{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T13:55:57Z","timestamp":1791208557127,"version":"4.1.0"},"reference-count":65,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T00:00:00Z","timestamp":1789862400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,20]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>This cross-sectional study investigated the main and interacting associations of physical activity (PA) and alcohol use with the number of metabolic syndrome (MetS) risk factors and odds of MetS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We used 2011\u20132014 (N\u2009=\u20093227) and 2015\u20132020 (N\u2009=\u20095586) National Health and Nutrition Examination Survey data for adults (20\u201380\u00a0years). We categorized participants into quartiles for device-based PA (2011\u20132014) and meeting or not meeting recommendations (\u2265150 vs &amp;lt;150\u00a0min of PA\/week) for self-reported PA (2015\u20132020). We calculated average self-reported drinks\/day. MetS risk factors were: (1) waist circumference \u226588\/\u2265102\u00a0cm for females\/males; (2) triglycerides \u2265150\u00a0mg\/dl; (3) blood pressure\u2009\u2265130\u00a0mm Hg\/\u226585\u00a0mm Hg; (4) fasting glucose \u2265100\u00a0mg\/dl; and (5) high-density lipoprotein cholesterol (HDL-C)\u2009&amp;lt;50\/&amp;lt;40\u00a0mg\/dl for females\/males. We categorized participants with MetS if they had \u22653 risk factors. We examined the direct and moderating associations of PA and alcohol use with number of MetS risk factors and odds of MetS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Compared to Q1, adults in Q2-Q4 had fewer MetS risk factors (Q2: incidence rate ratio [IRR]\u2009=\u20090.90, 95% confidence interval [CI]: 0.84, 0.97; Q3: IRR\u2009=\u20090.80, 95% CI: 0.74, 0.87; Q4: IRR\u2009=\u20090.73, 95% CI: 0.67, 0.80). Compared to Q1, adults in Q3 and Q4 had lower odds of MetS when consuming \u22640.50 drinks\/day (odds ratio [OR]\u2009=\u20090.44, 95%CI: 0.30, 0.64) or \u22640.75 drinks\/day (OR\u2009=\u20090.43, 95%CI: 0.30, 0.60), respectively. Meeting PA recommendations was associated with fewer risk factors (IRR\u2009=\u20090.90, 95%CI: 0.84, 0.96). CIs were wide for some estimates due to sparsity of data at higher alcohol levels.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Adults should consider engaging in more PA and limiting their alcohol use to reduce risk factors and overall MetS risk.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/alcalc\/agag066","type":"journal-article","created":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T11:16:16Z","timestamp":1790334976000},"source":"Crossref","is-referenced-by-count":0,"title":["Physical activity reduces but does not fully counteract the detrimental associations between alcohol use and metabolic syndrome"],"prefix":"10.1093","volume":"61","author":[{"given":"Jimikaye B","family":"Courtney","sequence":"first","affiliation":[{"name":"Department of Exercise and Sports Science, College of Arts and Sciences, University of North Carolina at Chapel Hill , 124A Fetzer Hall, Chapel Hill, NC 27599 ,","place":["United States"]},{"name":"Nutrition Obesity Research Center, University of North Carolina at Chapel Hill , 135 Dauer Drive, Chapel Hill, NC 27599 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9173-571X","authenticated-orcid":false,"given":"Ishrat Z","family":"Alam","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill , 123 W Franklin Street, Building C, Suite 410, Chapel Hill, NC 27599 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelly R","family":"Evenson","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill , 123 W Franklin Street, Building C, Suite 410, Chapel Hill, NC 27599 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,10,5]]},"reference":[{"key":"2026100509103896900_ref1","doi-asserted-by":"publisher","first-page":"191","DOI":"10.1016\/j.jhep.2022.08.030","article-title":"Alcohol consumption and metabolic syndrome: clinical and epidemiological impact on liver disease","volume":"78","author":"\u00c5berg","year":"2023","journal-title":"J Hepatol"},{"key":"2026100509103896900_ref2","doi-asserted-by":"publisher","first-page":"e14762","DOI":"10.1111\/sms.14762","article-title":"Daily and peak Monitor Independent Movement Summary (MIMS) values associated with metabolic syndrome: NHANES 2011\u201312 and 2013\u201314","volume":"34","author":"Aguiar","year":"2024","journal-title":"Scand J Med Sci Sports"},{"key":"2026100509103896900_ref3","doi-asserted-by":"publisher","first-page":"1640","DOI":"10.1161\/CIRCULATIONAHA.109.192644","article-title":"Harmonizing the metabolic syndrome: a joint interim statement of the international diabetes federation task force on epidemiology and prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of obesity","volume":"120","author":"Alberti","year":"2009","journal-title":"Circulation"},{"key":"2026100509103896900_ref4","doi-asserted-by":"publisher","first-page":"126","DOI":"10.1186\/1471-2458-5-126","article-title":"Patterns of alcohol drinking and its association with obesity: data from the third national health and nutrition examination survey, 1988\u20131994","volume":"5","author":"Arif","year":"2005","journal-title":"BMC Public Health"},{"key":"2026100509103896900_ref5","doi-asserted-by":"publisher","first-page":"878","DOI":"10.1111\/j.1530-0277.2000.tb02069.x","article-title":"Integrating person-centered and variable-centered approaches in the study of developmental courses and transitions in alcohol use: introduction to the special section","volume":"24","author":"Bates","year":"2000","journal-title":"Alcohol Clin Exp Res"},{"key":"2026100509103896900_ref6","doi-asserted-by":"publisher","first-page":"2455","DOI":"10.1249\/MSS.0000000000002726","article-title":"US population-referenced percentiles for wrist-worn accelerometer-derived activity","volume":"53","author":"Belcher","year":"2021","journal-title":"Med Sci Sports Exerc"},{"key":"2026100509103896900_ref7","doi-asserted-by":"publisher","first-page":"67","DOI":"10.1111\/j.1753-4887.2012.00548.x","article-title":"Is beer consumption related to measures of abdominal and general obesity? 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