People with the metabolic syndrome are at increased risk of coronary heart disease and other diseases related to plaque buildups in artery walls (e.g., stroke and peripheral vascular disease) and type 2 diabetes. The metabolic syndrome has become increasingly common in the United States. It’s estimated that over 50 million Americans have it.
The dominant underlying risk factors for this syndrome appear to be abdominal obesity and insulin resistance. Insulin resistance is a generalized metabolic disorder, in which the body can’t use insulin efficiently. This is why the metabolic syndrome is also called the insulin resistance syndrome.
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 the following components:
- Elevated waist circumference:
Men — Equal to or greater than 40 inches
Women — Equal to or greater than 35 inches
- 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
The primary goal of clinical management of the metabolic syndrome is to reduce the risk for cardiovascular disease and type 2 diabetes. Then, 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