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Metabolic Syndrome

Metabolic syndrome is the medical term for a combination of diabetes, high blood pressure (hypertension), and obesity.

It puts you at greater risk of getting coronary heart diseasestroke, and other conditions that affect the blood vessels.

On their own, diabeteshigh blood pressure, and obesity can damage your blood vessels, but having all 3 together is particularly dangerous.

They're very common conditions that are linked, which explains why metabolic syndrome affects an estimated 1 in 3 older adults aged 50 or over in the UK.

Symptoms of metabolic syndrome

Metabolic syndrome may be diagnosed if you have 3 or more of the following:

  • being very overweight or having too much fat around your waist

  • high triglyceride levels (fat in the blood) and low levels of HDL (the "good" cholesterol) in your blood, which can lead to atherosclerosis (where arteries become clogged with fatty substances such as cholesterol)

  • high blood pressure that's consistently 140/90mmHg or higher

  • an inability to control blood sugar levels (insulin resistance)

Find out more about the health problems linked to metabolic syndrome on Heart UK

Preventing or reversing metabolic syndrome

You can prevent or reverse metabolic syndrome by making lifestyle changes, including:

If necessary, a GP may prescribe medicine to help control your blood pressure, blood sugar, and cholesterol levels.

5 Signs You Might Have a Metabolic Disorder

A metabolic syndrome is not a condition per se but rather a set of risk factors that are linked to a higher chance of developing cardiovascular disease, stroke, and Type 2 diabetes. The condition can lead to the development of more serious illnesses, so it can be quite serious. And because the American Heart Association notes that 23 percent of adults currently have it, it’s not an uncommon condition.

At the offices of Ana Maria Kausel MD Endocrinology, we’re dedicated to improving and maintaining your health and wellbeing. That’s why we’ve compiled this helpful guide on metabolic syndrome and the five signs that you need to look out for.  

The five signs 

When diagnosing a metabolic disorder, we generally check to see if a patient exhibits at least three of the following signs:

A large waist

Carrying excess fat around your waist, in particular, is a large risk factor. This means at least 35 inches in women and 40 inches in men. 

A high triglyceride level

This is determined by a blood test that’s used to gauge the number of triglycerides, a type of fat in your blood. Levels are high when you consume more fat than your body needs. We look for levels that are over 150 milligrams per deciliter or 1.7 grams per liter.   

Reduced HDL or “good” cholesterol

In your body, you have good cholesterol and bad cholesterol. Bad cholesterol accumulates in your arteries, whereas good cholesterol scavenges and removes it, keeping the bad cholesterol from building up in your arteries. We look for levels that are lower than 40 milligrams per deciliter in men and less than 50 in women.  


Increased blood pressure

High blood pressure, or hypertension, is a condition where the force of your blood against your artery walls is strong enough, over a long period of time, to cause health problems, most commonly heart disease. This problem is one that develops slowly over the years, so it’s important to have your blood pressure checked regularly. We look for levels that are 130/85 mm Hg or higher.    

Elevated fasting blood sugar

A fasting blood test is a blood test that’s taken when you haven’t had anything to eat for an extended period of time, usually done before breakfast in the morning. Because your blood sugar usually peaks about an hour after you eat, doing a blood test when you haven’t eaten gives us the most accurate results. We are concerned when your levels are over 100 milligrams per deciliter.  

Metabolic syndrome can lead to a host of serious health problems, so it’s important to seek medical treatment sooner rather than later. Metabolic Syndrome Health Center

Metabolic Syndrome

Metabolic syndrome is a group of risk factors -- high blood pressure, high blood sugar, high triglycerides, low HDL cholesterol, and belly fat -- that increases the risk of heart disease and diabetes. Diet, exercise, and medications can help improve it.

What Is Metabolic Syndrome?

Metabolic syndrome is a health condition that everyone's talking about.

Although the first formal definition of metabolic syndrome entered medical textbooks not so long ago (1998), it is as widespread as pimples and the common cold. According to the American Heart Association, 47 million Americans have it. That's almost a staggering one out of every six people. The syndrome runs in families and is more common among African-Americans, Hispanics, Asians, and Native Americans. The risks of developing metabolic syndrome increase as you age.

Indeed, metabolic syndrome seems to be a condition that many people have, but no one knows very much about it. It's also debated by the experts -- not all doctors agree that metabolic syndrome should be viewed as a distinct condition.

