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Metabolic Syndrome: What’s NEW?

Posted on September 7, 2019 | No Comments on Metabolic Syndrome: What’s NEW?

It has been called Syndrome X, insulin resistance syndrome, dysmetabolic syndrome, hypertriglyceridemic waist, obesity syndrome. But what does it really mean when your doctor tells you that you have the “Metabolic Syndrome?”

Metabolic syndrome is the name for a group of risk factors linked to overweight and obesity that increases your chance for heart disease and other health problems such as diabetes and stroke. The term “metabolic” refers to the biochemical processes within the body responsible for health and normal body function.

Diagnosis
Doctors have not exactly agreed on the criteria for diagnosing the metabolic syndrome. The third report of the National Cholesterol Educaton Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults defines the metabolic syndrome as having three or more of the following abnormalities:

  • Waist circumference greater than 40 inches in men and 35 inches in women (for Asians: 35 inches for men and 31 inches for women)
  • Triglyceride (a type of bad fat) 150 or higher
  • High density lipoprotein (HDL), also known as good cholesterol, less than 40 mg/dL in men and 50 mg/dL in women
  • Blood pressure 130/85 or higher, or need for drug treatment for hypertension
  • Fasting sugar of 100 mg/dL or higher.

For the IDF (International Diabetes Federation), central obesity is an obligatory requirement in the criteria, plus two other features. For the WHO (World Health Organization), glucose intolerance or type 2 diabetes is a sine qua non for diagnosis, along with two other features.

Regardless of the diagnostic criteria, metabolic syndrome has evolved to be a pandemic. And we all know too well that our modern sedentary lifestyle and dietary habits are mostly to blame. There are around 47 million American adults who have the metabolic syndrome.

What Causes the Metabolic Syndrome?
There are causes you can control, and causes you just have to live with. The causes you can control include your weight and lifestyle. The causes you cannot control include growing old and genetics. Your chance of developing the metabolic syndrome increases with age. And your genes likewise increase your chances of developing insulin resistance even if you only have a little extra weight around your waist.

A study has implicated meat, fried food, and surprisingly, diet soda in the development of the metabolic syndrome. Inititated by the U.S. National Institutes of Health, the ARIC (Atherosclerosis Risk in Communities) study followed the diet of 9,500 adults in six years and tried to find a relationship with heart disease. They found that a Western dietary plan—rich in refined grains, processed meat, fried food, and red meat—was associated with a greater risk of developing metabolic syndrome. In particular, hamburgers, hotdogs, and processed meats were each associated with higher rates of metabolic syndrome. On the other hand, consumption of dairy seemed to lower the chance. In general, specific foods in themselves may not cause metabolic syndrome, but rather, may serve as markers of behavior that lead to its development.

New evidence has supported the role of genes in the development of metabolic syndrome. Researchers say that there is increased risk if you have five common gene variations. The gene variations were said to be on the CD36 gene found in chromosome 7. Better understanding of the associations of genes and susceptibility may lead to early identification and intervention for those at risk.

Associated Conditions
Other conditions that have probable links with the metabolic syndrome include: fatty liver, polycystic ovary syndrome, gallstones, and sleep apnea.

A study from Germany, the Netherlands, and the United Arab Emirates has implicated erectile dysfunction as a legitimate member of the constellation of features of the metabolic syndrome. Testosterone deficiency, they claim, is intertwined with the problems of high cholesterol, obesity, hypertension, and diabetes. Therefore, men with erectile dysfunction should be evaluated for testosterone deficiency and underlying metabolic syndrome.

Who Are At Risk?
You are at risk if you have a large waistline (abdominal obesity), are sedentary, or have insulin resistance.

What Are the Signs and Symptoms?
Metabolic syndrome itself usually has no signs and symptoms. Most of the risk factors usually have no signs nor symptoms as well, although a large waistline is a visible sign. Some people may experience symptoms of high blood sugar such as increased urination or thirst, or symptoms of high blood pressure such as headache and dizzy spells.

How Is the Metabolic Syndrome Treated?
Healthy lifestyle changes are first-line. The importance of weight loss, increased physical activity, improved diet, and quitting smoking cannot be overemphasized. Medications are used to treat the individual risk factors such as high blood pressure, high triglycerides, low HDL, and high blood sugar. Aspirin may be used to decrease the risk of blood clots, a condition Ethat occurs with the metabolic syndrome. The main goal of treatment is to decrease one’s risk for cardiovascular disease or a heart attack. Targeting to decrease LDL or bad cholesterol, therefore, is also a priority.

Weight loss of approximately seven to 10 percent in the first year of treatment is a realistic goal. Increased physical activity such as brisk walking for 30 minutes a day, five times a week is recommended. The ultimate goal is maintenance of moderate level of physical activity 60 minutes a day, five to seven times a week. Total fat intake should be significantly decreased, not more than 25 to 35 percent of total daily calories. There should be increased intake of foods high in soluble fiber, and fish. Limit salt, and likewise limit alcohol intake to one to two drinks a day.

What’s New?
So there is really nothing that is earth-shakingly new about the metabolic syndrome. The message remains the same: metabolic syndrome is lifelong. Lifestyle changes are paramount in reversing the risk factors for heart attack, stroke, and long-term effects of diabetes. Multiple medications are often needed because we are targeting several parameters such as sugar, lipids, and blood pressure. Work closely with your doctor so all these will be monitored, as well as complications. Set realistic short-and long-term goals, and try with all your might to reach them!

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