Metabolic Syndrome

Pennington Biomedical Research Center

Division of Education

PBRC 2009

Metabolic Syndrome: y Overview

Metabolic Syndrome is not a disease, but rather a cluster of disorders of your bodys metabolism, including:
o o o o

High blood pressure High insulin levels Excess body weight Abnormal cholesterol levels

Each of these disorders is by itself a risk factor for other diseases. In combination combination, however however, these disorders dramatically boost the chances of developing potentially life-threatening illnesses, such as diabetes, heart disease or stroke.

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Signs and Symptoms

The more components of the syndrome that you have, the greater the risks to your health. health
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Metabolic Syndrome y

The syndrome is closely related to a generalized metabolic disorder called insulin resistance, in which the body cant use insulin efficiently. Metabolic syndrome has been called many names, names including:
o o o

Syndrome X The deadly quartet Insulin Resistance Syndrome

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Prevalence

Affects as many y as one in four American adults (25%) For adults over the age of 40, more than 40% are affected. Metabolic syndrome prevalence has increased by 61% over the past decade. Rates differ among races and genders.

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National Health and Nutrition Examination Survey III, 1988-1994.

Risk Factors
The following factors increase your risk of developing Metabolic Syndrome:
Apple Pear

Age R Race Obesity

The prevalence of metabolic syndrome increases with age, affecting less than 10% of people in their 20s and 40% of people in their 60s. Metabolic M t b li syndrome d is i generally ll more common among blacks bl k and dM Mexican-Americans i A i than th among Caucasians. A body mass index (BMI) greater than 25 increases your risk of metabolic syndrome and abdominal obesity increase the risk of MS. Abdominal obesity refers to having an apple shape rather than a pear. Having a family history of type 2 diabetes or diabetes during pregnancy (gestational diabetes) increases the risk for developing metabolic syndrome. A diagnosis of hypertension, cardiovascular disease (CVD) or polycystic ovary syndrome (a hormonal disorder in which a womans body produces an excess of male hormones) also increases the risk for metabolic syndrome. syndrome
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History of diabetes Other diseases

When is it time to seek medical advice?

The presence of one feature of metabolic syndrome, such as high blood pressure, high cholesterol or an apple-shaped body, increases the risk. An individual may y already y have the condition and not know it. It is important to talk with your doctor about testing for other components of the syndrome and developing a plan to avoid serious diseases. diseases

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Prevention
Healthy lifestyle changes can prevent the onset of the syndrome.

Commit to a healthy diet o A healthy diet includes plenty of fruits and vegetables, choosing lean cuts of white meat and fish over red meat, avoiding processed or deep-fried p dinners, , and eliminating g table salt by y experimenting p g with other herbs and spices. Get moving o It i is iimportant t t to t stay t active. ti Get G t at t least l t 30 minutes i t of f moderately d t l strenuous activity on most days of the week is recommended. Schedule regular g check-ups p o This includes assessing blood pressure, cholesterol and blood sugar levels annually. Early detection of problems can help with formulating lifestyle modifications.

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Diagnosing g g Metabolic Syndrome y

According to the National Cholesterol Education Program (NCEP), the presence of three or more of the following traits indicates metabolic syndrome:

Waist Circumference o Greater than 35 inches in women and 40 inches in men (abdominal obesity) Triglyceride o Levels of 150 milligrams per deciliter (mg/dl) or higher Blood Bl dP Pressure o 130/85 millimeters of mercury or higher Fasting blood glucose o Level of 110 mg/dl or higher High-density lipoprotein cholesterol (HDL) o Lower than 50 mg/dl in women and 40 mg/dl for men
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Treatment

The underlying insulin resistant state is the primary target of therapy. The primary goal of treatment is to prevent: o Type 2 diabetes o Heart attack o Stroke

