"10.1016\/j.numecd.2021.10.021_bib43","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1016\/j.annepidem.2018.11.009","article-title":"Abdominal obesity, metabolic dysfunction, and metabolic syndrome in U.S. adolescents: national Health and Nutrition Examination Survey 2011-2016","volume":"30","author":"Gaston","year":"2019","journal-title":"Ann Epidemiol"},{"key":"10.1016\/j.numecd.2021.10.021_bib44","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1038\/sj.ijo.0801186","article-title":"Sagittal abdominal diameter compared with other anthropometric measurements in relation to cardiovascular risk","volume":"24","author":"Ohrvall","year":"2000","journal-title":"Int J Obes Relat Metab Disord \u2013 J Int Assoc Study Obes"},{"key":"10.1016\/j.numecd.2021.10.021_bib45","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1111\/j.1467-789X.2009.00623.x","article-title":"Subcutaneous and visceral adipose tissue: structural and functional differences","volume":"11","author":"Ibrahim","year":"2010","journal-title":"Obes Rev"},{"key":"10.1016\/j.numecd.2021.10.021_bib46","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1016\/j.jocd.2013.03.007","article-title":"Relationship between dual-energy X-ray absorptiometry volumetric assessment and X-ray computed tomography-derived single-slice measurement of visceral fat","volume":"17","author":"Xia","year":"2014","journal-title":"J Clin Densitom"},{"key":"10.1016\/j.numecd.2021.10.021_bib47","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1002\/oby.22712","article-title":"Magnetic resonance imaging and bioelectrical impedance analysis to assess visceral and abdominal adipose tissue","volume":"28","author":"Chaudry","year":"2020","journal-title":"Obesity"},{"key":"10.1016\/j.numecd.2021.10.021_bib48","doi-asserted-by":"crossref","first-page":"360","DOI":"10.1016\/j.numecd.2019.01.007","article-title":"Visceral obesity, but not central obesity, is associated with cardiac remodeling in subjects with suspected metabolic syndrome","volume":"29","author":"Cho","year":"2019","journal-title":"Nutr Metabol Cardiovasc Dis"},{"key":"10.1016\/j.numecd.2021.10.021_bib49","doi-asserted-by":"crossref","first-page":"850","DOI":"10.3389\/fendo.2019.00850","article-title":"Validity of dietary assessment methods when compared to the method of doubly labeled water: a systematic review in adults","volume":"10","author":"Burrows","year":"2019","journal-title":"Front Endocrinol"},{"key":"10.1016\/j.numecd.2021.10.021_bib50","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1080\/17461391.2014.987323","article-title":"Cardiovascular fitness is associated with bias between self-reported and objectively measured physical activity","volume":"16","author":"Tomaz","year":"2016","journal-title":"Eur J Sport Sci"},{"key":"10.1016\/j.numecd.2021.10.021_bib51","doi-asserted-by":"crossref","first-page":"761","DOI":"10.1186\/s12889-016-3348-7","article-title":"New insights into discrepancies between self-reported and accelerometer-measured moderate to vigorous physical activity among women \u2013 the mPED trial","volume":"16","author":"Fukuoka","year":"2016","journal-title":"BMC Publ Health"}],"container-title":["Nutrition, Metabolism and Cardiovascular Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0939475321005378?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0939475321005378?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,10,15]],"date-time":"2025-10-15T16:19:29Z","timestamp":1760545169000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0939475321005378"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,2]]},"references-count":49,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2022,2]]}},"alternative-id":["S0939475321005378"],"URL":"https:\/\/doi.org\/10.1016\/j.numecd.2021.10.021","relation":{},"ISSN":["0939-4753"],"issn-type":[{"value":"0939-4753","type":"print"}],"subject":[],"published":{"date-parts":[[2022,2]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Association of diet quality, physical activity, and abdominal obesity with metabolic syndrome z-score in black and white adolescents in the US","name":"articletitle","label":"Article Title"},{"value":"Nutrition, Metabolism and Cardiovascular Diseases","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.numecd.2021.10.021","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2021 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.","name":"copyright","label":"Copyright"}]}}