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Deadly syndrome is preventable, treatable
BY: EILEEN BEAL Freelance Writer
Metabolic syndrome is a cluster of medical conditions you are going to be hearing lots about in the future.
People with metabolic syndrome are overweight-to-obese and have a dramatically increased risk for both cardiovascular disease and diabetes and the complications that come with them: heart attacks, strokes, organ failure, blindness, amputations, dementia, and premature death. According to the National Institutes of Health’s Heart, Lung and Blood Institute, over 47 million U.S. citizens currently fit this unhealthy profile.
Health experts commenting on the death of Tim Russert n the moderator of NBC’s “Meet the Press” who suffered a fatal heart attack on June 13 n called him the “poster boy” for metabolic syndrome. Over the years he’d packed on the pounds, particularly around his middle, attaining what is described as the “apple shape” that is both the trigger for and hallmark of metabolic syndrome.
Three are enough
There are five standard risk factors for metabolic syndrome. Not surprisingly, they are also risk factors for cardiovascular disease and/or diabetes. If you have three of them, you are “diagnosed” with the syndrome.
The most obvious one is the girth you get with obesity: A 40-inch waist in men and a 35-inch waist in women is strike one. Because it’s near vital organs n i.e. liver, kidneys, heart n belly fat can be deadly.
“It seeps into and around the organs and interferes with their function,” explains Dr. Esa Davis, a diabetes specialist at University Hospitals Case Medical Center. “When these organs don’t function well, they aren’t able to control things like blood sugar and cholesterol.”
The other risk factors are:
• Elevated blood pressure (130/85 or higher)
• Elevated fasting glucose/blood sugar levels (100mg/dL or higher)
• Elevated triglycerides/blood fats (150 mg/dL or higher)
• Reduced levels of HDL (good) cholesterol (less than 40 mg/dL in men and 50 mg/dL in women)
Alone, but more so in concert, these factors increase the risk for developing atherosclerosis, which weakens, clogs, narrows and/or hardens arteries, says Dr. David Rosenbaum, director of the Heart and Vascular Center at MetroHealth Medical Center. Damaged arteries cause heart attacks and strokes and help set the stage for diabetes-related nerve and organ damage.
Who’s at risk
Since the cluster of conditions that make up metabolic syndrome are preventable, it’s important to know your risk status, says Dr. Robert Zimmerman, interim head of the Department of Endocrinology, Diabetes and Metabolism at The Cleveland Clinic. If you have one risk factor, you should be concerned. If you have two or more, you should be very concerned. Age is also part of the equation.
“Age itself is not a risk factor, but as people age,” says Rosenbaum, “they put on weight, high blood pressure worsens, they have more lipid (blood fat) abnormalities.”
Diagnosis and treatment
Primary care physicians can easily diagnose metabolic syndrome in their offices by identifying the individual components and assessing risk.
The best way to avoid developing metabolic syndrome is to exercise regularly and maintain a normal weight n below 25 on the BMI scale. (To calculate your BMI: www.nhlbisupport.com/BMI)
When prevention doesn’t work, first-line treatment is the same thing, only more so. Spend at least 150 minutes a week of moderate-to-vigorous exercise n the kind that “burns” fat and enables the body’s muscles and organs to better metabolize glucose (sugar), triglycerides (fats), and cholesterol. Follow a calorie-reduced diet that eliminates or severely limits intake of blood-pressure-raising salt and artery-clogging trans and saturated fats while increasing the intake of low-fat protein and fiber-dense foods, such as minimally processed whole grains, fruits, and vegetables.
“These can reduce the risk associated with every single component of metabolic syndrome,” says Rosenbaum.
Making those kinds of lifestyle changes often requires help, “a coach or some kind of support system,” and always requires time, says Cleveland Clinic dietitian Melissa Ohlson. “It takes time to get into the habit of doing things consistently. It takes time to see changes in (diagnostic) tests.”
When aggressive dietary changes and exercise don’t work n and for those who are obese or have traveled far down the metabolic syndrome pathway, they often don’t n medications to address each condition are added to the mix.
For those who are severely obese, weight loss (bariatric) surgery may be necessary. But surgery is not a cure, says Davis; it’s a tool that helps a person eat healthier and exercise.
Whether you prevent metabolic syndrome or “treat” it aggressively, the pay-off is pretty much the same n better overall health and a decidedly lower risk for heart attack, stroke and diabetes as you age.
For more information on metabolic syndrome, including diet and exercise information, see:
American Diabetes Association www.diabetes.org (type metabolic syndrome in box at upper right)
American Heart Association www.americanheart.org (go to Diseases & Conditions)
American Dietetic Association www.eatright.org (type in metabolic syndrome in box at upper right)
American Medical Association/Metabolic Syndrome www.jama.ama-assn.org/cgi/reprint/295/7/850.pdf
DASH Dietary Plan www.nhlbi.nih.gov/health/public/heart/ hbp/dash
National Heart, Lung, and Blood Institute www.nhlbi.nih.gov/health/ dci/Diseases/ms/ms_whatis.html
Medline Plus/Metabolic Disorders www.nlm.nih.gov/medlineplus/metabol icdisorders.html
Medline Plus/Metabolic Syndrome
www.nlm.nih.gov/medlineplus/metabol icsyndrome.html
People with metabolic syndrome are overweight-to-obese and have a dramatically increased risk for both cardiovascular disease and diabetes and the complications that come with them: heart attacks, strokes, organ failure, blindness, amputations, dementia, and premature death. According to the National Institutes of Health’s Heart, Lung and Blood Institute, over 47 million U.S. citizens currently fit this unhealthy profile.
