Metabolic syndrome is a combination of conditions that increase the risk of developing cardiovascular disease and diabetes. Unfortunately, it has become increasingly common in the United States, with more than 25% of Americans thought to have the syndrome.

 

It is generally agreed that the key components include:

• Central obesity - excessive fat in and around the abdomen.
• High blood pressure.
• Insulin resistance or glucose intolerance.
• High triglyceride and LDL levels.
• Low HDL (good) cholesterol levels.
• High C-reactive protein in the blood.
• High fibrinogen or plasminogen activator inhibitor-1 in the blood.

The cause of the metabolic syndrome is unknown. However, it appears that the most important factors are:

• Aging
• Genetics
• Hormonal imbalance
• Lifestyle (low physical activity, excess caloric intake)

How is the metabolic syndrome diagnosed?

 

The American Heart Association and the National Heart, Lung, and Blood Institute recommend that the metabolic syndrome be identified as the presence of three or more of these components:

 

Men

Women

Elevated waist circumference

Equal to or greater than 40 inches (102 cm)

Equal to or greater than 35 inches (88 cm)

Elevated triglycerides

Equal to or greater than 150 mg/dL

Equal to or greater than 150 mg/dL

Reduced HDL cholesterol

Men - Less than 40 mg/dL

Women - Less than 50 mg/dL

Elevated blood pressure

Equal to or greater than 130/85 mm Hg

Equal to or greater than 130/85 mm Hg

Elevated fasting glucose

Equal to or greater than 100 mg/dL

Equal to or greater than 100 mg/dL

 

Are lifestyle changes more beneficial than drugs?

 

A study published in the New England Journal of Medicine (2002) investigated the most effective way to reduce the incidence of type II diabetes in those at risk. They looked at the effects of the diabetic drug metformin, and lifestyle intervention (7% reduction in weight; 150 minutes of physical activity weekly), in comparison to the control group.

• Lifestyle intervention reduced the incidence of type II diabetes by 58%, compared to the control group.
• Metformin treatment alone gave a 31% reduction, compared to the control group.

Therefore, the study clearly indicates the benefits of diet and lifestyle interventions, even more so than drug treatments, in reducing the incidence of type II diabetes.

 

Preventing metabolic syndrome

 

The primary goal in the management of metabolic syndrome is to reduce the risk for cardiovascular disease and type II diabetes.

 

Therefore, reducing your LDL cholesterol, blood pressure and glucose levels to within recommended levels is particularly important. If you are currently a smoker you also need to consider giving up.

Key messages include:

Physical activity