The Metabolic Syndrome

Since cardiovascular (heart and blood vessel) disease is the leading cause of death for adults in developed countries, many medical studies focus on treating or preventing heart disease and stroke. The metabolic syndrome, a collection of unhealthy body measurements and abnormal laboratory test results, may identify persons at high risk for developing cardiovascular disease. Aggressive lifestyle modification and possible use of medications to treat the conditions that make up the metabolic syndrome may reduce a person's chances of developing heart disease or stroke. The metabolic syndrome has also been called syndrome X or insulin resistance syndrome.

How is the metabolic syndrome diagnosed?

There are no well-accepted criteria for diagnosing the metabolic syndrome. The criteria proposed by the National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP III), with minor modifications, are currently recommended and widely used.

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:

* Elevated waist circumference:
Men — Equal to or greater than 40 inches (102 cm)
Women — Equal to or greater than 35 inches (88 cm)
*
Elevated triglycerides:
Equal to or greater than 150 mg/dL
* Reduced HDL (“good”) 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
* Elevated fasting glucose:
Equal to or greater than 100 mg/dL

TREATING THE METABOLIC SYNDROME

Lifestyle modifications include weight loss, regular exercise, stopping smoking, and reducing dietary fat intake. Losing just 10% of excess body weight lowers blood pressure and improves insulin resistance. Some persons may be able to treat high blood pressure and hyperglycemia by altering their lifestyle alone. In many individuals, lifestyle modification is not adequate, and medications must be used to decrease blood pressure, lower triglycerides, and increase the level of HDL.

Because these problems are often linked, treating one aspect of the metabolic syndrome may help the other issues. For example, regular exercise can help you lose weight, reduce blood pressure, and manage hyperglycemia and insulin resistance. Combining healthful eating with a regular exercise program is the cornerstone of treating the metabolic syndrome and reducing risk for heart disease, stroke, diabetes, and other medical problems.


PREVENTION

* Exercise regularly throughout your life.
* Encourage children to have daily physical activity and make healthful food choices.
* Eat a healthful, balanced diet low in saturated fats and high in nutrient-rich fruits and vegetables.
* Do not smoke.
* Recognize that you may have a genetic (inherited) predisposition for diabetes, heart disease, and the metabolic syndrome.
* Have regular medical check-ups and initiate early treatment for high blood pressure.