Affecting over a quarter of all Canadian adults, the metabolic syndrome is the newest ‘silent killer’
By Sue Mah, registered dietitian
In fact, with metabolic syndrome, your chance of developing heart disease increases 2-3 times. Your risk for type 2 diabetes increases almost fivefold Chances are you’ve never heard of metabolic syndrome, but you should because it’s a major risk factor for cardiovascular disease and type 2 diabetes. Moreover, it’s a growing threat to our health that now affects about 26 percent of Canadians. Among First Nations’ people, the prevalence rate is as high as 42 percent, according to researchers at the Heart and Stroke Foundation. While the term metabolic syndrome cropped up nearly a decade ago, in 1999, it’s only more recently that health experts are better defining what makes up metabolic syndrome. Metabolic syndrome is essentially a cluster of health problems, with one key characteristic being excess fat around your belly or central obesity. Researchers also call it visceral fat or abdominal obesity, and your waist size is a good indicator of the bulge. Other risk factors for metabolic syndrome include high triglycerides, high blood pressure, high fasting blood glucose, and low hdl cholesterol (which protects against cardiovascular disease).
Experts suspect that what causes metabolic syndrome may be a combination of genetic factors and unhealthy lifestyle habits. For example, being overweight and a couch potato are the leading causes of metabolic syndrome. Insulin resistance may be another cause of metabolic syndrome, which is why it’s sometimes even called insulin resistance syndrome. Insulin resistance means that the body has trouble using insulin efficiently, so it results in higher than normal blood sugar levels, as well as increased triglycerides and lower hdl cholesterol levels. Plus, insulin resistance often seems to accompany abdominal obesity.
Here’s what you need to know about this growing public health concern, and how to guard your health against it.
The big fiveAre you in the danger zone? There’s still controversy over the exact cut-off measurements used to diagnose metabolic syndrome among different health organizations, including the World Health Organization and the International Diabetes Federation. In Canada, the criteria used are those set out by the National Cholesterol Education Program (a program of the us National Heart, Lung, and Blood Institute).
Your doctor would diagnose you as having metabolic syndrome if you have any three of
the following five symptoms:
> High waist measurement More than 102 cm (40 inches) for men, more than 88 cm (35 inches) for women
> High blood triglycerides 1.7 mmol/L or higher
> High blood pressure 130/85 mm Hg or higher
> High fasting blood glucose 6.2-7.0 mmol/L or higher
> Low HDL “good” cholesterol Less than 1 mmol/L for men, less than 1.3 mmol/L for Women
What’s the big deal?Each of these symptoms is a risk factor on its own. Put any three of them together though, and you’ve got a cocktail for a potential heart attack, stroke and diabetes. In fact, with metabolic syndrome, your chance of developing heart disease increases 2-3 times. Your risk for type 2 diabetes increases almost fivefold. “Metabolic syndrome may surpass cigarette smoking as the leading cause of coronary heart disease in Americans,” warns Catherine Freeze, a Registered Dietitian and Certified Diabetes Educator at the Department of Public Health in Charlottetown, Prince Edward Island.
Less is more
Big waistlines spell big trouble. Remember the age-old advice about a pear-shaped body (with more weight around the hips) being healthier than an apple-shaped body? That notion still holds true today. “Visceral fat is the bad guy. It can lead to hypertension, insulin resistance, and increased lipid levels,” explains Dr. Arya Sharma, Professor of Medicine and Chair of Obesity Research and Management at the University of Alberta.
Does weight still matter?While waist size is the best indicator of abdominal obesity and of how your body weight is distributed (apple or pear), knowing how much you weigh is still valuable information. Your weight helps to figure out if your Body Mass Index (bmi) is within a healthy weight range. Keeping track of your weight over time lets you see whether you’re gaining or losing weight. Still, your shape, or how your weight is distributed, is more of a predictor of disease risk than your overall weight or bmi. Research by Dr. Ian Janssen at Queen’s University in Kingston, Ontario explains the story more fully. “It doesn’t matter what your weight is: normal weight, overweight, or obese. As your waist size increases, so does your risk for metabolic syndrome.” And that rise in risk is dramatic. In Janssen’s study, about three percent among normal-weight women with a healthy waist measurement had the condition, compared with almost 13 percent of normal-weight women with a high waist measurement. The bottom line is that, when looking at your overall health, your waist measurement AND your bmi together can provide important information to
your doctor.
