What is metabolic syndrome?

Metabolic syndrome is a group of conditions that make a person more likely to get heart disease or type 2 diabetes.

To have metabolic syndrome, a person must have at least 3 of these 5 conditions:

• Obesity with a large belly – Doctors use the term “obese” to describe people who have a “body mass index” (BMI) of 30 or more. You can look up your BMI in this table (table 1). A large belly is based on waist measurement. The exact definition depends on your sex and ethnic background.
• Increased blood pressure – Blood pressure measurements have 2 numbers. For instance, your doctor might say your blood pressure is “140 over 90.” The top number is the pressure inside your arteries when your heart is contracting. The bottom number is the pressure inside your arteries when your heart is relaxed. You have increased blood pressure if:
  • The top number is 130 or higher.
  • The bottom number is 85 or higher.
  • You take medicine for high blood pressure.
• High blood sugar – All the cells in your body need sugar to work normally. Sugar gets into the cells with the help of a hormone called insulin. If there is not enough insulin, or if the body stops responding to insulin, sugar builds up in the blood. You have high blood sugar if your blood sugar is greater than or equal to 100 mg/dL when tested after you have not had anything to eat or drink (except water) for 8 hours. This is known as a “fasting” blood sugar test.
• High triglycerides – Triglycerides are fat-like substances in the blood. You have high triglycerides if your triglycerides are higher than 150 mg/dL.
• Low HDL cholesterol – HDL is the “good cholesterol.” That’s because having high HDL levels lowers your risk of heart attacks and other health problems. You have low HDL cholesterol if your HDL is less than 40 mg/dL if you’re male or less than 50 mg/dL if you’re female.

Some doctors don’t think it is important use the term “metabolic syndrome” for this group of conditions. That’s because the treatment of the metabolic syndrome is no different than the treatment of each individual condition. So, giving a special name to the problem is not really needed. The best and safest treatment for these conditions is to lose weight by eating a healthier diet and exercising more. Losing weight will improve your waist size, your triglyceride levels, and your high blood pressure.

Are there tests for metabolic syndrome?

Yes. As part of an exam, a doctor or nurse will:

• Take your blood pressure
• Measure your height and weight to calculate your BMI
• Measure the widest part of your belly with a tape measure. This measurement is called your “waist circumference”.
• You will also get blood tests to measure your blood sugar and blood lipids. “Lipids” is another word for fats. Blood lipids include triglycerides and cholesterol.

Can metabolic syndrome be prevented?

You can lower your chances of getting metabolic syndrome by:

• Losing weight if you are overweight
• Eating lots of fruits and vegetables and low-fat dairy products, but not a lot of meat or fatty foods
• Walking or doing some form of physical activity on most days of the week, and in general being as physically active as possible
• Quitting smoking, if you smoke

How is metabolic syndrome treated?

The goal of treatment is to lower your risk of problems like heart disease and diabetes. This usually involves taking medicines to treat the conditions you have that make up metabolic syndrome. You can further lower your risk by making changes like improving your diet, exercising more, and losing weight.

Treatment includes:

• Diet changes – Healthy diets that can help you lose weight include:
  • Mediterranean diet – This diet is high in fruits, vegetables, nuts, and whole grains, and uses olive oil instead of other fats. It can help to lower your weight, blood pressure, and blood sugar, and improve lipid levels.
  • DASH (Dietary Approaches to Stop Hypertension) diet – This diet is low in salt and fat. It includes 4 to 5 servings each of fruits and vegetables and 2 to 3 servings of low-fat dairy products per day. This diet can lower your blood pressure, weight, and blood sugar, and improve lipid levels.
  • High-fiber diet – Increasing dietary fiber (to at least 30 grams daily) can lower blood pressure and weight. Fiber is normally found in beans, grains, vegetables, and fruits (table 2). The nutrition label on packaged foods can show you how much fiber you are getting in each serving (figure 2).
• Exercise – Doctors recommend that people exercise at least 30 minutes a day, on 5 or more days of the week. If you can’t exercise for 30 minutes at a time, try to exercise for 10 minutes at a time, 3 or 4 times a day. Brisk walking is a good choice.
• Medicines – Doctors often recommend medicines to lower blood pressure, blood lipids, and blood sugar.