Metabolic syndrome

What is metabolic syndrome?

Metabolic syndrome, sometimes called Syndrome X, is a condition that happens when a particular group of metabolic risk factors exist alongside each other in your body. If you have metabolic syndrome you have a higher risk of going on to develop type 2 diabetes. You may already have the early signs of type 2 diabetes.

‘Any syndrome is a cluster of conditions, and this particular syndrome is a cluster of three: high blood pressure, diabetes and obesity. It is also associated with high cholesterol levels,’ explains Julie Ward, senior cardiac nurse at the British Heart Foundation.

‘When you have this particular cluster of conditions, you are at even higher risk of cardiovascular conditions, such as heart attacks and strokes. So, you don’t only have one, you have three or four health problems going on. So the diabetes damages the blood vessels, the blood pressure damages the blood vessels, the obesity puts a lot of strain on the blood vessels and heart, and of course the cholesterol causes furring up of the arteries, which can lead to heart attacks and strokes.

‘This syndrome usually affects people who are overweight, are eating a poor diet, with high levels of sugar and fat, and have high cholesterol and high blood pressure. It is quite a serious condition, and if you have this you need to be under the care and supervision of your GP.’

Other factors that increase your risk of developing metabolic syndrome include:

• your age – your risk increases as you get older
• your race – certain ethnic groups, such as Asian and African Caribbean people, may be at greater risk
• other conditions – your risk is greater if you've had cardiovascular disease, non-alcoholic fatty liver disease (NAFLD), or, in women, polycystic ovary syndrome (PCOS)

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How is metabolic syndrome diagnosed?

For you to be diagnosed with metabolic syndrome, you are likely to have at least three, possibly more, of these risk factors:

• You are a man and obese, particularly around your middle. This applies if you are European with a waist measurement of 94cm or 37 inches. The equivalent waist measurement for men from South Asia is 90cm or 35.5 inches.
• You are a woman and obese, especially around your middle. Women from Europe and South Asia are at risk if they have a waist circumference of 80cm or 31.5 inches
• You have high levels of the bad cholesterol LDL, and low levels of the good cholesterol, HDL. These measurements are important, because they can result in a condition known as atherosclerosis, where fatty deposits narrow, and may eventually block your arteries.
• You carry out little or no physical activity.
• You have insulin resistance, which means that your body isn’t able to keep your blood sugar at the right levels, so you can have too much glucose in your bloodstream. This is associated with having type 2 diabetes. If you have metabolic syndrome you are at greater risk of developing type 2 diabetes.

Metabolic syndrome is also known as syndrome X, so you may hear this term occasionally.

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How common is metabolic syndrome?

The conditions that together cause metabolic syndrome, specifically, diabetes, high blood pressure and obesity, are all quite common. They also tend to be linked together – if you have one of these conditions the chances are that you are more likely to have the others.

If you have all three conditions it makes you more predisposed to having metabolic syndrome. This is probably why around one in four adults in the UK are living with metabolic syndrome. It also seems to become more common with age. It is estimated that nearly 30% of those aged over 50 in Europe have metabolic syndrome.

What are the dangers in having metabolic syndrome?

Metabolic syndrome isn’t a single condition, but a mixture of diseases that have serious implications for your health. The combination of high blood pressure, obesity and diabetes, puts metabolic syndrome high up the list of dangerous conditions.

One of the most serious risks that comes with metabolic syndrome is the possibility of developing coronary heart disease.  This happens when plaque, (a combination of  fatty material and fibrous tissue), is deposited in your arteries, making them narrower, and less flexible.

This condition is called atherosclerosis, and it slows down the blood flow to your heart. This can be the cause of serious health problems, because your arteries may become so narrow that they may eventually block the flow of blood, rich with oxygen, to your heart. Another possibility is that the plaque may rupture, causing a blood clot, which can slow or block your blood flow, stopping it reaching your heart. If this happens you can have a heart attack.

If you don’t already have type 2 diabetes, metabolic syndrome may increase your risk of developing this condition. Type 2 diabetes can cause heart and kidney disease, can affect your vision. Because it affects your circulation, it can also lead to problems with the blood supply to your feet and legs.

Obesity also increases your risk of developing type 2 diabetes, and coronary heart disease, as well as stroke and breast and bowel cancer. So having this condition adds to your chances of developing metabolic disease through diabetes and heart disease, and increases your risk of two other life-threatening conditions.

