Metabolic Syndrome

Metabolic syndrome encompasses various conditions that heighten the risk of atherosclerotic cardiovascular issues such as heart attacks, strokes, and peripheral artery diseases, along with insulin resistance and type II diabetes. Metabolic syndrome is characterized by a combination of central obesity, insulin resistance, hypertension, and abnormal lipid levels.

A diagnosis of metabolic syndrome is made when a person has three or more of the following:

• Waist circumference exceeding 40 inches in men and 35 inches in women
• Triglyceride levels of 150 mg/dL or higher
• Low levels of HDL cholesterol (less than 40 mg/dL in men, less than 50 mg/dL in women)
• Fasting glucose levels of 100 mg/dL or higher
• Blood pressure readings of 130/85 mm Hg or higher

Those with metabolic syndrome face twice the risk of cardiovascular diseases and five times the risk of diabetes compared to the general population. It's linked to accelerated atherosclerosis and early-onset diabetes. Sedentary lifestyles and excessive calorie intake have contributed to the growing prevalence of obesity, consequently driving up the occurrence of metabolic syndrome.

Central obesity plays a pivotal role in metabolic syndrome, leading to insulin resistance, high blood pressure, and abnormal lipid levels. Symptoms vary but often include abdominal obesity, elevated blood pressure, and signs of insulin resistance. The condition poses significant health risks, but with intervention, its progression can be halted and potentially reversed, highlighting the importance of addressing it promptly.

What is the prevalence of metabolic syndrome?

The global occurrence of metabolic syndrome closely mirrors the rise in obesity rates. According to the National Health and Nutrition Examination Survey (NHNES), the percentage of adults with metabolic syndrome increased from 25.3% to 34.2% by 2012. The prevalence of metabolic syndrome in the Canadian adult population was 19.1% in 2011. In the United States, the prevalence of metabolic syndrome peaked at the turn of the 21st century, then gradually declined due to improved early detection and treatment of conditions like high cholesterol and high blood pressure, despite the ongoing rise in obesity rates.

Notably, metabolic syndrome is no longer restricted to adults; it has also been observed in children and adolescents. In 2020, globally, 3% of children and 5% of adolescents were identified as having metabolic syndrome. Surprisingly, the prevalence of metabolic syndrome in children appears slightly higher in low-income countries, indicating that economic status alone may not predict its occurrence. Additionally, the likelihood of having metabolic syndrome increases with age, with nearly 40% of individuals in their sixth decade of life affected. While metabolic syndrome affects both genders equally overall, certain ethnic groups show a slightly higher prevalence among women than men.

How is metabolic syndrome diagnosed?

Although diagnosing metabolic syndrome relies on physical exams and lab tests, understanding a patient’s history is crucial. This includes looking at their lifestyle, eating habits, and family history. For example, if a family member had early heart disease, it might mean the patient is at higher risk for metabolic syndrome. Symptoms like frequent urination, extreme thirst, and excessive eating can indicate diabetes, which is often linked to metabolic syndrome. Knowing a person’s history helps in identifying, treating, and preventing the disease. During the physical exam, the healthcare provider starts by checking vital signs and overall appearance, which can hint at metabolic syndrome. Our experienced nurse practitioner, Angena, and our knowledgeable naturopathic doctor, Dr. Wendy Zhou, are fully equipped to diagnose metabolic syndrome and develop a treatment plan to manage the individual components of metabolic syndrome.

After taking the patient's history and performing a physical exam, lab tests are necessary. These include tests for blood sugar levels and a type of hemoglobin to check for diabetes. A lipid panel is also needed to check cholesterol levels. Additionally, tests for kidney function and other possible related issues, like inflammation or thyroid problems, may be conducted. Our naturopathic doctor, Dr. Wendy Zhou, and our nurse practitioner, Angena, are both able to order and interpret lab tests to assess fasting blood glucose, triglycerides, HDL cholesterol, and other relevant markers.

How can metabolic syndrome be treated?

The primary aim of managing metabolic syndrome is to identify and address the risk factors to reduce the chance of cardiovascular problems. The approaches to managing metabolic syndrome can involve lifestyle changes and medical treatments.

Since metabolic syndrome is strongly linked to lifestyle, adopting healthy habits is an effective way to manage its risk factors and prevent heart-related issues. The goal is to balance calorie intake with calorie needs. Recommended lifestyle changes include regular physical activity, a nutritious diet, avoiding tobacco, ensuring good sleep, and reducing alcohol consumption. Guidelines suggest a 7% to 10% reduction in body weight over 12 months through exercise and calorie reduction. The long-term goal is to achieve and maintain a body mass index (BMI) of less than 25 kg/m². The American Heart Association and American College of Cardiology recommend 150 minutes of moderate-intensity or 70 minutes of high-intensity exercise weekly. Chiropractors and athletic therapists can design and supervise personalized exercise programs tailored to the patient’s abilities and goals, which is essential for managing metabolic syndrome. Our experienced chiropractor, Dr. David Tam, and our knowledgeable athletic therapist, Andy, can help patients with metabolic syndrome achieve better health outcomes and reduce the risk of cardiovascular complications.

A diet rich in vegetables, fruits, legumes, whole grains, nuts, and fish is encouraged, while avoiding processed foods, refined carbohydrates, saturated fats, and excess sodium. Social support and stress management are also important for maintaining a healthy lifestyle. Personalized lifestyle plans based on age, gender, and resources help sustain these changes. Our experienced naturopath, Dr. Wendy Zhou, can help recommend personalized dietary plans, certain supplements to support metabolic health, and create individualized exercise plans to encourage regular physical activity.

Before considering medications, it's crucial to implement a healthy lifestyle. Medications are commonly used to treat dyslipidemia (abnormal cholesterol levels), hypertension (high blood pressure), and insulin resistance or diabetes in patients with metabolic syndrome. Although some studies suggest plant extracts might help manage metabolic syndrome, current guidelines do not recommend them, pending further research. Patients with metabolic syndrome often need multiple medications to manage cholesterol, blood pressure, insulin resistance, and obesity, requiring close monitoring for treatment adherence.

For patients with severe obesity, bariatric surgery may be beneficial. This surgery is considered the most effective single treatment for metabolic syndrome. Common procedures include gastric banding, gastric bypass, and sleeve gastrectomy. Bariatric surgery is recommended for patients with a BMI of 40 kg/m² or higher, or those with a BMI of 35 kg/m² or higher with other health issues. Long-term follow-up is necessary after surgery to monitor for surgical, nutritional, and psychological complications.

If you have questions about metabolic syndrome or want to know if you might have it, our healthcare providers are here to help! Our naturopathic doctor, Dr. Wendy Zhou, and our nurse practitioner, Angena, will take a detailed look at your health history, lifestyle, and current symptoms to address your specific needs. Call us at (289) 554-9919 or visit our website to book your appointment today!

References

Riediger, N. D., & Clara, I. (2011). Prevalence of metabolic syndrome in the Canadian adult population. Canadian Medical Association Journal (CMAJ), 183(15), E1127–E1134. https://doi.org/10.1503/cmaj.110070

Swarup, S., Ahmed, I., Grigorova, Y., & Zeltser, R. (2024) Metabolic Syndrome. In: StatPearls [Internet]. StatPearls Publishing. Retrieved May 23, 2024 from https://www.ncbi.nlm.nih.gov/books/NBK459248/