Metabolic Syndrome: The Silent Epidemic

Serious condition is linked to obesity, lack of exercise

By Kathleen Zelman, MPH, RD/LD
WebMD Weight Loss Clinic - Feature

Reviewed By Louise Chang, MD

Call it a silent epidemic. An estimated one in four adults is afflicted with the condition known as metabolic syndrome, and many of them don't even know it.

Obesity and lack of exercise are key components of this dangerous condition, which puts you at risk of developing serious health problems. That makes metabolic syndrome yet another reason to adopt healthier eating and exercise habits.

What Is Metabolic Syndrome?

According to the National Cholesterol Education Panel, if you have at least three of the following characteristics, you're classified as having metabolic syndrome:

• Excess fat around the waist (a waist size of 40 inches or more for men, and 35 inches or more for women)
• Triglyceride levels of 150 or higher
• HDL (good cholesterol) of less than 40 in men and 50 in women
• Blood pressure of 130/85 or higher
• Fasting blood sugar of 110 or more

The clustering of these traits has been linked to an increased risk for heart disease, diabetes, heart attack, and stroke. And the more of them you have, the greater your risk.

Studies have shown that people with metabolic syndrome are at triple the risk for heart disease, heart attack, or stroke than those without the risk factors. Further, those with metabolic syndrome have a quadrupled risk of developing diabetes.

It's very important to "know your numbers'': your cholesterol levels, blood pressure, blood sugar, and triglyceride levels. That's because even someone who is only mildly overweight -- but who carries the extra fat around their middle and has mild high blood pressure and elevated blood sugar -- is at risk.

Most people with metabolic syndrome also have insulin resistance. That means the body does not properly use insulin, the hormone that regulates blood sugar levels. An estimated 86% of people with diabetes also have metabolic syndrome.

What Causes It?

A diet high in unhealthy fats, sugars, and calories along with a lack of regular physical activity can certainly contribute to the risk factors for metabolic syndrome.

The actual causes of metabolic syndrome may be many, but researchers lean toward insulin resistance as the underlying problem.

Overweight people tend to develop a resistance to insulin -- a hormone that regulates blood sugar levels, pushing sugar into the body's cells, where it is used for energy. When you're resistant to insulin, blood sugar isn't effectively delivered into the cells. That leads to high blood-sugar levels in the bloodstream, which is one of the symptoms (and causes) of type 2 diabetes.

A Growing Problem

A recent study in the Archives of Internal Medicine suggests that metabolic syndrome is on the rise, especially among adults in their mid-30s. Researchers found that the young adults with metabolic syndrome had gained fat around their midsections and were much less physically active in their 30s, compared to their teen years. The researchers also noted that more men were diagnosed with the condition than women in this age group.

According to the National Cholesterol Education Program, some 24% of young adults over 20 have metabolic syndrome. That number swells to 44% by age 50.

An Ounce of Prevention

To lower your odds of developing the risk factors of metabolic syndrome, make sure your eating plan is full of fruits, vegetables, whole grains, and low-fat dairy.

It makes perfect sense that the new dietary guidelines for Americans recommended three servings of whole grains each day. Studies have shown that whole grains can lower the risk of heart disease and certain cancers -- and now you can add metabolic syndrome to that list.

Eating whole grains can improve insulin sensitivity and reduce the risk of metabolic syndrome, according to a study published Diabetes Care. Whole-grain carbohydrates, fruits, and vegetables tend to be absorbed slowly by the body and help normalize blood sugar.

And wine lovers can rejoice; a glass or two per day is good for your health. The new dietary guidelines condone it -- and so does a study suggesting that a glass or two of wine may actually lower a person's risk for developing metabolic syndrome.

Moderation is key, though. The health benefits become risks if you overindulge and drink more than one or two glasses of wine a day.

Stay Active

Many studies have documented the effectiveness of physical activity along with a healthy diet. One study in the Archives of Internal Medicine found that exercise and weight loss helped to reduce blood pressure and improve insulin sensitivity in people with metabolic syndrome.

Exercise helps burn fat (especially around the waist), increases "good" cholesterol, and lowers blood pressure, according to a study published in the American Journal of Preventive Medicine.

And a study in the Journal of the American College of Cardiology found that fitness helps reduce the risk factors for metabolic syndrome by lowering "C-reactive protein" -- a marker for a person's risk of heart attack and stroke. Researchers found that fit people had lower C-reactive protein levels in their blood and a lower risk of heart disease-related complications than people who were not fit.

So add preventing metabolic syndrome to the long list of benefits that can result from a healthy diet and regular physical activity.

Originally published February 18, 2005.
Medically updated September 2006.

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