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home : columns : dr. k June 24, 2016

8/25/2012 10:47:00 AM
Dr. K for August 26, 2012
Metabolic syndrome affects millions of Americans

DEAR DOCTOR K: A friend recently told me about a condition called metabolic syndrome. What is it? And what can I do if I have it?

DEAR READER: Metabolic syndrome may be the most common condition you've never heard of. Many of my patients have it; nearly 50 million Americans have it -- and many of them don't know it.

Metabolic syndrome is dangerous. If you have it, you have a much higher risk of stroke or a heart attack, and of developing diabetes, kidney and liver disease. There's also evidence that older adults with metabolic syndrome are more likely to have memory problems.

Most important, you can cure it with changes in your lifestyle before you develop health problems.

You have metabolic syndrome if you have three or more of the following:
-- High blood pressure (hypertension).
-- Excess belly fat. This is measured as a waist size of 40 inches or more for men or 35 inches or more for women.
-- High triglycerides. This blood fat is often checked when you have a blood test for cholesterol.
-- Low levels of high-density lipoprotein (HDL). This is often called "good cholesterol."
-- High fasting blood sugar.

By the way, if you just determined that you have only one or two, but not three, of these factors, don't feel entirely relieved. You're still at higher risk of heart attack and stroke than people without any of these risk factors.

Fortunately, you can take many steps to prevent or avoid the metabolic syndrome:
-- Maintain a healthy body weight.
-- Get regular exercise.
-- Choose a healthy diet. It should be low in salt, in saturated and trans fats, and in highly processed foods such as white bread and sugary sodas. It should be high in omega-3 fats (as found in salmon and tuna, for example), in whole grains and fiber, and in vegetables and fruit.
-- Drink only moderate amounts of alcohol (one drink per day for women, one to two for men).
-- Don't smoke.

Talk to your doctor about whether you need medicines to lower blood pressure or triglycerides if they are high, and to raise HDL if it is low and is not raised just by exercising.

Also talk to your doctor about whether you need medicines to lower blood sugar if you have diabetes or "pre-diabetes." People with this condition have blood sugar that is above normal but not at diabetic levels.

Metabolic syndrome is a condition that doesn't always cause symptoms but does put your health at risk. This is especially true if you have other risk factors for heart disease, such as smoking or having other close relatives with heart disease.

If you have metabolic syndrome, you may be able to eliminate it completely without medicines -- just with changes in diet and exercise.

(Dr. Komaroff is a physician and professor at Harvard Medical School. To send questions, go to, or write: Ask Doctor K, 10 Shattuck St., Second Floor, Boston, MA 02115.)

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