So what is this mysterious syndrome -- which also goes by the scary-sounding name Syndrome X -- and should you be worried about it?

Understanding Metabolic Syndrome

Metabolic syndrome is not a disease in itself. Instead, it's a group of risk factors -- high blood pressure, high blood sugar, unhealthy cholesterol levels, and abdominal fat.

Obviously, having any one of these risk factors isn't good. But when they're combined, they set the stage for serious problems. These risk factors double your risk of the blood vessel and heart disease, which can lead to heart attacks and strokes. They increase your risk of diabetes by five times.

The good news is that metabolic syndrome can be controlled, largely with changes to your lifestyle.

Risk Factors for Metabolic Syndrome

According to the American Heart Association and the National Heart, Lung, and Blood Institute, there are five risk factors that make up metabolic syndrome.

To be diagnosed with metabolic syndrome, you would have at least three of these risk factors.

What Causes Metabolic Syndrome?

Experts aren't sure why metabolic syndrome develops. It's a collection of risk factors, not a single disease. So it probably has many different causes. Some risk factors are:

  • Insulin resistance. Insulin is a hormone that helps your body use glucose -- a simple sugar made from the food you eat - like energy. In people with insulin resistance, the insulin doesn't work as well, so your body keeps making more and more of it to cope with the rising level of glucose. Eventually, this can lead to diabetes. Insulin resistance is closely connected to having excess weight in the belly.

  • Obesity - especially abdominal obesity. Experts say that metabolic syndrome is becoming more common because of rising obesity rates. In addition, having extra fat in the belly - as opposed to elsewhere in the body - seems to increase your risk.

  • Unhealthy lifestyle. Eating a diet high in unhealthy processed foods and not getting enough physical activity can play a role.

  • Hormonal imbalance. Hormones may play a role. For instance, polycystic ovary syndrome (PCOS) - a condition that affects fertility - is related to hormonal imbalance and metabolic syndrome.

  • Smoking.

If you've just been diagnosed with metabolic syndrome, you might be anxious. But think of it as a wake-up call. It's time to get serious about improving your health. Making simple changes to your habits now can prevent serious illness in the future.

Are You at Risk for Metabolic Syndrome

Given how common metabolic syndrome is -- it's estimated that one out of four people meet the criteria -- everyone should be worried about their risk factors. After all, metabolic syndrome can dramatically increase your risk of serious health problems, such as diabetes, heart attacks, and strokes -- yet often people don't even know what it is.

Metabolic syndrome is generally defined as a cluster of risk factors, including high blood sugar, extra abdominal fat, high blood pressure, and unhealthy cholesterol levels.

Some of these risk factors you can control. Others are outside your control. But if you understand the entire range of risk factors, you can better protect your health. You may have a higher risk of metabolic syndrome if:

  • You are older. It's more common as people age. The risk of getting metabolic syndrome rises from 20% in your 40s to 35% in your 50s, to 45% in your 60s and beyond.

  • You are prone to blood clots and inflammation. Both are common in people with metabolic syndrome. Your doctor can do blood tests to find out if you have a high risk of clots and inflammation.

  • You have other medical conditions. Metabolic syndrome is associated with a number of medical conditions. These include polycystic ovary syndrome (PCOS), fatty liver, cholesterol gallstones, and lipodystrophy (which affects fat distribution).

  • It runs in the family. Even if you are not obese you may have inherited a higher risk. This includes people who have parents or other first-degree relatives with diabetes.

  • You are South Asian. South Asians seem to have a higher risk of insulin resistance and thus metabolic syndrome. Because of this, the American Heart Association and the National HeartLung, and Blood Institute have different recommendations for this group. A waist size above 35" (for men) and 31" (for women) is considered a metabolic syndrome risk factor.

Symptoms of Metabolic Syndrome

Most of the metabolic syndrome risk factors don't have any symptoms. You usually can't feel high blood pressure or high cholesterol. Often, the only outward sign is packing some extra weight in the belly.

So the only way to find out if you have metabolic syndrome is to meet with your doctor. They will check your blood pressureblood sugar, and cholesterol. It's another reason that regular check-ups are the key to staying healthy.

The risk factors that make up metabolic syndrome -- unhealthy cholesterol levels, high blood pressure, high blood sugar, and excess belly fat -- raise your odds of serious health problems. These include diabetes and blood vessel or heart disease.

