Metabolic Syndrome

Metabolic Syndrome Overview

Metabolic syndrome is a health condition that everyone’s talking about.

Although the first formal definition of metabolic syndrome entered medical textbooks not so long ago (1998), it is as widespread as pimples and the common cold . According to the American Heart Association, 47 million Americans have it. That’s almost a staggering one out of every six people. The syndrome runs in families and is more common among African-Americans, Hispanics, Asians, and Native Americans. The risks of developing metabolic syndrome increases as you age.

Indeed, metabolic syndrome seems to be a condition that many people have, but no one knows very much about. It’s also debated by the experts — not all doctors agree that metabolic syndrome should be viewed as a distinct condition.

So what is this mysterious syndrome — which also goes by the scary-sounding name Syndrome X — and should you be worried about it?

Understanding Metabolic Syndrome

Metabolic syndrome is not a disease in itself. Instead, it’s a group of risk factors — high blood pressure, high blood sugar, unhealthy cholesterol levels, and abdominal fat.

Obviously, having any one of these risk factors isn’t good. But when they’re combined, they set the stage for serious problems. These risk factors double your risk of blood vessel and heart disease, which can lead to heart attacksand strokes. They increase your risk of diabetes by five times.

The good news is that metabolic syndrome can be controlled, largely with changes to your lifestyle.

Risk Factors for Metabolic Syndrome

According to the American Heart Association and the National Heart, Lung, and Blood Institute, there are five risk factors that make up metabolic syndrome.

Large Waist Size

For men: 40 inches or larger
For women: 35 inches or larger

Cholesterol: High Triglycerides

  • Either​ ​150 mg/dL or higher​ ​or​ ​Using a cholesterol medicine
  • Cholesterol: Low Good Cholesterol (HDL)
  • Either​ ​For men: Less than 40 mg/dL​ ​For women: Less than 50 mg/dL​ or ​Using a cholesterol medicine
  • High Blood Pressure​ ​Either​ ​Having blood pressure of 130/85 mm Hg or greater​ ​or​ ​Using a high blood pressure medicine
  • Blood Sugar: High Fasting Glucose Level 100 mg/dL or higher

To be diagnosed with metabolic syndrome, you would have at least three of these risk factors.

What Causes Metabolic Syndrome?

Experts aren’t sure why metabolic syndrome develops. It’s a collection of risk factors, not a single disease. So it probably has many different causes. Some risk factors are:

  • Insulin resistance​:​ Insulin is a hormone that helps your body use glucose — a simple sugar made from the food you eat — as energy. In people with insulin resistance, the insulin doesn’t work as well, so your body keeps making more and more of it to cope with the rising level of glucose. Eventually, this can lead to diabetes. Insulin resistance is closely connected to having excess weight in the belly.
  • Obesity​: ​especially abdominal obesity. Experts say that metabolic syndrome is becoming more common because of rising obesity rates. In addition, having extra fat in the belly — as opposed to elsewhere in the body — seems to increase your risk.
  • Unhealthy lifestyle​: ​Eating a diet high in unhealthy processed foods and not getting enough physical activity can play a role.
  • Hormonal imbalance​:​ Hormones may play a role. For instance, polycystic ovary syndrome (PCOS) — a condition that affects fertility — is related to hormonal imbalance and metabolic syndrome.
  • Smoking.

If you’ve just been diagnosed with metabolic syndrome, you might be anxious. But think of it as a wake-up call. It’s time to get serious about improving your health. Making simple changes to your habits now can prevent serious illness in the future.

Given how common metabolic syndrome is — it’s estimated that one out of four people meet the criteria — everyone should be worried about their risk factors. After all, metabolic syndrome can dramatically increase your risk of serious health problems, such as diabetes, heart attacks, and strokes — yet often people don’t even know what it is.

Metabolic syndrome is generally defined as a cluster of risk factors, including high blood sugar, extra abdominal fat, high blood pressure, and unhealthy cholesterol levels.