Health experts commenting on the death of Tim Russert n the moderator of NBC’s “Meet the Press” who suffered a fatal heart attack on June 13 n called him the “poster boy” for metabolic syndrome. Over the years he’d packed on the pounds, particularly around his middle, attaining what is described as the “apple shape” that is both the trigger for and hallmark of metabolic syndrome.
Three are enough
There are five standard risk factors for metabolic syndrome. Not surprisingly, they are also risk factors for cardiovascular disease and/or diabetes. If you have three of them, you are “diagnosed” with the syndrome.
The most obvious one is the girth you get with obesity: A 40-inch waist in men and a 35-inch waist in women is strike one. Because it’s near vital organs n i.e. liver, kidneys, heart n belly fat can be deadly.
“It seeps into and around the organs and interferes with their function,” explains Dr. Esa Davis, a diabetes specialist at University Hospitals Case Medical Center. “When these organs don’t function well, they aren’t able to control things like blood sugar and cholesterol.”
The other risk factors are:
• Elevated blood pressure (130/85 or higher)
• Elevated fasting glucose/blood sugar levels (100mg/dL or higher)
• Elevated triglycerides/blood fats (150 mg/dL or higher)
• Reduced levels of HDL (good) cholesterol (less than 40 mg/dL in men and 50 mg/dL in women)
Alone, but more so in concert, these factors increase the risk for developing atherosclerosis, which weakens, clogs, narrows and/or hardens arteries, says Dr. David Rosenbaum, director of the Heart and Vascular Center at MetroHealth Medical Center. Damaged arteries cause heart attacks and strokes and help set the stage for diabetes-related nerve and organ damage.
Who’s at risk
Since the cluster of conditions that make up metabolic syndrome are preventable, it’s important to know your risk status, says Dr. Robert Zimmerman, interim head of the Department of Endocrinology, Diabetes and Metabolism at The Cleveland Clinic. If you have one risk factor, you should be concerned. If you have two or more, you should be very concerned. Age is also part of the equation.
“Age itself is not a risk factor, but as people age,” says Rosenbaum, “they put on weight, high blood pressure worsens, they have more lipid (blood fat) abnormalities.”
Diagnosis and treatment
Primary care physicians can easily diagnose metabolic syndrome in their offices by identifying the individual components and assessing risk.
The best way to avoid developing metabolic syndrome is to exercise regularly and maintain a normal weight n below 25 on the BMI scale. (To calculate your BMI: www.nhlbisupport.com/BMI)
When prevention doesn’t work, first-line treatment is the same thing, only more so. Spend at least 150 minutes a week of moderate-to-vigorous exercise n the kind that “burns” fat and enables the body’s muscles and organs to better metabolize glucose (sugar), triglycerides (fats), and cholesterol. Follow a calorie-reduced diet that eliminates or severely limits intake of blood-pressure-raising salt and artery-clogging trans and saturated fats while increasing the intake of low-fat protein and fiber-dense foods, such as minimally processed whole grains, fruits, and vegetables.
“These can reduce the risk associated with every single component of metabolic syndrome,” says Rosenbaum.
Making those kinds of lifestyle changes often requires help, “a coach or some kind of support system,” and always requires time, says Cleveland Clinic dietitian Melissa Ohlson. “It takes time to get into the habit of doing things consistently. It takes time to see changes in (diagnostic) tests.”
When aggressive dietary changes and exercise don’t work n and for those who are obese or have traveled far down the metabolic syndrome pathway, they often don’t n medications to address each condition are added to the mix.
For those who are severely obese, weight loss (bariatric) surgery may be necessary. But surgery is not a cure, says Davis; it’s a tool that helps a person eat healthier and exercise.
Whether you prevent metabolic syndrome or “treat” it aggressively, the pay-off is pretty much the same n better overall health and a decidedly lower risk for heart attack, stroke and diabetes as you age.
For more information on metabolic syndrome, including diet and exercise information, see:
American Diabetes Association www.diabetes.org (type metabolic syndrome in box at upper right)
American Heart Association www.americanheart.org (go to Diseases & Conditions)
American Dietetic Association www.eatright.org (type in metabolic syndrome in box at upper right)
American Medical Association/Metabolic Syndrome www.jama.ama-assn.org/cgi/reprint/295/7/850.pdf
DASH Dietary Plan www.nhlbi.nih.gov/health/public/heart/ hbp/dash
National Heart, Lung, and Blood Institute www.nhlbi.nih.gov/health/ dci/Diseases/ms/ms_whatis.html
Medline Plus/Metabolic Disorders www.nlm.nih.gov/medlineplus/metabol icdisorders.html
Medline Plus/Metabolic Syndrome
www.nlm.nih.gov/medlineplus/metabol icsyndrome.html
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