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Metabolic SyndromePennington Biomedical Research Center

Division of Education

PBRC 2009

Metabolic Syndrome: Overview

Metabolic Syndrome is not a disease, but rather a cluster of disorders of your body’s metabolism, including:

o High blood pressureo High insulin levelso Excess body weighto Abnormal cholesterol levels

Each of these disorders is by itself a risk factor for other diseases.

In combination, however, these disorders dramatically boost the chances of developing potentially life-threatening illnesses, such as diabetes, heart disease or stroke.

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

Signs and Symptoms

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Metabolic Syndrome

The syndrome is closely related to a generalized metabolic disorder called insulin resistance, in which the body can’t use insulin efficiently.

Metabolic syndrome has been called many names, including:o Syndrome Xo The deadly quarteto Insulin Resistance Syndrome

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Prevalence

Affects as many 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.

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

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Risk FactorsThe following factors increase your risk of developing

Metabolic Syndrome:

Age The prevalence of metabolic syndrome increases with age, affecting less than 10% of people in their 20s and 40% of people in their 60s.

Race Metabolic syndrome is generally more common among blacks and Mexican-Americans than among Caucasians.

Obesity 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.

History of diabetes

Having a family history of type 2 diabetes or diabetes during pregnancy (gestational diabetes) increases the risk for developing metabolic syndrome.

Other diseases

A diagnosis of hypertension, cardiovascular disease (CVD) or polycystic ovary syndrome (a hormonal disorder in which a woman’s body produces an excess of male hormones) also increases the risk for metabolic syndrome.

Apple Pear

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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 already 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.

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Prevention

Commit to a healthy dieto 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 dinners, and eliminating table salt by experimenting with other herbs and spices.

Get movingo It is important to stay active. Get at least 30 minutes of moderately

strenuous activity on most days of the week is recommended.

Schedule regular check-upso This includes assessing blood pressure, cholesterol and blood sugar

levels annually. Early detection of problems can help with formulating lifestyle modifications.

Healthy lifestyle changes can prevent the onset of the syndrome.

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Diagnosing Metabolic Syndrome

Waist Circumference o Greater than 35 inches in women and 40 inches in men (abdominal obesity)

Triglycerideo Levels of 150 milligrams per deciliter (mg/dl) or higher

Blood Pressureo 130/85 millimeters of mercury or higher

Fasting blood glucoseo 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

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

metabolic syndrome:

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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 diabeteso Heart attacko Stroke

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Treatment

To reduce insulin resistance in overweight and obese individuals, the preferred 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 Weighto Blood glucoseo Cholesterolo Blood pressure

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Self-care

Lose weighto Losing as little as 5 to 10% of your body weight can reduce insulin levels and

high blood pressure, thus reducing your risk of 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 smokingo Smoking cigarettes increases insulin resistance and worsens health

consequences associated with MS. Eat fiber-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.

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:

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Weight loss drugs

Along with diet and exercise, it may be necessary to prescribe weight loss drugs. Two commonly prescribed weight-loss drugs include sibutramine (Meridia) and orlistat (Xenical).

Insulin sensitizer

s

In individuals with 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.

TreatmentMedications to control the syndrome’s individual risk

factors include:

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Treatment

Aspirin Aspirin is often prescribed to help reduce the risk for a heart attack.

Medications to lower

blood pressure

Major types of medications used to control high blood pressure include diuretics, angiotensin-converting enzymes (ACE) inhibitors, calcium channel blockers and beta blockers.

Medications to regulate cholesterol

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)By increasing the level of high-density (HDL) cholesterol (“good” cholesterol)By decreasing the level of triglycerides (Another “bad” component of cholesterol)

Medications to control the syndrome’s individual risk factors include:

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Division of EducationPhillip Brantley, PhD, Director

Pennington Biomedical Research CenterClaude Bouchard, PhD, Executive Director

Heli J. Roy, PhD, RDShanna Lundy, BS

Beth Kalicki

Edited: October 2009

About Our Company

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, Alzheimer’s 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, cancer, diabetes, hypertension and 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 Pennington

 Center in Baton Rouge, Louisiana. If you would like to take part, visit the clinical trials web page at www.pbrc.edu or call (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 . Accessed September 20, 2005.