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Publix GreenWise Market Magazine - Summer 2009
Risky Business
Without a catchy name or a celebrity spokesperson, it’s no wonder metabolic syndrome enjoys low public awareness. In a large recent survey, fewer than 15 percent of U.S. adults said they’d even heard of the syndrome, and under 1 percent said they’d been diagnosed with it (International Journal of Clinical Practice, August 2008). Yet based on previous research, about one-quarter of adults actually meet the diagnostic criteria. This discrepancy is unfortunate because this is one condition that may yield readily to lifestyle changes.
The American Heart Association estimates that approximately 47 million adults in the United States have metabolic syndrome, a cluster of risk factors that increase the chance of developing heart disease, stroke and diabetes. But until recently, even scientists referred to it as Syndrome X, a generic tag for what should by all rights be a brand-name condition.
Even if you know the name, you probably can’t rattle off all the risk factors that can lead to metabolic syndrome. It’s worth familiarizing yourself with them because, taken together, they pose a major threat to your health. In general, people with metabolic syndrome are twice as likely as those without it to develop heart disease and five times as likely to develop diabetes.
Three Strikes
Ready to wise up? Metabolic syndrome is defined as having at least three of the following:
- A large waistline: Referred to as “an apple-shape” body.
- Above-normal triglycerides: 150 mg/dL or higher.
- Low HDL (“good”) cholesterol: Below 40 mg/dL in men and under 50 mg/dL in women.
- Above-normal blood pressure: Systolic blood pressure (the upper number) of 130 mm Hg or higher or diastolic blood pressure (the lower number) of 85 mm Hg or higher.
- Above-normal blood glucose (sugar): Fasting glucose of 100 mg/dL or higher.
You can have any of these components alone, but they tend to occur together—and the more of them you have, the greater the health threat. One thing these risk factors have in common is that they’re all associated with obesity, especially excess fat around the abdomen.
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Obesity can lead to insulin resistance, a condition in which the body can’t efficiently use insulin, a hormone that helps convert blood glucose into energy. When the body is resistant to insulin, excess glucose can build up in the blood, setting the stage for diabetes. Insulin resistance also is associated with high blood pressure, high triglycerides and low HDL, all of which raise the risk of cardiovascular disease.
The relationship between obesity and insulin resistance is complicated, though. Genes can boost your odds of becoming insulin-resistant, even if you have only a small spare tire. On the other hand, physical activity can help insulin work better, even if you don’t lose weight.
Beat The Odds
You can’t change your genes, but you can change your lifestyle—and that’s often enough to prevent or treat metabolic syndrome. “All of the components of metabolic syndrome are favorably affected by an increase in physical activity combined with a healthful diet,” says Robert Ross, Ph.D., professor of kinesiology and health studies at Queen’s University in Kingston, Ontario.
Here’s how to help yourself to better metabolic health:
Move more. Aim for 30 to 60 minutes of moderate-intensity physical activity five or more days a week. If doing it all at once is a problem, you can break up your daily total into chunks of 10 minutes or longer. Results vary from person to person, but on average, Ross says, regular exercise combined with a healthful diet reduces blood pressure by 3 to 4 mm Hg and decreases waist circumference by 6 percent, triglycerides by 12 percent and fasting glucose in people with diabetes by 15 percent. It also increases HDL by an average of 4 percent, making exercise an all-around antidote.
Be a picky eater. A steady diet of burgers, fries and soda may supersize both your waistline and your health risk. A recent study found that a Western diet pattern—characterized by high intakes of refined grains, fried foods and red and processed meats—was associated with an increased risk of developing metabolic syndrome (Circulation, February 2008).
“The message is to eat more fish, chicken, fruit, vegetables and whole grains,” says study coauthor Lyn Steffen, Ph.D., R.D., an associate professor of epidemiology at the University of Minnesota. Surprisingly, people who drank diet soda also were at increased risk, while dairy products seemed to be protective. “We should also go back to drinking low-fat milk instead of soda,” Steffen says.
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Watch your weight. To shed extra pounds, combine exercise with moderate cuts in calories. Consuming 500 to 700 fewer calories a day can lead to improvements in waist circumference, triglycerides, HDL and blood pressure as well as reductions in blood glucose for those with diabetes, says Ross.
Eat three squares. A Swedish study found that eating breakfast, lunch and dinner every day was associated with a reduced risk of developing metabolic syndrome (Obesity, June 2008). So resist the temptation to skip meals in an effort to lose weight. Just be sure to watch those portion sizes, says Steffen.
Hit the sack. “Inadequate sleep has been shown to compromise insulin sensitivity, increase hunger and raise blood pressure in experimental studies,” says James Gangwisch, Ph.D., an assistant professor in the department of cognitive neuroscience at Columbia University. Aim for seven to nine hours of sleep a night.
Dial down stress. A British study found that employees who faced chronic stress at work were more than twice as likely as those without work stress to develop metabolic syndrome, after other risk factors were taken into account (BMJ, March 2006). Make relaxation a priority. Set aside time each day to visit with friends, engage in exercise, pursue a hobby or just sit quietly.
Stub out cigarettes. Smoking can raise triglyceride levels and lower HDL cholesterol. Plus, smoking is a major contributor to cardiovascular disease in its own right. If you’re trying to quit, you can double your chances of success by using proven cessation methods, such as medication or counseling.
When lifestyle changes aren’t enough, your doctor may prescribe medications to help treat unhealthy blood fat levels, high blood pressure and high blood glucose. So don’t hesitate to ask about your level of risk for this silent condition. It’s time to talk about metabolic syndrome—and the steps you can take to derail it.
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Are You At Risk?
While a diagnosis of metabolic syndrome requires that you have at least three of the designated factors, having even one can increase your risk of eventually developing the condition. This quick checklist can help you assess your odds.
- 1. Is your waist measurement:
- 40 inches or more if you’re a man?
- OR
- 35 inches or more if you’re a woman?
- 2. Is your blood glucose level:
- 100 mg/dL or higher on a fasting glucose test (measured after not eating overnight)?
- OR
- 140 mg/dL or higher on a glucose tolerance test (measured after eight hours of fasting and two hours after drinking a sugar solution)?
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3. Do you get less than 30 minutes of moderate physical activity most days of the week?
4. Is your body mass index (BMI) 25 or above? (To calculate your BMI: first, multiply your weight in pounds by 703; second, divide that answer by your height in inches; third, divide that answer by your height in inches again.)
5. Have you ever been diagnosed with diabetes?
6. Do you have a parent or sibling with diabetes?
7. Have you ever been diagnosed with high blood pressure or heart disease?
8. Are you age 60 or older?
9. Are you of Mexican American or South Asian descent?
10. Are you a woman with polycystic ovarian syndrome (a tendency to develop cysts on the ovaries)?
A “yes” answer to any of the first three questions: Highest risk
A “yes” answer to any of the other questions: Increased risk |
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