Metabolic Syndrome, also known as Syndrome X, refers to a number of conditions that occur simultaneously and increase the risk of diabetes, stroke and heart disease. People with metabolic syndrome have high blood sugar levels, hypertension (high blood pressure), too much fat around their belly, and unhealthy cholesterol and triglyceride levels.
Metabolic syndrome is a preventable and reversible condition. With certain lifestyle changes, including exercise, eating a healthy and well balanced diet, losing weight, and possibly taking medications as well, it is usually possible to overcome all the conditions and reduce your risk of developing diabetes, or having a stroke or heart attack.
According to the Journal of Diabetes, 36.1% of adult men and 32.4% of women had metabolic syndrome in the USA in 2010. This was a considerable increase from 21.8% and 23.7% respectively in 2002.
What are the signs and symptoms of metabolic syndrome?
A symptom is something only the patient feels, and describes to others, while a sign is detectable by others. An example of a symptom could be pain, and a sign might be a skin rash.
A person with metabolic syndrome should have at least three of the conditions described below:
- Obesity - especially if you have an apple shape, with too much fat built up around the waist, known as "central obesity" or "abdominal obesity". A man's waist will be at least 102 centimeters (40 inches) and a woman's 89 centimeters (35 inches). The waist circumferences can vary, according to the height and frame of the individual.
- Hypertension (high blood pressure) - blood pressure of at least 130/85mmhg. Some countries, such as the UK place the threshold at 140/90mmHg .
- High blood sugar - a fasting blood glucose of at least 5.6 mmol/L (100 mg/dL). The person's body is unable to control blood sugar levels, also known as insulin resistance.
- Abnormal blood cholesterol - low levels of HDL, also known as high-density lipoprotein or "good cholesterol", less than 40mg/dL (1.04mmol/L)
- High blood triglycerides - triglycerides are a form of circulating fats. Levels of at least 150mg/dL or 1.7mmol/L.
What are the causes of metabolic syndrome?
We know what conditions are associated with metabolic syndrome, but nobody is exactly sure what its causes are. In all cases, there is a close association with "insulin resistance". Insulin resistance is a condition in which the body is able to produce insulin, but cannot use it effectively. Glucose accumulates in the blood instead of being absorbed by the cells, resulting in pre-diabetes and eventually type 2 diabetes.
The main risk factors for metabolic syndrome are:
- Genetics - some people are genetically more inclined to develop insulin resistance, which can lead to metabolic syndrome. People from Asian, African-Caribbean and Hispanic (Latin-American) backgrounds have a higher risk of developing metabolic syndrome. People with a family history of type 2 diabetes, high blood pressure and early heart disease are are also more susceptible.
- Obesity/overweight - especially if the person continues gaining weight every year and has too much belly fat (abdominal obesity).
- Physical inactivity - lack of exercise is a major contributory factor towards metabolic syndrome risk. Women are more likely to develop metabolic syndrome due to lack of exercise than men.
- Diet - some studies have linked sugary drinks with metabolic syndrome. High-fat diets can also induce insulin resistance, even after a few days.
- Age - metabolic syndrome rates are much higher among older people. Over 40% of people aged 60+ years have metabolic syndrome, compared to less than 10% among twenty-year-olds. However, metabolic syndrome can occur at any age.
- Sleep apnea - people with sleep apnea are more likely to suffer from insulin resistance, which in turn raises the risk of metabolic syndrome.
- Hormonal imbalance - people with hormonal problems may have a higher risk of developing metabolic syndrome. An example is PCOS (polycystic ovary syndrome).
Diagnosing metabolic syndrome
Doctors are not usually seeking out metabolic syndrome, because it is a collection of conditions which the physician should know about. If the patient has at least three of those conditions, a good health care professional will probably apply the metabolic syndrome label.
To be diagnosed with metabolic syndrome, you need to have three of the conditions listed below:
- Low blood levels of "good" cholesterol
- High blood levels of triglycerides
- High blood sugar (insulin resistance)
- Obesity, or excess abdominal fat (abdominal obesity).
People who have been diagnosed with metabolic syndrome may become alarmed and anxious. Remember that unlike type 2 diabetes, this diagnosis is a warning, or a wake-up call. Metabolic syndrome is reversible.
What are the treatment options for metabolic syndrome?
Treatment for metabolic syndrome is a question of addressing the three to five health abnormalities. Some people may find this overwhelming - tackling just one, e.g. obesity is hard enough, but all of them....!