How is metabolic syndrome treated?

Your doctor will look at the conditions that you have and make sure that you are receiving the right treatment for all of these.

If you haven’t yet been diagnosed with metabolic syndrome, but are at risk of developing it, your medical team will probably focus on trying to stop it developing. This will depend on which risk factors you already have, and which may develop if you carry on as you are. Taking the correct medication, at the right time of day, is very important, as this can help prevent your condition becoming worse,

Making changes to the way you live may be able to prevent some of the various risk factors - type 2 diabetes, high blood pressure and obesity - developing, if you are able to make healthy life changes in time. According to the British Heart Foundation, making healthy changes to your life that lead to weight loss can improve metabolic syndrome, and can even rid you of this condition.

Change your diet and eating habits

Changing what you eat, and how often you eat may take some getting used to, but it can make a big difference to your health. Changing your diet, and losing weight is known to help reduce blood pressure, the level of glucose in your blood, and the size of your waist. All of these factors can contribute to improving your health and your well-being.

Heart-healthy diet habits

Making weight loss simple, and easy, will help you stay with your weight loss plan. So aim for slow and steady weight loss. The British Heart Foundation suggests one to two lbs (0.5-1kg) a week.

• Start by using a food diary, for a week or so before you plan to start changing your diet. Make a list of what you eat, and when you eat it, every day for a week. This should help you see how you can cut back on high-calorie food.
• Try to eat at least five portions of fruit and vegetables a day. Add fruit to your breakfast, have some for a mid-day and an afternoon snack, add salad to your lunch, and a couple more servings with dinner, and you’re there.
• Watch out for salt. You should try to keep your salt intake under 6g a day. Make sure you check the labels on tinned, frozen and packaged food, for their salt content.
• Remember that snacks count. Try to cut back on biscuits and cheese and crackers and other high-calorie treats.
• Cut back on saturated fats. They can raise your cholesterol levels, and your risk of heart disease. They are in sausages, cakes, biscuits, pies, butter, cheese and many other foods.
• Alcohol has calories too. A 175ml glass of wine can contain 159 calories, while a pub measure of vodka, and tonic, contains 96 calories.

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Do more exercise

The British Heart Foundation has recently published a report on physical activity in the UK. The results show that around 20 million adults are physically inactive. This means that they are at an increased risk of heart and circulatory disease, and so are at increased risk of premature death.

These figures are worrying, but, they don’t have to include you. Unless you are unwell, and have health reasons for not being active, put on a pair of comfortable shoes, and start walking. This is the easiest form of exercise you can take. It involves very little expense, and can very quickly make you feel better, both physically and mentally. It can also help you make new friends. Look online, for walking groups in your area.

This doesn’t mean that you can’t try other forms of exercise. Swimming is a good, gentle way of exercising, and has been found to reduce the risk of heart disease, stroke and type 2 diabetes. If you can’t swim, or are out of practice, ask about lessons at your local sports centre or swimming pool.

Whatever exercise you choose to do, make sure you do it regularly, and keep it up. Research has found that people who do regular exercise reduce their risk of chronic health problems including type 2 diabetes and some types of cancer.

What if lifestyle changes don’t work to treat metabolic syndrome?

Following the advice on changing your lifestyle is important in helping you to feel and be healthier. Even if it doesn’t prevent or help reverse metabolic syndrome, you will still be taking positive steps to improve your health.

However, that doesn’t mean that you should ignore the medical issues that make up your metabolic syndrome. People with this condition don’t all have exactly the same contributing health issues, so you need to focus on the conditions that affect you.

High blood pressure, type 2 diabetes, obesity and high cholesterol can all combine to cause metabolic syndrome. Make sure that you talk to your GP about the conditions that you have (you may not have all of those mentioned above, and may have other conditions, such as cardiovascular disease, that need treating).

Taking good care of your health when you have multiple conditions may seem complicated, but it is important.

• Make sure that you take you medication regularly, and at the right time of day.
• Eat a healthy diet, and if you are overweight, try to lose weight.
• Exercise regularly – start gently and build up the time you spend exercising.
• If you smoke, stop. Ask your GP for help quitting.
• Cut back on your drinking. Having too much alcohol on a regular basis can have long-term effects on your health, including cancer, liver disease and stroke.

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