What is Metabolic Syndrome?

by Lynn Marquardt, NP

People with the metabolic syndrome are at increased risk of coronary heart disease and other diseases related to plaque buildups in artery walls and type 2 diabetes. Metabolic syndrome has become increasingly common in the United States. It’s estimated that over 50 million Americans have it.

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

AHA Recommendation for Managing the Metabolic Syndrome:
The primary goal of clinical management of the metabolic syndrome is to reduce the risk for cardiovascular disease and type 2 diabetes. Therefore, the first-line therapy is to reduce the major risk factors for cardiovascular disease: stop smoking, and reduce LDL cholesterol, blood pressure and glucose levels to the recommended levels.

For managing both long- and short-term risk, lifestyle therapies are the first-line interventions to reduce the metabolic risk factors. These lifestyle interventions include:

• Weight loss to achieve a desirable weight (BMI less than 25 kg/m²)
• Increased physical activity, with a goal of at least 30 minutes of moderate-intensity activity on most days of the week
• Healthy eating habits that include reduced intake of saturated fat, trans fat and cholesterol

a. 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.

b. Get moving. Get 30 to 60 minutes of moderately strenuous activity most days of the week.

c. Lose weight. Losing as little as 5 percent to 10 percent of your body weight can reduce insulin levels and blood pressure, and decrease your risk of diabetes.

d. Stop smoking. Smoking cigarettes increases insulin resistance and worsens the health consequences of metabolic syndrome

e. Eat fiber-rich foods. Make sure you include whole grains, beans, fruits and vegetables in your grocery cart. These items are packed with dietary fiber, which can lower your insulin levels.

Summary

The term "metabolic syndrome" is a way of identifying individuals at high risk for the development of heart disease and diabetes. Patients at risk should receive education and counseling on lifestyle modification, and all risk factors for heart disease should be treated aggressively.

http://www.americanheart.org/presenter.jhtml?identifier=534

http://www.nhlbi.nih.gov/health/dci/Diseases/ms/ms_whatis.html