Metabolic syndrome is defined as the co-existence of various factors that can increase the cardiovascular risk. These include visceral obesity, high blood pressure, hyperglycemia , and dyslipidemia (reduced high-density lipoprotein cholesterol or raised triglycerides).
Other names for metabolic syndrome:
- Dysmetabolic syndrome
- Hypertriglyceridemic waist
- Insulin resistance syndrome
- Obesity syndrome
- Syndrome X
Diagnostic criteria according to American heart association: Presence of three or more of the following risk factors:
- High blood glucose (sugar)
- Low levels of HDL (“good”) cholesterol in the blood
- High levels of triglycerides in the blood
- Large waist circumference or “apple-shaped” body
- High blood pressure
Risks of metabolic syndrome
- Cardiovascular disorders - High cholesterol and high blood pressure can lead to inflammatory changes in the lining of blood vessels predisposing a person to risk of heart attack & stroke.
- visceral fat causes insulin resistance due to which the cells cannot uptake glucose causing glucose built-up in the blood called hyperglycemia.
Negative outcomes of Metabolic syndrome
- Damage to the internal lining of coronary and other arteries,which can lead to development of heart disease or stroke
- Changes in the kidneys' ability to flush salt, leading to high blood pressure, heart disease and stroke
- An increase in triglyceride levels, resulting in an increased risk of developing cardiovascular disease
- An increased risk of clot formation, which can block arteries and cause heart attacks and strokes
- Resistance to the action of insulin, which can signal the start of type 2 diabetes, which is associated with an increased risk for a heart attack or stroke. Uncontrolled hyperglycemia is also associated with complications of the eyes, nerves, and kidneys.
- Fatty liver, which is sometimes associated with inflammation of the liver (non-alcoholic steatohepatitis, or NASH). If untreated, NASH could lead to cirrhosis and ultimately liver failure.
Dietary interventions
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Negative energy balance for weight loss.
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A weight loss as small as 5–10% of body weight can significantly reduce triglycerides and increase HDL-Cholesterol.
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Avoiding common sources of added sugars in the diet like soft drinks, cakes, cookies, pies, fruit drinks, dairy desserts, and candy.
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A diet high in complex, unrefined carbohydrates with an emphasis on fiber (15 g/1000 calories) and low in added sugars (<25% of caloric intake) is recommended for individuals with or at risk for the Metabolic syndrome.
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A protein intake of 10–35% of total caloric intake is recommended.
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A reduction in saturated fat intake (<7% of caloric intake) and an increase in the unsaturated fatty acids, specifically linoleic (5–10% of caloric intake) and α-linolenic ( 0.7 -- 1.6% of caloric intake).
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Daily sodium intake should be restricted to no more than 65–100 mmol/day.
Exercise recommendations
- Regular moderate intensity aerobic exercise reduces systolic and diastolic blood pressure.
- Aerobic exercise training has shown to increase HDL-Cholesterol and decrease triglycerides.
- Resistance training improves glycemic control and insulin sensitivity.
- It also indirectly brings metabolic improvements through reductions in abdominal fat.
- At least 150 minutes of physical activity per week is recommended.
References:
- Bonsignore, M. R. and Steiropoulos, P. (2015) ‘Metabolic syndrome’, ERS Monograph. doi: 10.1183/2312508X.10006014.
- Mendrick, D. L. et al. (2018) ‘Metabolic syndrome and associated diseases: From the bench to the clinic’, Toxicological Sciences. doi: 10.1093/toxsci/kfx233.
- Myers, J., Kokkinos, P. and Nyelin, E. (2019) ‘Physical activity, cardiorespiratory fitness, and the metabolic syndrome’, Nutrients. doi: 10.3390/nu11071652.
- O’Neill, S. and O’Driscoll, L. (2015) ‘Metabolic syndrome: A closer look at the growing epidemic and its associated pathologies’, Obesity Reviews. doi: 10.1111/obr.12229.
- Zimmet, P. et al. (2019) ‘The Circadian Syndrome: is the Metabolic Syndrome and much more!’, Journal of Internal Medicine. doi: 10.1111/joim.12924.
- Bonsignore, M. R. and Steiropoulos, P. (2015) ‘Metabolic syndrome’, ERS Monograph. doi: 10.1183/2312508X.10006014.
