..... Health Behavior ..... Physical Activity, Metabolic Syndrome, and Overweight in Rural Youth Justin B. Moore, PhD; 1 Catherine L. Davis, PhD; 2 Suzanne Domel Baxter, PhD; 3 Richard D. Lewis, PhD; 4 and Zenong Yin, PhD 5 ABSTRACT: Background: Research suggests significant health differences between rural dwelling youth and their urban counterparts with relation to cardiovascular risk factors. This study was conducted to (1) determine relationships between physical activity and markers of metabolic syndrome, and (2) to explore factors relating to physical activity in a diverse sample of rural youth. Methods: Data were collected from 4th, 6th, 8th, and 11th grade public school students in the rural Southeastern United States in the spring of 2002. Physiological data included anthropometrics, fasting glucose, lipids, hemodynamics, and skinfold measurements. Psychosocial data included parental support for physical activity, accessibility of physical activity facilities, and safety concerns for physical activity. Behavioral data included self-reported physical activity and sedentary behaviors. Results: After adjusting for sex, race, and age, subjects with low level of physical activity were 3 times more likely to be positive for metabolic syndrome compared to those reporting a high level of physical activity. Subjects reporting a low level of physical activity were 2.4 times more likely to be overweight compared to subjects reporting a high level of physical activity. Students with high levels of physical activity were more likely to have parents who provided money for physical activity lessons and sports teams. Conclusions: Rural youth with low levels of physical activity participation were at increased risks for metabolic syndrome and overweight. Effective physical activity promotions addressing supports for physical activity are urgently needed in rural America. M etabolic syndrome in children has gained attention recently as the health consequences of the emerging obesity pandemic become known. 1 Metabolic syndrome in children is characterized as the presence of 3 or more of the following abnormalities: hypertriglyceridemia, low HDL, hyperglycemia, obesity, and hypertension. 2 Much of this increased interest in metabolic syndrome stems from the lifelong increase in the risk for diabetes mellitus, associated cardiovascular disease (CVD) 3 and the related economic consequences. 4 This attention has been highlighted in the increase of obesity-related medical care sought for children and adolescents and the associated cost. 5 As a result of this growing health and economic burden, obesity and physical inactivity have been identified as 2 of the top indicators in Healthy People 2010. 6 In a 2005 study, 65%-84% of overweight children (M age 9.7 y at baseline) followed for an average of 17.1 years were found to be obese as adults. 7 Lack of physical activity (PA) in childhood has been linked to 1 Division of Community Health and Preventive Medicine, Department of Family Medicine, The Brody School of Medicine, East Carolina University, Greenville, NC. 2 Georgia Institute for the Prevention of Human Diseases, Department of Pediatrics, Medical College of Georgia, Augusta, Ga. 3 Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC. 4 Department of Foods and Nutrition, College of Family and Consumer Sciences, University of Georgia, Athens, Ga. 5 Department of Health and Kinesiology, College of Education and Human Development, University of Texas at San Antonio, San Antonio, Tex. This study was supported by a State of Georgia Biomedical Initiative grant to the Georgia Center for the Prevention of Obesity and Related Disorders. Dr. Suzanne Domel Baxter is recognized for her leadership in this project. We would like to thank the students, parents, and school staff in Washington-Wilkes, Ga, for their participation in the study. For further information, contact: Justin B. Moore, PhD, Assistant Professor, Master of Public Health Program, Division of Community Health and Preventive Medicine, The Brody School of Medicine at East Carolina University, Hardy Building – 1709 West 6th Street, Greenville, NC 27834; e-mail moorej@ecu.edu. C  2008 National Rural Health Association 136 Spring 2008