What you need to know about metabolic syndrome

Metabolic syndrome is a clustering of several heart disease risk factors.

The prevalence in Africa is increasing, and it tends to increase with age. This is thought to be due to departure from traditional African to western lifestyles. In Africa, it is also becoming common among young people.

Obesity and dyslipidemia (an abnormal amount of lipids – triglycerides, cholesterol and/or fat phospholipids – in the blood) seem to be the most common. While obesity appears more common in females, hypertension tends to be more predominant in males. Insulin resistance remains the most important underlying cause.

One in every two South Africans suffers from obesity, which increases the individual’s risk to develop metabolic syndrome.

In the future, metabolic syndrome may overtake smoking as the leading risk factor for heart disease. It is estimated that already one in every four South Africans already have the syndrome.

Picture: iStock

You have metabolic syndrome when you have the following cluster of conditions:

• Increased blood pressure
• High blood sugar
• Excess body fat around the waist, and
• Abnormal cholesterol or triglyceride levels.

With all these, you are at increased risk of developing heart disease, stroke and diabetes.

If you have metabolic syndrome or any of its components, aggressive lifestyle changes can delay or even prevent the development of serious health problems. Your risk for heart disease, diabetes and stroke increases with the number of metabolic risk factors you have.

Blood pressure. Picture: iStock

Causes

The most obvious cause is being overweight and obese, and lack of physical activity.

Insulin resistance is also closely linked to metabolic syndrome. Insulin is a hormone made by your pancreas that helps break down the sugar that you take in to be used as fuel by the cells.

In people with insulin resistance, cells don’t respond normally to insulin, and glucose can’t enter the cells as easily. As a result, glucose levels in your blood rise.

Risk factors

• Age. Your risk of metabolic syndrome increases with age.

• Obesity. Carrying too much weight, especially in your abdomen, increases your risk.

• Diabetes. You’re more likely to get it if you had diabetes during pregnancy (gestational diabetes) or if you have a family history of type 2 diabetes.

• Your risk is higher if you’ve ever had cardiovascular disease, nonalcoholic fatty liver disease or polycystic ovary syndrome.

Gestational diabetes. Picture: iStock

Complications

The complications are very serious and chronic and they include:

• Hardening of the arteries (atherosclerosis)
• Diabetes mellitus
• Heart attack
• Kidney disease
• Stroke
• Nonalcoholic fatty liver disease
• Peripheral artery disease
• Cardiovascular disease

Further complications may occur from having diabetes mellitus, and they include:

• Eye damage (retinopathy)
• Nerve damage (neuropathy)
• Kidney disease
• Amputation of limbs

Heart attack. Picture: iStock

Diagnosis

According to guidelines used by the National Institutes of Health, you have metabolic syndrome if you have three or more of these conditions:

• Large waist circumference: a waistline that measures more than 90cm for women and 102 cm for men;

• High triglyceride level: fat levels more than 1.7 mmol/L in blood;

• Reduced high-density lipoprotein (HDL) cholesterol: this is the good cholesterol found in blood tests;

• Increased blood pressure: blood pressure more than 140/90 mmHg;

• Elevated fasting blood sugar: blood sugar of more than 6mmol/l tested in the morning before you have anything to eat.

Picture: iStock

Treatment

Aggressive lifestyle changes, such as diet and exercise, will be necessary. Speak to a dietician and physician. Other changes may include losing between seven and 10% of your current weight and getting at least 30 minutes of moderate to intense exercise five to seven days a week.

In situations where there are already increased blood pressure, blood sugar and cholesterol abnormalities, medical treatment will also have to be included.

With the prescribed lifestyle changes, dosages of medication required will be reduced and you may even be able to stop treatment if successful.

This lifestyle is a lifelong commitment. Successfully controlling metabolic syndrome requires long-term effort and teamwork with your health care providers.

Picture: iStock

Prevention

Preventing metabolic syndrome is possible. Maintaining a healthy waist circumference, healthy blood pressure levels and healthy cholesterol levels reduce your risk.

In particular, you should eat a healthy diet that is very low in carbohydrates and sugars. Be careful of the hidden sugars in fruit and juices (nature’s candy), cereals, condiments.

Regular physical activity will reduce your blood pressure, blood sugar levels, and cholesterol levels. The key is to try to maintain a healthy weight (talk to your healthcare provider).

Get your blood pressure, sugar and cholesterol checked regularly and measure your waist circumference.

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