What Is Metabolic Syndrome, Exactly?

When you hear the term "metabolic syndrome," you might think it has to do with a slow or wonky metabolism, but the condition is actually much more complicated. It occurs when several health factors (think: high blood pressure and cholesterol) come together and, like a brewing storm, signal a higher risk for more serious ailments like diabetes and heart disease.

Since it's not exactly a household name, here's what you need to know about the condition and what you can do to avoid or even help reverse it.

Think of metabolic syndrome as a cluster of risk factors — specifically, high blood pressure, high triglycerides, elevated blood sugar levels, low HDL or "good" cholesterol and abdominal obesity (aka having too much fat around the waist) — that can snowball into chronic disease, says Sudipa Sarkar, MD, assistant professor and endocrinologist at Johns Hopkins School of Medicine.

The condition can double your risk for heart disease and rocket up your chances of developing type 2 diabetes by five-fold, according to a study published March 2017 in ‌Preventing Chronic Disease‌. It's also been linked to arthritis, several types of cancer and early death.

Metabolic syndrome affects 34 percent of adults in the United States, per the above study, an increase of more than 35 percent from 20 years ago. Your chances of developing the condition also increase with age.

Metabolic syndrome is like a big blinking light on your dashboard, warning that you're at risk of developing diabetes or heart disease: "It's the perfect time to intervene and to re-double efforts to turn things around."

"We see this in clinic every day," says Mark Benson, MD, physician and director of preventive cardiology at Beth Israel Deaconess Medical Center. "There's been a rapid uptick of people who qualify for metabolic syndrome in large part driven by the increasing number of people who have overweight and obesity, changes in diet on the population level and decreasing physical activity."

Dr. Benson says that the five risk factors are a barometer for an individual's metabolic health, over and above just their weight or body mass index.

"What's likely happening is that in some people who [have] overweight or [obesity], the body starts to rewire itself metabolically, which ultimately leads to a state of insulin resistance," he says. "That insulin resistance can lead to inflammation of the coronary arteries and an abnormal cholesterol profile," slowly leading to diabetes and coronary heart disease.

You know the drill. During your annual check-up, your doctor notes your height, weight and blood pressure and runs tests to measure things like your cholesterol and blood sugar levels. He or she will be on alert if abnormal levels pop up across several different measures.

When diagnosing metabolic syndrome, physicians look for at least three of the following:

• ‌Waist circumference:‌ Greater than 35 inches for women and 40 inches for men
• ‌Triglyceride levels:‌ 150 mg/dL or higher
• ‌HDL cholesterol:‌ Lower than 50 mg/dL for women and 40 mg/dL for men
• ‌Blood pressure:‌ 130/85 mmHg or higher
• ‌Fasting blood sugar levels:‌ 100 mg/dL or greater

"These risk factors seem to cluster and co-occur before people get either diabetes or coronary heart disease," says Dr. Benson. "When you find one, it's a signal to evaluate for the others."

No only does metabolic syndrome put you at risk for diabetes and heart disease, it can also raise your risk for stroke, nonalcoholic fatty liver disease, polycystic ovarian syndrome and sleep apnea. For people with diabetes, it could also up the chances of damage to your nerves and retina, says Dr. Sarkar.

"Make sure you have a good primary care doctor and talk to them about what is considered a healthy weight and blood pressure for you, and if you need to be screened for conditions like diabetes," says Dr. Sarkar.

‌Read more:‌ The Long-Term Effects of Obesity on Health

Here's the good news: There are simple ways you can decrease your risk for metabolic syndrome or help reverse it if you've been diagnosed.

Metabolic syndrome is like a big blinking light on your dashboard, warning that you're at risk of developing diabetes or heart disease. "It's the perfect time to intervene and to re-double efforts to turn things around," says Dr. Benson. "You can reverse your risk."

‌1. Lose weight.‌ Weight loss can counter each individual risk factor and your chances of developing metabolic syndrome overall. But go slow and steady to make sure you can maintain the changes. "Try to shoot for reducing your body weight by 5 to 10 percent, which is about one to two pounds a month," says Dr. Benson. Ultimately, he says people should aim for a BMI of 25 or less.

‌Read more:‌ How Weight Loss Really Works — and How to Get Started

‌2. Move more.‌ Exercise helps, but you don't have to work out at a gym five times a week. You can walk, swim, practice yoga or garden — anything that gets you moving more. "Every time you take a flight of stairs, park one space further or walk to the water cooler, it counts," says Dr. Benson.

The Physical Activity Guidelines for Americans recommend getting a minimum of 150 minutes of moderate-intensity physical activity (like walking) or 75 minutes of vigorous-intensity activity (like running) each week. You could schedule in 20- or 30-minute workouts, but if you're strapped for time or just starting out, Dr. Benson says it's OK to break up the time into even smaller intervals.

‌3. Tweak your diet.‌ What you eat plays an important role too. A diet high in carbohydrates and simple sugars is a risk factor for metabolic syndrome, says Dr. Sarkar, so limit your intake of refined carbohydrates and other high-glycemic-index foods. Dr. Sarkar often recommends that her patients avoid sugar-sweetened beverages like soda and sports drinks. "Beverages can have a lot of carbohydrates and increase the risk of abnormal blood sugar levels. Cutting back is one easily identifiable goal," she says.

Instead, stick with a diet that includes whole grains, lean proteins like chicken and fish, heart-healthy fats and lots of vegetables and fruits, advises Sandra Allonen, RD, a dietitian at Beth Israel Deaconess Medical Center. A September 2019 meta-analysis in the journal ‌Nutrients‌ found that this eating pattern led to a lower risk for metabolic syndrome.

The Mayo Clinic recommends the DASH diet and Mediterranean diet as two good options for those who want to reverse a metabolic syndrome diagnosis.

‌Read more:‌ How to Find the Right Diet Plan for Your Health Goals

"Focus on making healthy choices. They don't have to be big, sweeping changes," says Allonen. "Once you get good at that one or two things, you can add a couple more. If you try to take on everything at once, it can be really overwhelming."