Metabolic Syndrome: Definition, Risk Factors, and Complications

Metabolic syndrome considers a few key numbers of a person's health—waist circumference, blood sugar, blood pressure, cholesterol, and triglycerides—to determine your risk for diseases, like heart disease, stroke, and diabetes.

Metabolic syndrome is common—one in three adults in the US have it. However, if you know the risk factors and make lifestyle changes, you can reduce your chances of developing metabolic syndrome. Learn what the risk factors are.

What Is Metabolic Syndrome?

Metabolic syndrome is a group of medical conditions that increase your risk for diseases such as heart disease, stroke, and type 2 diabetes. Only about 12% of adults in the US have ideal levels of five factors—blood pressure, cholesterol, triglycerides, blood sugar, and waist circumference—without having to take medication.

If you have three or more of the following, you may have metabolic syndrome:

• Large waist circumference
• High fasting blood sugar: Above 100 mg/dL, or you're taking diabetes medication
• High blood pressure: 130/85 mm Hg or more, or you're taking blood pressure medication
• High fasting triglycerides: 150 mg/dL or more, or you're taking medication to control triglycerides, a type of fat found in the blood
• Low high-density lipoprotein (HDL): less than 40 mg/dL for men and 50 mg/dL for women, or you're taking medication to raise your HDL

Risk Factors

Some risk factors for metabolic syndrome that can be controlled include:

• Being inactive
• Eating unhealthy
• Lack of sleep

There are other risk factors largely out of your control. These include:

• Age: The older you are, the higher your risk.
• Environment: For example, not being able to access healthy foods or not having a regular place to sleep may increase your risk.
• Genetics and family history: A family history of diabetes increases your risk of developing diabetes or insulin resistance.
• Other medical conditions: Overweight, obesity, issues with hormones or your immune system, sleep problems, and some medications increase your risk.
• Sex: The risk is higher in people going through menopause, pre-menopause, or the menopausal transition due to hormone changes that lead to a larger waistline, weight gain, and sleep interruption.
  

While a person who has metabolic syndrome has a higher risk of type 2 diabetes than a person who does not, this classification is not a good predictor of whether a person would develop diabetes. Metabolic health is a bit more complicated than just the numbers of your waist circumference, HDL, blood sugar, blood pressure, and triglycerides.

Social Stigma

Waist circumference shouldn't be considered in diagnosing metabolic syndrome, according to Lindo Bacon, Ph.D., a nutritionist and author of Health at Every Size: The Surprising Truth About Your Weight. Some people have waists bigger than 34 or 40 inches, no other risk factors, and do not develop diabetes or heart disease. It is important to note these people still have the same risk of metabolic syndrome.

The more experiences of weight stigma—judging a person's health solely based on weight—a person has, the more likely they are to have high levels of stress hormones like cortisol, which may cause issues like high blood pressure and insulin resistance and, therefore, increase the likelihood of developing metabolic syndrome, noted Bacon.

Another common risk factor for metabolic disease is socioeconomic status. Like weight stigma, worrying about whether or not your next paycheck will cover your expenses can adversely affect your risk for metabolic syndrome. These so-called social determinants of health—socioeconomic status, education, and racism—can affect a person's health just as much as their behaviors, said Bacon.

Complications of Metabolic Syndrome

There are several complications of having metabolic syndrome:

• Certain cancers
• Coronary heart disease
• Erectile dysfunction
• Heart failure
• Inflammation and problems with your immune system
• Organ damage, especially damage to your pancreas, liver, gall bladder, and kidneys
• Polycystic ovary syndrome (PCOS)
• Pregnancy complications such as preeclampsia, eclampsia, and gestational diabetes
• Thinking and memory issues
• Sleep apnea
• Stroke
• Type 2 diabetes

The biggest consequence of having metabolic syndrome is an increased risk of premature death, or mortality. Mortality increases regardless of whether or not you are living with obesity.

On the other hand, people living with obesity or overweight and metabolic syndrome are more likely to die from cancer than people not living with overweight, obesity, or metabolic syndrome.

This means the increase in mortality from metabolic syndrome is separate from obesity. However, obesity is a risk factor for metabolic syndrome.

Reducing Your Metabolic Syndrome Risk

Getting a diagnosis of or being at risk for metabolic syndrome doesn't have to be permanent. You can improve your condition or chances of developing metabolic syndrome by reducing your lifestyle risk factors.

• Increase physical activity: Physical activity, especially combining aerobic and anaerobic exercise, reduces blood pressure, triglyceride levels, blood sugar, insulin resistance, and inflammation
• Improve sleep habits: Aim to regularly get seven hours of uninterrupted sleep, which is the ideal amount of time to reduce insulin resistance and inflammation in the body
• Improve eating habits: A comparison of various diets, including DASH, plant-based, low-carbohydrate, high-protein, and low-fat diets, found that the Mediterranean Diet improved complications of metabolic syndrome.
• Maintain a healthy weight: Bringing your waist circumference within recommended ranges can help reduce your risk of metabolic syndrome and its complications.

A Quick Review

Being aware of your risk of developing metabolic syndrome is important because ignoring it can increase premature mortality. There are factors you can control to lower your risk—exercise more, sleep more, and eat healthier.