In the world of fitness and health, metabolic syndrome is the great unknown. Historically, metabolic syndrome was known as Syndrome X — largely because it was a multifaceted syndrome with an unclear treatment paradigm. Today, health professionals define metabolic syndrome as a cluster of symptoms and conditions that generally indicate poor cardiovascular health and increased risk for type 2 diabetes.

Understanding what metabolic syndrome is crucial because it can have a significant impact on your overall health and longevity. So, with this in mind, the next question is: are you at risk?

This article will explain what you need to know about metabolic syndrome, including how to recognize the signs, prevention tips, and treatment options. By the end of this article, you’ll have a clear understanding of the metabolic syndrome symptoms, how to identify them, and ways to improve metabolic health.

What is Metabolic Syndrome?

Metabolic Syndrome is a cluster of risk factors, including high blood pressure, high blood sugar, unhealthy cholesterol levels, excess abdominal fat, and high triglycerides, that together increase your risk for heart disease, stroke, and type 2 diabetes.

It is a serious health condition that often goes undiagnosed, but it can be managed and even prevented with lifestyle changes such as a healthy diet, regular physical activity, and weight management.

The American Heart Association, in tandem with the National Heart, Lung, and Blood Institute, describes it as a medical condition that meets at least three out of the five following conditions:

Summary: Conditions for Clinical Diagnosis (AHA/NHLBI)

The information above includes the standardized metrics; however, remember that depending on your health history and lifestyle, these could differ.

If you are experiencing one or two of the above symptoms, consider scheduling an appointment with your physician or healthcare provider to discuss your risk for metabolic syndrome.

Symptoms of Metabolic Syndrome

Metabolic syndrome is often called a “silent” condition because it may not show obvious symptoms until it has progressed. However, there are certain signs and conditions associated with metabolic syndrome that can signal an increased risk. Here are the key symptoms and indicators to watch for explained in more detail:

Increased Waist Circumference (Abdominal Obesity)

One of the most noticeable symptoms of metabolic syndrome is abdominal obesity, particularly visceral fat, which is fat stored around the organs. This type of fat is closely linked to insulin resistance and increases the risk of developing heart disease and diabetes.

• For women: A waist circumference greater than 35 inches.

• For men: A waist circumference greater than 40 inches.

High Blood Pressure (Hypertension)

Elevated blood pressure, especially a reading higher than 130/85 mm Hg, is a key component of metabolic syndrome. Hypertension can damage blood vessels and increase the risk of heart disease and stroke. Often, high blood pressure has no immediate symptoms, which is why it’s important to monitor it regularly.

Elevated Blood Sugar Levels

High blood sugar, or insulin resistance, occurs when the body cannot effectively use insulin to manage blood glucose. If your blood sugar level is consistently above 100 mg/dL (when fasting), this could be an early warning sign of metabolic syndrome.

Abnormal Cholesterol Levels

Having high levels of LDL cholesterol (the “bad” cholesterol) and low levels of HDL cholesterol (the “good” cholesterol) is another symptom of metabolic syndrome. Elevated LDL can lead to plaque buildup in arteries, increasing the risk of cardiovascular diseases.

• Low HDL cholesterol: Less than 50 mg/dL for women, less than 40 mg/dL for men.

• High LDL cholesterol: Over 129 mg/dL.

High Triglyceride Levels

Triglycerides are a type of fat found in the blood. Elevated triglyceride levels (150 mg/dL or higher) are a key sign of metabolic syndrome. High triglycerides often accompany other symptoms like obesity, high blood sugar, and high blood pressure.

Fatigue and Low Energy

People with metabolic syndrome may experience chronic fatigue and a general lack of energy. This is often linked to poor blood sugar control and insulin resistance, which affects the body’s ability to use glucose for energy.

Skin Changes (Acanthosis Nigricans)

One of the more visible signs of insulin resistance is the appearance of dark, velvety patches of skin in areas such as the neck, armpits, and groin. This condition is called acanthosis nigricans and can be an indicator of metabolic syndrome.

Metabolic Syndrome Causes

Metabolic syndrome is not caused by a single factor. Instead, it results from a combination of conditions that contribute to metabolic dysfunction in the body. This dysfunction stems from a variety of factors, including diet, exercise, sleep, and genetics. But at its core, metabolic syndrome is the outcome of disrupted metabolic homeostasis, which is the body’s ability to maintain a stable internal environment.

