Metabolic Syndrome

What is metabolic syndrome?

Metabolic syndrome is the name for a group of risk factors for heart disease, diabetes, and other health problems. You can have just one risk factor, but people often have several of them together. When you have at least three of them, it is called metabolic syndrome. These risk factors include:

• A large waistline, also called abdominal obesity or "having an apple shape." Too much fat around the stomach is a greater risk factor for heart disease than too much fat in other parts of the body.
• Having a high triglyceride level. Triglycerides are a type of fat found in the blood.
• Having a low HDL cholesterol level. HDL is sometimes called the "good" cholesterol because it helps remove cholesterol from your arteries.
• Having high blood pressure. If your blood pressure stays high over time, it can damage your heart and lead to other health problems.
• Having a high fasting blood sugar. Mildly high blood sugar may be an early sign of diabetes.

The more factors you have, the higher your risk for heart disease, diabetes, and stroke is.

What causes metabolic syndrome?

Metabolic syndrome has several causes that act together:

• Overweight and obesity
• An inactive lifestyle
• Insulin resistance, a condition in which the body can't use insulin properly. Insulin is a hormone that helps move blood sugar into your cells to give them energy. Insulin resistance can lead to high blood sugar levels.
• Age - your risk goes up as get older
• Genetics - ethnicity and family history

People who have metabolic syndrome often also have excessive blood clotting and inflammation throughout the body. Researchers don't know whether these conditions cause metabolic syndrome or worsen it.

Who is at risk for metabolic syndrome?

The most important risk factors for metabolic syndrome are:

• Abdominal obesity (a large waistline)
• An inactive lifestyle
• Insulin resistance

There are certain groups of people who have an increased risk of metabolic syndrome:

• Some racial and ethnic groups. Mexican Americans have the highest rate of metabolic syndrome, followed by White and Black people.
• People who have diabetes
• People who have a sibling or parent who has diabetes
• Women with polycystic ovary syndrome (PCOS)
• People who take medicines that cause weight gain or changes in blood pressure, blood cholesterol, and blood sugar levels

What are the symptoms of metabolic syndrome?

Most of the metabolic risk factors have no obvious signs or symptoms, except for a large waistline.

How is metabolic syndrome diagnosed?

Your health care provider will diagnose metabolic syndrome based on the results of a physical exam and blood tests. You must have at least three of the risk factors to be diagnosed with metabolic syndrome:

• A large waistline, which means a waist measurement of
  • 35 inches or more for women
  • 40 inches or more for men
• A high triglyceride level, which is 150 mg/dL or higher
• A low HDL cholesterol level, which is
  • Less than 50 mg/dL for women
  • Less than 40 mg/dL for men
• High blood pressure, which is a reading of 130/85 mmHg or higher.
• A high fasting blood sugar, which is 100 mg/dL or higher

What are the treatments for metabolic syndrome?

The most important treatment for metabolic syndrome is a heart-healthy lifestyle, which includes:

• A heart-healthy eating plan, which limits the amount of saturated and trans fats that you eat. It encourages you to choose a variety of nutritious foods, including fruits, vegetables, whole grains, and lean meats.
• Aiming for a healthy weight
• Managing stress
• Getting regular physical activity
• Quitting smoking (or not starting if you don't already smoke)

If making lifestyle changes is not enough, you may need to take medicines. For example, you may need medicines to lower cholesterol or blood pressure.

Can metabolic syndrome be prevented?

The best way to prevent metabolic syndrome is through the heart-healthy lifestyle changes.

NIH: National Heart, Lung, and Blood Institute

How to Prevent Heart Disease

Heart disease is the leading cause of the death in the United States. It is also a major cause of disability. But you can take steps to improve your health and help prevent heart disease. The first step is understanding your risk of heart disease. Your risk depends on many factors, some of which are changeable and others that are not. Learning about them and working on the things that you can change can lower your risk of heart disease.

What are the heart disease risk factors that I cannot change?

There are some risk factors for heart disease that you cannot change:

• Your age. Your risk of heart disease increases as you get older. The risk is higher in:
  • Men age 45 and older
  • Women age 55 and older
• Your sex. Some risk factors may affect heart disease risk differently in women than in men. For example:
  • The hormone estrogen provides women some protection against heart disease
  • Diabetes raises the risk of heart disease more in women than in men.
• Your race or ethnicity. Certain groups have higher risks than others. For example:
  • African Americans are more likely than Whites to die of heart disease, while Hispanic Americans are less likely to die of it
  • Asian Americans as a group have lower rates of heart disease than other groups, but South Asian Americans have higher rates
• Your family history. You have a greater risk if you have a close family member who had heart disease at an early age, for example if:
  • Your father or brother was diagnosed before age 55
  • Your mother or sister was diagnosed before age 65

What are the heart disease risk factors I can change and what can I do to lower my risk?