Some of these risk factors you can control. Others are outside your control. But if you understand the entire range of risk factors, you can better protect your health. You may have a higher risk of metabolic syndrome if:

  • You are older. It’s more common as people age. The risk of getting metabolic syndrome rises from 20% in your 40s, to 35% in your 50s, to 45% in your 60s and beyond
  • You are prone to blood clots and inflammation. Both are common in people with metabolic syndrome. Your doctor can do blood tests to find out if you have a high risk of clots and inflammation
  • You have other medical conditions. Metabolic syndrome is associated with a number of medical conditions. These include polycystic ovary syndrome (PCOS), fatty liver, cholesterol gallstones, and lipodystrophy(which affects fat distribution)
  • It runs in the family. Even if you are not obese you may have inherited a higher risk. This includes people who have parents or other first-degree relatives with diabetes
  • You are South Asian. South Asians seem to have a higher risk of insulin resistance and thus metabolic syndrome. Because of this, the American Heart Association and the National Heart, Lung, and Blood Institute have different recommendations for this group. A waist size above 35″ (for men) and 31″ (for women) is considered a metabolic syndrome risk factor

Symptoms of Metabolic Syndrome

Most of the metabolic syndrome risk factors don’t have any symptoms. You usually can’t feel high blood pressure or high cholesterol. Often, the only outward sign is packing some extra weight in the belly.

So the only way to find out if you have metabolic syndrome is to meet with your doctor. He or she will check your blood pressure, blood sugar, and cholesterol. It’s another reason that regular check-ups are the key to staying healthy.

The risk factors that make up metabolic syndrome — unhealthy cholesterol levels, high blood pressure, high blood sugar, and excess belly fat — raise your odds of serious health problems. These include diabetes and blood vessel or heart disease.

Specifically, metabolic syndrome can lead to arteriosclerosis, or “hardening of the arteries.” This is when fats, cholesterol, and other substances stick to the sides of the arteries. The arteries then become clogged and brittle. Blood clots form when the arterial walls are damaged. If a blood clot forms, it can cause a heart attack or stroke.

Here are some sobering statistics from the American Heart Association and the American Diabetes Association:

  • Heart disease is the leading cause of death in the U.S.
  • This year 1.5 million Americans will have a heart attack — 500,000 will die
  • This year 795,000 Americans will have a stroke
  • 68% of people over the age of 65 with diabetes die from heart disease

Metabolic syndrome is a group of risk factors that include abdominal fat, high blood pressure, high blood sugar, and unhealthy cholesterol levels. Treatment is focused on tackling each of these conditions. The goal is to cut your odds of blood vessel disease and heart disease, as well as diabetes.

Treatment

In most cases, the best treatment for metabolic syndrome rests with you. Changes to your behavior — such as eating healthier and getting more exercise — are the first things your doctor will suggest. By adopting some healthy habits, you may be able to eliminate your risk factors completely.

Make These Lifestyle Changes

Get some exercise​:​ Exercise is a great way to lose weight, but don’t get down if the scale isn’t showing progress. Even if you don’t lose a single pound, exercise can lower blood pressure, improve cholesterol levels, and improve insulin resistance. If you’re out of shape, start slowly. Try walking more. Work more physical activity into your day. When you’re on foot, allow a little extra time to take the scenic route to get some extra steps. To keep track, buy a pedometer (step counter). Gradually increase your physical activity until you’re doing it on most days of the week. But don’t get too ambitious. If you try a workout regime that’s too tough, you may give up. You need to find a level of exercise that fits your personality.
Eat a healthy diet​:​ Eating a healthy diet can improve your cholesterol, insulin resistance, and blood pressure — even if your weight stays the same. For advice on healthy eating, ask your doctor or registered dietitian. If you have heart disease or diabetes, you may need special meal plans. In general, a diet that’s low in saturated fats, trans fat, cholesterol, and salt — and high in fruits, vegetables, lean protein, beans, low fat dairy, and whole grains​: ​has been shown to help people with high blood pressure and a higher risk of cardiovascular disease. Many doctors suggest a “Mediterranean” diet or the DASH diet. These meal plans emphasize “good” fats (like the monounsaturated fat in olive oil) and a balance of carbohydrates and proteins.
Lose some weight​:​ Obviously, weight loss is often a by-product of exercising and eating well. But it’s a key goal in itself if you’re overweight or obese. Weight loss can improve every aspect of metabolic syndrome.
If you smoke, quit. It’s not a risk factor for what’s considered metabolic syndrome, yet smoking greatly increases your risk of blood vessel and heart disease.

