Metabolic Syndrome

Metabolic syndrome is diagnosed when a person has three or more of five specific risk factors: a waist circumference greater than 40 inches in men or 35 inches in women, triglycerides above 150 mg/dL, HDL cholesterol below 40 mg/dL in men or 50 mg/dL in women, blood pressure above 130/85 mmHg, and fasting blood sugar above 100 mg/dL.

Approximately one-third of American adults meet the criteria for metabolic syndrome, and prevalence increases with age. Having metabolic syndrome doubles the risk of cardiovascular disease and increases the risk of developing type 2 diabetes fivefold. The underlying drivers are typically insulin resistance and chronic low-grade inflammation, often worsened by excess visceral fat.

Treatment focuses on aggressive lifestyle modification as the first line of defense. Regular physical activity of at least 150 minutes per week, a Mediterranean-style or DASH diet rich in vegetables, whole grains, and healthy fats, weight loss of 7 to 10 percent of body weight, smoking cessation, and stress management can reverse metabolic syndrome in many cases. Medications may be added to address individual components when lifestyle changes alone are insufficient.