Metabolic syndrome (MetS) is a group of conditions that occur together and significantly increase the risk of heart disease, stroke, and type 2 diabetes. These conditions include high blood pressure, high blood sugar, excess fat around the waist, and abnormal levels of cholesterol or triglycerides.
What is metabolic syndrome?
Metabolic syndrome is not a single disease, but a collection of health problems that combine to increase your risk of serious conditions like heart disease, diabetes, and stroke. Think of it as an unhealthy team: high blood pressure, high blood sugar, abnormal cholesterol levels, and excess belly fat all team up to affect your well-being. If you have three or more of these risk factors, you likely have metabolic syndrome.
Dr. Sadiya Sana Khan, a cardiologist and assistant professor of medicine at Northwestern University Feinberg School of Medicine, underscores the importance of early intervention: “This is especially important right now as we are seeing more and more young people developing heart disease.”
How common is metabolic syndrome in the United States?
The condition is becoming more common, affecting one-third of U.S. adults. If you have metabolic syndrome or any of its components, making significant lifestyle changes can help delay or even prevent serious health complications.
Main components of metabolic syndrome
Metabolic syndrome includes the following:
High blood pressure
High blood pressure, or hypertension, occurs when your heart has to pump blood with more force than usual to move it through your arteries. This extra pressure can damage your blood vessels and heart over time, increasing your risk of heart disease, kidney disease, and stroke. Chronic high blood pressure is often called the “silent killer” because it has no noticeable symptoms until serious damage has occurred.
High fasting blood sugar
Elevated blood sugar levels, especially when measured after an overnight fast, can indicate insulin resistance. Insulin is a hormone that helps your cells absorb sugar from your bloodstream for energy. When your body doesn’t respond well to insulin, your blood sugar levels rise. Over time, this can lead to type 2 diabetes, a condition in which your body can no longer regulate blood sugar effectively. Insulin resistance is also associated with increased fat storage, especially in the abdomen, and higher levels of inflammation in the body.
Unhealthy cholesterol levels
Cholesterol is a type of fat found in your blood. While your body needs cholesterol to build healthy cells, consuming too much of it can increase your risk of heart disease.
– High levels of LDL (low-density lipoprotein), known as “bad” cholesterol, can lead to plaque buildup in your arteries, making them narrow and stiff, which impedes blood flow.
– Low levels of HDL (high-density lipoprotein), or “good” cholesterol, mean less cholesterol is removed from your bloodstream, which can also increase your risk of heart disease.
Maintaining a balance between LDL and HDL cholesterol is important for cardiovascular health.
Abdominal obesity
Belly fat, or visceral fat, the fat that accumulates around your waist, is particularly concerning. Unlike subcutaneous fat (fat under the skin), visceral fat surrounds your internal organs, such as your liver, pancreas, and intestines. This type of fat is metabolically active and contributes to insulin resistance, inflammation, and other metabolic disorders. Abdominal obesity is associated with a higher risk of cardiovascular disease and type 2 diabetes.
Signs and symptoms of metabolic syndrome
Metabolic syndrome often has no obvious symptoms. But you should watch out for the following:
- A waist circumference of more than 40 inches for men or 35 inches for women.
- A fasting blood sugar level of more than 100 mg/dL.
- A blood pressure measurement of 130/85 mmHg or higher.
- High triglycerides (150 mg/dL or higher).
- Low HDL cholesterol (“good” cholesterol) below 40 mg/dL for men or 50 mg/dL for women.
What causes metabolic syndrome?
Several factors contribute to the development of metabolic syndrome. These include:
One of the key factors in metabolic syndrome is insulin resistance. Normally, when you eat, your digestive system breaks down food into sugar. Insulin, a hormone produced by your pancreas, helps transport this sugar into your cells, where it is used for energy. However, with insulin resistance, your body does not respond effectively to insulin, which can lead to high blood sugar levels.
When your body cannot produce enough insulin to regulate blood sugar, it results in high blood sugar (hyperglycemia) and can lead to prediabetes or type 2 diabetes. Insulin resistance can contribute to:
- Obesity
- Fatty liver disease
- Cardiovascular disease
- Polycystic ovary syndrome
Dr. Anne Thorndike, associate professor of medicine at Harvard Medical School and director of the Metabolic Syndrome Clinic at Massachusetts General Hospital, emphasizes the growing concern: “Metabolic syndrome is not going down, and it’s probably worsening in some of these subgroups.”
The following people are more likely to develop metabolic syndrome:
- People who are overweight, especially those with excess belly fat.
- People who are sedentary.
- A genetic history and a family history of diabetes or heart disease.
- Aging increases the risk of developing metabolic syndrome.
- Conditions such as polycystic ovary syndrome (PCOS) in women can contribute to metabolic syndrome.
The Link Between Metabolic Syndrome and Chronic Diseases
If left unchecked, metabolic syndrome can lead to:
Type 2 Diabetes
Insulin resistance occurs when the body’s cells don’t respond properly to insulin, the hormone that helps regulate blood sugar levels. Over time, this can cause blood sugar to rise to unhealthy levels. If left untreated, insulin resistance can develop into full-blown type 2 diabetes, where the body either can’t produce enough insulin or doesn’t use it effectively. This leads to chronic high blood sugar, which can damage organs and tissues, and increases the risk of complications like kidney disease, nerve damage, and vision problems.
