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What Is Metabolic Syndrome?

Metabolic syndrome is the name for a group of risk factors linked to overweight and obesity that increase your chance for heart disease and other health problems such as diabetes and stroke. In this article, “heart disease” refers to coronary heart disease.

The five conditions listed below are metabolic risk factors for heart disease. Metabolic syndrome is diagnosed when a person has at least three of these heart disease risk factors:

    1.   A large waistline. This is also called abdominal obesity or “having an apple shape.” The Economist Cover
    2.   A higher than normal triglyceride level in the blood.
    3.   A lower than normal level of HDL cholesterol (high-density lipoprotein cholesterol) in the blood.
    4.   Higher than normal blood pressure (or you’re on medicine to treat high blood pressure).
    5.   Higher than normal fasting blood sugar (glucose).
    • In general, a person with metabolic syndrome is twice as likely to develop heart disease and five times as likely to develop diabetes as someone without metabolic syndrome. The chance of developing metabolic syndrome is closely linked to being overweight or obese and to a lack of physical activity. Another cause is insulin resistance. Insulin resistance is a condition in which the body can’t use its insulin properly.


About 47 million adults in the United States (almost 25 percent) have metabolic syndrome, and the numbers continue to grow. The increasing number of people with this condition is connected to the rise in obesity rates among adults. In the future, metabolic syndrome may overtake smoking as the leading risk factor for heart disease.

What Causes Metabolic Syndrome? syndrome has several causes that act together. Some can be controlled, while others can’t. Causes that can be controlled include overweight and obesity, lack of physical activity, and insulin resistance. Some causes you can’t control are growing older and genetics. Your chance of developing metabolic syndrome increases with age.
The two conditions that are found in people with metabolic syndrome are a tendency to form blood clots and a tendency to have a constant, low-grade inflammation throughout the body.
Additional conditions that are being studied to see whether they have links to metabolic syndrome include:

  • Fatty liver (excess triglycerides and other fats in the liver)
  • ovarian syndrome (a tendency to develop cysts on the ovaries)
  • Gallstones
  • Breathing problems during sleep such as sleep apnea



Who Is At Risk for Metabolic Syndrome?

You’re at greatest risk for metabolic syndrome if you have these underlying causes:

  • -A large waistline (abdominal obesity)
  • -Lack of physical activity
  • -Insulin resistance
WALKINGTHEDOG Some people are at risk for metabolic syndrome because the medicines they take may cause weight gain or changes in blood pressure, cholesterol, and blood sugar levels. These medicines are most often used for inflammation, allergies, HIV, and depression and other kinds of mental illnesses. Having metabolic syndrome increases your risk for heart disease.

What Are the Signs and Symptoms of Metabolic Syndrome?

Metabolic syndrome is made up of a group of factors that can increase risk even if they are only moderately raised (borderline-high risk factors). Metabolic syndrome itself usually has no symptoms. Most of the risk factors linked to metabolic syndrome have no signs or symptoms, although a large waistline is visible sign.
Some people may have symptoms of high blood sugar (if diabetes is present) or, occasionally, high blood pressure. Symptoms of high blood sugar often include increased thirst; increased urination, especially at night; fatigue (tiredness); and blurred vision. High blood pressure is generally considered to have no signs or symptoms. However, a few people in the early stages of high blood pressure may have dull headaches, dizzy spells, or more nosebleeds than usual.

How Is Metabolic Syndrome Treated?

Healthy lifestyle changes are the first line of treatment for metabolic syndrome. Lifestyle changes include weight loss, increased physical activity, an improved diet, and quitting smoking.
Medicines are the next line of treatment. They’re used to treat and control individual risk factors such as high blood pressure, high triglycerides, low HDL cholesterol (high-density lipoprotein cholesterol), and high blood sugar. Medicines such as aspirin also may be used to reduce the risk of blood clots, a condition that often occurs with metabolic syndrome.

