BY JUDITH HURLEY, R.D.

The metabolic syndrome, also called syndrome X, sounds like a mystery disease in a science fiction story. But this serious health condition is fact, not fiction. About 47 million Americans have the disorder — and the high risk for diabetes, heart disease, stroke and kidney disease that comes with it.

The metabolic syndrome is on the rise because it’s triggered by being overweight — and more people are overweight than ever before. There’s welcome news, though: By making healthy lifestyle choices, you may be able to lower your risk for health problems.

A Cluster of Conditions
The metabolic syndrome isn’t a disease itself. It’s a cluster of conditions that increases your risk for disease. These include high blood pressure, high levels of blood fats such as cholesterol and triglycerides, poor blood sugar control and too much fat around the waist. (See “Are You At Risk for the Metabolic Syndrome?”) Each of these conditions can lead to serious health problems on its own. But it’s the combined impact of several disorders that makes the metabolic syndrome so dangerous — and the more conditions you have, the higher your risk.

What Causes Syndrome X
Scientists have been unraveling the threads of this complex condition for years, and it’s still not completely understood. But they do know it’s caused by three things: genetic factors, being overweight or obese, and a sedentary lifestyle.

Some people are genetically prone to developing the metabolic syndrome. In the United States, about one in every four white people has the disorder, while nearly one in every three Mexican Americans has it. It occurs in about one in every five black people.

About two-thirds of adult Americans are overweight or obese, one reason that doctors are seeing more patients with the metabolic syndrome. Obesity can lead to a condition called insulin resistance. Insulin is made by the body to shuttle glucose (blood sugar) into muscle, fat and liver cells to be used for energy. But obesity can cause the cells to resist insulin. Unable to enter the cells, glucose builds up in the bloodstream. In response, the body makes more insulin. Eventually, the large amount of insulin and glucose in the bloodstream sets the stage for the metabolic syndrome.

Apple or Pear?
Not everyone who is overweight is equally at risk for the metabolic syndrome. If you have an “apple” shape, you carry excess fat around the waist. This is known as abdominal or central obesity. It is strongly linked to insulin resistance and the metabolic syndrome. If you have a “pear” shape, your excess weight is mostly in the hips and buttocks, and your risk for the metabolic syndrome is lower.

Lack of exercise also underlies the metabolic syndrome. Physical activity burns calories, helping you control your weight. But just as important, exercise prods muscle cells to take in glucose from the bloodstream. That helps keep both glucose and insulin at normal levels.

Good News From Research
If obesity and lack of exercise can set the stage for the metabolic syndrome, perhaps exercising and losing weight can help prevent it. That’s exactly what researchers at George Washington University in Maryland set out to study. They asked people with the condition to consume a lowcalorie, low-fat diet and to exercise for at least two-and-ahalf hours a week for three years. The result? Forty-one percent of the participants who had the metabolic syndrome at the start of the study no longer had it at the end.

The Bogalusa Heart Study explored whether a healthy diet can prevent the metabolic syndrome. Researchers found that people who consumed more low-fat dairy products, fruits and vegetables, and fewer sweetened beverages, were less likely to have the disorder.

Are You At Risk for the Metabolic Syndrome?
The National Cholesterol Education Program defines the metabolic syndrome as having any three of the following conditions:

• Excess weight around the waist (a waist measurement greater than 40 inches for men or 35 inches for women)
• High triglyceride, a type of fat in the blood (150 mg/dl or higher)
• Too little HDL (“good”) cholesterol (less than 40 mg/dl for men; less than 50 mg/dl for women)
• High blood pressure (130/85 mm Hg or higher)
• High blood glucose (a fasting level of 110 mg/dl or higher)

What You Can Do
Because the metabolic syndrome significantly increases your risk for major disease — including diabetes, heart disease, stroke and kidney disease — your best approach is prevention. Follow these five steps to lower your risk for the condition and the diseases it’s linked to.

Shed your extra pounds. Obesity— especially apple-shaped, or central, obesity — worsens insulin resistance. But losing even 10 pounds can make a difference. Talk with your doctor about a plan to lose weight that will work for you. Instead of a drastic, lose-it-fast approach, make healthy eating and exercise changes that you can stick with for a lifetime. A dietitian can help you plan lowcalorie meals and snacks that include your favorite foods. Group weightloss programs offered by health plans and hospitals and support groups such as Weight Watchers can help you achieve your goals, too.

Get moving. Exercise burns calories and stimulates muscle cells to take in glucose. That helps keep blood levels of glucose and insulin normal, warding off insulin resistance. Exercise also builds muscle, which helps your body burn more calories. You don’t need special equipment or a fancy gym. Brisk walking is one of the best forms of exercise — and one of the easiest. Aim for 30 to 60 minutes of physical activity on most days of the week. But you can get started with just 10-minute sessions, three times a day. Be sure to check with your doctor before beginning an exercise program.

Manage blood pressure. Losing weight and getting regular exercise can lower blood pressure. A healthy diet is important, too. Emphasize whole grains, fruits and vegetables, and low-fat or nonfat dairy products. If you take blood pressure medication, be sure to take it as directed.

Control your cholesterol. Losing weight and exercising more can boost HDL (“good”) cholesterol. To reduce LDL (“bad”) cholesterol, eat less saturated fat (red meat, butter, cheese, cream and whole-fat milk) and trans fat (partially hydrogenated vegetable oils, common in packaged baked goods and snack foods). Choose foods with fiber, such as whole grains, fruits, vegetables and legumes. And be sure to take any cholesterol medication as directed.

Stop smoking. Smoking increases your risk for diseases linked to the metabolic syndrome, including heart disease and stroke. Ask your doctor about smoking-cessation resources in your community. Quitting isn’t easy, but it’s one of the best things you can do for your health.

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