Determinants of adherence to diet and exercise behaviours among individuals with metabolic syndrome based on the Capability, Opportunity, Motivation, and Behaviour model: a cross-sectional study

Aims Adherence to diet and exercise recommendations is crucial among metabolic syndrome (MetS) individuals. However, no studies have focused on comprehensive behavioural changes of diet and exercise among individuals with MetS. The present study aimed to explore determinants of adherence to diet and exercise behaviours among people with MetS based on the Capability, Opportunity, Motivation, and Behaviour (COM-B) model. Methods and results A cross-sectional study was conducted in a health promotion centre of a large and general university hospital in Zhejiang Province, China, in 2021. A total of 241 individuals with MetS completed all scales. The mediation model was tested using structural equation modelling with bootstrapped samples. In the regression-based path analysis, MetS knowledge (beta = 0.140), socioeconomic status (beta= 0.162), and social support (beta = 0.143) directly positively influenced diet behaviour. In addition, social support indirectly positively influenced exercise behaviour through coping and adaptation beta = 0.090). The final theoretical model showed a good fit (root mean square error of approximation = 0.057, comparative fit index = 0.946). Conclusion Factors associated with diet behaviour were knowledge of MetS, socioeconomic status, and social support. Adaptation may be a mediator between social support and exercise behaviour. Intervention programmes targeting increased adherence to diet and exercise could include these factors for individuals with MetS. [GRAPHICS] .

Automated summary

Adherence to diet and exercise recommendations is crucial among individuals with metabolic syndrome (MetS). However, there has been a lack of comprehensive studies on the behavioral changes related to diet and exercise among MetS individuals. This study aimed to explore the determinants of adherence to diet and exercise behaviors among people with MetS using the Capability, Opportunity, Motivation, and Behavior (COM-B) model. The findings revealed that MetS knowledge, socioeconomic status, and social support directly influenced diet behavior, while social support indirectly influenced exercise behavior through coping and adaptation.