It is important to remember that metabolic syndrome is the prelude to some chronic and potentially dangerous diseases, including heart disease, type 2 diabetes and stroke. Once you have a stroke, type 2 diabetes or heart disease it is much harder, some would say impossible, to completely reverse things. With metabolic syndrome it is still not too late - metabolic syndrome is often completely reversible.
In order to tackle metabolic syndrome head-on, you will need commitment to some lifestyle changes, and probably medication to improve the syndrome's components.
Below are some of the lifestyle changes that have been proven to help "cure" metabolic syndrome:
- Physical activity - physical activity is good for general health, it can reduce insulin resistance, improve heart and lung health, helps you sleep better, and if done properly and regularly results in healthy weight loss without losing lean tissue (muscle).
Before venturing into any exercise program, check with your doctor. If you have metabolic syndrome, you are likely to be overweight/obese, this means your physical activity should follow a well planned, tailor-made schedule which is ideal for your current abilities, general health, and ultimate goals.
According to the American Heart Association, you should incorporate at least thirty minutes of moderate-to-vigorous physical activity into your daily routine".
Walking is the best exercise to start with. It is simple to do, costs nothing, is safe and easy, and has the lowest drop-out rate, meaning you are more likely to do it regularly long-term.
If you keep up the regular walking, you might eventually build up to regular running. According to the American Academy of Sports Medicine, runners are much less likely to develop metabolic syndrome.
- Losing weight - you do not have to lose that much weight to start noticing a difference, although the long-term aim is to bring your BMI (body mass index) down to below 25. A person with a BMI of 25 to 29.99 is overweight, people with a BMI of 30 or more are obese.
For successful weight loss, researchers from the Fred Hutchinson Cancer Research Center reported in the Journal of the Academy of Nutrition and Dietetics that the person should never skip meals, try to avoid eating out, and keep a food journal. Team leader, Anne McTiernan, M.D., Ph.D., said "When it comes to weight loss, evidence from randomized, controlled trials comparing different diets finds that restricting total calories is more important than diet composition such as low-fat versus low-carbohydrate. Therefore, the specific aim of our study was to identify behaviors that supported the global goal of calorie reduction."
- Healthy eating - many doctors and nutritionists today are focusing more on the overall nutritional balance of meals, combined with exercise for weight loss, rather than severe calorie counting. The Mediterranean diet has proved popular and extremely effective in achieving short- and long-term weight loss.
Researchers from the Hospital Clinic of Barcelona, Spain, reported in NEJM (New England Journal of Medicine) that a Mediterranean diet supplemented with nuts and extra-virgin olive oil significantly reduced the risk of heart attack, stroke and cardiovascular death among high risk people. People with metabolic syndrome are "high risk people".
The Mediterranean diet includes olive oil as the main source of fat, plenty of vegetables and fruits, legumes (pulses), a moderate-to-high amount of fish and seafood, small quantities of red meat and dairy products, and moderate amounts of wine.
Natural components in grapes, polyphenols, help protect organ damage caused by metabolic syndrome.
- Quit smoking - smoking causes fatty substances to build up in the arteries (atherosclerosis), a major risk factor for heart disease, stroke and early death. Smoking also raises blood pressure and insulin resistance. Many people are not aware that smoking does not just cause lung cancer, but contributes significantly to the conditions that make up metabolic syndrome. If you smoke, quitting is a crucial part of your treatment.
It is important to work together with your doctor and other health care professionals to bring down your weight, find an ideal exercise program and keep it going, reduce your blood pressure, blood sugar and cholesterol levels, and adopt all the new lifestyle measures successfully. If any of the metabolic syndrome components cannot be resolved with lifestyle measures, there are medications that can help treat hypertension, cholesterol levels and body weight control.
Bariatric surgery - for obese patients who find it extremely difficult to bring their weight down, bariatric surgery is an option. Researchers from the Cleveland Clinic, Ohio, reported in the journal Heart that bariatric surgery is much more effective in preventing strokes and heart disease than medications. A study carried out at the Sahlgrenska Academy, University of Gothenburg, Sweden, and published in NEJM found that bariatric surgery reduces the long-term risk of developing type 2 diabetes by over 80% in obese patients.
Vitamin D and elderly people - seniors commonly have low vitamin D levels. Low vitamin D is a risk factor for metabolic syndrome. It is important that elderly patients with metabolic syndrome have healthy levels of vitamin D.
Weight Loss Expert Dr. Kent Sasse discusses Metabolic Syndrome
Written by Christian Nordvist