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Treatment

To reduce d insulin l resistance in overweight h and d obese b individuals, d d l the h preferred f d method is an aggressive regimen of self-care strategies focusing on diet and exercise. It is common for your doctor to routinely monitor the following to ensure that lifestyle modifications are working: o Weight o Blood glucose o Cholesterol o Blood pressure

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Self-care
Although metabolic syndrome creates a real risk for developing diabetes, stroke or heart disease, these conditions can be prevented. Insulin resistance can be controlled by the following:

Lose weight o Losing as little as 5 to 10% of your body weight can reduce insulin levels and high blood pressure, pressure thus reducing your risk of diabetes diabetes. Exercise o Walking just 30 minutes a day or engaging in other aerobic activities can help prevent the serious diseases associated with MS. Stop smoking o Smoking cigarettes increases insulin resistance and worsens health consequences associated with MS. Eat fiber fiber-rich rich foods o Whole grains, beans, fruits and vegetables are high in dietary fiber. These are important foods to eat since dietary fiber is known to lower insulin levels.

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Treatment
Medications to control the syndromes individual risk factors include:

Weight l loss drugs d

Along with diet and exercise, it may be necessary to prescribe weight loss drugs. T commonly Two l prescribed ib d weight-loss i ht l d drugs iinclude l d sibutramine ib t i (M (Meridia) idi ) and d orlistat (Xenical). In individuals with diabetes, diabetes doctors often prescribe thiazolidinediones and metformin (Glucophage, Glucophage XR) to decrease insulin resistance. These medications may also be useful in improving insulin metabolism in individuals with MS.

Insulin sensitizers

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Treatment
Medications to control the syndromes individual risk factors include:
Aspirin Medications to lower blood pressure p Medications to regulate cholesterol Aspirin is often prescribed to help reduce the risk for a heart attack. Major types of medications used to control high blood pressure include diuretics, angiotensin-converting enzymes (ACE) inhibitors, calcium channel blockers and beta blockers. Medications such as niacin, statins and fibrates can help improve cholesterol in the following ways: By reducing the level of low-density lipoprotein (LDL) cholesterol (bad cholesterol) B increasing By i i the th level l l of f hi high-density h d it (HDL) cholesterol h l t l ( (good d cholesterol) h l t l) By decreasing the level of triglycerides (Another bad component of cholesterol)

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PhillipBrantley,PhD,Director PenningtonBiomedicalResearchCenter ClaudeBouchard, Bouchard PhD, PhD ExecutiveDirector HeliJ.Roy,PhD,RD ShannaLundy,BS BethKalicki

DivisionofEducation

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Edited: October 2009

About Our Company p y

The Pennington Biomedical Research Center is a world-renowned nutrition research center. Mission: To promote healthier lives through research and education in nutrition and preventive medicine. The Pennington Center has several research areas, including: Clinical Obesity Research Experimental Obesity Functional Foods Health and Performance Enhancement Nutrition and Chronic Diseases Nutrition and the Brain Dementia, Alzheimers and healthy aging Diet, exercise, weight loss and weight loss maintenance The research fostered in these areas can have a profound impact on healthy living and on the prevention of common chronic diseases such as heart disease diseases, disease, cancer cancer, diabetes diabetes, hypertension and osteoporosis osteoporosis. The Division of Education provides education and information to the scientific community and the public about research findings, training programs and research areas, and coordinates educational events for the public on various health issues. We invite people of all ages and backgrounds to participate in the exciting research studies being conducted at the P Pennington i t C t in Center i B Baton t Rouge, R L Louisiana. i i If you would ld lik like t to t take k part, t visit i it th the clinical li i l t trials i l web b page at t www.pbrc.edu b d or call ll (225) 763-3000.

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Sites

Smith S. Metabolic syndrome targets. Current Drug Targets. 2004;3: 431-439. Mayo Clinic: Metabolic syndrome. Available at: http://www.mayoclinic.com . Accessed September 20, 2005. The American Heart Association: Metabolic Syndrome. Available at: http://www.americanheart.org p g . Accessed September p 20, , 2005.

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