Metabolic syndrome is a condition that appears to increase the risk of a cluster of diseases. These include cardiovascular disease, type 2 diabetes, high cholesterol, and obesity, among others. It is also known as insulin resistance syndrome.

The syndrome is not a specific condition, but it groups together a set of risk factors that have been linked to a higher chance of developing cardiovascular disease and type 2 diabetes.

The American Heart Association (AHA) describe metabolic syndrome as a “cluster of metabolic disorders,” that includes high blood pressure, high fasting glucose levels, and abdominal obesity, which, combined, increase the risk of heart disease.

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According to the AHA, a doctor will often consider metabolic syndrome if a person has at least three of the following five symptoms:

  1. Central, visceral, abdominal obesity, specifically, a waist size of more than 40 inches in men and more than 35 inches in women
  2. Fasting blood glucose levels of 100 mg/dL or above
  3. Blood pressure of 130/85 mm/Hg or above
  4. Blood triglycerides levels of 150 mg/dL or higher
  5. High-density lipoprotein (HDL) cholesterol levels of 40 mg/dL or less for men and 50 mg/dL or less for women

Having three or more of these factors signifies a higher risk of cardiovascular diseases, such as heart attack or stroke, and type 2 diabetes.

The DASH diet is recommended for preventing and treating metabolic syndrome. The diet aims to prevent hypertension.

It recommends:

  • choosing foods from healthful sources
  • limiting intake of red meats, sodium, saturated fats and total fats, and sweetened foods and drinks
  • consuming plenty of fruits and vegetables, wholegrains, fish, and nuts

The DASH diet focuses on what people eat rather than how to reduce calories, but those who wish to lose weight can follow the diet at a lower calorie level.

Not all medical guidelines agree on the exact thresholds to use for a diagnosis of metabolic syndrome.

Controversy remains, for instance, about the best way to measure and define obesity. Options include body mass index (BMI), height-waist ratio, or other means. A person may also have high blood pressure or high blood glucose, for example, that is not related to obesity.

The above criteria were created in an attempt to harmonize diagnoses. However, doctors will also consider an individual’s circumstances.

Metabolic syndrome and childhood obesity

Metabolic syndrome, sometimes abbreviated to MetS, can start in childhood, alongside early obesity, dyslipidemia, and high blood pressure.

Due to concerns about the rise in obesity among young people in recent years, some have called for early screening to identify those with a higher cardiovascular risk.

This could make it possible to target changes toward a healthier lifestyle and reduce the chance of health problems later in life.

How and when to screen for and diagnose metabolic syndrome and obesity in children, however, remains controversial. One reason is that growing children show wide variance in these factors.

According to the Centers for Disease Control (CDC), in the United States overall, almost 1 in 5 young people aged 6 to 19 years now live with obesity, three times the number in the 1970s. These people could be at risk of developing health problems as they enter adulthood.

Metabolic syndrome is a collection of risk factors, so there is not a single cause.

Having central obesity or overweight is a major factor, but abnormal blood lipid and cholesterol levels, high blood pressure, and prediabetes also contribute to cardiometabolic risk.

Unavoidable risk factors, such as family history and ethnic background, can increase the chance of developing some components.

However, lifestyle choices can impact all these factors.

A diet that is high in fat and sugar, together with a lack of exercise, has been associated with the development of obesity and related conditions.

However, symptoms such as insulin resistance do not necessarily accompany obesity or indicate metabolic syndrome.

Insulin resistance, is a feature of metabolic syndrome and obesity, and it can lead to cardiovascular disease and type 2 diabetes, but it can also be a sign of other conditions. Examples include Cushing’s disease, polycystic ovary syndrome (PCOS), nonalcoholic fatty liver disease, and chronic kidney disease.

Other problems that are sometimes associated with metabolic syndrome, insulin resistance, and high blood sugar include low-level inflammation and blood clotting defects. These can also contribute to the development of cardiovascular disease.

The following factors increase the risk of developing metabolic syndrome:

  • a large waistline
  • a family history of metabolic syndrome
  • a lack of exercise combined with a high-calorie diet
  • insulin resistance
  • the use of some medications

Some drugs that are used to treat inflammation, HIV, allergies, and depression can increase the risk of gaining weight gain or experiencing changes in blood pressure, cholesterol, and blood sugar levels.

Find out more from the following MNT pages:

  • How much should I weigh? This article includes information on various measures of obesity, including BMI, waist-to-hip ratio and body fat percentage
  • How to lose weight This article provides information on how to adjust diet and exercise and lose the high-risk fat tissue

Read this article in Spanish.