Metabolism is the process your body uses to get or make energy from the food you eat. Food is made up of proteins, carbohydrates and fats. Chemicals in your digestive system break the food parts down into sugars and acids, your body's fuel. Your body can use this fuel right away, or it can store the energy in your body tissues, such as your liver, muscles and body fat. A metabolic disorder occurs when abnormal chemical reactions in your body disrupt this process. When this happens, you might have too much of some substances or too little of other ones that you need to stay healthy.
As is true with many medical conditions, genetics and the environment both play important roles in the development of the metabolic syndrome. Genetic factors influence each individual component of the syndrome, and the syndrome itself. A family history that includes type 2 diabetes, hypertension, and early heart disease greatly increases the chance that an individual will develop the metabolic syndrome. Environmental issues such as low activity level, sedentary lifestyle, and progressive weight gain also contribute significantly to the risk of developing the metabolic syndrome. Metabolic syndrome is present in about 5% of people with normal body weight, 22% of those who are overweight and 60% of those considered obese. Adults who continue to gain five or more pounds per year raise their risk of developing metabolic syndrome by up to 45%. While obesity itself is likely the greatest risk factor, others factors of concern include: women who are post-menopausal, smoking, eating an excessively high carbohydrate diet, lack of activity (even without weight change), and consuming an alcohol-free diet.
Abdominal obesity: a waist circumference over 102 cm (40 in) in men and over 88 cm (35 inches) in women. Serum triglycerides 150 mg/dl or above. HDL cholesterol 40mg/dl or lower in men and 50mg/dl or lower in women. Blood pressure of 130/85 or more. Fasting blood glucose of 110 mg/dl or above. (Some groups say 100mg/dl) The World Health Organization (WHO) has slightly different criteria for the metabolic syndrome: High insulin levels, an elevated fasting blood glucose or an elevated post meal glucose alone with at least 2 of the following criteria: Abdominal obesity as defined by a waist to hip ratio of greater than 0.9, a body mass index of at least 30 kg/m2 or a waist measurement over 37 inches. Cholesterol panel showing a triglyceride level of at least 150 mg/dl or an HDL cholesterol lower than 35 mg/dl. Blood pressure of 140/90 or above (or on treatment for high blood pressure).
The major goals are to treat both the underlying cause of the syndrome, and also to treat the cardiovascular risk factors if they persist. As has been discussed, the majority of people with metabolic syndrome are overweight and lead a sedentary lifestyle. Lifestyle modification is the preferred treatment of metabolic syndrome. Weight reduction usually requires a specifically tailored multifaceted program that includes diet and exercise. Sometimes medications may be useful. Diet A detailed discussion of diet therapies, pros and cons of various diets etc. is beyond the scope of this article. However, there is now a trend toward the use of a Mediterranean diet -- one that is rich in "good" fats (olive oil) and contains a reasonable amount of carbohydrates and proteins (such as from fish and chicken). The Mediterranean diet is palatable and easily sustained. In addition, recent studies have shown that when compared to a low fat diet, people on the Mediterranean diet have a greater decrease in body weight, and also had greater improvements in blood pressure, cholesterol levels, and other markers of heart disease -- all of which are important in evaluating and treating metabolic syndrome. Exercise A sustainable exercise program, fore example 30 minutes five days a week is reasonable to start, providing there is no medical contraindication. (If you have any special concerns in this regard, check with your doctor first.) There is a beneficial effect of exercise on blood pressure, cholesterol levels, and insulin sensitivity, regardless of whether weight loss is achieved or not. Thus, exercise in itself is a helpful tool in treating metabolic syndrome. Cosmetic surgery to remove fat Some people may ask: Why not just have liposuction of the abdomen and remove the large amount abdominal fat, which is a big part of the problem? Data thus far shows no benefit in liposuction on insulin sensitivity, blood pressure, or cholesterol. As the saying goes, "If it's too good to be true, it probably is." Diet and exercise are still the preferred primary treatment of metabolic syndrome.