What is Metabolic Syndrome?

Metabolic syndrome is a group of five conditions that increase your risk for heart disease, stroke, and type 2 diabetes. A diagnosis is made when three or more are present: high glucose, low HDL cholesterol, high triglycerides, excess abdominal fat, or high blood pressure.

At a glance:

• Insulin resistance, where cells don't respond well to insulin, is considered a primary driver behind metabolic syndrome.
• Learn about the common clinical tests used for diagnosis, including a lipid panel and a fasting glucose test.
• The Nutrisense program is currently available only within the United States.

What is Metabolic Syndrome?

Sedentary time and convenience foods have increased the prevalence of metabolic syndrome.

Metabolic syndrome is defined as a cluster of interconnected risk factors that increase the likelihood of developing heart disease, stroke, and type 2 diabetes. The main risk factors of metabolic syndrome include:

• High blood pressure
• High glucose
• Excess abdominal fat
• Low HDL levels
• High levels of triglycerides

Diagnosis Threshold

A diagnosis of metabolic syndrome occurs when you have three or more of these health conditions. Understanding what metabolic syndrome is and how to avoid it can be paramount to your overall health.

In this article, we’ll cover the causes of metabolic syndrome, signs and symptoms to look out for, and lifestyle changes that can potentially help you lower your risk of developing this condition and improve your metabolic health.

What Causes Metabolic Syndrome?

Many factors contribute to metabolic syndrome, and while some of these factors can potentially be avoided through lifestyle changes, others may be harder to avoid. Here are the causes of metabolic syndrome to be aware of.

Genetics

Certain people with a family history of this condition may be genetically predisposed to be more likely to develop metabolic syndrome. A study found that having family members with metabolic syndrome can increase your risk of developing metabolic syndrome. While you cannot change your genetics, you can take proactive steps to lower risk factors if you know this health condition runs in your family.

Insulin Resistance

Insulin resistance is the hallmark feature of metabolic syndrome. Insulin resistance occurs when your cells cannot correctly respond to insulin, leaving them unable to use the glucose in your blood for energy. Insulin resistance can lead to type 2 diabetes, cardiovascular disease, stroke, and other medical problems.

Several factors can increase your risk of developing insulin resistance, including:

• Excess body fat
• Inappropriate levels of physical activity
• Poor dietary choices, such as excessive consumption of ultra-processed foods
• Sleep deprivation and high stress levels

Visceral vs Subcutaneous Fat

According to Dr. Brandy Zachary of the Functional Medicine Academy,

“Visceral fat stored in the abdominal cavity has a particularly adverse impact on metabolic health compared to subcutaneous fat. Visceral fat is metabolically active and produces higher levels of proteins and hormones that can drive insulin resistance, inflammation, and other metabolic abnormalities. Additionally, a sedentary lifestyle with low levels of physical activity leads to reduced glucose uptake in muscles and organs, worsening insulin resistance across bodily tissues.”

Other Medical Conditions

Medical conditions such as polycystic ovary syndrome, Cushing’s syndrome, hypothyroidism, and nonalcoholic fatty liver disease are also linked to an increased risk of metabolic syndrome.

• PCOS: A hormonal disorder that can contribute to insulin resistance and other metabolic abnormalities.
• Cushing’s syndrome: A condition that results from excessive cortisol production, leading to weight gain and metabolic changes.
• Hypothyroidism: A condition linked to thyroid functioning that can lead to weight gain, high cholesterol, and other metabolic issues, including insulin resistance.
• Nonalcoholic fatty liver disease (NAFLD): A condition that can cause insulin resistance and metabolic syndrome, often a result of obesity.

Environmental Factors

Environmental factors such as air pollution can also be a factor leading to certain metabolic risk factors. According to research, excessive exposure to endocrine disruptor compounds like BPA and PFAs can lead to impaired immune function and increase your risk of conditions like type 2 diabetes and obesity.

Diet and Lifestyle

Implementing habits such as following a balanced and healthy diet, getting appropriate levels of physical activity, reducing stress, limiting alcohol, and not smoking can help you lower the risk of metabolic syndrome.

When your diet is unbalanced and you’re not physically active, you may be at a higher risk of obesity, high cholesterol, high triglycerides, high blood pressure, and diabetes—all the components of metabolic syndrome.

What are the Signs and Symptoms of Metabolic Syndrome?

There are many common signs and symptoms of metabolic syndrome. It is important to remember that just because you have one of the symptoms listed, it does not mean that you have metabolic syndrome. Three or more of these metabolic risk factors are required for a diagnosis of metabolic syndrome.

