Behavior Change Trajectories and Metabolic Syndrome Risk Factor Clustering During the Transition to College: A...

Metabolic syndrome (MetS) is typically diagnosed in adults; however, MetS risk factors are growing in prevalence during youth and young adulthood. Though the transition from high school to college is associated with adverse changes in lifestyle behaviors that may contribute to MetS risk factor development, the relationship between pre-college MetS risk status and transition-related behavior change is unknown. This prospective study aimed to describe the relationship between pre-college MetS risk status and transition-related behavior change trajectories in college-bound students. Moreover, it aimed to assess the feasibility of the study design, including acceptability to both participants and investigators, prior to implementation in a larger sample. Participants (n = 21, 18.3 ± 0.3 y/o) were assessed for MetS risk factors during their last semester of high school. Self-report behavioral data on dietary habits, physical activity, sleep, stress, and alcohol consumption were collected at baseline and during the fall and spring semesters of the first year of college. Linear mixed models revealed drastic increases in alcohol consumption (β₁₁ = 0.39, p < 0.001) and apparent decreases in moderate-vigorous physical activity (β₁₁ = -0.15, p = 0.185) during the college transition. Furthermore, 47.6% of students had ≥ 1 MetS risk factor at baseline and those with a greater number of risk factors experienced a more severe alcohol-related behavior change trajectory (β₁₁ = 0.29, p < 0.050). These findings highlight the importance of primordial prevention strategies against early MetS risk development, given the potential relationship with future behavioral trajectories. Future research should aim to further characterize this relationship using comprehensive, longitudinal measures that span the college transition in larger, more diverse samples.