Increasing prevalences of obesity and type 2 diabetes (T2DM) increase cardiovascular risks. Since poor diet and inadequate exercise are primary behavioral causes of obesity and T2DM, our objective was to examine health beliefs and associations with diet, exercise, and metabolic syndrome (MetSyndr) characteristics. A total of 117 overweight and obese family medicine patients enrolled in this study. Subjects completed questionnaires for health beliefs and vegetable, fruit, and fat intake; other data were from medical charts. Seventy-four percent of subjects were women; 69% were black, 72% were obese, 36% were hypertensive, 22% had T2DM, and 23% had hypertriglyceridemia. MetSyndr subjects had significantly higher triglyceride levels and a higher percentage of hypertension and T2DM. Although not statistically significant, overweight subjects without MetSyndr had higher vegetable and fruit intake and lower fat intake than obese subjects without MetSyndr and subjects with MetSyndr. More exercise was associated with less MetSyndr and less obesity; however, this also was not statistically significant. For health beliefs, there were no significant differences between subjects with MetSyndr versus those without MetSyndr or for subjects without MetSyndr who were obese versus those who were overweight. However, for subjects with above-median nutrition scores and exercise, scores were significantly higher for the health belief "certainty" compared to those with below-median scores (P < .0001). This research suggests that health beliefs and specifically less certainty may be a useful marker for individuals who require more education and/or training. Effective programs that address certainty may promote better diets, more exercise, and reduced cardiovascular risk.

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