Specifically, metabolic syndrome can lead to atherosclerosis, or "hardening of the arteries." This is when fats, cholesterol, and other substances stick to the sides of the arteries. The arteries then become clogged and brittle. Blood clots form when the arterial walls are damaged. If a blood clot forms, it can cause a heart attack or stroke.

Here are some sobering statistics from the American Heart Association and the American Diabetes Association:

  • Heart disease is the leading cause of death in the U.S.

  • This year 1.5 million Americans will have a heart attack -- 500,000 will die.

  • This year 795,000 Americans will have a stroke.

  • 68% of people over the age of 65 with diabetes die from heart disease.

How Do You Treat Metabolic Syndrome?

A metabolic syndrome is a group of risk factors that include abdominal fat, high blood pressure, high blood sugar, and unhealthy cholesterol levels. Treatment is focused on tackling each of these conditions. The goal is to cut your odds of blood vessel disease and heart disease, as well as diabetes.

In most cases, the best treatment for metabolic syndrome rests with you. Changes to your behavior -- such as eating healthier and getting more exercise -- are the first things your doctor will suggest. By adopting some healthy habits, you may be able to eliminate your risk factors completely.

Make These Lifestyle Changes

  • Get some exercise. Exercise is a great way to lose weight, but don't get down if the scale isn't showing progress. Even if you don't lose a single pound, exercise can lower blood pressure, improve cholesterol levels, and improve insulin resistance. If you're out of shape, start slowly.

  • Try walking more. Work more physical activity into your day. When you're on foot, allow a little extra time to take the scenic route to get some extra steps. To keep track, buy a pedometer (step counter). Gradually increase your physical activity until you're doing it on most days of the week. But don't get too ambitious. If you try a workout regime that's too tough, you may give up. You need to find a level of exercise that fits your personality.

  • Eat a healthy diet. Eating a healthy diet can improve your cholesterol, insulin resistance, and blood pressure -- even if your weight stays the same. For advice on healthy eating, ask your doctor or registered dietitian. If you have heart disease or diabetes, you may need special meal plans. In general, a diet that's low in saturated fats, trans fat, cholesterol, and salt -- and high in fruits, vegetables, lean protein, beans, low-fat dairy, and whole grains -- has been shown to help people with high blood pressure and a higher risk of cardiovascular disease. Many doctors suggest a "Mediterranean" diet or the DASH diet. These meal plans emphasize "good" fats (like the monounsaturated fat in olive oil) and a balance of carbohydrates and proteins.

  • Lose some weight. Obviously, weight loss is often a by-product of exercising and eating well. But it's a key goal in itself if you're overweight or obese. Weight loss can improve every aspect of metabolic syndrome.

  • If you smoke, quit. It's not a risk factor for what’s considered a metabolic syndrome, yet smoking greatly increases your risk of blood vessel and heart disease.

How Do You Treat Metabolic Syndrome?

Talk to Your Doctor About Medication

You may need medicine to help with metabolic syndrome if lifestyle changes aren't enough to reduce your risks. Some drugs you might use are:

  • Low-dose aspirin, which can reduce the risks of heart attacks and strokes. It may be especially important for people who are "prothrombotic," or prone to blood clots.


Keep in mind that all medicines can have side effects and risks. Talk with your doctor about the pros and cons.

How Can You Prevent Metabolic Syndrome?

A metabolic syndrome is a group of risk factors: high blood pressure, high blood sugar, unhealthy cholesterol levels, and excess fat in the abdomen. Having these risk factors drastically raises your risk of diabetes, and blood vessel, and heart disease.

Experts say you can prevent metabolic syndrome in the same way you would treat it.

You need to make sensible changes to your lifestyle. You should:

  • Exercise. Start slowly. The American Heart Association recommends, if possible, that you gradually step up to exercising on most days of the week for 30-60 minutes.

  • Consult your health care provider if you have any physical limitations or concerns.

  • Eat a healthy diet with fruits and vegetables, lean protein, whole grains, and low-fat dairy, and go easy on saturated fats, trans fat, cholesterol, and salt.

  • Lose weight if you're overweight.

  • Quit smoking if you smoke -- now.

  • Schedule regular checkups with your doctor. Since metabolic syndrome doesn't have symptoms, you need regular doctor visits to check your blood pressure, cholesterol, and blood sugar.

