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home : columns : ask the doctors June 24, 2018

5/3/2018 7:44:00 AM
Metabolic syndrome more prevalent among older adults

Dear Doctor: My doctor says I'm on the verge of being diagnosed with something called "metabolic syndrome." Is it serious? Can I get rid of it?

Dear Reader: Metabolic syndrome refers to a collection of largely preventable conditions that add up to a serious health threat. As family doctors, the "preventable" part of that sentence is at the core of our work, which means you've hit on a topic near and dear to our hearts. Our mission, as we work with our patients over the years, is to track the big picture of an individual's health. When it comes to metabolic syndrome, it's not a pretty one.

Individuals who have high blood pressure, elevated levels of cholesterol and triglycerides, abnormal blood sugar, and who carry excess fat in the abdomen and around the waist are considered to have metabolic syndrome. When these conditions are all present at the same time, they lead to an increased likelihood of developing diabetes and heart disease, and an increased risk of heart attack and stroke.

Researchers who analyzed data collected by the Centers for Disease Control and Prevention between 2003 and 2012 found that up to 35 percent of adults in the United States meet the diagnostic criteria of metabolic syndrome. When sorting by age, it turned out that almost half of all people over the age of 60 have metabolic syndrome. (By contrast, slightly fewer than 20 percent of adults between the ages of 20 and 39 qualify for the diagnosis.) That's because we slow down as we age, both physically and metabolically.

And while being overweight or obese, inactive and insulin resistant are primary causes of metabolic syndrome, the researchers found that race, age and ethnicity play a role as well. For reasons that are not yet fully understood, the condition is more prevalent among Asians, African-Americans, Native Americans and Hispanics, who have the highest rate of metabolic syndrome of all ethnic groups.

The good news is that metabolic syndrome is preventable. The even better news for the tens of millions of Americans now entering their senior years is that it's also reversible. The challenge is that it's as much about lifestyle changes as it is about medication. Yes, there are effective drugs to address issues of blood pressure and high cholesterol. But the addition of regular exercise to daily life, as well as wide-ranging dietary changes are also necessary.

-- Change your diet: Say goodbye to refined and processed foods. Cut as much sugar from your diet as possible. Start getting your calories from lean proteins, whole grains and legumes, nuts, healthful fats, fresh vegetables and fruits, and plenty of leafy greens. A moderate drop in body weight, even just 5 or 10 percent, can have an effect on the body's ability to recognize and respond to insulin.

-- Get moving: Walk instead of drive. Choose stairs over the elevator. Join a walking group. Start biking. Go for a swim. Start lifting weights. By choosing activities you enjoy and have done in the past, you'll have a better shot at sticking with it. And start small. Set goals that are realistic, manageable and sustainable.

Eve Glazier, M.D., MBA, is an internist and assistant professor of medicine at UCLA Health. Elizabeth Ko, M.D., is an internist and primary care physician at UCLA Health. Send your questions to, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA, 90095. Owing to the volume of mail, personal replies cannot be provided.

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