There are many heart disease risk factors that you can change. If you make these changes, you don't just help protect your heart. You can also improve your overall health and well-being.

You may have a lot of changes to make. If you need to, you can make the changes gradually, one at a time. What's most important is that you make them. Depending on your lifestyle, these changes could include:

• Controlling your blood pressure.High blood pressure is a major risk factor for heart disease. It is important to get your blood pressure checked regularly - at least once a year for most adults, and more often if you have high blood pressure. You can also take steps, including lifestyle changes, to prevent or control high blood pressure.
• Keeping your cholesterol and triglyceride levels under control:
  • High levels of cholesterol can clog your arteries and raise your risk of coronary artery disease and heart attack. Lifestyle changes and medicines (if needed) can lower your cholesterol.
  • Triglycerides are another type of fat in the blood. High levels of triglyceride may also raise the risk of coronary artery disease, especially in women.
• Staying at a healthy weight. Being overweight or having obesity can increase your risk of heart disease. This is mostly because they are linked to other heart disease risk factors, including high blood cholesterol and triglyceride levels, high blood pressure, and diabetes. Controlling your weight can lower these risks.
• Eating a healthy diet. Try to limit saturated fats, foods high in sodium (salt), and added sugars. Instead, eat plenty of fresh fruit, vegetables, and whole grains. The DASH diet is an example of an eating plan that can help you to lower your blood pressure and cholesterol, two things that can lower your risk of heart disease.
• Getting regular physical activity. Regular physical activity has many benefits, including strengthening your heart and improving your circulation. It can also help you maintain a healthy weight and lower cholesterol and blood pressure. All of these can lower your risk of heart disease.
• Limiting alcohol. Drinking too much alcohol can raise your blood pressure. It also adds extra calories, which may cause weight gain. Both of those raise your risk of heart disease. It's best not to drink, but if you do:
  • Have no more than 2 drinks per day if you are a man.
  • Have no more than 1 drink per day if you are a woman.
• Not smoking. Cigarette smoking raises your blood pressure and puts you at higher risk of heart attack and stroke.
  • If you do not smoke, don't start.
  • If you do smoke, quitting will lower your risk of heart disease. You can talk with your health care provider for help in finding the best way for you to quit.
• Managing stress.Stress is linked to heart disease in many ways. It can raise your blood pressure. Extreme stress can be a "trigger" for a heart attack. Also, some common ways of coping with stress, such as overeating, heavy drinking, and smoking, are bad for your heart. Some ways to help manage your stress include exercise, listening to music, focusing on something calm or peaceful, and meditating.
• Managing diabetes. Having diabetes doubles your risk of diabetic heart disease. That is because over time, high blood glucose (blood sugar) from diabetes can damage your blood vessels and the nerves that control your heart and blood vessels. So, it is important to get tested for diabetes, and if you have it, to keep it under control.
• Getting enough sleep. If you don't get enough sleep, you raise your risk of high blood pressure, obesity, and diabetes. Those three things can raise your risk of heart disease. To improve your sleep:
  • If you are an adult, try to get 7 to 9 hours of sleep per night.
  • Make sure that you have good sleep habits, such as keeping a regular sleep schedule and creating a good sleeping environment in your bedroom.
  • If you have frequent sleep problems, contact your health care provider. One problem, sleep apnea, causes people to briefly stop breathing many times during sleep. This interferes with your ability to get a good rest and can raise your risk of heart disease. If you think you might have sleep apnea, ask your provider about having a sleep study. And if you do have sleep apnea, make sure that you get treatment for it.

Eye Care

Your eyes are an important part of your health. Most people rely on their eyes to see and make sense of the world around them. But some eye diseases can lead to vision loss, so it is important to identify and treat eye diseases as early as possible. You should get your eyes checked as often as your health care provider recommends it, or if you have any new vision problems. And just as it is important to keep your body healthy, you also need to keep your eyes healthy.