Metabolic Homeostasis

Metabolic homeostasis refers to the body’s ability to regulate energy balance, keeping things like glucose and fat levels in check to maintain stability. When this balance is disturbed, it can contribute to the development of metabolic syndrome.

Insulin and Glucose

One of the main contributors to metabolic syndrome is insulin resistance, a condition where the body becomes less responsive to the hormone insulin. This hormone regulates glucose levels in the body. Here’s how it works:

• After eating, when glucose levels in the blood rise, insulin is released by the pancreas to help the body absorb glucose and store it as energy. This maintains balanced glucose levels.

• However, when glucose levels stay elevated for prolonged periods (due to poor diet or genetics), the body becomes less sensitive to insulin. This insulin resistance can disrupt metabolic processes and lead to higher glucose levels, which is a key feature of metabolic syndrome.

Abnormal Fat Metabolism

One of the central causes of metabolic syndrome is dysregulated fat metabolism. When fat is not metabolized properly, it accumulates in tissues like the liver and muscle, leading to fat buildup (called fatty liver and intramuscular fat) and the onset of insulin resistance. This contributes to elevated triglycerides and LDL cholesterol, both of which are part of metabolic syndrome.

Chronic Inflammation

Chronic low-level inflammation is a common feature of metabolic syndrome. When the body’s fat cells expand, especially in the abdominal area, they produce inflammatory molecules that interfere with insulin’s ability to work effectively. This creates a cycle where inflammation worsens insulin resistance, contributing to the syndrome.

Hormonal Imbalances

Hormonal imbalances, such as those related to cortisol (stress hormone) or thyroid function, can lead to metabolic dysfunction. Elevated cortisol levels, often due to chronic stress, can lead to abdominal weight gain and insulin resistance. Additionally, low thyroid hormone levels can contribute to weight gain and poor metabolism.

Risk Factors for Metabolic Syndrome

These metabolic syndrome risk factors are not direct causes but are conditions that make you more susceptible to metabolic syndrome. Here’s a breakdown:

1. Obesity and Excess Belly Fat

Excess fat around your abdomen (specifically visceral fat) is one of the most important risk factors for metabolic syndrome. Visceral fat, which is stored deep inside your abdominal cavity, can disrupt normal metabolic processes and contribute to insulin resistance. If your waist circumference exceeds 35 inches for women or 40 inches for men, you’re at an increased risk for metabolic syndrome.

2. Age

As you get older, your risk of metabolic syndrome increases, particularly after the age of 45. While age alone is not a modifiable risk factor, the conditions that contribute to metabolic syndrome often become more prevalent as we age.

3. Genetics and Family History

A family history of type 2 diabetes, heart disease, or metabolic syndrome can increase your risk. Genetics can affect how your body handles glucose and fats, making you more susceptible to developing insulin resistance and the other components of metabolic syndrome.

4. Physical Inactivity

A lack of physical activity is a key risk factor. Regular exercise helps regulate blood sugar, improve cholesterol levels, and maintain a healthy weight. A sedentary lifestyle, on the other hand, increases the likelihood of developing obesity, insulin resistance, and high triglyceride levels, all of which are part of metabolic syndrome.

5. Poor Diet and Nutrition

A diet high in processed foods, refined sugars, and unhealthy fats can lead to obesity, insulin resistance, and high cholesterol levels. Consuming excess sugary beverages, fast food, and a lack of nutrient-dense foods like fruits, vegetables, and whole grains all contribute to metabolic syndrome.

6. Smoking

Smoking is another modifiable risk factor that can contribute to metabolic syndrome. It can raise blood pressure, cause inflammation, and damage blood vessels. Smoking also affects insulin sensitivity, contributing to the development of insulin resistance.

7. Sleep Apnea

Untreated sleep apnea has been linked to metabolic syndrome. Sleep apnea disrupts normal sleep patterns, affecting insulin sensitivity, glucose regulation, and fat metabolism, which can worsen the risk factors of metabolic syndrome.