Good advice all aroundBecause overweight and physical inactivity head the list as leading causes of metabolic
syndrome, losing some weight, especially around the middle, is one of the first steps in preventing and treating the condition. Results from the Diabetes Prevention Program, the first major study of over 3,200 adults at high risk for type 2 diabetes, found that weight loss was key to lowering one’s chances of developing diabetes. For every kilogram (2.2 pounds) of weight loss, there was a 16 percent reduction in the risk of developing type 2 diabetes. Moreover, research shows that if you’re overweight, dropping even 5-10 percent of your body weight can improve your health. (That’s equivalent to losing about 7.5 to 15 pounds if you weigh 150 pounds right now.) Aim to lose the weight gradually (over 6-12 months) and you improve your chances of keeping it off for good. Lowering your riskIf you want to ward off metabolic syndrome, it boils down to following a healthy lifestyle,
and keeping tabs on your risk factors. See your doctor for routine check-ups of your
blood pressure, blood cholesterol, and blood glucose levels. The risk for metabolic syndrome increases as you get older. And don’t forget to ask to have your waist measured too! You can also follow these basic tips for losing weight and lowering your chances of developing metabolic syndrome:
> Cut 500 calories a day (through eating and exercise) to lose about one pound a week. See our Calorie Counter for ideas to get you started.
> Eat vegetables and fruit with every meal and snack. Low in calories, high in fibre and antioxidants, and virtually fat-free, they can help to reduce your risk of insulin resistance and type 2 diabetes.
> Choose whole grains for at least half of all the grain products you eat (e.g. oatmeal, barley, bulgur, brown rice, quinoa, and 100% whole-grain, whole-wheat bread). With more fibre, vitamins, minerals, and disease-fighting compounds than refined grains have, they’re linked to lower triglycerides, lower blood pressure, and better insulin sensitivity.
> Get enough calcium. It can help to lower your risk of developing type 2 diabetes. Drink at least two cups of lower-fat milk every day, and choose other calcium-containing foods like low-fat yogurt, low-fat cheese, almonds, beans, greens and canned salmon (with bones).
> Buy lower-sodium or sodium-reduced products whenever you can, and hold the salt when you’re cooking. Too much sodium can drive up your blood pressure.
> Eat fish for their heart-healthy fats at least twice a week, and choose lean meats.
> Go easy on the processed meats. Pass on the extra sodium and fat they pack, and choose more low-fat meat alternatives, such as beans, lentils and tofu.
> Eat less saturated fat and trans fat. These unhealthiest types of fat raise “bad” low-density lipoprotein (ldl) cholesterol levels. Trans fat poses a double whammy by lowering the “good” hdl cholesterol.
> Exercise for at least 30 minutes a day. Sixty minutes daily would be fabulous!
Try these lifestyle changes first. If you can’t control your risk factors through healthy choices alone, your doctor may prescribe medications to treat the symptoms of
metabolic syndrome.
THE RIGHT WAY TO MEASURE YOUR WAIST
Measure the midline between your lower ribcage and the top of your hip bone. Keep the measuring tape parallel to the floor. Don’t measure at your belly button, since it actually shifts when you lose weight.
5 EASY WAYS TO CUT ABOUT 100 CALORIES> Leave three or four bites of your meal on your plate.
> Order the small fries instead of medium.
> Or skip the fries and save over 250 calories!
> Ask for your latté to be made with skim milk instead of 2% milk, and skip the whipped topping.
> Enjoy two small mini donut holes instead of the whole donut.
> Always put everything you eat on a plate to stop you from eating mindlessly. Eating 10 plain potato chips means banking 100 calories, but hit the bottom of the bag and you’ve just swallowed over 1,300 calories. CALORIE COUNTER: 10 WAYS TO BURN ABOUT 200 CALORIES*> Run (7 mph) for 15 minutes
> Spin hard on a stationary bike for 15 minutes
> Serve up a game of indoor volleyball for 20 minutes
> Mow the lawn for 30 minutes (with a push mower!)
> Walk briskly for 30 minutes
> Swim laps for 30 minutes
> Play a game of doubles tennis for 30 minutes
> Golf (without carts) for 40 minutes
> Shoot baskets on the driveway for 40 minutes
> Garden for 45 minutes
*These are based on a 150-pound adult. If you weigh more, you’ll burn more calories. Conversely, if you weigh less, you’ll burn fewer calories.
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