Longitudinal association between binge eating and metabolic syndrome in adults: findings from the ELSA-Brasil cohort

OBJECTIVE: Individuals with bulimia nervosa and binge eating disorder have greater cardiovascular morbidity than the general population. Longitudinal research on the association between binge eating and metabolic syndrome is limited. We tested the longitudinal association between binge eating and metabolic syndrome and its components in a large population sample of Brazilian adults. METHODS: We used data from Brazilian Longitudinal Study of Adult Health (ELSA-Brasil, N=15,105). To test for the association between binge eating at baseline (2008-2010) and metabolic syndrome at follow-up (2012-2014), we used univariable and multivariable logistic regression models progressively adjusting for potential socio-demographic confounders, and number of metabolic syndrome components, and body mass index (BMI) at baseline. RESULTS: In total, 13,388 participants (54.8% female; 52.2% white) had complete data on all variables of interest. Binge eating was associated with increased odds of metabolic syndrome at follow-up (odds ratio (OR):1.66, 95% confidence intervals (CI): 1.44,1.75). However, the size of this association was attenuated after including number of metabolic syndrome components at baseline (OR:1.19, 95%CI: 1.05,1.35), and was no longer present after adjusting for baseline BMI (OR:1.09, 95%CI: 0.96, 1.02). Binge eating was also associated with higher odds of hypertension (OR:1.14, 95%CI: 0.99,1.37) and hypertriglyceridemia (OR:1.21, 95%CI: 1.06,1.37) at the follow-up assessment after adjustment for all confounders. CONCLUSIONS: Individuals who binge eat are at increased risk of metabolic syndrome via increased BMI, and of hypertriglyceridemia and hypertension independently of BMI. If these are causal associations, effective interventions for binge eating could also have beneficial effects on metabolic health outcomes.