Eye Care Tips

There are things you can do to help keep your eyes healthy and make sure you are seeing your best:

• Eat a healthy, balanced diet. Your diet should include plenty or fruits and vegetables, especially deep yellow and green leafy vegetables. Eating fish high in omega-3 fatty acids, such as salmon, tuna, and halibut can also help your eyes.
• Maintain a healthy weight. Being overweight or having obesity increases your risk of developing diabetes. Having diabetes puts you at higher risk of getting diabetic retinopathy or glaucoma.
• Get regular exercise. Exercise may help to prevent or control diabetes, high blood pressure, and high cholesterol. These diseases can lead to some eye or vision problems. So if you exercise regularly, you can lower your risk of getting these eye and vision problems.
• Wear sunglasses.Sun exposure can damage your eyes and raise your risk of cataracts and age-related macular degeneration. Protect your eyes by using sunglasses that block out 99 to 100% of both UV-A and UV-B radiation.
• Wear protective eye wear. To prevent eye injuries, you need eye protection when playing certain sports, working in jobs such as factory work and construction, and doing repairs or projects in your home.
• Avoid smoking. Smoking increases the risk of developing age-related eye diseases such as macular degeneration and cataracts and can damage the optic nerve.
• Know your family medical history. Some eye diseases are inherited, so it is important to find out whether anyone in your family has had them. This can help you determine if you are at higher risk of developing an eye disease.
• Know your other risk factors. As you get older, you are at higher risk of developing age-related eye diseases and conditions. It is important to know your risk factors because you may be able to lower your risk by changing some behaviors.
• If you wear contacts, take steps to prevent eye infections. Wash your hands well before you put in or take out your contact lenses. Also follow the instructions on how to properly clean them, and replace them when needed.
• Give your eyes a rest. If you spend a lot of time using a computer, you can forget to blink your eyes and your eyes can get tired. To reduce eyestrain, try the 20-20-20 rule: Every 20 minutes, look away about 20 feet in front of you for 20 seconds.

Eye Tests and Exams

Everyone needs to have their eyesight tested to check for vision and eye problems. Children usually have vision screening in school or at their health care provider's office during a checkup. Adults may also get vision screenings during their checkups. But many adults need more than a vision screening. They need a comprehensive dilated eye exam.

Getting comprehensive dilated eye exams is especially important because some eye diseases may not have warning signs. The exams are the only way to detect these diseases in their early stages, when they are easier to treat.

The exam includes several tests:

• A visual field test to measure your side (peripheral) vision. A loss of peripheral vision may be a sign of glaucoma.
• A visual acuity test, where you read an eye chart about 20 feet away, to check on how well you see at various distances
• Tonometry, which measures your eye's interior pressure. It helps to detect glaucoma.
• Dilation, which involves getting eye drops that dilate (widen) your pupils. This allows more light to enter the eye. Your eye care provider examines your eyes using a special magnifying lens. This provides a clear view of important tissues at the back of your eye, including the retina, macula, and optic nerve.

If you have a refractive error and are going to need glasses or contacts, then you will also have a refraction test. When you have this test, you look through a device that has lenses of different strengths to help your eye care professional figure out which lenses will give you the clearest vision.

At what age you should start getting these exams and how often you need them depends on many factors. They include your age, race, and overall health. For example, if you are African American, you are at higher risk of glaucoma and you need to start getting the exams earlier. If you have diabetes, you should get an exam every year. Check with your health care provider about if and when you need these exams.

Islet Cell Transplantation

Islets are cells found in clusters throughout the pancreas. They are made up of several types of cells. One of these is beta cells, which make insulin. Insulin is a hormone that helps the body use glucose for energy. Islet cell transplantation transfers cells from an organ donor into the body of another person. It is an experimental treatment for type 1 diabetes.

In type 1 diabetes, the beta cells of the pancreas no longer make insulin. A person who has type 1 diabetes must take insulin daily to live. Transplanted islet cells, however, can take over the work of the destroyed cells. The beta cells in these islets will begin to make and release insulin. Researchers hope islet transplantation will help people with type 1 diabetes live without daily insulin injections.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

Pancreatic Diseases

The pancreas is a gland behind your stomach and in front of your spine. It produces juices that help break down food and hormones that help control blood sugar levels. Problems with the pancreas can lead to many health problems. These include:

• Pancreatitis, or inflammation of the pancreas: This happens when digestive enzymes start digesting the pancreas itself
• Pancreatic cancer
• Cystic fibrosis, a genetic disorder in which thick, sticky mucus can also block tubes in your pancreas

The pancreas also plays a role in diabetes. In type 1 diabetes, the beta cells of the pancreas no longer make insulin because the body's immune system has attacked them. In type 2 diabetes, the pancreas loses the ability to secrete enough insulin in response to meals.