{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T06:24:14Z","timestamp":1786947854673,"version":"build-2736575974"},"reference-count":59,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T00:00:00Z","timestamp":1786924800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Schoolteachers are considered at increased risk for metabolic syndrome due to high psychosocial demands, sedentary occupational routines, and restricted opportunities for regular physical activity. However, the prevalence of metabolic syndrome among primary and secondary schoolteachers has not been systematically quantified.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To synthesize and quantify the available evidence on the prevalence of metabolic syndrome in primary and secondary school teachers worldwide through a systematic review and meta-analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A systematic review and meta-analysis were conducted in accordance with the PRISMA 2020 guidelines and the protocol was prospectively registered in PROSPERO (CRD420251034493). Searches were performed in the PubMed, Scopus, and Web of Science databases from their inception until April 27, 2026. Observational studies reporting the prevalence of MetS in primary and secondary school teachers were included. Methodological quality was assessed using the National Heart, Lung, and Blood Institute\u2019s tool for cohort and cross-sectional observational studies. Prevalence estimates were logit-transformed and pooled using a random-effects model with restricted maximum likelihood estimation. Heterogeneity was quantified using I\n                      <jats:sup>2<\/jats:sup>\n                      and Cochran\u2019s Q. Subgroup and sensitivity analyses were performed by sex, methodological quality, diagnostic criteria, and geographic region. Publication bias was assessed using Egger\u2019s test and the trim-and-fill procedure.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Fourteen cross-sectional studies involving 8,107 schoolteachers from 10 countries were included. The pooled prevalence of MetS was 30% (95% CI: 22\u201338%), with very high between-study heterogeneity (\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u202f=98.34%). Central obesity, dyslipidemia, and hypertension were the most frequently reported components. The highest pooled prevalence was observed in studies conducted in Asia (35, 95% CI: 25\u201345%), whereas the single European study reported the lowest prevalence (9, 95% CI: 8\u201310%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Across the included studies, approximately three in 10 schoolteachers met the diagnostic criteria for MetS, although prevalence estimates varied widely across settings. These findings support the integration of cardiometabolic risk assessment into occupational health services for schoolteachers and the development of workplace health promotion strategies focused on physical activity, healthy eating, and routine monitoring of metabolic health. Educational institutions and public health authorities should consider context-specific preventive approaches, while future longitudinal studies using standardized diagnostic criteria and detailed occupational exposure assessments are needed to strengthen the evidence base.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic review registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>https:\/\/www.crd.york.ac.uk\/PROSPERO\/view\/CRD420251034493<\/jats:ext-link>\n                      , CRD420251034493.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1913303","type":"journal-article","created":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T05:25:47Z","timestamp":1786944347000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Prevalence of metabolic syndrome among primary and secondary school teachers: a systematic review and meta-analysis"],"prefix":"10.3389","volume":"14","author":[{"given":"Tuillang","family":"Yuing-Far\u00edas","sequence":"first","affiliation":[{"name":"Facultad de Salud, Escuela de Kinesiolog\u00eda, Universidad Santo Tom\u00e1s","place":["Vi\u00f1a del Mar, Chile"]},{"name":"Programa de Doctorado en Ciencias de la Actividad F\u00edsica y del Deporte, Universidad Pablo de Olavide de Sevilla","place":["Sevilla, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pablo","family":"Hern\u00e1ndez-Araya","sequence":"additional","affiliation":[{"name":"Exercise and Rehabilitation Sciences Institute, School of Physical Therapy, Faculty of Rehabilitation Sciences, Universidad Andr\u00e9s Bello","place":["Santiago, Chile"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sudip