The Western Pacific region, including Guam, reports some of the highest rates of prediabetes and type 2 diabetes mellitus (T2DM), both of which are linked to metabolic syndrome (MetS), a cluster of preventable risk factors. Offspring of parents with MetS are at elevated risk of developing MetS themselves. However, the prevalence of MetS in Guam and its impact on children are not well documented. This study utilized data from the Pacific Islands Cohort on Cardiometabolic Health (PICCAH) to assess MetS among adults and MetS risk among children. Adult MetS was defined using International Diabetes Federation (IDF) criteria, while child risk was determined based on age- and sex-specific waist circumference percentiles for abdominal obesity. MetS Z-scores were calculated, and associations between MetS indicators and lifestyle factors—including physical activity and sleep for both parents and children, sedentary behavior and stress for parents, and screen time for children—were analyzed. Linear regression evaluated relationships between adult and child MetS Z-scores, revealing direct correlations within parent–child dyads. The high adult MetS prevalence underscores the need for interventions targeting both parents and children. Further research incorporating additional lifestyle factors, such as dietary patterns, is needed to inform family-centered prevention strategies.
