When your health risks come in clusters, it’s time to get serious about your lifestyle habits.

It’s bad enough to weigh too much or to have elevated blood pressure or blood sugar readings. Each of these health measures, by itself, raises your chance over time of developing a serious chronic disease.

But when you have not just one risk factor but several, it’s past time to pay close attention to your unhealthy habits. Research shows that when certain risk factors come in clusters, your risks for three deadly conditions—heart attack, stroke, and diabetes—are all multiplied.

A Serious Syndrome
That’s the case with metabolic syndrome. Nearly one in four Americans, including many children, have metabolic syndrome, and the likelihood increases with age. People are said to have this syndrome when they have any three or more of the following five health risks:

• A large waistline—meaning excess fat in the abdomen, or an “apple shape”
• A higher than normal level of triglycerides, a type of fat found in the blood
• A lower than normal level of HDL, the “good” cholesterol
• Higher than normal blood pressure
• Higher than normal blood sugar

Notice the phrases “higher than normal” and “lower than normal.” You don’t have to have what doctors consider high blood pressure, for example, to fit the guidelines for metabolic syndrome—just a level that’s modestly above normal. You don’t have to be obese, either—just “apple shaped.”

Having three or more of these health risks doubles your risk for heart disease, gives you five times the risk for diabetes, and multiplies your risk for stroke.

“There’s a whole host of other medical problems that can be associated with metabolic syndrome,” notes endocrinologist Scott Isaacs, M.D., coauthor of the book Overcoming Metabolic Syndrome. “A common one is nonalcoholic fatty liver disease, which can progress to cirrhosis of the liver. I have patients with metabolic syndrome who progressed to a liver transplant and never drank a drop of alcohol.”

Metabolic syndrome also increases the risk for gout, and it lowers levels of testosterone, the male hormone, in about half of the men with the syndrome, he adds. “For women, metabolic syndrome actually can raise testosterone levels, leading to menstrual cycle irregularly, acne, and growth of facial hair.”

What Triggers It?
Metabolic syndrome is closely linked to being overweight or obese and to a sedentary lifestyle. It appears to be triggered by insulin resistance, a precursor to diabetes in which the body fails to properly process the hormone insulin, resulting in high levels of blood sugar.

The role of insulin resistance is strong enough, Isaacs and some experts contend, that a more accurate label might be “insulin resistance syndrome.” Although the definition and even the existence of metabolic syndrome have been disputed, it seems evident that this collection of associated risk factors is becoming more common.

What to Do About It
First, realize that you can have metabolic syndrome without experiencing any symptoms. The only way to know you or a loved one has it is to take note of waist circumference plus the results of a standard blood test your doctor provides during a routine checkup.

The best prevention for metabolic syndrome, as well as the best treatment, is to take steps to control your weight and eating habits. (See It’s Not as Hard as You Think below) By losing as little as 5 to 10 percent of your weight, you can reduce your blood pressure and insulin resistance while lowering your risk for diabetes.

Quitting smoking is critical, Isaacs stresses. When combined with the health risks associated with metabolic syndrome, “Smoking adds a triple to quadruple whammy to your risk for heart disease.” The effect can be so pronounced, Isaacs adds, that he automatically sends metabolic syndrome patients who smoke to a cardiologist for a heart disease evaluation. Even if they have no symptoms, he considers them a heart attack waiting to happen.

Medications for controlling blood pressure, cholesterol levels, or blood sugar can play a key role in managing the health risks related to metabolic syndrome. But medications are not a substitute for a regular program of physical activity and healthy eating. “Lifestyle measures are far and away the best treatment,” Isaacs says.

If you remember just one thing about metabolic syndrome, Isaacs adds, it should be that you can do something about it. It’s not incurable. You can manage your health aggressively through lifestyle to get it under control.

“Sure, it may be hard to pass on the cheese burrito and choose a salad with chicken breast and fat-free dressing,” Isaacs says. “But if you make healthier choices, you’ll feel better and be healthier over the long term.”

Polly Turner spoke with Scott Isaacs, M.D., F.A.C.P., F.A.C.E., coauthor of Overcoming Metabolic Syndrome. Isaacs is a board certified endocrinologist in Atlanta; clinical instructor of medicine at Emory University School of Medicine; and medical director for Atlanta Endocrine Associates.

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