Datta","family":"Banik","sequence":"additional","affiliation":[{"name":"Laboratory of Biometry and Nutrition, Department of Human Ecology, Centro de Investigaci\u00f3n y de Estudios Avanzados del Instituto Polit\u00e9cnico Nacional (CINVESTAV)","place":["M\u00e9rida, Yucat\u00e1n, Mexico"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francisco Jos\u00e9","family":"Berral-de la Rosa","sequence":"additional","affiliation":[{"name":"Centro de Investigaci\u00f3n en Rendimiento F\u00edsico y Deportivo (CIRFD), Universidad Pablo de Olavide de Sevilla","place":["Sevilla, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pablo A.","family":"Lizana","sequence":"additional","affiliation":[{"name":"Laboratory of Epidemiology and Morphological Sciences, Instituto de Biolog\u00eda, Pontificia Universidad Cat\u00f3lica de Valpara\u00edso","place":["Valpara\u00edso, Chile"]},{"name":"Center for Interdisciplinary Research in Biomedicine, Biotechnology and Well-Being (CID3B), Pontificia Universidad Cat\u00f3lica de Valpara\u00edso","place":["Valpara\u00edso, Chile"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,17]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"2251","DOI":"10.3390\/ijms25042251","article-title":"The metabolic syndrome, a human disease","volume":"25","author":"Alemany","year":"2024","journal-title":"Int J Mol Sci"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1113","DOI":"10.1016\/j.jacc.2010.05.034","article-title":"The metabolic syndrome and cardiovascular risk","volume":"56","author":"Mottillo","year":"2010","journal-title":"J Am Coll Cardiol"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"573","DOI":"10.1038\/s41467-025-67268-5","article-title":"Worldwide trends in metabolic syndrome from 2000 to 2023: a systematic review and modelling analysis","volume":"17","author":"Noubiap","year":"2025","journal-title":"Nat Commun"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"1307","DOI":"10.3390\/ijerph20021307","article-title":"Systematic review and meta-analysis of metabolic syndrome and its components in Latino immigrants to the USA","volume":"20","author":"Paix\u00e3o","year":"2023","journal-title":"Int J Environ Res Public Health"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"1552","DOI":"10.1161\/01.CIR.0000093203.00632.2B","article-title":"Metabolic syndrome epidemic","volume":"108","author":"Kereiakes","year":"2003","journal-title":"Circulation"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1007\/s11906-018-0812-z","article-title":"The global epidemic of the metabolic syndrome","volume":"20","author":"Saklayen","year":"2018","journal-title":"Curr Hypertens Rep"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"102","DOI":"10.1186\/1475-2840-10-102","article-title":"Impact of metabolic syndrome and its components on cardiovascular disease event rates in 4,900 patients with type 2 diabetes assigned to placebo in the FIELD randomized trial","volume":"10","author":"Scott","year":"2011","journal-title":"Cardiovasc Diabetol"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"10706","DOI":"10.3390\/ijerph191710706","article-title":"Stress, burnout, anxiety and depression among teachers: a scoping review","volume":"19","author":"Agyapong","year":"2022","journal-title":"Int J Environ Res Public Health"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"189","DOI":"10.1007\/s11218-018-9471-9","article-title":"Burnout syndrome in secondary school teachers: a systematic review and meta-analysis","volume":"22","author":"Garc\u00eda-Carmona","year":"2019","journal-title":"Soc Psychol Educ"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"76","DOI":"10.1016\/j.jad.2015.11.054","article-title":"Teachers\u2019 wellbeing and depressive symptoms, and associated risk factors: a large cross-sectional study in English secondary schools","volume":"192","author":"Kidger","year":"2016","journal-title":"J Affect Disord"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"1015","DOI":"10.3233\/WOR-203351","article-title":"Low interest in physical activity and higher rates of obesity among rural teachers","volume":"67","author":"Lizana","year":"","journal-title":"Work"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"1772876","DOI":"10.3389\/fpsyt.2026.1772876","article-title":"Nocturnal salivary cortisol and perceived stress in schoolteachers: a pilot study","volume":"17","author":"Lizana","year":"2026","journal-title":"Front Psych"},{"key":"ref13","volume-title":"Condiciones de trabajo y salud docente: estudios de casos en Argentina, Chile, Ecuador, M\u00e9xico, Per\u00fa y Uruguay","author":"Robalino