Joya Lara Carnes, Admission Manager


Understanding Metabolic Syndrome

Metabolic syndrome (MS) is a group of individual diseases that occur together and, when combined, significantly increase the risk of heart disease, strokes and type 2 diabetes. These individual diseases include, for example

  • High blood pressure
  • high blood sugar
  • Excess body fat around the waist (brown belly fat)
  • Elevated cholesterol or triglyceride levels.
Author: Dr. Philipp Sabanas, an American-Austrian Primary Care Physician (PCP), Internist, and Senior Partner at Dotorum Leopoldstadt in Vienna 1020, Austria.

Global impact of the metabolic syndrome

The World Health Organisation recognised obesity as a major challenge to global health in 1997. At the same time, the metabolic syndrome was defined (James, Rigby, & Leach, 2006). The metabolic syndrome is already widespread worldwide and represents a significant problem for individual health as well as for the healthcare system. Early life deprivation in the sense of hunger can be a problem in developing countries and is an additional problem beacause it can also cause obesity at an advanced age. (James, Rigby, & Leach, 2006).

Criteria for diagnosis

Metabolic syndrome encompasses a wide range of criteria, but generally focuses on abdominal obesity, insulin resistance, hypertension and dyslipidaemia. The disease is defined by three or more of the following criteria:

– Waist circumference over 102 cm in men or 88 cm in women

– Triglycerides ≥ 150 mg/dL

– HDL (the “good” cholesterol) < 40 mg/dL in men or < 50 mg/dL in women

– Blood pressure ≥ 130/85 mmHg

– Fasting glucose ≥ 100 mg/dL (Nadulska, Szwajgier, & Opielak, 2005).

Using these criteria, people at high risk of cardiovascular disease and type 2 diabetes can be easily identified and measures can be initiated.

The role of insulin resistance

Insulin resistance is a central feature of metabolic syndrome. It occurs when the cells in the muscles, fat and liver do not respond well to insulin and are unable to utilise glucose from the blood to produce energy. As a result, the pancreas has to produce more insulin to get the glucose into the cells. Over time, the increased insulin levels contribute to the metabolic abnormalities that are typical of metabolic syndrome (Despres, 2006). Insulin resistance is often exacerbated by abdominal obesity (men are more likely to be affected), which is often associated with an increased risk of cardiovascular disease and diabetes.

Metabolic syndrome and cardiovascular risk

Metabolic syndrome therefore significantly increases the risk of cardiovascular disease. The combination of risk factors accelerates the development of atherosclerosis (calcification of the blood vessels), which leads to coronary heart disease and strokes (Despres & Lemieux, 2006). The presence of metabolic syndrome can double the risk of cardiovascular events compared to people without this syndrome (Grundy, 2000). Therefore, the identification and treatment of the disease is of central importance for the prevention of cardiovascular sequelae. In this way, the mortality rate for this area can be reduced.

Diet and lifestyle management

Diet and lifestyle measures are the cornerstone of metabolic syndrome treatment. A reduction in calorie intake and a balanced diet of fruit, vegetables, wholemeal products and lean proteins can significantly improve key metabolic parameters. Physical activity is also important as it increases insulin sensitivity, reduces abdominal fat and improves lipid profiles (Marchesini et al., 2004). It is well known that people should exercise regularly: at least 150 minutes of moderate-intensity exercise per week. Behavioural changes, such as avoiding physical inactivity and reducing stress, also play a key role in the treatment of metabolic syndrome.

Pharmacological interventions

Pharmacological treatment may be necessary for individuals who do not respond adequately to lifestyle changes or make insufficient efforts to maintain a healthy lifestyle with exercise (Vega, 2004). New therapies targeting insulin resistance and inflammation avoidance are also being explored to provide more comprehensive management or treatment.

Effects of physical activity

Physical activity has a profound effect on metabolic syndrome. Regular exercise improves insulin sensitivity, reduces (not only) harmful brown belly fat, lowers blood pressure and improves lipid profiles. Studies show that physically active people are significantly less affected by MS compared to people who are often sedentary (Marchesini et al., 2004). Activities such as walking, cycling (in the endurance range) in combination with balanced strength training are particularly effective. If physical activity is integrated into the daily routine and becomes a lifelong habit, the risk of the consequences of metabolic syndrome and the associated complications can be significantly reduced.

Long-term health effects

The long-term health consequences of metabolic syndrome are serious and include an increased risk of type 2 diabetes, cardiovascular disease and subsequent increased mortality. Effective treatment can significantly reduce these risks. Improved nutrition, more physical activity and appropriate medical diagnostics. Genetics should be mentioned here. Epigenetic interventions, for example, can help to achieve weight loss and minimise the risks. It is essential to prevent the progression of metabolic syndrome as this leads to more serious health problems over time (Lechleitner, 2008). Continuous monitoring to intervene early by managing symptoms well is crucial to minimise the long-term health effects.