Q and A: Metabolic syndrome and lifestyle changes

I just turned 40 and had my annual physical, which included a large panel of blood tests. I was told that I have metabolic syndrome and could develop diabetes. I was told to limit my sugar intake. Can you explain more about the condition and how I can avoid diabetes?

ANSWER: When a person is diagnosed with metabolic syndrome, it means he or she has several conditions that, if left untreated, significantly raise the risk of developing diabetes. Metabolic syndrome also increases the risk of heart and blood vessel problems. Treatment for metabolic syndrome typically focuses on healthy lifestyle changes.

Although the specific definition health care professionals use may vary somewhat, metabolic syndrome generally includes having three or more of the following characteristics: a larger waistline, high triglyceride level, low HDL cholesterol (also called "good" cholesterol), high blood pressure and a blood glucose level that is higher than normal.

High blood sugar, also known as blood glucose, is the hallmark sign of diabetes. When a blood sample is taken after a person fasts overnight and his or her blood sugar measures 80 to 100 milligrams per deciliter, or mg/dL, that level is considered normal. A fasting blood sugar measurement of 126 mg/dL or higher on two separate tests is considered diabetes. The range between the two—100 to 125 mg/dL—is referred to as prediabetes. The blood sugar level of people who have metabolic syndrome often falls into the prediabetes range.

Treatment for metabolic syndrome usually focuses on three areas of lifestyle modification:

• Weight loss
• Exercise
• Dietary changes

Many people who have metabolic syndrome are overweight. Getting to and staying at a healthy weight can make a big difference in reducing the risk of health problems associated with metabolic syndrome.

Losing weight also may help lower blood pressure, blood sugar and triglyceride levels. But weight loss that results in a reduced waist size is important, too, as studies have shown that carrying a lot of weight around your abdomen raises the risk of developing diabetes, heart disease and other complications of metabolic syndrome. To reduce the risk, doctors generally recommend a waistline of less than 35 inches for women and less than 40 inches for men.

Regular exercise can help with weight loss, as well as improve some of the medical concerns associated with metabolic syndrome. A good goal is 30 minutes or more every day of activity that is moderately intense, such as brisk walking, swimming or biking.

Long term, healthy eating is a crucial component of treatment for metabolic syndrome. It may be worthwhile for you to speak with a dietitian about a specific diet. Two diets that often are recommended for people with metabolic syndrome are the Dietary Approaches to Stop Hypertension (DASH) diet and the Mediterranean diet. These diets limit unhealthy fats and focus on fruits, vegetables, fish and whole grains. Beyond weight loss, studies have shown that both diets offer essential health benefits for people who have components of metabolic syndrome.

Finally, do not smoke. Smoking cigarettes can make many of the health complications of metabolic syndrome worse. Smoking also can significantly raise the risk for other illnesses and diseases.

Depending upon your personal situation, if lifestyle changes are not enough to control metabolic syndrome, medication also may be part of your treatment plan. Medicine to control blood pressure, manage triglycerides and lower blood sugar can be useful in treating some cases of metabolic syndrome. I would recommend that you follow up with your health care specialist on an annual basis and repeat blood work to monitor your progress and adjust your approach as necessary.

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