Metabolic syndrome

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at March 31, 2016
StartDiseasesMetabolic syndrome

Metabolic syndrome refers to several health conditions that occur together, substantially increasing a person's risk for having a heart attack, diabetes, and stroke. These conditions include high blood pressure, high blood sugar, high cholesterol, high triglycerides, and excess fat in the abdominal area.

While each of these conditions alone increases a person's risk for cardiovascular disease and other chronic disease, having two or more of these factors multiplies the risk. Left untreated, metabolic syndrome leaves one vulnerable to heart disease, heart attack, stroke, diabetes, and other serious chronic conditions that have a profound impact on quality of life.


Definition & Facts

As obesity rates rise, metabolic syndrome is becoming more common, particularly among older adults. Aside from smoking, it's the biggest risk factor for heart disease. In fact, metabolic syndrome affects up to 34 percent of American adults, many of whom are not aware that they have this serious health condition. Worldwide, the estimated prevalence of metabolic syndrome is about 25 percent.

Those who are obese, lead a sedentary lifestyle, and/or have a family history of metabolic syndrome, diabetes, or cardiac issues should talk with their doctors about screening for metabolic syndrome and related conditions.

Symptoms & Complaints

Most people who have metabolic syndrome do not experience symptoms though the visible sign of extra weight carried around the waist is cause for concern. Those with high blood sugar might experience fatigue, vision problems, increased thirst, and frequent urination. Some research has shown that many people with metabolic syndrome also experience excessive blood clotting and/or constant, low-grade inflammation throughout the body.


The primary cause of metabolic syndrome is an inactive lifestyle that leads to being overweight or obese. The conditions that make up this syndrome are more common among:

Diagnosis & Tests

Metabolic syndrome is diagnosed when at least three of the five conditions described are present: high blood pressure, high blood sugar, high cholesterol, high triglycerides, and excess fat in the abdominal area. Specifically, guidelines for determining whether each condition is present include a waist circumference of at least 35 inches for women or 40 inches for men; triglyceride level of at least 150 mg/dL; HDL cholesterol level of less than 40 mg/dL in men or less than 50 mg/dL in women; blood pressure of 130/85 mm Hg or higher; and fasting blood sugar of 100 mg/dL (5.6 mmol/L) or higher.

These criteria were defined by the International Diabetes Federation; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. An individual's doctor will conduct a physical examination as well as lab tests to make the determination of metabolic syndrome.

Treatment & Therapy

Left untreated, metabolic syndrome leaves a person at substantial risk for developing diabetes and heart problems, including heart attack, stroke, and cardiovascular disease. Fortunately, lifestyle changes can often effectively reverse metabolic syndrome and reduce one's risk for becoming chronically ill.

The most important way to reverse metabolic syndrome is by losing weight and keeping it off, with the guidance of one's doctor and, if necessary, a registered dietitian. Focusing on eating a heart-healthy diet rich in whole grains, fruits, vegetables, lean meats and fish, and low-fat or fat-free dairy products can help treat metabolic syndrome.

Most experts recommend eating two servings a week of fish with high levels of heart health omega-3 fatty acids, such as tuna and salmon. Steering clear of processed and fried food as well as items that are high in salt, sugar, or fat can also help. Red meat and palm and coconut oils should also be avoided.

Healthy adults should get at least 150 minutes of moderately vigorous aerobic exercise each week. Those who are unaccustomed to exercise should start slowly by walking and gradually increasing the length and intensity of their workouts. In addition, alcohol should be limited to one drink per day for women and two for men, keeping in mind that one drink refers to a 12 ounce beer, 5 ounce glass of wine, or ounce ("shot") of spirits.

In addition to lifestyle changes, one's doctor may prescribe medications for blood pressure, cholesterol, and other symptoms of metabolic syndrome. It's important to take all medication as prescribed and discuss any side effects with one's doctor, as well as take steps to make healthy lifestyle changes.

Prevention & Prophylaxis

Leading a healthy lifestyle can greatly reduce the risk for developing metabolic syndrome. While some risk factors cannot be changed, most are under one's control. Healthy diet and regular exercise are essential in preventing metabolic syndrome.

Managing stress can also help one lead a more healthy life. Sessions with a licensed therapist can help reduce stress and anxiety. There are also techniques like yoga, meditation, massage, or even simple acts of self care like reading a good book or taking a hot bath.

Smoking cessation is also one of the most important things individuals must do for their heart health. Methods for quitting include cognitive behavioral therapy, medications, and support groups. It is important for individuals to develop a relationship with a primary care physician whom they trust, and begin having screenings for blood pressure, cholesterol, and other levels as he or she recommends. This frequency will depend on a person's age, overall health, and other factors.