The Metabolic Syndrome

If you have the metabolic syndrome, you have an increased risk for heart disease. The syndrome isn’t a disease itself but a cluster of risk factors for heart disease and other disorders, such as diabetes. One risk factor alone increases your chance of developing heart disease—having a group of them boosts your risk more. This is true even though  some of the factors in the metabolic syndrome may be at levels below those for full-fledged heart disease risk factors. In fact, research indicates that having the metabolic syndrome can raise your chance of developing heart disease and diabetes even if your LDL cholesterol isn’t elevated.

Heredity can play a role in whether a person develops the metabolic syndrome, but its underlying causes are  abdominal obesity—too large a waist—and physical inactivity. The metabolic syndrome also is related to a condition called “insulin resistance”— which can lead to diabetes.

Insulin is a hormone that helps your body convert glucose (sugar) in the blood into energy. With insulin resistance, the body cannot properly use the insulin it produces. As more and more Americans have become obese in recent years, the problem of metabolic syndrome has become more widespread. Today about one-quarter of all adults in the United States have the metabolic syndrome.

If you have three or more of the following factors, you have the metabolic syndrome:

  • Large waist measurement—35 inches or more for women,40 inches or more for men (this is also one of the measurements that determine if you need to lose weight)
  • Triglyceride level of 150 mg/dL or higher
  • HDL cholesterol of less than 50 mg/dL in women,less than 40 mg/dL in men
  • Blood pressure of 130/85 mmHg or higher (either number counts as a raised blood pressure)
  • Fasting blood sugar of 100 mg/dL or higher

If you have the metabolic syndrome, it is especially important for you to follow the diet Program. Lifestyle changes are the main treatment for metabolic syndrome. diet can help you reverse or reduce all of the metabolic syndrome’s risk factors, which will reduce your risk of developing heart disease and diabetes.

Your first goal is to move toward getting your LDL under control. Then you’ll focus on the risk factors of the metabolic syndrome.

The key parts of the diet Program for treating the metabolic syndrome are:

  • Achieve a healthy weight 
  • Become physically active 
  • Follow the  diet 

As was said earlier, the diet calls for total fat to be 25–35 percent of the day’s calories. Some experts recommend that people with the metabolic syndrome should aim for the higher end of this range   about 35 percent of calories from total fat. This is meant to keep carbohydrate consumption from being too high, which could further raise triglycerides and lower HDL. Other experts hold that, since weight loss is so important for treating the metabolic syndrome risk factors, a diet with less fat could be right for you if it helps you lose weight. Whichever diet you follow, remember to choose complex carbohydrates rather than simple sugars.  There are a couple of added points. First, if you have the metabolic syndrome and drink alcoholic beverages, it’s doubly important to do so only in moderation. Drinking too many alcoholic beverages increases the risk for elevated triglycerides and high blood pressure. Further, alcoholic beverages add extra calories. So drinking too much also can add pounds. See page 30 for what “moderate drinking” means. Second, the “don’t smoke” advice that goes for everyone applies especially to you if you have the metabolic syndrome. Smoking tends to raise triglycerides and lower HDL. If you smoke, quitting can help reduce your triglyceride level and raise your HDL.

If lifestyle changes do not sufficiently control the metabolic syndrome risk factors, then drug therapy may be needed to manage one or more of them. For instance, you may need medication to treat high blood pressure, or elevated triglycerides and low HDL. Aspirin also may be prescribed to help prevent blood clots. All of these actions will help reduce your risk for heart disease.