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Metabolic syndrome (MetS) is a constellation of abnormalities that increase the risk of coronary heart disease and diabetes mellitus (DM). 5 The diagnostic criteria is dictated by the International Diabetes Federation, the National Heart Lung Blood Institute, and the American Heart Association, among others. The prevalence is highly variable due to the different diagnostic criteria, but generally increases with age and is more frequent in men older than 20 yr with an estimated 17–40%, 30% in the age range from 40–50 yr, and 40–45% in those older than 50 yr

may be difficult to overcome, creating a negative caloric balance, which could hinder the benefits of the exercise. 20 Therefore, in order to increase the DSS on a long duration mission to Mars and subsequently reduce the bone loss and risk of fracture, nondisruptive, low-metabolic cost methods to load the skeleton are needed. Neuromuscular electrical stimulation (NMES) is a technique that uses electrical pulses to cause involuntary muscular contractions 7 and has been previously used as a space-based muscle atrophy countermeasure by Roscosmos. 26