Metabolic syndrome is a disorder that typically involves a group of factors — such as high blood pressure, obesity, and high blood sugar — which are linked to an increased risk of heart disease and type 2 diabetes.
People with metabolic syndrome (also called insulin resistance syndrome or syndrome X) are twice as likely to develop heart disease and five times more likely to develop type 2 diabetes.

What Is Metabolic Syndrome?

“Metabolic syndrome is not well-defined,” says Vivian Fonseca, MD, professor of medicine and pharmacology and chief of endocrinology at Tulane University Health Sciences Center in New Orleans.
It’s a little bit more than prediabetes, says Dr. Fonseca, but metabolic syndrome has several other components to it, including high blood pressure and cholesterol problems. "Much of it is linked with obesity,” says Fonseca.
Metabolic syndrome is diagnosed when a patient has at least three of these risk factors:
  • Abdominal obesity: Defined by a waist circumference of over 35 inches for women and 40 inches for men.
  • High triglycerides: Triglycerides, a component of dietary fat, are said to be borderline at 150 mg/dL (deciliter) and elevated at over 200 mg/dL.
  • Low HDL cholesterol: HDL cholesterol is often referred to as “good” cholesterol because at higher levels it can actually protect against heart disease. Low HDL cholesterol is a risk factor for metabolic syndrome when it is below 40 mg/dL in men and below 50 mg/dL in women.
  • High blood pressure: At least 130/85, or you are taking medication to control blood pressure.
  • High fasting blood sugar: A blood sugar level of 100 mg/dL or greater after not eating for at least eight hours, or you are taking medication to control blood sugar.
Metabolic syndrome is linked to insulin resistance, which means that your body is not able to use insulin properly to remove blood sugar from your blood. This is what causes high blood sugar levels in many people who go on to develop type 2 diabetes.

Prevention is Possible

Close to one in four adults in the United States has metabolic syndrome. However, the good news is that metabolic syndrome can be prevented by making changes in diet and exercise habits.
Furthermore, for people already diagnosed with metabolic syndrome, making appropriate lifestyle changes can prevent it from turning into diabetes.
Research in more than 1,500 people with high fasting blood sugar (but without actual diabetes) who participated in a study called the Diabetes Prevention Program (DPP) indicates that the same weight-reducing changes in diet and lifestyle that prevent type 2 diabetes also cut the risk of developing metabolic syndrome.
Study participants who ate a low-fat, calorie-controlled diet and got at least 30 minutes of exercise most days of the week cut their risk of developing metabolic syndrome by 41 percent.
One third of the subjects in the DPP study were given metformin (Glucophage), a medication that controls blood sugar. After three years, these patients were also at lower risk of developing metabolic syndrome, although lifestyle changes had a greater impact.

What You Can Do

Fortunately, many of the factors that contribute to the development of diabetes and metabolic syndrome can be controlled. Here are five steps you can take to prevent diabetes and metabolic syndrome:
  • Maintain a healthy weight. If you are overweight or obese, losing as little as 5 to 10 percent of your body weight can cut your risk of diabetes in half and will also reduce your risk of metabolic syndrome.
  • Be active. Thirty minutes of physical activity a day most days of the week — or more if possible — can help cut your risk of metabolic syndrome and diabetes. Exercise is crucial because it helps control your weight, lowers your blood pressure, and helps your body to use insulin more effectively, thereby reducing your blood sugar and risk of diabetes. A study of 6,410 middle-aged men over the course of 28 years showed that the more active they were when they were not at work, the less likely they were to develop either diabetes or metabolic syndrome. Be sure to find activities you enjoy, such as walking or playing sports.
  • Don’t smoke. Although cigarette smoking is not a risk factor for developing diabetes, it is a risk factor for developing high blood pressure, elevated triglycerides, heart disease, and metabolic syndrome.
  • Limit alcohol consumption. A study of more than 1,500 people found that men who drank more than two drinks a day and women who drank more than one alcoholic drink per day had an increased risk of metabolic syndrome. Excess alcohol consumption can lead to weight gain, high blood pressure, and high triglycerides, all key components of metabolic syndrome.
  • Sleep seven to eight hours a night. Although the relationship between daily amount of sleep and metabolic syndrome is not yet fully understood, a study of 1,214 adults found that metabolic syndrome was more likely to occur in those who slept fewer than seven hours or more than eight hours a night. After the researchers took the use of high blood pressure medications into account (some of which can cause fatigue and longer sleep duration), the risk of metabolic syndrome was only found to be increased among those who slept less than seven hours nightly.