Campos","year":"2005"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"534","DOI":"10.1186\/1471-2458-14-534","article-title":"Associations between different types of physical activity and teachers\u2019 perceived mental, physical, and work-related health","volume":"14","author":"Bogaert","year":"2014","journal-title":"BMC Public Health"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"248","DOI":"10.1093\/her\/cyl073","article-title":"Occupational well-being of school staff members: a structural equation model","volume":"22","author":"Saaranen","year":"2006","journal-title":"Health Educ Res"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"345","DOI":"10.2486\/indhealth.2019-0170","article-title":"Association between sedentary behavior, obesity and hypertension in public school teachers","volume":"58","author":"Delfino","year":"2020","journal-title":"Ind Health"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"e0004681","DOI":"10.1371\/journal.pgph.0004681","article-title":"Predictors of metabolic syndrome among teachers in under-resourced schools in South Africa: baseline findings from the KaziHealth workplace health intervention","volume":"5","author":"Joubert","year":"2025","journal-title":"PLOS Glob Public Health"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"309","DOI":"10.13075\/ijomeh.1896.02584","article-title":"Metabolic syndrome prevalence and cardiovascular disease risk among school teachers","volume":"38","author":"Ramadan","year":"2025","journal-title":"Int J Occup Med Environ Health"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"251","DOI":"10.1007\/s00420-020-01576-9","article-title":"Self-reported cardiovascular health of teachers: results from the 5-year follow-up of the Gutenberg health study cohort","volume":"94","author":"Riechmann-Wolf","year":"2021","journal-title":"Int Arch Occup Environ Health"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"e1","DOI":"10.4102\/phcfm.v14i1.3133","article-title":"The relationship between physical activity, body fatness and metabolic syndrome in urban south African school teachers: the sympathetic activity and ambulatory blood pressure in Africans study","volume":"14","author":"Veldsman","year":"2022","journal-title":"Afr J Prim Health Care Fam Med"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"S223","DOI":"10.1016\/j.dsx.2016.12.035","article-title":"Metabolic syndrome and occupation: any association? Prevalence among auto technicians and school teachers in south West Nigeria","volume":"11","author":"Akintunde","year":"2017","journal-title":"Diabetes Metab Syndr"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"229","DOI":"10.4103\/ijoem.ijoem_261_22","article-title":"Metabolic syndrome among female school teachers: a sedentary occupational sector","volume":"27","author":"Monica","year":"2023","journal-title":"Indian J Occup Environ Med"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"LC10","DOI":"10.7860\/JCDR\/2016\/14868.7631","article-title":"Metabolic syndrome among secondary school teachers: exploring the ignored dimension of school health programme","volume":"10","author":"Narayanappa","year":"2016","journal-title":"J Clin Diagn Res"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"216","DOI":"10.33155\/j.ramd.2017.05.003","article-title":"Prevalence of metabolic syndrome and associated factors in basic education teachers","volume":"12","author":"Oliveira","year":"2019","journal-title":"Rev Andal Med Deporte"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"1343","DOI":"10.5958\/0976-5506.2019.02083.7","article-title":"Dominant factors of metabolic syndrome among a sample of school teachers in Jakarta, Indonesia","volume":"10","author":"Rachmah","year":"2019","journal-title":"Indian J Public Health Res Dev"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"7","DOI":"10.22452\/jummec.vol25no2.2","article-title":"The association of psychosocial health with metabolic syndrome among school teachers in the state of Malacca","volume":"25","author":"Lee","year":"2022","journal-title":"J Health Transl Med"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: an updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"557","DOI":"10.1136\/bmj.327.7414.557","article-title":"Measuring inconsistency in meta-analyses","volume":"327","author":"Higgins","year":"2003","journal-title":"BMJ"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"53","DOI":"10.4103\/nmj.NMJ_53_19","article-title":"Components and risk factors of metabolic syndrome among rural Nigerian workers","volume":"60","author":"Ayogu","year":"2019","journal-title":"Niger Med