What is metabolic syndrome?

Metabolic syndrome is a cluster of risk factors that together increase a person's risk of stroke, heart disease and type 2 diabetes. These risk factors are:

• high blood pressure
• excess abdominal weight
• low levels of ‘good’ cholesterol (HDL cholesterol)
• insulin resistance, where your cells don't respond to insulin and your blood sugar levels rise

Metabolic syndrome is also known as syndrome X or insulin-resistance syndrome.

People with metabolic syndrome have 2 to 3 times the risk of having a heart attack and stroke, type 2 diabetes or chronic kidney disease than people without the condition.

Metabolic syndrome affects many adults in Australia, and can also affect children and adolescents.

What are the symptoms of metabolic syndrome?

Some of the disorders that contribute to metabolic syndrome have obvious signs and symptoms, but others (such as high blood pressure and high cholesterol) do not.

A build-up of fat around the waist is a sign of the risk of metabolic syndrome. This is known as abdominal obesity or central obesity. It can be diagnosed by measuring a person’s waist circumference. Anything over the recommended threshold qualifies as abdominal obesity. Your doctor can measure your waist circumference for you. The thresholds differ for men and women, and also for different ethnicities.

High blood sugar, resulting from insulin resistance, may lead to symptoms of type 2 diabetes such as increased thirst and urination, fatigue, and blurred vision.

What causes metabolic syndrome?

The elements that contribute to metabolic syndrome are influenced by lifestyle factors, such as diet and physical activity, and also by genetics. A sedentary lifestyle with a poor diet is thought to be the most common cause of metabolic syndrome.

How is metabolic syndrome diagnosed?

A person may be diagnosed with metabolic syndrome if they have at least 3 of the following:

• high waist circumference
• raised level of triglycerides, which are a type of fat in the blood
• high blood pressure
• low levels of HDL cholesterol (good cholesterol)
• type 2 diabetes or insulin resistance (increased blood sugar after fasting)

What is the treatment for metabolic syndrome?

Treatment of metabolic syndrome is focussed on the same lifestyle measures that can help prevent it in the first place.

These recommended lifestyle measures include:

• maintaining a healthy weight or losing weight if you need to — which should improve insulin resistance, lower blood pressure and improve cholesterol levels
• exercising for 30 to 60 minutes on most days — this will help reduce weight, improve cholesterol and blood glucose levels and help lower blood pressure (anyone new to exercise should check with their doctor before starting)
• eating well, by reducing kilojoule intake if you are overweight, reducing saturated fat and salt and increasing whole grains, fruits and vegetables — this helps with weight loss, improves cholesterol levels and reduces the risk of type 2 diabetes
• stopping smoking, as smoking increases the risk of metabolic syndrome

In children and adolescents, lifestyle changes like reducing screen time and increasing sport can reduce the risk of developing metabolic syndrome later in life.

Are there any medicines to treat metabolic syndrome?

There are no medicines specifically to treat metabolic syndrome, but you may need medicines to treat some of the contributing conditions, such as high blood pressure or high cholesterol.

Can metabolic syndrome be prevented?

A healthy lifestyle is the most powerful way to prevent metabolic syndrome.

All of the risk factors associated with metabolic syndrome tend to make the other risk factors worse. For example, being overweight can lead to insulin resistance; insulin resistance can worsen your cholesterol levels, and also lead to high blood pressure.

Improving your lifestyle (see below), in terms of physical activity, diet, and being a healthy weight, can help prevent these risk factors or delay their development.

What to do if you think you have metabolic syndrome?

If you think you might have metabolic syndrome, it is important to see your doctor. Medication and lifestyle modification can treat metabolic syndrome and reduce the risk of developing heart disease, stroke, type 2 diabetes and chronic kidney disease.

Your doctor can measure and assess your waist circumference, take your blood pressure and organise for blood tests to measure your cholesterol and triglycerides and blood sugar levels. They can also comprehensively measure your risk of diabetes and heart disease.

Lifestyle modification can treat metabolic syndrome and reduce the risk of developing heart disease, stroke, type 2 diabetes and chronic kidney disease. Medications may also help treat some of the individual risk factors that make up metabolic syndrome, such as high blood pressure and poor cholesterol levels.

Your doctor can advise you on appropriate lifestyle changes and may refer you to a dietitian or exercise physiologist.

Resources and support

For more information and support, try these resources:

• Get Healthy NSW is a free telephone service that is available in NSW that is staffed by qualified health coaches who supports adults to make lifestyle changes regarding healthy eating, physical activity and reaching and/or maintaining a healthy weight.
• Better Health Coaching Service is a free and confidential telephone service that is available in South Australia. It supports South Australians to be active, eat well and reduce the risk of chronic disease.
• LiveLighter is a program that aims to encourage Australians to make changes to what they eat and drink, and to be more active.