One 2005 study published in the Annals of Internal Medicine showed how well lifestyle changes could prevent metabolic syndrome. Researchers looked at more than 3,200 people who already had impaired glucose tolerance, a pre-diabetic state. One group was instructed to make lifestyle changes.


They exercised 2.5 hours a week and ate a low-calorie, low-fat diet. After three years, people in the lifestyle group were 41% less likely to have metabolic syndrome than those who got no treatment. The lifestyle changes were also about twice as effective as using a diabetes medicine, Glucophage.

Of course, if you already have some of the risk factors, your odds of getting metabolic syndrome are higher. You need to work hard to prevent it. You must not wait if you have:

If these conditions apply to you, take action now, before you actually develop metabolic syndrome. Losing as little as 5% to 10% of your body weight can help lower blood pressure, blood sugar, and blood cholesterol levels.

In addition to making lifestyle changes, you might also need medicine. Drugs can get your blood pressure, blood sugar, and cholesterol under control. Talk to your doctor.

Questions About Metabolic Syndrome

Metabolic syndrome is a group of risk factors -- unhealthy cholesterol levels, high blood pressure, high blood sugar, and excess belly fat -- that may raise your risks of serious illness, such as diabetes, and blood vessel, and heart disease.

If you've been diagnosed with metabolic syndrome -- or are worried you might have it -- here are some questions to ask your doctor. Print them out before your next appointment.

  • Do I have any metabolic syndrome risk factors?

  • Will I need medicine to control them? If so, how will the medicine help? What are the side effects?

  • Do I need to have blood tests to see if I have a higher risk of blood clots and inflammation?

  • What is my BMI (body mass index) and waist circumference?

  • Should I lose weight? What's a reasonable weight goal for me?

  • What changes should I make to my diet? Do I need to take any special precautions?

  • Should I consider seeing a registered dietician to talk about improving my diet? Can you refer me to one?

  • Do you have suggestions for how I could get more physical activity?

  • Could any medicines I'm taking be affecting my metabolic syndrome risk factors?

  • How might my family history affect my risk of getting metabolic syndrome and having cardiovascular problems?

  • Should I be taking aspirin therapy?

Remember that when you meet with your doctor, tell them about all of the medicines, herbs, and supplements you use. "Natural" medicines can be powerful, and they can interfere with the effectiveness of other drugs.

You could also keep a food diary for about a week before your next appointment. Just jot down the foods you eat each day. Then, you and your doctor can go over it together and talk about ways of improving your eating habits.

Hydrogen Water and Metabolic Syndrome

Molecular hydrogen affects body composition, metabolic profiles, and mitochondrial function in middle-aged overweight women

D Korovljev 1T Trivic 1P Drid 1S M Ostojic 2 3 4

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Background: Molecular hydrogen (H2) effectively treats obesity-related disorders in animal models, yet no studies have investigated the effectiveness and safety of H2 for improving biomarkers of obesity in humans.

Aim: In this double-blind, placebo-controlled, crossover pilot trial, we evaluated the effects of H2 intervention on body composition, hormonal status, and mitochondrial function in ten (n = 10) middle-aged overweight women.

Methods: Volunteers received either hydrogen-generating minerals (supplying ~6 ppm of H2 per day) or placebo by oral administration of caplets for 4 weeks. The primary end-point of treatment efficacy was the change in the body fat percentage from baseline to 4 weeks. In addition, assessing other body composition indices, screening laboratory studies, and evaluating side effects were performed before and at follow-up. Clinical trial registration, ID number NCT02832219.

Results: No significant differences were observed between treatment groups for changes in weight, body mass index, and body circumferences at 4-week follow-up (P > 0.05). H2 treatment significantly reduced body fat percentage (3.2 vs. 0.9%, P = 0.05) and arm fat index (9.7 vs. 6.0%, P = 0.01) compared to placebo administration, respectively. This was accompanied by a significant drop in serum triglycerides after H2 intervention compared to placebo (21.3 vs. 6.5%; P = 0.04), while other blood lipids remained stable during the study (P > 0.05). Fasting serum insulin levels dropped by 5.4% after H2 administration, while placebo intervention augmented insulin response by 29.3% (P = 0.01).

Conclusions: It appears that orally administered H2 as a blend of hydrogen-generating minerals might be a beneficial agent in the management of body composition and insulin resistance in obesity.