0828 Associations Between 24-Hour Movement Behavior Guideline Adherence and Metabolic Syndrome in Postmenopausal Women from the SWAN Study

Abstract Introduction Adherence to 24-hour movement behavior guidelines for sleep, sedentary behavior (SB), light-intensity physical activity (LPA), or moderate-to-vigorous intensity physical activity (MVPA) are independently associated with metabolic syndrome (MetS) risk in postmenopausal women, but adherence to these guidelines has rarely been examined together. Possible heterogeneity in associations with MetS by race/ethnicity and socioeconomic status (e.g., education and financial strain) are unclear. This study aimed to examine the association between adherence to the Canadian 24-hour movement guidelines and MetS in postmenopausal women. Methods Data from 1,078 participants (65.5 ± 2.6 y) in the Study of Women’s Health Across the Nation were analyzed. Sleep and waking behaviors (SB, LPA, and MVPA) were assessed with wrist- (Actiwatch 2) and waist-worn (ActiGraph wGT3X-BT) accelerometry. Guideline adherence was based on the Canadian 24-hour movement guidelines; MetS was defined by National Cholesterol Education Program Adult Treatment Panel III criteria. Multivariable logistic regression estimated adjusted odds ratios (ORs) and 95% confidence intervals (CIs), adjusting for age, race/ethnicity, education, financial strain, and study site. Primary models included adherence to each guideline, while secondary models included the number of guidelines met. Interaction terms and stratified models tested modification by race/ethnicity, educational attainment, and financial strain. Results Overall, 26.9, 63.7, 88.2, and 86.1% met guidelines for sleep, SB, LPA, and MVPA, and 32.1% met criteria for MetS. Meeting SB (OR=0.55, 95% CI: 0.39-0.76), LPA (OR=0.56, 95% CI: 0.36-0.88), and MVPA guidelines (OR=0.59, 95% CI: 0.40-0.88) were each associated with lower odds of MetS; meeting the sleep guideline was not (OR=0.78, 95% CI: 0.56-1.08). Each additional guideline met was associated with 40% lower odds of MetS (OR=0.60, 95% CI: 0.52-0.70) and lower odds of elevated blood pressure, impaired glucose, low HDL, and high triglycerides. Interaction terms did not indicate heterogeneity by race/ethnicity, educational attainment, or financial strain, and stratified analyses did not reveal meaningful group differences. Conclusion In this diverse cohort of postmenopausal women, adherence to SB, LPA, and MVPA guidelines, particularly meeting more guidelines, was associated with lower odds of MetS and components. These findings suggest the value of considering multiple 24-hour movement guidelines to minimize MetS risk in postmenopausal women. Support (if any)