According to the present study, six out of ten Mexican adults had MetSx. Among its components, AO, hypoalphalipoproteinemia and hypertriglyceridemia were the most frequent ones. These figures are more than twice than those reported worldwide in 2006 (prevalence of MetSx of ≈ 25.0%) [35]. Since both separately and combined AO and dyslipidemias are the most prevalent MetSx components in Mexican adults, which places this population at a high risk of diabetes [36, 37] and CVD [38], strengthening its preventive and control strategies is a priority. The information here presented highlights once again the necessity of implementing rigorous plans of action to enhance dietary choices, promote and increase physical activity, and secure access to pharmacological therapies able to counteract weight excess and lipid abnormalities in Mexico.
Implementation of the above-mentioned strategies is crucial especially considering the lifestyle-related epidemiological scenario in the country. According to National Health and Nutrition Survey 2012, some of the most consumed foods such as processed meats and sugary drinks are those that have a high content of saturated fat and/or sugar [26]. In relation to this, it has been described that in Mexican adults the highest contribution to total energy intake came from products high in saturated fat and/or added sugar (16%), and sugar sweetened beverages (9.8%). These products are casually linked to obesity, diabetes, and hypertension, which besides, hypertriglyceridemia, low HDL-c levels, and insulin resistance, are risk factors for MetSx [39]. On the other hand, in the Mexican population the consumption of vegetables is low since only 40% include them in their diet [40]. This fact is associated with an increased risk of having MetSx [41].
There is enough evidence in literature demonstrating that physical inactivity is one of the main risk factors of MetSx [42]. In relation to this behavior, it has been described that 11.4% of Mexican adults reported not performing enough PA in 2006 and this percentage rose to 14.4% in 2016 [43].
The prevalence of MetSx registered and increment of 21% in the 2006–2016 period [44]. This increase could be in part due to the Western lifestyle diffusion, which entails an unhealthy diet [45] and sedentary behaviors [46], but also to other factors such as population ageing. According to the National Institute of Statistics and Geography in Mexico, the median population age ranged from 24 in 2005 to 28 in 2015 [47]. Given that an increasing trend in the prevalence of MetSx is observed as age increases, it is possible that part of this increment in the prevalence is due to the existence of a larger proportion of adults aged > 40 years in 2016 compared to 2006. However, the prevalence of MetSx in each age group was higher in 2016 compared with 2006. For example, in 2006 [4], 67.9% of adults aged ≥ 60 years had MetSx, whereas in 2016 the prevalence was 76.9%. As it was expected, as age increases, the prevalence of its components also increases, except for low HDL-c. For this reason, execution of actions to tackle MetSx must be directed to every age group, but especially it must start at young ages, since one out of two 20 to 49-year-old adults had this syndrome.
Altogether, MetSx elements are associated with a higher risk of diabetes and CVD [48]. Equally important, its components have been separately associated with these diseases [49]. According to the trend analysis carried out in this study, the prevalence of AO, impaired fasting glucose, low HDL-c, and hypertension relatively remained stable between 2006 and 2016. In contrast, the proportion of Mexican subjects who suffered from hypertriglyceridemia increased by 74%, being this the component that explains to a greater extent the observed increase in the general prevalence of MetSx in this period. Further, the prevalence of hypertriglyceridemia in Mexico is higher than in other developing and developed countries, such as India, Nigeria, China, Japan, and the United States [50]. This scenario exposes the need to continue reinforcing health and nutrition policies able to decrease population’s triglycerides concentration, such as soda tax since sweetened-sugar beverages consumption is strongly associated with hypertriglyceridemia [51], and an adequate front-of-pack food labeling system that would allow consumers to take more informed dietary choices and diminish purchases and consumption of high-sugar products. Undoubtedly, early diagnosis and treatment through mass health promotion and screening campaigns, enhancements in the health system infrastructure, an improved medical personnel training, and greater accessibility to pharmacological treatments and nutrition counseling are also crucial strategies to diminish the burden of hypertriglyceridemia and the rest of MetSx components.
The main limitation of this study is its cross-sectional design, which did not allow us to establish causal associations. However, the population-based information generated in this investigation is highly essential to continue designing, evaluating, and reformulating strategies to reduce the burden of MetSx in Mexico.