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Metabolic Syndrome


​​​​​​​​​​​​​Metabolic syndrome is a cluster of conditions or risk factors that occur together, increasing your risk of heart disease, stroke and diabetes.

These conditions include increased blood pressure, a high blood sugar level (glucose), excess body fat around the waist and abnormal cholesterol levels.​

Your risk for all three increases with the number of metabolic risk factors you have. A person who has metabolic syndrome is twice as likely to develop heart disease and five times as likely to develop diabetes.

Having one factor doesn’t mean you have metabolic syndrome, but it does raise your risk for heart disease. 

Genetics (ethnicity and family history) and older age are other factors that may play a role in causing metabolic syndrome. 

For instance, if you have a family history of diabetes or if you’re of Asian descent, either increases your risk of insulin resistance. 

This is when the body can’t use insulin properly, leading to high blood sugar levels, which is closely linked to overweight and obesity.

Metabolic syndrome is becoming more common due to a rise in obesity rates among adults. In the future, metabolic syndrome may overtake smoking as the leading risk factor for heart disease. 

If you do smoke and you think you have one risk factor, you should stop smoking immediately.

If you have metabolic syndrome or any of the components of this syndrome, aggressive lifestyle changes can delay or even prevent the development of serious health problems. 

A healthy lifestyle is a lifelong commitment and successfully controlling metabolic syndrome requires a long-term effort and teamwork with your health care providers.

Symptoms of Metabolic Syndrome

Most of the metabolic risk factors have no symptoms, although a large waistline is a visible sign.

Some people may have symptoms of high blood sugar if diabetes - especially type 2 diabetes - is present. Symptoms of high blood sugar often include increased thirst; increased urination, especially at night; fatigue (tiredness); and blurred vision. 

High blood pressure usually has no symptoms. However, some people in the early stages may have dull headaches, dizzy spells, or more nosebleeds than usual.

Causes of Metabolic Syndrome

There are six major metabolic risk factors. You can have any one of these risk factors by itself, but they tend to occur together. In general, you must have at least three metabolic risk factors to be diagnosed with metabolic syndrome.

  • A large waistline. This also is called abdominal obesity or "having an apple shape." Excess fat in the stomach area is a greater risk factor for heart disease than excess fat in other parts of the body, such as on the hips.
  • A high triglyceride level (or you're on medicine to treat high triglycerides). Triglycerides are a type of fat found in the blood.
  • A low HDL cholesterol level (or you're on medicine to treat it). HDL sometimes is called "good" cholesterol because it helps remove cholesterol from your arteries. A low HDL cholesterol level raises your risk for heart disease.
  • High blood pressure (or you’re on medicine to treat high blood pressure). Blood pressure is the force of blood pushing against the walls of your arteries as your heart pumps blood. If this pressure rises and stays high over time, it can damage your heart and lead to plaque buildup.
  • High fasting blood sugar – also called blood glucose – (or you're on medicine to treat high blood sugar). Mildly high blood sugar may be an early sign of diabetes.
  • Insulin Resistance - Insulin is a hormone that helps move blood sugar into cells where it's used for energy. Insulin resistance is when the body can’t use insulin properly, leading to high blood sugar levels that’s closely linked to overweight and obesity.

Diagnosis of Metabolic Syndrome

Typically your doctor is not looking for metabolic syndrome, however the condition may apply if you have three or more of the traits associated with this condition. 

Several organizations have established criteria for diagnosing metabolic syndrome. The National Cholesterol Education Program created the guidelines with modifications by the American Heart Association. 

According to these guidelines, you have metabolic syndrome if you have three or more of the risk factors described in the “Causes of Metabolic Syndrome” section above.

Treatment of Metabolic Syndrome

The kind of treatment(s) you may receive depends on the severity of your condition. Possible treatments can include the following lifestyle changes and medical management:

  • Diet
  • Exercise
  • Lose weight
  • Quit smoking
  • Medical Management

Preventing Metabolic Disorder

Whether you have one, two or none of the risk factors for metabolic syndrome, the following lifestyle changes will reduce your risk of heart disease, diabetes and stroke:

  • Commit to a healthy diet. Eat plenty of fruits and vegetables. Choose lean cuts of white meat or fish over red meat. Avoid processed or deep-fried foods. Eliminate table salt and experiment with other herbs and spices.
  • Get moving. Get plenty of regular, moderately strenuous physical activity.
  • Schedule regular checkups. Check your blood pressure, cholesterol and blood sugar levels on a regular basis. Make additional lifestyle modifications if the numbers are going the wrong way.

When to see a doctor

If you know you have at least one risk factor for metabolic syndrome – such as high blood pressure, high cholesterol or an apple-shaped body – you may have the others and not know it. It's worth checking with your doctor. 

Ask whether you need testing for other risk factors of the syndrome and what you can do to avoid serious diseases.

Medications and methods for managing Metabolic Syndrome

Tackling one of the risk factors of metabolic syndrome is tough; taking on all of them can feel a bit overwhelming. But aggressive lifestyle changes and, in some cases, medication can help improve your life while lowering or eliminating your risks. 

Getting more physical activity, losing weight and quitting smoking will help reduce blood pressure, while improving cholesterol and blood sugar levels. These changes are key to reducing your risk.

Work with your doctor to monitor your weight, blood glucose, cholesterol and blood pressure levels to ensure that lifestyle modifications are working. 

If you're not able to reach your goals with lifestyle changes, your doctor may also prescribe medications to lower blood pressure, control cholesterol or help you lose weight. Taking a daily aspirin – after discussing it with your doctor – may help reduce your risk of heart attack and stroke.

About BMI, healthy weight and healthy waistlines for men and women?

Making healthy lifestyle choices is the best way to prevent metabolic syndrome. One important lifestyle choice is to maintain a healthy weight. 

Other than weighing yourself on a scale, you can find out if you're at a healthy weight using your waist measurement and body mass index (BMI).

A waist measurement indicates your abdominal fat, which is linked to your risk for heart disease and other diseases. To measure your waist, stand and place a tape measure around your middle, just above your hipbones. 

Measure your waist just after you breathe out. Make sure the tape is snug but doesn't squeeze the flesh. A waist measurement of less than 35 inches for women and less than 40 inches for men is the goal for preventing metabolic syndrome; it's also the goal when treating metabolic syndrome.

BMI measures your weight in relation to your height and gives an estimate of your total body fat. A BMI between 25 and 29.9 is considered overweight. 

​​A BMI of 30 or more is considered obese. A BMI of less than 25 is the goal for preventing metabolic syndrome; it's also the goal when treating metabolic syndrome. You can figure out your BMI by using the National Heart, Lung and Blood Institute’s online calculator or your doctor can help you.​​​