Metabolic Syndrome

Metabolic syndrome, also known as insulin resistance syndrome, occurs when an individual has a cluster of conditions (such as hypertension and measurements (such as large waist size) that substantially increase his risk for cardiovascular diseases (including coronary heart disease, heart attack, and stroke) and diabetes.

An estimated 50 million Americans have metabolic syndrome. Several genetic, environmental, and lifestyle factors interact to create metabolic syndrome in individuals. Most at risk include those who

• Are overweight – have a body mass index (BMI) of >25 and/or have abdominal obesity
• Engage in little physical activity
• Have been diagnosed with hypertension, cardiovascular disease, or polycystic ovary syndrome (PCOS)
• Have a family history of type 2 diabetes or have a personal history of gestational diabetes
• Are Hispanic or Asian

Criteria Used to Diagnose

Although there is no standard diagnosis for metabolic syndrome, the American Heart Associate (AHA) and the National Heart, Lung, and Blood Institute adopted the criteria proposed by the National Cholesterol Education Program (NCEP) and identify metabolic syndrome in those who meet at least three of the following criteria:

• Elevated waist circumference or abdominal obesity - >= 40 inches in men or >=35 in women (>-32 inches in Asian women)
• High triglycerides – 150 mg/dL or higher or if taking medication to treat high triglycerides
• Low HDL cholesterol - < 40 mg/dL in men and <50 mg/dL in women or if taking medicine to raise HDL cholesterol • Elevated blood pressure – systolic (top number) >= 130 and/or diastolic (bottom number) of >= 85 mmHg or taking medicine to lower blood pressure
• Elevated fasting blood glucose levels - >=100 md/dL

Diet and Lifestyle Prevention Recommendations

Many nutrition and lifestyle strategies used to optimize health and prevent cardiovascular disease, hypertension, and diabetes can also be used to prevent or treat metabolic syndrome and associated diseases and conditions. These include

• Weight loss if overweight, especially if you have abdominal obesity.
• Engaging in regular, consistent exercise.
• Consuming a dietary pattern consistent with MyPyramid that emphasizes fruits, vegetables, whole grains, low-fat dairy foods, fish, legumes, nuts and seeds, and healthy oils and minimizes added sugars and solid fats. It should also be rich in fiber and other key nutrients and low in saturated and trans fats, dietary cholesterol, and sodium. A Mediterranean-type diet that emphasizes plant foods and foods rich in monounsaturated fats (such as olive oil and avocados) is also a healthful option.
• Quitting smoking, if you are able to successfully stop smoking, make an effort to prevent weight gain by eating healthfully and engaging in regular physical activity.
• Getting annual check-ups with a physician to determine if you have any risk factors associated with metabolic syndrome.

Following are some specific strategies to help you improve HDL cholesterol and triglyceride levels as well as blood pressure (and therefore reduce your risk for metabolic syndrome and other diet-related diseases and conditions).

You can raise HDL or “good” cholesterol levels by:

• Losing weight
• Increasing aerobic exercise
• Emphasizing foods rich in monounsaturated and polyunsaturated fats over those rich in saturated and trans fats
• Quitting smoking
• Drinking moderately (having up to one drink a day for women and up to two drinks a day for men) if you already drink

Lowering Triglycerides

You can lower your blood triglyceride level by:

• Taking 2-4 grams of fish oil supplements (in capsule form); be sure to discuss this with your physician first
• Emphasizing foods rich in monounsaturated and polyunsaturated fats over those rich in saturated and trans fats
• Replacing refined grains with whole grains and reducing your intake of foods and beverages rich in simple sugars and low in nutrients (such as soda and candy)
• Avoiding alcohol
• Avoiding cigarette smoking

You can lower your blood pressure by:

• Losing weight
• Reducing sodium intake
• Increasing potassium intake

Polycystic ovary syndrome (PCOS) is a condition (possibly inherited) that involves menstrual irregularities and elevated levels of androgens (male hormones) in women with no other diseases. Symptoms can include multiple ovarian cysts, amenorrhea, failure of ovaries to release eggs (anovulation), excess body hair, a high rate of miscarriage, and/or infertility.