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Metabolic syndrome (also known as syndrome X) is a group of risk factors that can cause serious chronic conditions such as heart disease and diabetes. If you are overweight, have high blood pressure and high levels of sugar or fats in your blood, you may suffer from metabolic syndrome. Lifestyle modification is the treatment of choice for managing metabolic syndrome.

A person is deemed to have the metabolic syndrome when three or more of the following criteria are present:

1. waist circumference > 90 cm in men and 80 cm in women
2. triglyceride level of 1.7 mmol/l or more
3. HDL cholesterol of 1.0 mmol/l or less in men, and 1.3 mmol/l or less in women
4. blood pressure of 130/85 mmHg or more, or on treatment for high blood pressure
5. fasting glucose level of 6.1 mmol/l or more, or on treatment for diabetes.

Causes & risk factors

Risk factors for metabolic syndrome include:

• Age. The prevalence of metabolic syndrome increases with age.
• Race. In Singapore, there seems to have a higher proportion of metabolic syndrome among the Indians and Malays.
• Overweight/Obesity. A Body Mass Index (BMI) of 23 and above increases your risk of metabolic syndrome.
• Family history of diabetes. Women with high blood glucose during pregnancy (gestational diabetes) also have greater risk of getting metabolic syndrome.
• Other medical conditions. People with high blood pressure, lipid disorders, or polycystic ovarian syndrome have higher chance of developing metabolic syndrome.

The more risk factors you have, the higher your risk of getting heart disease. If you have all of the risk factors, you are six times as likely to get heart disease. Even if your cholesterol level is normal, you may still get a heart attack or stroke, if the other risk factors are present. If you have a history of Type 2 diabetes, you are likely to have the metabolic syndrome.

If you adopt a sedentary lifestyle and become obese, you are also likely to have a higher risk. In fact, metabolic syndrome (like Type 2 diabetes) can most often be prevented with exercise and weight loss. Anyone with a family history of Type 2 diabetes who is also overweight and who gets little exercise should be evaluated for the glucose, lipid and blood pressure abnormalities.

Signs & symptoms

The only obvious sign is a large waistline with an "apple-shaped" body figure. Most of the conditions linked to metabolic syndrome have no signs and symptoms. Persons with high blood glucose (diabetes) may have symptoms of increased thirst and urination, tiredness and blurred vision.

Treatment

Since physical inactivity and excess weight are the main risk factors to developing metabolic syndrome, getting more exercise and losing weight can help reduce the risk or prevent the complications associated with this condition. Medications may be prescribed to manage some of the underlying problems.

Prevention

Some of the ways you can reduce your risk include:

Exercise

The amount and type of exercise depends on your fitness level. If you have not been exercising regularly, you can start by walking for five minutes every day. If you have a medical problem, discuss with your doctor on a suitable exercise plan before you start. Once you are on a regular walking regime, you can gradually increase the distance and the pace of your walking. You should work towards the goal of walking for 30 to 60 minutes at least five days a week. If you are already exercising regularly, consider adding resistance exercises (e.g. carrying low weight dumbbells) to build muscle strength.

More information on exercise.

Diet

Your diet affects your likelihood of having the metabolic syndrome. Make healthy changes to what you eat so as to reduce the risk factors.

• Start by eating fewer calories, by eating less at each meal and avoiding dessert or food cooked using unhealthy methods such as deep frying. If you have to snack, opt for low-calorie foods such as carrot sticks. When eating out, ask for less gravy, sauces, or salad dressings. Also, cut down on the amount of fat added to your starches, (for example, by not putting butter on your slice of bread) and remove the skin from chicken after cooking and before eating.
   
• Try to eat less saturated fat by choosing reduced-fat or low-fat products instead of the full-fat versions. When it comes to meat, eat smaller portions of red meat or choose leaner cuts of meat. At least once a week, go without meat for your meals but do not replace meat with eggs or cheese or other food high in fat content.
   
• Eat more whole grains. Instead of white bread and white rice, choose whole wheat bread, brown rice, oatmeal, and puffed-grain cereals.
   
• Include fruits and vegetables in your diet. Every individual should have at least two servings of fruit and two servings of vegetables daily.
   
• Fish is also a good component to keep in your diet. With their omega-3 fatty acids, which are good for your heart, fish is definitely healthier than red meat. Avoid breading and frying the fish. Instead, choose to bake, broil or poach.
   
• Olive oil, canola oil, corn oil, soya oil and sunflower oil are healthier than lard or vegetable oil. For cooking, use the healthier oils.

Small changes like these will bring you huge benefits to your health so start making the changes today.