What is the Metabolic Syndrome and Do You Have It?

It's estimated that nearly one in four American adults has this dangerous condition but you needn't be one of them. Also known as syndrome X or insulin resistance syndrome, metabolic syndrome triples the risk of developing heart disease and is a precursor of type 2 diabetes. Along with expanding waistlines, Americans are experiencing an epidemic of metabolic syndrome.

Defining Metabolic Syndrome
This condition is not in and of itself a disease. Instead metabolic syndrome involves a cluster of symptoms that predispose you to diabetes and heart disease. They include:
1. Obesity, particularly excessive fat in the waist and stomach area, which makes a person look “apple-shaped"
2. High levels of triglycerides
3. Although LDL (“bad") cholesterol is usually within normal range, the size of the LDL particles tends to be the small, more dangerous type.
4. High blood pressure
5. Elevated blood glucose
6. Chronically elevated inflammation
7. Abnormal blood vessel function

Do You Have Metabolic Syndrome?
You do if you have three or more of the following markers:

MenWomen
Waist Circumference≥ 40 inches≥ 35 inches
Triglycerides≥ 150 mg/dL *≥ 150 mg/dL
HDL ("good") cholesterol≤ 40 mg/dL≤ 50 mg/dL
Blood pressure≥ 130 / 85 mm Hg or use of medication for hypertension≥ 130 / 85 mm Hg or use of medication for hypertension
Fasting glucose≥ 100 mg/dL or use of medication for high blood glucose≥ 100 mg/dL or use of medication for high blood glucose

*Milligrams per deciliter.

What Causes Metabolic Syndrome?
Why do the diverse problems that characterize metabolic syndrome occur? It appears that all of them are signs of insulin resistance, meaning that a given amount of insulin doesn't exert its normal effect on blood glucose. When insulin resistance develops, it impacts a variety of metabolic pathways that can lead to the specific markers described above. But not everyone responds to insulin resistance in the same way. Also, the time frame in which certain signs develop varies. This variability makes defining—and treating—metabolic syndrome tricky—and controversial.

How to Treat Metabolic Syndrome
Nutritional approaches have been generally downplayed in favor of multiple medications that target the individual markers. Conventional recommendations tend to emphasize caloric restriction and reduced fat intake, even though the metabolic syndrome can best be described as carbohydrate intolerance. Elevated LDL (“bad") cholesterol is typically not a problem in metabolic syndrome, so there's no valid argument for restricting dietary fat. The most effective treatment for metabolic syndrome is actually restricting carbohydrate, not fat, intake. And the Atkins Diet does just that.

If you have three or more of the indicators listed in the chart above, have a family history of type 2 diabetes or have reason to think you may have metabolic syndrome, we suggest that you bring it to the attention of your health care provider immediately.