Metabolic Syndrome


Could you be unknowingly putting yourself at risk for heart disease, stroke, or type 2 diabetes? Metabolic syndrome may be putting your future in jeopardy. Fortunately, it’s very easy to detect – and once you know you have it, it’s very responsive to treatment.

By Jenna Haines

What is metabolic syndrome?  

An estimated 1 in 6 Americans has metabolic syndrome, also known as Syndrome X and insulin resistance syndrome. The name can be a little misleading, because it’s actually not a disease in itself. Rather, it’s a cluster of risk factors that will have a serious impact on your life and health if no intervention is taken.
Metabolic syndrome can be considered a type of warning. If it isn’t addressed, it will lead to serious health problems later down the line, most notably heart disease, stroke, and type 2 diabetes. Metabolic syndrome increases your risk of diabetes by five times and doubles your risk of blood vessel and heart disease, which can lead to heart attacks and strokes.
Something else that is important to understand about metabolic syndrome is that it is closely linked with prediabetes and insulin resistance. Insulin resistance is a condition in which the body doesn’t respond properly to insulin, a hormone produced by the pancreas that allows glucose to be distributed throughout the body to supply us with energy. As a result, the body generates more and more insulin to no avail. (For more on this, see our article on prediabetes beginning on page 30.)
“Metabolic syndrome is a constellation of disorders – insulin resistance, diabetes, and depending on the extent of the metabolic syndrome, there’s some element of hypertension in there and some element of high cholesterol,” says Dr. Jack Rutledge, who specializes in metabolic weight loss surgery at CHI Memorial. “Those are the things that make up metabolic syndrome, but behind them is obesity.”

How is it diagnosed? 

A person is diagnosed with metabolic syndrome when they have at least three of five “red flags.” If you have any three of the following traits, you meet the criteria for metabolic syndrome:
Extra weight around the middle. You have this risk factor if you have a waistline (measured across the belly) of 40 inches or more (102 centimeters) for men and 35 inches (89 centimeters) or more for women. “Central obesity, or extra weight around the middle, is the most classic symptom of metabolic syndrome,” says Dr. Rutledge. “If you have central obesity, it’s a really good indicator that you may have it.”
Excess fat in this particular part of the body poses greater health risks than excess fat in other parts of the body, Dr. Rutledge explains. Why? “It appears to be a factor behind metabolic syndrome, and may even be driving it,” he says.

Jack. F. Rutledge, M.D. Memorial Metabolic and Weight Loss Surgery, CHI Memorial
Jack. F. Rutledge, M.D.
Memorial Metabolic and Weight Loss Surgery, CHI Memorial

High blood pressure. You have this risk factor if your blood pressure is at least 130/85 millimeters of mercury or higher or you are already taking blood pressure medications. You are at risk if either your systolic blood pressure (the top number) is higher than 130 or diastolic blood pressure (the bottom number) is higher than 85.
High triglyceride levels. You have this risk factor if you have a triglyceride level of at least 150 milligrams per deciliter or you are already receiving treatment for high triglycerides.
High fasting blood sugar. You have this risk factor if you have a fasting blood glucose (sugar) level greater than 100 milligrams per deciliter or are already receiving treatment for high blood sugar.
High cholesterol. You have this risk factor if your HDL cholesterol (high density lipoprotein level, or good cholesterol) is less than 40 milligrams per deciliter for men or less than 50 milligrams per deciliter for women.
If you know you have any of the risk factors listed above or have a family history of heart disease, obesity, diabetes, or early cardiac death, see a doctor at your earliest possible chance. As with any condition, it is important to get an accurate diagnosis so you can pursue the best possible line of treatment. If you do, in fact, have metabolic syndrome, don’t panic – a diagnosis in no way guarantees that you’ll come down with heart disease or type 2 diabetes. Rather, it means that you have a higher chance of getting them if you continue on the same path.

Why It’s Important to Get a Diagnosis    

Part of the danger of metabolic syndrome is that in most cases there are no symptoms – the syndrome functions more like a ticking time bomb than a wrecking ball. If symptoms do occur, they vary based on the specific risk factors of the individual.
The longer you go with metabolic syndrome without knowing it, the higher the danger. Beyond cardiovascular disease and insulin resistance/diabetes, metabolic syndrome can lead to other issues in the body such as poor kidney function. People with metabolic syndrome also have a significantly increased risk of kidney issues, particularly lower kidney function, which can lead to chronic kidney disease. Another common illness associated with metabolic syndrome is polycystic ovary syndrome, a condition that affects fertility.

What causes it?   

Weight gain and a sedentary lifestyle are the most significant factors. Experts say metabolic syndrome is becoming more and more common with rising obesity. A few other variables are age (metabolic syndrome affects 40% of people over the age of 60), a poor diet (which is related to weight gain), family history of diabetes, hormonal imbalance, and an overall unhealthy lifestyle.
“I think the public should understand that metabolic syndrome is a disease of lifestyle, and specifically, of Western lifestyle,” says Dr. Charles Campbell, chief of cardiology at UT Erlanger Cardiology. “It affects those of us that are too sedentary and have diets high in saturated fat, trans fat, and sugar.”

Making Changes 

Unlike many disorders, metabolic syndrome can often be treated (and prevented) through lifestyle changes. “The good news is that you can reverse it,” says Dr. Rutledge. However, if you already have the syndrome, lifestyle changes need to be aggressive to prevent any further damage and to avoid more serious health issues.

Charles Campbell, M.D., FACC Chief of Cardiology, UT Erlanger Cardiology, Erlanger Health System
Charles Campbell, M.D., FACC
Chief of Cardiology, UT Erlanger Cardiology, Erlanger Health System

“I suggest developing a lifestyle plan in the context of your health care provider,” says Dr. Campbell. “Set a target for improvement that is a month out, and another one that is a year out. Metabolic syndrome creeps up on us and we have to take a long, slow determined approach to fight it. The good news is, you can actually see measurable improvements in your health in a week or two by treating it very aggressively.”
Exercise. Exercise is a great first step. Not only can getting in shape lower the number on the scale and trim down that troubling abdominal fat, it can also lower your blood pressure. Doctors recommend getting 30 minutes of moderate-intensity exercise at least 5 days per week. If you’re just starting out, create a workout regimen that you know you can consistently follow, like walking with increasing intensity as you get in better shape. This is important because you don’t want to become frustrated and quit or, worse, hurt yourself.
Diet. The next step is diet. Again, this can help you lose weight, but it also will improve your cholesterol levels, insulin resistance, and blood pressure. If you are unsure of how to clean up your diet, you should ask your doctor or a registered dietician. Start by minding your portions; limiting foods high in saturated fat, trans fat, sugar, sodium, and preservatives; and incorporating more vegetables, fruits, low-fat dairy, lean protein, and whole grains into your diet.
Weight Loss. Last but not least, weight loss is crucial. It will improve almost every aspect of metabolic syndrome. Fortunately, if you’re eating healthy and exercising, weight loss will almost always result. However, for people who are working hard to make changes, but don’t see immediate results, Dr. Campbell says it’s important to be patient. “An active lifestyle and a healthier diet will help manage the condition, even if you don’t see the weight loss you would like in the short term,” he says. “Weight loss is a critical component of treatment, but today you can try to walk, today you can eat more fruits and vegetables. Today you can start to make a difference.”

Learn More 

The best place for accurate information is your doctor, but you can read more about metabolic syndrome by visiting the American Heart Association’s website at And in the meantime, get moving and get healthy! It might just save your life.

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