What’s This Metabolic Syndrome I’ve Been Hearing So Much About?

Andrew Siegel, M.D.    Blog #71


The “metabolic syndrome” is a cluster of risk factors that are dangerous to your health.  These include visceral obesity as defined by waist circumference, elevated blood glucose level, high blood pressure, elevated triglycerides, and low HDL cholesterol (the good cholesterol).  Visceral obesity is a collection of fat within the abdomen as opposed to under the skin (subcutaneous fat).

When a patient walks into the office and the first thing observed is a protuberant and bulging belly, a siren goes off screaming “metabolic syndrome, metabolic syndrome, metabolic syndrome.”

If you have at least three of the following five risk factors, you have metabolic syndrome.  Those who have metabolic syndrome often develop cardiovascular disease and/or type-2 diabetes.

 Features of Metabolic Syndrome:


  • Elevated waist circumference: men > 40 inches; women > 35 inches
  • Elevated triglycerides: > 150 mg/dL
  • Reduced HDL (“good”) cholesterol: men < 40 mg/dL; women

< 50 mg/dL

  • Elevated blood pressure: > 130/85 mm Hg
  • Elevated fasting glucose (sugar): >100 mg/dL

One of every four Americans has metabolic syndrome. This syndrome is caused by insulin resistance—the body’s inability to properly process nutrients including sugars and fats because the pancreatic hormone insulin no longer works in an efficient manner to get nutrients into our cells.  The root cause of insulin resistance is too much waist and not enough movement.  Essentially, our well-engineered systems are “flooded” by taking in excessive calories.  Our bodies simply were not designed for chronic caloric overload, and the only people who can handle this caloric flooding are endurance athletes who burn the calories, such as Michael Phelps.

Triglycerides are the main fat in food and the bloodstream.  One in three adults have a fasting triglyceride level higher than 150; optimally, triglycerides should be under 100.  Even a non-fasting triglyceride level should not be that high, because no healthy person should ever develop an extremely high level even in response to a fatty meal.  Diets high in sugar are the major underlying cause of elevated triglycerides.

The good news is that lifestyle modification has a very positive impact on triglyceride level—it is very possible for triglycerides to decline as much as 30% based upon a diet with less calories, sugar, saturated fat and alcohol.  EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid) are marine-derived omega fats that are capable of lowering triglycerides.  Fish contain these two omega-3 fats because they consume algae that are rich in them.   Exercise is an equally important component of lowering triglycerides, since it activates lipoprotein lipase, which breaks down triglycerides.

Ways To Avoid Metabolic Syndrome:

  • Lose excess weight to improve each of the five features of metabolic syndrome
  • Eat a diet with abundant fruit, vegetables, and fiber
  • Minimize saturated fats and refined carbohydrates
  • Minimize sugar: the American Heart Association recommends a maximum of 6 teaspoons daily for women and 9 for men, including the sugar in processed foods
  • Eat fatty fish high in EPA and DHA including salmon, herring, sardines, halibut and trout; if you don’t eat fish, take fish oil capsules
  • Exercise will facilitate weight loss and will improve every feature of metabolic syndrome

Andrew Siegel, M.D.

Author of Promiscuous Eating: Understanding and Ending Our Self-Destructive Relationship with Food


Now available on Amazon Kindle


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