Metabolic syndrome is a term often used in healthcare, but not everyone understands what it really means or why it’s important. Rather than being a single disease, metabolic syndrome is a cluster of conditions that occur together, increasing the risk of serious health problems such as heart disease, type 2 diabetes, and stroke. Here’s the low-down on what metabolic syndrome is, its causes, its symptoms, how it’s diagnosed, and how it can be managed and treated effectively.
What Is Metabolic Syndrome?
Metabolic syndrome is not a disease but a collection of risk factors that raise the likelihood of developing chronic health conditions. It is sometimes referred to as metabolic syndrome X, metabolic disorder, or insulin resistance syndrome. These factors include:
1. High blood pressure (≥130/85 mmHg)
2. Elevated fasting blood sugar levels (aka blood glucose ≥5.6 mmol/L)
3. High triglycerides (a type of fat that circulates in the blood stream and is stored in fat cells ≥1.7 mmol/L)
4. Low HDL cholesterol (high-density lipoprotein cholesterol, or ‘good cholesterol’ <1.0 mmol/L for men and <1.3 mmol/L for women)
5. Abdominal obesity, often defined as a waist circumference >102 cm for men and >88 cm for women.
If you have at least three of these markers, you may have metabolic syndrome.
Though these risk factors might develop independently, when they occur together, they significantly increase the likelihood of cardiovascular disease (e.g. heart attack and stroke), type 2 diabetes (aka type 2 diabetes mellitus), non-alcoholic fatty liver disease (NAFLD), and kidney disease.
The Role of Inflammation in Metabolic Syndrome
Recent research highlights the role of inflammation in metabolic syndrome. It’s not entirely clear whether inflammation causes metabolic syndrome or if metabolic syndrome leads to inflammation, but the two are closely linked. Excessive fat, particularly visceral fat around the organs (known as central obesity), is thought to play a pivotal role.
Visceral fat becomes inflamed and secretes inflammatory molecules known as cytokines. These cytokines disrupt normal metabolism and impair insulin signalling, making the body less sensitive to insulin. This insulin resistance is a defining feature of metabolic syndrome. Once insulin resistance develops, blood sugar levels rise, further exacerbating inflammation and creating a vicious cycle.
Inflammation also damages the lining of blood vessels, increasing the risk of atherosclerosis (plaque buildup in the arteries). This damage makes the blood vessels more prone to clot formation and reduces their ability to relax, a process regulated by nitric oxide. The result is higher blood pressure and an increased risk of cardiovascular events.
Moreover, inflammation disrupts lipid metabolism, leading to high cholesterol, a high triglyceride level, lower HDL cholesterol, and fatty deposits in the blood vessels. Emerging evidence also suggests that the gut microbiome may contribute to this systemic inflammation, as imbalances in gut bacteria (known as dysbiosis) can trigger immune responses that worsen metabolic syndrome.
What Causes Metabolic Syndrome?
The causes of metabolic syndrome are multifactorial, involving a combination of genetic predisposition, lifestyle factors, and environmental influences.
One major contributor is a sedentary lifestyle coupled with a diet high in saturated fat, refined sugars, and ultra-processed foods. These dietary habits not only lead to weight gain but also contribute to gut dysbiosis and abnormal cholesterol levels. Lack of exercise further compounds the problem by reducing insulin sensitivity and promoting abdominal fat storage.
Genetics also play a role. Individuals with a family history of diabetes, cardiovascular disease, or other metabolic disorders are at higher risk. Additionally, the risk of metabolic syndrome increases with age, with a particularly high prevalence in individuals over 50.
Hormonal imbalances, such as those seen in polycystic ovarian syndrome (aka PCOS), are also associated with metabolic syndrome. Chronic stress is another contributing factor, as elevated cortisol levels from prolonged stress can lead to weight gain, insulin resistance, and unhealthy eating habits.
What Does Metabolic Syndrome Feel Like?
Metabolic syndrome itself doesn’t always produce noticeable symptoms, but the individual components can.
High blood pressure often goes unnoticed, but sometimes cause headaches or dizziness, while elevated blood sugar can lead to fatigue, increased thirst, and the need to pee more often. Abdominal obesity can creep up on people (many people aren’t really aware of how overweight they may be), but some people certainly notice being ‘out of puff’ when climbing stairs or have a general feeling of ‘being unfit’. High triglycerides and low HDL cholesterol don’t tend to cause symptoms, and yet they significantly elevate cardiovascular risk. This is why it’s key to have a check up on a regular basis.
How Is Metabolic Syndrome Diagnosed?
Diagnosing metabolic syndrome involves taking a history, physical examination and laboratory tests. We measure waist circumference to check for abdominal obesity and take blood pressure readings to see if you are developing hypertension (high blood pressure). Next, we take blood tests to measure fasting glucose, HbA1c, triglycerides, HDL cholesterol, and LDL cholesterol.
In some cases, metabolic syndrome is ‘picked up’ because the person has abnormal liver function tests (LFTs), prompting an ultrasound that reveals fatty liver disease. This is why it’s so important to have regular health checks.
What Is the Best Diet for Metabolic Syndrome?
Diet plays a central role in managing metabolic syndrome. A healthy diet can improve all components of the condition and significantly reduce the risk of complications.
Following a ‘Mediterranean diet’ is a great way to tackle metabolic syndrome, focusing on fresh vegetables, fruits, whole grains, lean proteins, and healthy fats like olive oil. This diet also limits saturated fats, processed foods, and refined sugars, which contribute to weight gain and poor metabolic health.
Fibre-rich foods such as legumes and wholegrains improve insulin sensitivity and even our your blood glucose level, while omega-3 fatty acids found in fish help reduce inflammation and improve lipid profiles. Cutting down on your salt intake is crucial for managing blood pressure.
How Is Metabolic Syndrome Treated?
Treatment for metabolic syndrome involves a combination of lifestyle changes, medical management, and regular monitoring.
Lifestyle changes
are the cornerstone of treatment. These include adopting a healthier diet, engaging in regular physical activity, getting to a healthy weight, and managing stress through techniques like mindfulness or yoga. Even modest weight loss can significantly improve metabolic markers and reduce health risks.
Medications
may be prescribed to address specific components of metabolic syndrome. For example, antihypertensive drugs manage high blood pressure, statins lower cholesterol, and metformin improves insulin sensitivity in individuals with high blood sugar or type 2 diabetes. Aspirin may also be recommended to reduce the risk of blood clots.
Regular monitoring is essential to track blood pressure, glucose levels, cholesterol, and liver function. Screening for complications such as type 2 diabetes, NAFLD, and cardiovascular means we can take action, promptly.
The Psychological Impact of Metabolic Syndrome
Chronic stress and mental health challenges often accompany metabolic syndrome. Stress-induced eating and poor dietary choices can worsen the condition. Even knowing that you have metabolic syndrome can weigh heavy on your mind. This is why we believe in adopting a ‘whole person’ approach to treating metabolic syndrome. As the saying goes, ‘the body keeps the score’! On the flip-side, having knowledge of what is happening can enable you to make a start, and take back control of your health.
Metabolic syndrome is common, affecting millions of people worldwide, but it is also manageable and, in some cases, reversible. By understanding its causes, symptoms, and treatments, you can take proactive steps to improve your health and reduce the risk of complications.
If you think you might have metabolic syndrome, booking an appointment with a GP is the first step. At Essex Private Doctors, we provide personalised care tailored to your unique needs, helping you regain control of your health and well-being. Take charge today for a healthier tomorrow.
