Metabolic Syndrome: Could You Have It?

This silent precursor to diabetes is all too easy to overlook. Here’s what you can do to help reverse or even prevent it.

Medically reviewed in January 2022

Updated on January 27, 2022

Over 1 in 3 adults in the U.S. have a condition that could increase their risk of developing many other serious medical problems—and many don’t even know it. It’s called metabolic syndrome, also known as syndrome X or insulin resistance syndrome, and it’s on the rise.

The list of health problems that metabolic syndrome can lead to is long and concerning. It doubles a person's risk of both heart attack and stroke. It also may lead to high blood pressure, type 2 diabetes, polycystic ovary syndrome (PCOS), fatty liver, cholesterol gallstones, asthma, and even some forms of cancer.

But here's the good news: Metabolic syndrome is treatable with lifestyle changes and it can sometimes be reversed. Adding a brisk walk to your routine every day may be enough to stop this syndrome and the accompanying health ills in its tracks.

Do you have metabolic syndrome?
Unfortunately, most of the symptoms of metabolic syndrome are silent. Finding out if you have it requires medical testing. But you can ask yourself the following questions to help determine whether a medical appointment is in order:

  • Do you carry excess weight around your middle?
  • Are you physically inactive?
  • Does someone in your family have diabetes?
  • Have you had gestational diabetes during a pregnancy?
  • Do you have nonalcoholic fatty liver disease, polycystic ovary syndrome, or sleep apnea?
  • Do you take medications that cause weight gain or that change your blood pressure, cholesterol, or blood sugar?
  • Are you Hispanic?

In addition, older age is associated with especially high risk. But metabolic syndrome is also increasing in younger adults, affecting over 1 in 5 between the ages of 20 and 39.

Answering yes to any of the above questions means that you have at least one personal factor that may be cause for concern. If you suspect you are at risk, make an appointment with your healthcare provider (HCP). An early diagnosis may help prevent the serious health problems associated with metabolic syndrome.

A cluster of 5 factors
The following health measures will let your HCP make the diagnosis.

  • Abdominal obesity: Obesity in general has been linked to metabolic syndrome, but excess fat around the waistline correlates even more closely. For men, a waistline of 40 inches or more is considered high-risk. For women, it’s a waistline of 35 inches or more.
  • Elevated blood pressure: In particular, a level over 130/85.
  • High blood triglycerides: Specifically, a level over 150 mg/dL.
  • Low HDL (aka “good” cholesterol): For men, low HDL is below 40 mg/dL. For women, low HDL is below 50 mg/dL.
  • Insulin resistance: As indicated by a fasting blood glucose level at or above 100 mg/dL.

Having three of these five characteristics can indicate the presence of metabolic syndrome.

If you do have the syndrome, your HCP can introduce you to immediate lifestyle changes that can reverse it.

Walk off the weight
Reversing metabolic syndrome may be as straightforward as exercising more and losing extra weight. Weight loss can improve all characteristics of metabolic syndrome, from your blood fat levels to your body's resistance to insulin. An exercise program as simple as walking a couple of miles each day is an excellent start.

Watch what you eat
You can also make basic changes to your diet. For example, by switching from animal-based fats  that are high in saturated fats (such as those in red meats or full-fat dairy products) to healthy polyunsaturated and monounsaturated fats (such as canola, olive, and peanut oils), you may reduce your body's LDL ("bad" cholesterol) levels and increase HDL levels. Poly- and monounsaturated fats are also found in certain foods like nuts and avocados.

If you need help managing your diet and cutting back on unhealthy foods, a nutritionist can set you up with a healthful eating plan.

Medication? Maybe.
In addition to lifestyle changes, medication therapies may be useful. Two promising types of drugs for treating metabolic syndrome are insulin sensitizers, called the thiazolidinediones, and metformin. Medication may also help to treat some of the factors involved in this syndrome, such as high blood pressure, high triglycerides, and low HDL.

Take evasive action
It's not completely clear what causes metabolic syndrome. Some people may be genetically predisposed, while others may have a combination of lifestyle and medical factors that put them at risk. But metabolic syndrome is preventable. By getting plenty of exercise and maintaining a healthy weight, there is a strong possibility that you can avoid this condition.

Article sources open article sources

National Heart, Lung, and Blood Institute. Metabolic Syndrome. Accessed January 26, 2022.
National Library of Medicine MedlinePlus. Metabolic Syndrome. Page last updated August 17, 2021.
Moore JX, Chaudhary N, Akinyemiju T. Metabolic Syndrome Prevalence by Race/Ethnicity and Sex in the United States, National Health and Nutrition Examination Survey, 1988–2012. Prev Chronic Dis 2017;14:160287.
Mayo Clinic. Metabolic syndrome. Accessed January 26, 2022.
Johns Hopkins Medicine. Metabolic Syndrome. Accessed January 26, 2022.
Cleveland Clinic. Metabolic Syndrome. Last reviewed April 13, 2019.
Robert H. Shmerling, MD. Harvard Health Publishing. Metabolic syndrome is on the rise: What it is and why it matters. October 2, 2020.

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