Metabolic syndrome is a group of health risk factors that often occur together and increase the likelihood of heart disease and type 2 diabetes. The risk factors that make up metabolic syndrome include high blood glucose levels, high blood pressure, high waist circumference or waist-to-hip ratio, low HDL-cholesterol levels, and high triglyceride levels. A diagnosis of metabolic syndrome is made if a person has three or more of these conditions, and the more aspects of metabolic syndrome a person has, the greater their risk of type 2 diabetes, atherosclerosis, heart attack, and stroke.1, 2 In addition, metabolic syndrome is associated with increased risks of fatty liver disease, chronic kidney disease, Alzheimer’s disease and other forms of dementia, and cancer.3, 4, 5, 6 Women with polycystic ovary syndrome (PCOS) frequently develop a similar group of metabolic disturbances.7
It is now widely accepted that the interrelationship between insulin resistance and malfunctioning fat tissue underlies metabolic syndrome. Insulin resistance occurs when insulin is no longer effective at getting cells to respond to rising glucose levels. Over time, insulin resistance causes impaired functioning of fat cells, which play a critical role in regulating metabolism. Expansion of malfunctioning fat tissue, particularly in the abdomen, further reduces sensitivity to insulin signaling. Together, these conditions lead to chronically increased production of tissue-damaging inflammatory chemicals. This chronic inflammatory state is linked to progressive injury to the inner lining of the blood vessels and to organs and tissues throughout the body.8, 9, 10
In addition to the recommendations discussed below, people with metabolic syndrome may benefit from some of the recommendations given for type 2 diabetes and cardiovascular disease, as well as obesity, high cholesterol and triglyceride levels, and hypertension.
Most people with obesity have or will develop metabolic syndrome.11 Excess fat tissue, especially when it accumulates in the abdominal region, increases the likelihood and severity of insulin resistance and is an independent risk factor for cardiovascular disease and diabetes.12, 13 Abdominal obesity is the most common component of metabolic syndrome.14 Weight loss, even when modest, has been shown to improve all components of metabolic syndrome, as well as other aspects of health.15 Therefore, an achievable weight loss goal, such as 5%–10% of body weight, is an important part of metabolic syndrome treatment.
Physical activity is associated with decreased risks of metabolic syndrome, type 2 diabetes, cardiovascular disease, and most other chronic diseases.16, 17 Exercise interventions have been shown to improve metabolic signs such as waist circumference, blood pressure, and HDL-cholesterol levels in people with metabolic syndrome, and physical activity in general improves fitness and positively impacts health outcomes associated with metabolic syndrome.18, 19 Although more research is needed to identify the optimal type, intensity, and duration of exercise necessary for metabolic benefits, an exercise program that includes both aerobic exercise and strength training may have some advantages over aerobic exercise alone.20, 21
Chronic psychological stress has been linked to the development and progression of metabolic syndrome in multiple observational studies.22, 23 Stress-related changes in immune function, insulin sensitivity, glucose metabolism, and eating patterns may all play a role, and may also underlie the observed relationship between metabolic syndrome and major depression.24, 25, 26 Mindfulness training interventions have been found to moderate the stress response and improve eating patterns and some metabolic signs in people with metabolic syndrome.27, 28
Although the mechanism is not completely understood, a growing body of research suggests tobacco smoking is independently associated with insulin resistance and abdominal obesity, and may compound the negative impact of metabolic syndrome on vascular health.29, 30 Smoking has also been linked to high blood pressure and high glucose levels.31 Smoking cessation has been found to improve blood pressure and levels of triglycerides, glucose, and HDL-cholesterol in the short term in individuals with metabolic syndrome, despite modest weight gain.32 The possibility that nicotine replacement therapy, such as using nicotine gums or patches, may contribute to metabolic disturbance needs further exploration.33, 34
Alcohol consumption increases the risk and severity of fatty liver disease in people with obesity and metabolic syndrome.35, 36 Even a low level of alcohol use increases progression of liver fibrosis and risk of liver cancer and other severe liver disease in those with fatty liver.37 Although light to moderate drinking, particularly of wine, has been correlated with reduced risks of metabolic syndrome, type 2 diabetes, and some cardiovascular outcomes, abstinence may nonetheless be more beneficial for those with obesity and metabolic syndrome.38, 39, 40, 41
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The information presented by TraceGains is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. Self-treatment is not recommended for life-threatening conditions that require medical treatment under a doctor's care. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires December 2024.