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Understanding and Treating Metabolic Syndrome

It seems appropriate that one of the alternate names for metabolic syndrome is "Syndrome X," a label that sounds mysterious and even a little secretive. The syndrome itself is like that in many ways: The exact cause is unknown, and typically there aren't immediate physical symptoms.

The condition — which strikes an estimated one in five Americans — occurs when a patient has several disorders at the same time: excess weight around the waist (more than 40 inches for men and 35 inches for women), raised plasma triglycerides or low HDL (good cholesterol), insulin resistance, high blood glucose and hypertension (high blood pressure). It also can include problems with blood clotting.

Having metabolic syndrome increases one's chance of diabetes, as well as heart disease and stroke.

The good news is that some components of the condition — including insulin resistance — can be reduced. A 2004 article in Diabetes Care says that doctors and other health care providers should encourage patients with the syndrome to "adopt preventive lifestyles that are conducive to . reversing this syndrome."

Because a poor diet and lack of exercise may lead to metabolic syndrome, health care providers urge people with the condition to increase their activity levels and eat healthier foods. That means a diet including healthy meats and fats, in addition to complex carbohydrates instead of simple sugars.

"The primary goals of dietary change for metabolic syndrome are to reduce the risk of cardiovascular disease and diabetes mellitus," says a recent report from the journal American Family Physician.

Exercise is key to treating metabolic syndrome. Since a lack of vigorous exercise is one of the primary causes of the condition, experts encourage people who have the syndrome or who are at risk of developing it to increase their physical activity. Exercise and a healthy diet are important factors in treating insulin resistance, a chief problem associated with metabolic syndrome.

"You don't have to join a gym or buy any special equipment to get active," advises the American Diabetes Association. "So, walk your dog. Take the stairs instead of the elevator. Take walking breaks during breaks at work." Regular activity helps to lower cholesterol and blood pressure, and is an important component in weight loss.

Screening for metabolic syndrome includes some checks regularly performed during doctor appointments: testing of triglyceride and HDL cholesterol and measurements of glucose. Because people with metabolic syndrome tend to be apple-shaped rather than pear-shaped, measurements of patients' waists also may be helpful.

While the syndrome typically affects adults, children also can have it. The number of people with metabolic syndrome is increasing in general, but it also is climbing among specific groups of people at significant rates.

Researchers publishing in Diabetes Care estimate that about 50 million people had metabolic syndrome in 1990, a number they say grew to about 64 million people by 2000. The rates among people in the United States have shot up in some categories, including women ages 20-39.

Adapted by Editorial Staff, February, 2005
Last update, July 2008