How to Prevent Metabolic Syndrome

Preventing metabolic syndrome involves adopting a healthy lifestyle with a focus on diet, exercise, and overall wellness. Here’s a more detailed guide on the steps you can take to reduce your risk:

Adopt a Healthy, Balanced Diet

The food you eat plays a critical role in preventing metabolic syndrome. To maintain stable glucose levels and improve insulin sensitivity, aim for a diet that is:

• High in fiber: Fiber helps control blood sugar levels and promotes healthy digestion. Include plenty of vegetables, whole grains, legumes, and fruits in your meals. There is growing research that a high-fat, high-saturated diet may decrease insulin sensitivity.

• Low in refined sugars: Minimize your intake of sugary beverages, snacks, and processed foods. These can cause spikes in glucose and promote insulin resistance.

• Rich in healthy fats: Opt for healthy fats like those found in avocados, nuts, seeds, and olive oil. Healthy fats can support your heart health and help manage weight when consumed in moderation.

The Mediterranean diet is often recommended for those at risk of metabolic syndrome. This diet is rich in fruits, vegetables, whole grains, and healthy fats while being low in refined sugars and processed foods.

Stay Hydrated

Proper hydration is essential for metabolic health. Drinking enough water helps regulate blood sugar levels and supports overall cardiovascular function. Dehydration can cause blood sugar levels to rise, making it harder for your body to control glucose.

Incorporate Regular Physical Activity

Exercise is one of the most effective ways to improve metabolic health and reduce the risk of metabolic syndrome. Physical activity helps regulate blood sugar, improves insulin sensitivity, and aids in weight management.

Best Types of Exercise:

• Aerobic exercise: Activities like walking, running, swimming, and cycling improve cardiovascular health and help manage glucose levels.

• Strength training: Building muscle mass with weight training or bodyweight exercises can improve insulin sensitivity and support healthy metabolism.

Maintain a Healthy Weight

Obesity, particularly abdominal obesity, is one of the most significant risk factors for metabolic syndrome. Losing even a modest amount of weight can reduce your risk of developing the syndrome and improve insulin sensitivity.

Get Enough Sleep

Lack of sleep or poor sleep quality has been linked to metabolic syndrome. Chronic sleep deprivation can increase insulin resistance and contribute to weight gain. Aim for 7-9 hours of quality sleep each night to support metabolic health.

Manage Stress

Chronic stress can elevate cortisol levels, which in turn can contribute to weight gain, insulin resistance, and higher blood pressure. Stress management is crucial for preventing metabolic syndrome.

Stay on Top of Regular Health Screenings

Even if you’re not yet experiencing symptoms of metabolic syndrome, it’s important to monitor your blood pressure, blood sugar levels, and cholesterol levels regularly, especially if you’re at risk. Early detection can help prevent complications and allow for lifestyle adjustments before the condition progresses.

How Common is Metabolic Syndrome?

The prevalence of metabolic syndrome has remained relatively stable in recent years. (Remember: prevalence refers to the percentage of the population that is currently affected by a disease or syndrome, while incidence refers to the number of new cases each year.)

Currently, researchers estimate that around 50 million Americans are affected by metabolic syndrome, a significant portion of the population. This number has remained consistent in the United States over the past decade, despite various public health efforts aimed at addressing it.

However, some components of metabolic syndrome, such as high blood pressure, obesity, and high cholesterol levels, are becoming more common. Cases of these risk factors have been steadily increasing, which could lead to a rise in the overall clinical burden of metabolic syndrome in the coming years. This indicates that while the syndrome’s prevalence may not be growing rapidly, the impact on public health could significantly increase due to worsening individual risk factors.

In Summary

To recap, metabolic syndrome is a name for a set of symptoms and conditions revolving around cardiovascular health. Obesity and a high amount of visceral fat is a large risk factor for being diagnosed with metabolic syndrome. There are certain things you can do to prevent metabolic syndrome in your life, from focusing on minimizing your visceral fat to maximizing your lean mass which may lead to weight loss. A diet that boosts your HDL is also important, as well as hydration.

If these aren’t successful, future treatments are on the horizon. Remember that Body composition analysis can be an essential tool for understanding your approach to preventing the onset of metabolic syndrome. Knowledge about how to identify your risk for metabolic syndrome based on your body composition, as well as understanding the syndrome itself, can support you in making informed decisions throughout your healthcare journey.

**Jahnavi Curlin is a graduate of Harvard College and a physician-in-training. She currently writes on health and wellness for national and global publications.