J"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"99","DOI":"10.4321\/S0465-546X2021000200003","article-title":"Determination of different cardiovascular risk scales in Spanish teaching staff: associated variables","volume":"67","author":"L\u00f3pez Gonz\u00e1lez","year":"2021","journal-title":"Med Segur Trab"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"130","DOI":"10.1016\/j.je.2016.10.006","article-title":"Metabolic syndrome among non-obese adults in the teaching profession in Melaka, Malaysia","volume":"27","author":"Lee","year":"2017","journal-title":"J Epidemiol"},{"key":"ref32","first-page":"237","article-title":"Dietary approach and its relationship with metabolic syndrome components","volume":"9","author":"Bajaber","year":"2016","journal-title":"Int J PharmTech Res"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"29","DOI":"10.31436\/imjm.v18i2.100","article-title":"Prevalence of metabolic syndrome (MetS) and determinants among obese teachers in Makassar, Indonesia","volume":"18","author":"Hasan","year":"2019","journal-title":"Int Med J Malaysia"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"30","DOI":"10.1186\/s12905-023-02876-1","article-title":"Association between healthy eating index-2015 scores and metabolic syndrome among Iranian women: a cross-sectional study","volume":"24","author":"Jowshan","year":"2024","journal-title":"BMC Womens Health"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"233","DOI":"10.3390\/ijerph14030233","article-title":"A cross-sectional study of the prevalence of metabolic syndrome and associated factors in Colombian collegiate students: the FUPRECOL-adults study","volume":"14","author":"Mart\u00ednez-Torres","year":"2017","journal-title":"Int J Environ Res Public Health"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"101","DOI":"10.1186\/s12889-017-4041-1","article-title":"Prevalence and trends of metabolic syndrome among adults in the Asia-Pacific region: a systematic review","volume":"17","author":"Ranasinghe","year":"2017","journal-title":"BMC Public Health"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"2898","DOI":"10.3389\/fpsyg.2019.02898","article-title":"Association between chronic health conditions and quality of life in rural teachers","volume":"10","author":"Lizana","year":"","journal-title":"Front Psychol"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"5968","DOI":"10.3390\/ijerph19105968","article-title":"Depression, anxiety, and stress among teachers during the second COVID-19 wave","volume":"19","author":"Lizana","year":"2022","journal-title":"Int J Environ Res Public Health"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"2520","DOI":"10.1210\/clinem\/dgab389","article-title":"Changes in regional fat distribution and anthropometric measures across the menopause transition","volume":"106","author":"Greendale","year":"2021","journal-title":"J Clin Endocrinol Metab"},{"key":"ref40","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":"ref41","doi-asserted-by":"publisher","first-page":"26","DOI":"10.70818\/nmcj.v02i02.017","article-title":"Sedentary lifestyle, stress, and metabolic syndrome: a triad of health risks for female teachers in urban Bangladesh","volume":"2","author":"Ali","year":"2025","journal-title":"Naogaon Med Coll J"},{"key":"ref42","doi-asserted-by":"publisher","first-page":"2606","DOI":"10.3390\/ijerph19052606","article-title":"Association between emotional exhaustion and tobacco consumption in teachers","volume":"19","author":"Portilla","year":"2022","journal-title":"Int J Environ Res Public Health"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"81","DOI":"10.1348\/096317904322915928","article-title":"Organizational citizenship behaviours in relation to job status, job insecurity, organizational commitment and identification, job satisfaction and work values","volume":"77","author":"Feather","year":"2004","journal-title":"J Occup Organ Psychol"},{"key":"ref44","doi-asserted-by":"publisher","first-page":"7566","DOI":"10.3390\/ijerph18147566","article-title":"Teacher teleworking during the COVID-19 pandemic: association between work hours, work-family balance and quality of life","volume":"18","author":"Lizana","year":"2021","journal-title":"Int J Environ Res Public Health"},{"key":"ref45","doi-asserted-by":"publisher","first-page":"213","DOI":"10.1348\/000709905X92045","article-title":"The association between job strain and emotional exhaustion in a cohort of 1,028 Finnish teachers","volume":"77","author":"Santavirta","year":"2007","journal-title":"Br J Educ Psychol"},{"key":"ref46","doi-asserted-by":"publisher","first-page":"391","DOI":"10.2337\/diacare.28.2.391","article-title":"Metabolic