Talk to Your Doctor About Medication

You may need medicine to help with metabolic syndrome, if lifestyle changes aren’t enough to reduce your risks. Some drugs you might use are:

  • High blood pressuremedicines, which include ACE inhibitors (like Capotenand Vasotec), angiotensin II receptor blockers (like Cozaarand Diovan), diuretics, beta-blockers, and other drugs.
  • Cholesterol medicines, which include statins (like Crestor, Lescol, Lipitor, Mevacor, Pravachol, and Zocor), niacin (like Niacor, Niaspan, and Nicolar), bile acid resins (like Colestid and Questran), Zetia, and other drugs.
  • Diabetes medicines, which may be necessary if you have glucose intolerance. Drugs include Glucophage, Actos, and Avandia.
  • Low-dose aspirin, which can reduce the risks of heart attacks and strokes. It may be especially important for people who are “prothrombotic,” or prone to blood clots.

Keep in mind that all medicines can have side effects and risks. Talk with your doctor about the pros and cons.

How Can You Prevent Metabolic Syndrome?

Metabolic syndrome is a group of risk factors: high blood pressure, high blood sugar, unhealthy cholesterol levels, and excess fat in the abdomen. Having these risk factors drastically raises your risk of diabetes, and blood vessel and heart disease.

Experts say you can prevent metabolic syndrome in the same way you would treat it. You need to make sensible changes to your lifestyle. You should:

Exercise​:

​Start slowly. The American Heart Association recommends, if possible, that you gradually step up to exercising on most days of the week for 30-60 minutes. Consult your health careprovider if you have any physical limitations or concerns.
Eat a healthy diet with lots of fruits and vegetables, lean protein, whole grains, and low fat dairy, and go easy on the saturated fats, trans fat, cholesterol, and salt.
Lose weight if you’re overweight.
Quit smoking if you smoke — now.
Schedule regular checkups with your doctor. Since metabolic syndrome doesn’t have symptoms, you need regular doctor visits to check your blood pressure, cholesterol, and blood sugar.

One 2005 study published in the Annals of Internal Medicine showed how well lifestyle changes could prevent metabolic syndrome. Researchers looked at more than 3,200 people who already had impaired glucose tolerance, a pre-diabetic state. One group was instructed to make lifestyle changes. They exercised 2.5 hours a week and ate a low- calorie, low-fat diet. After three years, people in the lifestyle group were 41% less likely to have metabolic syndrome than those who got no treatment. The lifestyle changes were also about twice as effective as using a diabetes medicine, Glucophage.

Of course, if you already have some of the risk factors, your odds of getting metabolic syndrome are higher. You need to work hard to prevent it. You must not wait if you have:

  • Unhealthy cholesterol levels
  • High blood pressure
  • High blood sugar
  • Excess weight, particularly around the belly

If these conditions apply to you, take action now, before you actually develop metabolic syndrome. Losing as little as 10% of your body weightcan help lower blood pressure, blood sugar, and blood cholesterol levels.

In addition to making lifestyle changes, you might also need medicine. Drugs can get your blood pressure, blood sugar, and cholesterol under control. Talk to your doctor.​

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