Metabolic Syndrome: The Silent Killer

Metabolic Syndrome: The Silent Killer

Metabolic syndrome is made up of several conditions, and is not only on the rise, but also is often not recognized by people experiencing it. 

The underlying issue as the cause of this syndrome is insulin resistance, which creeps up slowly, leading to inflammation, abnormal fat deposition and eventually, many complications. 

According to the CDC, data from 1988-2012 showed the prevalence of metabolic syndrome rose for all ethnicities and is rising. By 2012, 1 in 3 people or more than a third of all US adults met the definition and criteria for metabolic syndrome.

How do you know if you could have this syndrome? 

According to guidelines from the National Heart, Lung, and Blood Institute (NHLBI) and the American Heart Association (AHA), if 3 of these 5 conditions are present, the diagnosis of metabolic syndrome is made:

1. Obesity: 

  • Waist circumference over 40 inches for men and over 36 inches in women of Caucasian/European, African & Middle Eastern descent, waist circumference 
  • Waist circumference over 36 inches for men and over 31.5 inches for women of South Asian, Chinese, Japanese, South & Central American descent 
  • BMI over 30 or BMI over 27 with weight related condition

2. Elevated blood triglycerides over 150 

3. Low HDL (below 40 for men or below 50 for women)

4. High blood pressure ( > 130/85)

5. Elevated fasting blood sugar over 100 or diagnosis of diabetes

As you can see, these conditions are fairly common, yet putting it all together to give this syndrome a name is not often done. Each condition can of course cause health issues, but all together, they can increase the risk much more for certain conditions. 

Which conditions is a person at risk for?

  • Cardiovascular disease like heart disease and strokes
  • Kidney disease
  • Liver disease, including Non-Alcoholic Fatty Liver Disease 
  • Alzheimer's dementia & cognitive decline
  • Obstructive sleep apnea
  • Some cancers

Who could be at risk?

There are particular individuals at a higher risk for metabolic condition. Those with family history of type 2 diabetes, premature heart disease, women with polycystic ovarian syndrome and those with a history of gestational diabetes and people belonging to certain ethnicities like Asian and Hispanic are at an increased risk. This increased risk between ethnicities could be mediated by genetic factors as well significant health disparities. For those with obesity, they can be at risk, but specifically abdominal weight gain is of concern even for those with "normal" BMI. 

How can you reduce your risk?

Prevention is KEY! Taking a comprehensive approach to optimize your lifestyle habits can absolutely make a difference. 

Some things that can help:

  • Know your numbers! Awareness is the first step. Get labs and see your PCP regularly. Beyond that, keep an eye on blood pressure and your waist size. 


  • If you have changes on your labs that are concerning or you are noticing increasing waist size or struggling with abdominal weight gain, have a discussion with your physician and get resources for a plan of action and treatment. Do not wait until numbers are "really bad"


  • Lose excess body fat (especially visceral fat from around the abdominal area). Consult with a weight loss or obesity and metabolic health physician like me to discuss a plan of action


  • Make dietary changes to follow an eating pattern like the Mediterranean diet. Eating a PLANT FORWARD diet high in vegetables, fruit, whole grains, plant proteins like beans & lentils, unsaturated fats (nuts, seeds, olive oil) in place of less saturated fat, fish and less meat/red meat can be a healthful pattern and SUSTAINABLE. Separate from weight loss, changing your diet can help improve your risk factors. 


  • Move! Exercise, especially weight training to build muscle has lots of benefits to your heart, brain and whole body, including improved insulin sensitivity. Exercise is an effective tool for living longer, healthier and benefits go way beyond weight loss!


  • Medications to address excess body fat, normalize blood pressure, cholesterol and blood sugar levels can be helpful 

I hope you use this information to empower yourself to identify your own risk factors & make lifestyle changes and a plan of action that help support your metabolic health!

In health, 

Richa Mittal MD

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