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Metabolic syndrome

Dr Roger Henderson
Reviewed by Dr Roger HendersonReviewed on 13.10.2023 | 3 minutes read

Metabolic syndrome describes a collection of symptoms including obesity, high blood pressure and diabetes mellitus. Each one can cause long-term damage to your blood vessels, but if you have all three then together they significantly raise your chance of developing heart disease, early age heart attacks, strokes and serious and life-threatening conditions.

The combination is very common, affecting 33% of adults over 50 in the UK, and that figure is growing as obesity becomes more common.

What are the symptoms of metabolic syndrome?

Metabolic syndrome is a collection of three clearly-defined conditions:

  • Obesity, defined as a waistline of at least 89 centimetres for women and 102 centimetres for men
  • High blood pressure, defined as higher than 140/90
  • Diabetes, diagnosed on a blood test where HbA1C is higher than 48mmol/mol (or 6.5%)
  • High cholesterol, as defined by high triglycerides and low HDL levels

What can I do to improve my risk?

Unfortunately it’s hard work to bring down your risk and get healthy. Medications can help, for example with high cholesterol and diabetes, but much of it comes down to you and making substantial lifestyle changes.

A good place to start is educating yourself and setting goals. Weight is the biggest factor to change, and adding in a healthy diet with healthy proportions plus exercise will also help diabetes and high cholesterol. The ability to lose weight, just 7% of your body weight, is a big factor in reducing inflammation in the blood vessels and insulin resistance.

A well-balanced, nutritional diet includes foods low in salt, sugar and saturated fat, and increase your intake of fibre, fruit, vegetables and lean protein. Getting at least 30 minutes of moderately intense physical activity most days helps build a healthier you.

Stress is an understated risk factor in disease progression and where possible you should manage your emotional, mental, and physical wellbeing.

And smoking and excess alcohol add more injury to your blood vessels, so stopping smoking and cutting down on alcohol, if applicable, should also be in your goals. Plus alcohol contains lots of hidden calories, which undoes the other good work you are aiming at.

What are the risk factors?

Metabolic syndrome increases with increasing age, affecting more people over the age of 50. Your risk of metabolic syndrome is increased if you have other medical conditions such as non-alcoholic fatty liver disease, sleep apnoea or polycystic ovarian syndrome. Having a family history of diabetes, high blood pressure and high cholesterol all increase your risk also.

Metabolic syndrome alone increases your chance of infertility, and as PCOS is related, this then makes it even harder if you’re trying to get pregnant.

How is metabolic syndrome diagnosed?

If you think you are overweight or obese, it’s worth seeing your doctor to consider if there are any medical problems contributing to this, and any means by which the NHS can help – local weight loss programmes or exercise on prescription, for example.

The NHS offers a free on-off health check for those over 40, to review your cardiovascular risk. This will involve a conversation understanding your personal history and family history, examination of your weight, height and blood pressure and having blood tests taken to assess your risk of developing metabolic syndrome.

If you have any of these conditions before the age of 40, your doctor will assess your risk of having the other conditions regularly and will encourage you to undertake lifestyle changes to reduce your risk.

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Dr Roger Henderson
Reviewed by Dr Roger Henderson
Reviewed on 13.10.2023