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Metabolic Syndrome -- Lifestyle Changes Are Key

October 23, 2014

By Jill Pluhar R.D., L.D.N.
Brigham and Women's Hospital

Metabolic syndrome is the name for a group of five closely-related conditions that can increase a person's risk of heart disease, stroke and diabetes. The more you have at one time, the greater your risk.

In general, a person with metabolic syndrome is twice as likely to develop heart disease and five times as likely to develop diabetes as someone without metabolic syndrome. As the name suggests, metabolic syndrome is related to your body's metabolism.

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What Is Metabolic Syndrome?

According to the National Cholesterol Education Program and the American Heart Association, a person has metabolic syndrome if they have three or more of the following conditions:

  • Obesity, particularly around your waist:
    • A waist size greater than 35 inches for women
    • A waist size greater than 40 inches for men
  • Elevated blood pressure (one or more of the following):
    • 130 mm Hg or greater systolic (the top number)
    • 85 mm Hg of greater diastolic (the bottom number)
    • Being treated for high blood pressure
  • Elevated triglycerides
    • 150 mg/dL or higher
  • Low HDL or "good" cholesterol
    • Less than 50 mg/dL in women
    • Less than 40 mg/dL in men
    • Being treated for low HDL
  • Insulin resistance
    • Fasting blood sugar 100 mg/dL or higher
    • Being treated for high blood sugar

Having just one of these conditions does not mean you have metabolic syndrome. But it does increase your risk of serious diseases. The more conditions you have, the greater the risk to your health. Metabolic syndrome is diagnosed with blood tests and a physical exam.

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What Puts Me at Risk for Developing Metabolic Syndrome?

  • Age: Ten percent of people in their 20's have metabolic syndrome compared with 40% of people in their 60's. This difference may be due to physical changes that occur as we age, or due to a decrease in physical activity and changes in diet.
  • Race: Hispanics and Asians appear to be at greater risk of developing metabolic syndrome.
  • Obesity: A BMI (body mass index) greater than 25 (Calculate your BMI using the online BMI calculator.)
  • History of diabetes: A family history of type 2 diabetes or a history of gestational diabetes (diabetes during pregnancy)
  • Polycystic Ovary Syndrome (PCOS): Women with PCOS have high levels of hormones called androgens. They are made by the body. Increased androgen levels can lead to weight gain, especially around the abdominal area. It also can lead to insulin resistance and high cholesterol.

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How is Metabolic Syndrome Treated?

Treating metabolic syndrome can reduce a person's risk of developing heart disease. The best way to do this is through lifestyle changes. Lifestyle changes can also help prevent metabolic syndrome if you are at risk.

Weight loss — Losing just 7% to 10% of your body weight can drastically decrease your chances of developing health problems associated with metabolic syndrome. Ultimately you want to have a BMI less than or equal to 25.

Physical activity — You need at least 30 minutes of moderate intensity exercise five days a week for good health. Here are ways to fit more activity into a busy schedule.

  • Get off the bus a few stops early and walk the rest of the way.
  • Take the stairs instead of riding the elevator.
  • Park your car at the far end of the parking lot when running errands.
  • Walk or bike to work instead of driving.
  • Exercise while watching TV (stationary bike, lift weights, walk on the treadmill).
  • Take a brisk 10-minute walk in the morning, at lunch, and after dinner.
  • Use your manual wheelchair.
  • Rake your leaves instead of using a leaf blower.

Healthy diet — A diet high in fruits, vegetables, nuts, whole grains, olive oil and lean protein may reduce your risk of heart disease. A recent study published in the Archives of Internal Medicine showed that adding nuts to your diet can reduce the prevalence of metabolic syndrome by 13.7%. Using olive oil reduced metabolic syndrome prevalence by 6.7%. Without these changes, the prevalence of metabolic syndrome dropped by only 2%. To decrease your risk of metabolic syndrome:

  • Aim for 3 to 5 servings of fruits and vegetables daily.
    • Add fresh or frozen berries to your cereal.
    • Keep apples and bananas on hand for a quick and easy snack.
    • Add a side salad to your lunch or dinner.
    • Try baby carrots, celery, and grape tomatoes as an afternoon snack.
  • Eat healthy fats such as olive oil and canola oil.
    • Replace your cooking oil with olive and/or canola oil.
    • Try drizzling olive oil and balsamic vinegar on your salad.
    • Dip your bread in olive oil as an alternative to butter.
  • Eat small portions of nuts.
    • Keep walnuts, pecans, almonds and hazelnuts on hand for snacks.
    • Try adding chopped nuts to your salad.
    • Tip: A serving of nuts is equal to ¼ cup.
  • Limit red meat to 3 oz once or twice a week.
    • Avoid sausage, bacon, and other high fat meats.
  • Eat fish once or twice a week.
    • Salmon, trout, light tuna and herring are excellent choices.
    • Canned light tuna is a great way to add flavor and variety to a salad.
    • Try sautéing your fish in a small amount of olive oil.
  • Choose more whole grains.
    • Start your day with a bowl of whole grain cereal.
    • Warm up on a cold winter day with a bowl of hot oatmeal.
    • Make a trail mix with popcorn, nuts, and dried fruit.
    • Brown rice is a heart healthy alternative to white rice.

It's possible to reverse metabolic syndrome by making these changes to your diet, by losing weight and by exercising. If you reduce the number of risk factors to fewer than two, you will no longer meet criteria for a diagnosis of metabolic syndrome.

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Jill Pluhar R.D., L.D.N. is a registered dietitian working in the Department of Nutrition at Brigham and Women's Hospital. She completed her nutrition training at Oregon State University, and she holds a B.A. in Neuroscience and Behavior from Mount Holyoke College.

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