"Metabolic Syndrome" Increases the Risk of Chronic Diseases
Dr. Wala’a Hafez
Although approximately one in four adults in the United Kingdom suffers from metabolic syndrome, also known as dysmetabolic syndrome, many are unaware of what it entails. Previously known by various names, such as Syndrome X and insulin resistance syndrome, its diagnostic criteria have evolved alongside research advancements. While it may not cause obvious symptoms, it is linked to an increased risk of heart disease, kidney disease, stroke, diabetes, liver failure, and premature death. A recent global study also indicated that its prevalence has nearly doubled over the past two decades. So, what is metabolic syndrome, and how can it be managed? Here are the details, according to the British newspaper The Telegraph.
**How the Body Processes Fats**
Understanding metabolic syndrome, according to Professor Stephen O’Rahilly, begins with understanding how the body handles fats. The problem is not the fats themselves, but their accumulation in inappropriate locations. Adipose tissue plays a crucial role in storing excess energy; however, when food intake exceeds its storage capacity, fats are redirected to the liver, blood vessels, and other organs. This accumulation can lead to insulin resistance, high blood sugar, and hypertension, placing additional strain on the heart and kidneys. Gradually, a cluster of disorders emerges, contributing to the development of metabolic syndrome.
**Not All Fats Are Alike**
The risks associated with fat are not determined solely by quantity, but by where it is stored and distributed. Visceral fat, which accumulates around internal organs, is linked to an increased risk of metabolic disorders, whereas subcutaneous fat serves as a relatively safer storage depot. Individuals’ capacity to store fat safely varies significantly and is largely influenced by genetic factors.
Professor O’Rahilly points out that a reduced ability to store fat in the buttocks and thighs may increase the risk of developing metabolic syndrome. Consequently, some obese individuals may enjoy relatively good metabolic health because their bodies store fat in safer locations. Fat distribution and its impact on health vary by age and sex. Notably, about 25% of obese individuals do not suffer from metabolic disturbances, despite the persistence of other obesity-related risks. Conversely, a severe deficiency in adipose tissue can lead to early-onset diabetes, fatty liver disease, and hypertension due to the impaired ability to store fat safely.
**Key Indicators**
Metabolic syndrome is defined as a cluster of metabolic risk factors occurring simultaneously. A person is typically diagnosed with metabolic syndrome if they exhibit three or more of the following factors:
* Increased waist circumference, indicating abdominal fat accumulation.
* Elevated blood glucose levels.
* Elevated triglyceride levels.
* High blood pressure.
* Low levels of high-density lipoprotein (HDL) cholesterol, commonly known as “good cholesterol.”
However, the definition and diagnostic criteria for metabolic syndrome remain a subject of debate among experts, with some criteria varying across medical organizations and studies. German endocrinologist Professor Norbert Stefan argues that the current definition may be too narrow. It fails to consider a person “metabolically healthy” simply because they exhibit only two of the aforementioned risk factors. For instance, if a person has both high blood pressure and high blood sugar, the presence of these two factors alone may suffice to indicate an increased risk of metabolic-related diseases. Therefore, many experts believe that having two or more factors may be sufficient to classify a person as having a high metabolic risk, rather than requiring three.
**Body Shape Matters**
Professor Stefan emphasizes that body shape and fat distribution are important factors in assessing metabolic health, not just waist circumference. Increased fat around the abdomen is associated with higher visceral fat and metabolic risks, while fat around the hips and thighs is relatively safer. Thus, the critical issue is not just the amount of fat, but where it is stored.
**Managing Metabolic Syndrome**
The good news is that metabolic syndrome responds significantly to lifestyle changes. Even small, consistent improvements in daily habits can help improve insulin sensitivity, lower blood pressure, reduce fat accumulation in the liver, and improve cholesterol levels. The key strategies for managing metabolic syndrome include:
1. **Eat Better, Not Less**
Focusing solely on calorie reduction may not be sufficient. The quality of food, timing of meals, and distribution throughout the day also affect insulin levels, inflammation, and appetite. Therefore, it is better to focus on nutrient-dense, minimally processed foods while reducing sugary and manufactured items.
2. **Include Protein in Every Meal**
It is best to distribute protein intake across daily meals. This helps regulate blood sugar spikes, preserve muscle mass, and enhance feelings of fullness. Sources include fish, eggs, lean meats, legumes, and plant-based options.
3. **Choose Carbohydrates Carefully**
Refined carbohydrates and sugars can cause rapid blood sugar spikes. Therefore, it is advisable to choose whole grains and vegetables while reducing white bread, white rice, and sugary drinks. Additionally, consuming vegetables and protein before carbohydrates can help mitigate post-meal blood sugar spikes.
4. **Move After Eating**
Walking for 10–15 minutes after a meal helps lower blood sugar by stimulating muscles to use glucose and reducing the need for insulin. It is also advisable to avoid constant snacking and allow appropriate intervals between meals, which supports lower insulin levels and the use of stored fat for energy without requiring strict fasting.
5. **Build Strong Muscle Mass**
Muscles are among the most important tissues for glucose consumption. Therefore, resistance exercises, such as weightlifting, help improve insulin sensitivity and maintain muscle mass. This is not limited to organized sports; daily movement is also important, such as taking the stairs and avoiding prolonged sitting. Generally, at least 150 minutes of moderate aerobic activity per week is recommended, along with more intense exercises once or twice a week, depending on ability and health status.
6. **Prioritize Sleep**
Sleep is no less important than diet and physical activity in maintaining metabolic health. Sleep deprivation can disrupt hormones that regulate appetite, increase the desire for highly processed foods, and cause a temporary decrease in insulin sensitivity. Therefore, it is recommended to maintain regular sleep and wake times, reduce exposure to blue light in the evening, and avoid heavy meals and alcohol before bed.
7. **Manage Chronic Stress**
Chronic stress and elevated cortisol levels can increase abdominal fat, raise blood sugar and blood pressure, and affect appetite. Therefore, stress management techniques, such as meditation, yoga, breathing exercises, and mindfulness, can support metabolic health.