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When 'Doing Everything Right' Isn't Enough

You leave the doctor's office with more questions than answers. Your blood pressure is still high, and your lab work shows elevated triglycerides. You’ve been consistently active and mindful of your diet, but your waist measurement is now over 35 inches. 

It’s frustrating to feel like, despite all your effort, your body is working against you. As one member shares: “I feel more confident and I think I'm healthier and I understand how glucose work in my body.”

High Blood Pressure

High blood pressure is one of the common signs of metabolic syndrome. A normal blood pressure is 120/80 mmHg. Elevated blood pressure occurs when your systolic (top number) or diastolic (bottom number) pressure is higher than normal.

High Glucose

If your fasting glucose is consistently higher than 100 mg/dL, it is considered abnormal. A fasting glucose of 100-125 mg/dL is an indication of prediabetes.

High Triglycerides

Triglycerides are a type of fat (called lipids) that are found in your blood. When you eat more than your body needs, the excess calories are converted into triglycerides. A normal triglyceride level for adults is less than 150 mg/dL. High triglycerides can put you at risk for a heart attack, diabetes, stroke, and metabolic syndrome.

Low HDL Cholesterol

HDL cholesterol refers to the “high-density lipoprotein” in your blood. HDL cholesterol is called the “good” cholesterol because it helps remove other types of cholesterol in your blood. Having an HDL level lower than 40 mg/dL in men and lower than 50 mg/dL in women can indicate that you are at risk for metabolic syndrome and heart disease.

Excess Belly Fat

According to the American Heart Association, having a waist circumference above 35 inches (88.9 cm) for women and 40 inches (101.6 cm) for men is considered abnormal. Excess fat around the waistline that is associated with metabolic syndrome is sometimes described as “apple-shaped.”

If you experience abdominal obesity, your doctor may advise weight loss in order to reach a healthier body mass index (BMI).

Other Symptoms

Beyond the markers we’ve already discussed, other symptoms of metabolic syndrome may include:

• Increased thirst and urination
• Blurred vision
• Skin darkening on the back of the neck and skin folds
• Fatigue and weakness

How is Metabolic Syndrome Diagnosed?

If you possess any of the risk factors for metabolic syndrome, there are tests that your healthcare provider can conduct to determine if you have this condition or if you’re at risk.

Fasting Glucose

A fasting glucose test is given after you’ve had nothing to eat or drink for the previous eight hours. Your healthcare provider will take a small amount of blood to measure the level of glucose present.

Blood Pressure Measurement

This test measures the force of blood flowing through your arteries using a blood pressure cuff placed around your upper arm or wrist. High blood pressure is a key component of metabolic syndrome.

Lipid Panel

This blood test measures the levels of different types of cholesterol and triglycerides in your blood. High amounts of triglycerides, high LDL cholesterol, or low levels of HDL cholesterol are other components of metabolic syndrome.

Hemoglobin A1C

This blood test, also known as an A1C test, measures your glucose average over the past two to three months. The result is provided as an average of your glucose levels during that time. If your A1C level is higher than 5.7 percent, you are at risk for developing prediabetes or diabetes.

How Can You Lower Your Risk of Metabolic Syndrome?

If you’ve been given a diagnosis of metabolic syndrome, not to fear! By working with a healthcare professional and implementing healthy lifestyle habits, it may be possible to improve or reverse symptoms.

As Dr. Zachary shares, “lifestyle changes I would recommend to reduce one's risk of developing metabolic syndrome include:

• Improving diet quality
• Increasing physical activity and exercise
• Achieving or maintaining a healthy body weight
• Ensuring adequate sleep

Adopting these healthy lifestyle factors can help prevent or mitigate several components of metabolic syndrome, including excess abdominal obesity, high blood pressure, blood lipid abnormalities, and insulin resistance.”

Here are a few more tips to help you create healthier habits for metabolic health:

• Eat a healthy diet: Include plenty of fruits, vegetables, lean proteins, and healthy fats, and reduce things like ultra-processed foods, trans fats, added sugar, and alcohol. Working with a qualified nutritionist is a great way to make sure you’re following a balanced diet that’s suited to your nutritional needs.
• Exercise regularly: Being physically active can decrease your likelihood of being overweight and can help your body utilize insulin more efficiently.
• Get plenty of sleep: Sleep deprivation can lead to insulin resistance. Make sure to prioritize getting seven to nine hours of sleep per night.
• Reduce stress: Chronic stress is also a major contributor to impaired insulin sensitivity and can contribute to metabolic dysfunction. Taking steps to reduce stress can support better metabolic health.

Stop smoking: Smoking tobacco damages blood vessels and contributes to inflammation, which can increase your risk of heart disease.