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Should You be Concerned About Metabolic Syndrome?

Metabolic syndrome, a collection of risk factors that has been blamed on sedentary lifestyles, is on the rise in the United States. According to the American Heart Association, an estimated 50 million Americans have metabolic syndrome.

What Is Metabolic Syndrome?

Metabolic syndrome is a cluster of risk factors for cardiovascular disease that when occur together, nearly triples the risk of heart disease or stroke and doubles the risk for diabetes. Surprisingly, these conditions may each be quite mild, but when present together, the combined effect of each individual risk is multiplied. Metabolic syndrome is a particularly serious problem for women because the risk factors are often more common and more dangerous than in men.

According to the International Diabetes Association, you may have metabolic syndrome if you have:

Why Are Doctors Concerned?

The criteria for metabolic syndrome applies to about 30 percent of the adult U.S. population. Although individual risks vary and genetic predisposition plays a role, the components of the syndrome can lead to serious complications, such as coronary heart disease, hypertension and other diseases related to plaque buildup in artery walls.

"Abdominal obesity is central to the development of metabolic syndrome," says Kristine Batten, M.D., F.A.C.C, a cardiologist on staff at John Muir Health. "Fat around the waist is more than just a little extra padding that makes your clothing too tight. The fact is that fat cells which surround, or are in close proximity to, the abdominal organs are constantly secreting toxic chemicals that promote inflammation and clot formation within the arteries.These chemicals, or cytokines, decrease the activity of the insulin that is naturally secreted by the pancreas. This then leads to a pre-diabetic state." Research has shown that diabetes is a more important risk factor for the development of heart attack, heart failure and stroke in women than in men.

Overweight individuals also tend to have high blood pressure. "When the inside lining of the blood vessels are inflamed, even a mild elevation of blood pressure becomes important for the development of plaque in the arteries. Although blood pressure may not be high enough to require medication, lifestyle modifications alone are often successful in lowering the blood pressure to safer levels," Batten adds. "Loosing just 10 pounds can make a big difference."

Cholesterol also plays a role in metabolic syndrome. Elevation of the LDL (bad) cholesterol is considered the most important cause of arterial plaque formation. In women, high triglycerides and low HDL (good) cholesterol seem to have an increased role in the deposition of plaque within the arteries. These two abnormalities tend to run together, and can be present and cause disease even if the LDL is normal.

The triglyceride value is the part of the cholesterol profile that is more diet-dependent, and may indicate an excessive intake of empty calories like sweets, sodas, alcohol, and highly processed carbohydrates such as white bread or white rice.The chemicals secreted by fat cells also contribute to triglyceride elevation. Fortunately, for most individuals, triglycerides can be controlled with a healthy diet.

On the other hand, HDL (good) cholesterol acts like a sponge, coursing through the arteries cleaning up plaque and transporting it back to the liver for removal. Even if the LDL (bad) cholesterol is normal, a low HDL puts one at risk; the higher your HDL, the better.

Is Metabolic Syndrome A Disease?

The American Diabetes Association recently co-authored a paper that called metabolic syndrome a "misleading" diagnosis, and said it shouldn't be treated as a separate malady. According to Paul McWhirter, M.D., F.A.A.C., a cardiologist on staff at John Muir Health, it is very difficult to call metabolic syndrome a disease. "It's actually a cluster of adverse metabolic responses that are the consequences of poor diet and lack of exercise.Whether these risks are called a syndrome or not is a matter of semantics."

What Should You Do?

"I continue to recommend treating each of the health risks individually," says McWhirter. "This may include medication to improve the body's sensitivity to insulin, to lower cholesterol and/or to lower blood pressure. For most people, though, the most important goal is simply to lose excess pounds and to maintain a healthy weight. The best treatment is not drugs—it's proper diet and exercise."

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