Heart Disease
High blood pressure (hypertension) and abnormal cholesterol levels are key contributors to heart disease. High blood pressure puts excessive strain on the heart and arteries, making them stiff and narrowing them over time. This limits blood flow and increases the risk of heart attack, heart failure, and other cardiovascular issues. Additionally, high levels of “bad” LDL cholesterol can lead to plaque buildup in the arteries, a condition known as atherosclerosis, further restricting blood flow and increasing the likelihood of heart disease.
Stroke
A stroke occurs when blood flow to the brain is interrupted, either due to a blocked or ruptured blood vessel. Conditions like high blood pressure, high cholesterol, and insulin resistance increase the risk of stroke by damaging the blood vessels. Narrowed or weakened arteries are more likely to become blocked, cutting off oxygen and nutrients to brain cells. This can lead to brain damage, disability, or even death.
How is metabolic syndrome diagnosed?
If a healthcare provider suspects you may be at risk for or have metabolic syndrome, they will perform a physical examination and may order blood tests. They will check your blood pressure and may also measure your waist circumference to assess the amount of abdominal fat.
Is metabolic syndrome preventable?
Yes. It is preventable. Do the following:
- Exercise for at least 30 minutes most days.
- Maintain a healthy weight and control your waistline.
- Try not to smoke. Smoking makes almost all risk factors worse.
- Don’t drink alcohol. Drinking alcohol can raise blood pressure and triglycerides.
- Focus on whole foods, fruits, vegetables, lean proteins, and healthy fats.
Treatment options for metabolic syndrome
Treatment starts with lifestyle changes, such as eating better and exercising. Your doctor may also prescribe medications for the following:
Lifestyle changes
Healthy diet
Eating a balanced diet is very important for managing metabolic syndrome.
Regular exercise
Exercise plays a key role in improving insulin sensitivity, controlling blood sugar levels, lowering blood pressure, and losing weight.
The American Heart Association recommends:
150 minutes of moderate-intensity exercise per week, such as brisk walking or cycling, or
75 minutes of vigorous-intensity exercise per week, such as running or swimming, along with strength training twice a week.
Weight loss
If you are overweight or obese, losing even a small amount of weight can significantly reduce the risk factors associated with metabolic syndrome. Aim for a gradual weight loss of 5 to 10 percent of your body weight, which can help lower blood pressure, improve cholesterol levels, and improve blood sugar control.
Medications
In addition to lifestyle changes, your healthcare provider may prescribe medications to help manage specific components of metabolic syndrome.
– For high blood pressure: Angiotensin-converting enzyme (ACE) inhibitors, angiotensin II receptor blockers (ARBs), calcium channel blockers, or diuretics may be used to help lower blood pressure.
– For high blood sugar: If you have insulin resistance or prediabetes, medications such as metformin can help control blood sugar. In some cases, other medications or even insulin therapy may be needed.
– For high cholesterol: Statins or other lipid-lowering medications can help manage high cholesterol and reduce your risk of heart disease.
– For high triglycerides: Fibrates, omega-3 fatty acid supplements, or niacin may be recommended to lower triglyceride levels.
Regular monitoring and checkups
Because metabolic syndrome is a complex condition, regular monitoring of key health metrics is essential. This includes checking:
– Blood pressure: Regular measurements to ensure it stays within a healthy range.
– Blood sugar: Blood glucose level testing to monitor for prediabetes or diabetes.
– Cholesterol levels: Ensure cholesterol levels stay within a safe range.
– Waist circumference and weight: Tracking these measurements helps assess the effectiveness of lifestyle changes.
Support and education
Living with metabolic syndrome can be challenging, but having a support system and understanding of the condition is vital. Working closely with your healthcare team, including a dietitian, exercise physiologist, or even a psychologist, can give you the tools and encouragement to make lasting changes.
Do genetics play a role in metabolic syndrome?
If the condition runs in your family, you need to be extra careful. Genetics can affect things like insulin resistance and where fat is stored. Knowing your family history can help you and your doctor anticipate problems.
Do children and teens get metabolic syndrome?
Unfortunately, yes. Rising obesity rates mean more children are at risk. But the following healthy habits can help prevent the condition:
- Limit sugary snacks and drinks.
- Encourage children and teens to be physically active.
- Educate them about balanced nutrition.
Do stress and sleep play a role in metabolic syndrome?
Stress and lack of sleep aren’t just annoying, they’re risk factors. Stress can increase cortisol, which disrupts blood sugar and fat storage. Poor sleep affects hormones that control hunger and metabolism. Prioritize rest and get 7 to 9 hours of sleep a night.
What are the long-term complications of metabolic syndrome if left untreated?
Ignoring metabolic syndrome can lead to:
- Strokes
- Heart attacks
- Kidney disease
- Fatty liver disease
Frequently Asked Questions About Metabolic Syndrome
Is metabolic syndrome reversible? Yes, with lifestyle changes and sometimes medication.
Can thin people have metabolic syndrome? Yes, it’s less common, but possible if they have other risk factors.
Is it the same as diabetes? No, but it greatly increases your risk of diabetes.
Resources and Support for Living with Metabolic Syndrome
Check out resources like the American Heart Association or Diabetes.org. Joining a support group can also help you stay motivated and share tips with others facing the same challenges.
Taking control of metabolic syndrome isn’t easy, but it’s absolutely doable.
Conclusion
Metabolic syndrome is a serious condition that increases the risk of heart disease, stroke, and type 2 diabetes. While the condition can be mild in its early stages, if left untreated, the consequences can be severe. Regular checkups, monitoring, and close collaboration with a healthcare provider are essential to keeping the condition under control. With proper care, metabolic syndrome can be managed, helping to prevent complications and promote long-term health.
