Metabolic Syndrome is also sometimes called Metabolic Syndrome X or simply
Syndrome X. It is also sometimes called insulin resistance syndrome because it
is closely associated with a generalized metabolic disorder called insulin
resistance. Gerald Reaven, MD, a researcher at Stanford University School of
Medicine, coined the term “Syndrome X” in 1988. Syndrome X affects millions of
people, many of which are unaware of this silent killer. A national survey said
that one-out-of-five Americans have this syndrome. In people in their 60s and
70s, two-out-of-five have the syndrome. It is estimated that about 47 million
people in the U.S. have Syndrome X. A medical check-up that includes blood work
is needed for diagnosis. Metabolic syndrome happens when you eat a diet with too
many calories and too much saturated fat and do not get enough exercise.
Metabolic syndrome increases the risk for type 2 adult-onset diabetes, heart disease, stroke and possibly even cancer. As many as half of people with
metabolic syndrome will develop diabetes. Several characteristics of metabolic
syndrome are also factors for diabetes type 1 and 2 and heart disease. These
include factors such as:
- insulin resistance
- glucose intolerance
- high triglycerides
- low hdl cholesterol.
It is thought that Syndrome X runs in families. The same families who have a
history of type 2 diabetes are at risk for metabolic syndrome X. For clinical
diagnosis of this syndrome a person must have three or more risk factors. The
National Cholesterol Education Program (NCEP) guidelines give the following
guidelines for diagnosis of metabolic syndrome:
- Abdominal obesity. Waist circumference exceeds 40 inches for men or 35
inches for women.
- Fasting blood glucose is at least 110 mg./dl.
- Triglycerides at least 150 mg./dl.
- HDL-cholesterol no more than 40 mg./dl for men or 50 mg./dl. For women.
- Blood pressure at least 130/85.
- Blood fat disorders
Metabolic syndrome is not found in children. Lifestyle factors are just as
important as genetics here. Two warning signs are inactivity and weight gain
(especially around the abdomen). Two key ways of reducing one’s risk are
exercise and weight loss. Other steps for managing the metabolic syndrome are
also important for patients and their doctors. These include monitoring body
weight routinely (especially the index for central obesity), routinely monitoring
blood glucose, lipoproteins and blood pressure, treating individual risk factors
according to established guidelines and carefully choosing anti-hypertensive drugs due to their different effects on insulin sensitivity.
The body of a person with metabolic syndrome has trouble with insulin
resistance. Blood sugar rises in response to food and extra insulin needs to be
made to absorb all of the sugar. The body can still make enough insulin to keep
the blood sugar in the normal range but just barely. There is not any one diet
that works for everyone with metabolic syndrome. Weight loss and exercise are
what doctors recommend. Limiting alcohol and eliminating smoking are also
advised. Sometimes medications to reduce high blood lipids and high blood
pressure are also needed.
In people who have metabolic syndrome the ideal amount of dietary fat and carbohydrate for weight loss
varies. Low-fat, high carbohydrate diets are probably not
beneficial. This is because carbohydrates can raise blood insulin levels and
triglycerides and reduce HDL-cholesterol. More fat and less carbohydrates are
probably better for improving insulin sensitivity and blood lipids. This is
especially true when the carbohydrates are mostly complex and the fat is mostly
unsaturated. Diets like Atkins are not recommended because saturated fat raises
triglycerides and LDL-cholesterol which increases risk for heart disease.
The amount and kind of exercise a person with metabolic syndrome does depends
on their current fitness level. The biggest risk factor for heart disease is not
being active. A good way to begin being active is by walking 5 minutes a day.
Once a person is walking regularly they should slowly increase how far and how
fast they walk, until they eventually walk for 30 to 60 minutes at least five
days a week.
One way of reducing your risk is eating fewer calories. This can be done by
eating less at each meal and skipping dessert. For snacks choose things like
carrot sticks or rice cakes instead of candy bars or chips. When eating out ask
that sauces and salad dressings be served on the side and use as little as
possible of them. Instead of whole milk, cheese, yogurt, cottage cheese, etc.
use reduced and then low-fat versions. Eat more whole grains, fruits,
vegetables, and fish.
It is unfortunate that most people are not aware of the syndrome or their
risk for developing it. Many experts are recommending an increased vigilance to
identify patients at increased risk of this syndrome. They predict this syndrome
could foster future epidemics of diabetes, strokes, and heart attacks. Health
officials hope to address this serious public-health threat head-on by
motivating patients to lose weight and exercise. Symptoms of metabolic syndrome
can often be reversed through diet and exercise.
To understand the relationship between metabolic risk factors and the
effectiveness of drug therapy in people who have metabolic syndrome more studies
are needed. To gain the most benefit from modifying multiple metabolic risk
factors, the underlying insulin resistant state must become a target of therapy.
Once again, the best way is through exercise and weight loss.
I wrote this node because my dear friend suffers from metabolic syndrome. I worry about him and hope this write-up will remind him and others like him to watch what they eat and to be active.
FoodService Director, 2/15/2003, Vol. 16 Issue 2, p52, 1p
Medical Update, 2005, Vol. 30 Issue 10, p5, 1p