Goals of Treatment major goal of treating metabolic syndrome is to reduce a person’s risk for heart disease. Treatment is directed first at reducing LDL cholesterol (low-density lipoprotein cholesterol), high blood pressure, and diabetes (if these conditions are present).
The second goal of treatment is to prevent the onset of type 2 diabetes (if it hasn’t already developed). Long-term complications of diabetes often include heart and kidney disease, vision loss, and foot or leg amputation. The main emphasis in the treatment of metabolic syndrome is to lessen the effects of the underlying risk factors that can be controlled, such as overweight, lack of physical activity, and an unhealthy diet.



Specific Types of Treatment

Weight lossWeight Loss
In general, people with metabolic syndrome who are overweight or obese are urged to reduce their weight by 7 to 10 percent during the first year of treatment. For example, a person weighing 250 pounds should try to lose 18 to 25 pounds. A person weighing 300 pounds should try to lose 21 to 30 pounds.
Your health care provider can calculate your BMI. For more information on losing and maintaining your weight, see the Diseases and Conditions Index article on Overweight and Obesity.

Healthy Eating Plan
With the Therapeutic Lifestyle Changes diet, less than 7 percent of your daily calories should come from saturated fat, and no more than 25 to 35 percent of your daily calories should come from all fats, including saturated, trans, monounsaturated, and polyunsaturated fats. You also should consume less than 200 mg a day of cholesterol. The amounts of fat and cholesterol in prepared foods can be found on the food’s nutritional label.
Foods high in soluble fiber also are part of a healthy eating plan. These foods include:

  • Whole grain cereals such as oatmeal and oat bran
  • Fruits such as apples, bananas, oranges, pears, and prunes
  • Legumes such as kidney beans, lentils, chick peas, black-eyed peas, lima beans

Fish are an important part of a heart healthy diet. Fish are a good source of omega-3 fatty acids, which may help protect the heart from blood clots and inflammation and reduce the risk for heart attack.
You also should try to limit the amount of sodium and salt that you eat. This means choosing low-sodium and low-salt foods and “no added salt” foods and seasonings at the table or when cooking. The nutritional label on food packaging shows the amount of sodium in the item.
Try to limit alcoholic beverages. Too much alcohol will raise your blood pressure and triglyceride level. It will also add extra calories, which will cause weight gain. Men should have no more than two drinks containing alcohol a day. Women should have no more than one drink containing alcohol a day. Physical Activity
In general, people with metabolic syndrome are urged to keep up a moderate level of activity, such as brisk walking for at least 30 minutes at least 5 days of the week. This activity can be broken into shorter periods as needed—for example, three 10-minutes sessions.

Smoking If you smoke, quitting is important. Among other known harmful effects on your heart, smoking will raise your triglyceride level and lower your HDL cholesterol.

Medicines Your doctor may recommend medicines to help treat unhealthy cholesterol levels, high blood pressure, and high blood sugar. Unhealthy cholesterol levels are treated by one or more cholesterol-lowering medicines such as statins, fibrates, or nicotinic acid.

How Can Metabolic Syndrome Be Prevented? healthy lifestyle choices is the best way to prevent metabolic syndrome. Maintaining a healthy weight is important. Other than weighing yourself on a scale, there are two ways to know whether you’re at a healthy weight: waist measurement and body mass index (BMI).
A waist measurement indicates your abdominal fat and 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 provides 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, and it’s also the goal when treating metabolic syndrome.

Living With Metabolic Syndrome

Metabolic syndrome is a lifelong condition. However, lifestyle changes can help you reverse or reduce your risk factors and reduce your risk of heart disease and diabetes. If you already have heart disease and/or diabetes, lifestyle changes can help you prevent or delay complications such as heart attack, stroke, and the long-term effects of diabetes (damage to your eyes, nerves, kidneys, feet, and legs).


Insulin resistance is a silent condition that increases the chances of developing diabetes and heart disease.



Metabolic syndrome is the name for a group of risk factors linked to overweight and obesity.



Polycystic (pah-lee-SIS-tik) ovary syndrome (PCOS) is a health problem that can affect a woman's menstrual cycle.


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