syndrome, obesity, and mortality: impact of cardiorespiratory fitness","volume":"28","author":"Katzmarzyk","year":"2005","journal-title":"Diabetes Care"},{"key":"ref47","doi-asserted-by":"publisher","first-page":"e1419","DOI":"10.1002\/hsr2.1419","article-title":"Cardiometabolic syndrome among the general adult population in Ghana: the role of lipid accumulation product, waist circumference-triglyceride index, and triglyceride-glucose index as surrogate indicators","volume":"6","author":"Anto","year":"2023","journal-title":"Health Sci Rep"},{"key":"ref48","doi-asserted-by":"publisher","first-page":"1884","DOI":"10.2337\/dc08-0431","article-title":"Occupation-related differences in the prevalence of metabolic syndrome","volume":"31","author":"S\u00e1nchez-Chaparro","year":"2008","journal-title":"Diabetes Care"},{"key":"ref49","doi-asserted-by":"publisher","first-page":"2390","DOI":"10.2337\/dc10-0681","article-title":"Prevalence of the metabolic syndrome among U.S. workers","volume":"33","author":"Davila","year":"2010","journal-title":"Diabetes Care"},{"key":"ref50","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1186\/s13098-016-0174-0","article-title":"Occupation and metabolic syndrome: is there correlation? A cross-sectional study in different work activity occupations of German firefighters and office workers","volume":"8","author":"Strau\u00df","year":"2016","journal-title":"Diabetol Metab Syndr"},{"key":"ref51","doi-asserted-by":"publisher","first-page":"e417","DOI":"10.1093\/milmed\/usz144","article-title":"Metabolic syndrome prevalence among armed forces personnel\u2014military personnel and police officers: a systematic review and meta-analysis","volume":"184","author":"Rostami","year":"2019","journal-title":"Mil Med"},{"key":"ref52","doi-asserted-by":"publisher","first-page":"469","DOI":"10.1111\/j.1464-5491.2006.01858.x","article-title":"Metabolic syndrome\u2014a new world-wide definition. A consensus statement from the international diabetes federation","volume":"23","author":"Alberti","year":"2006","journal-title":"Diabet Med"},{"key":"ref53","doi-asserted-by":"publisher","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":"ref54","doi-asserted-by":"publisher","first-page":"131","DOI":"10.25182\/jgp.2023.18.Supp.1.131-133","article-title":"Differences in risk factors for metabolic syndrome and stress levels between school teachers living in rural and urban areas in Karawang, Indonesia during the COVID-19 pandemic","volume":"18","author":"Bhagya","year":"2023","journal-title":"J Gizi Pangan"},{"key":"ref55","doi-asserted-by":"publisher","first-page":"1651","DOI":"10.1111\/obr.12915","article-title":"The association between psychological stress and metabolic syndrome: a systematic review and meta-analysis","volume":"20","author":"Kuo","year":"2019","journal-title":"Obes Rev"},{"key":"ref56","doi-asserted-by":"publisher","first-page":"97","DOI":"10.1002\/jrsm.12","article-title":"A basic introduction to fixed-effect and random-effects models for meta-analysis","volume":"1","author":"Borenstein","year":"2010","journal-title":"Res Synth Methods"},{"key":"ref57","doi-asserted-by":"publisher","first-page":"228","DOI":"10.3889\/oamjms.2020.4605","article-title":"Improved knowledge, attitudes, and practices of balanced nutrition after educational intervention based on self-determination theory: an intervention study in senior school teachers in Makassar City","volume":"8","author":"Jafar","year":"2020","journal-title":"Open Access Maced J Med Sci"},{"key":"ref58","doi-asserted-by":"publisher","first-page":"327","DOI":"10.3390\/metabo14060327","article-title":"Comprehensive strategies for metabolic syndrome: how nutrition, dietary polyphenols, physical activity, and lifestyle modifications address diabesity, cardiovascular diseases, and neurodegenerative conditions","volume":"14","author":"Martemucci","year":"2024","journal-title":"Meta"},{"key":"ref59","doi-asserted-by":"publisher","first-page":"426","DOI":"10.1055\/s-0030-1262902","article-title":"Metabolic implications of menopause","volume":"28","author":"Polotsky","year":"2010","journal-title":"Semin Reprod Med"}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1913303\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T05:25:48Z","timestamp":1786944348000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1913303\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,17]]},"references-count":59,"alternative-id":["10.3389\/fpubh.2026.1913303"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2026.1913303","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,17]]},"article-number":"1913303"}}