Metabolic syndrome: what it is, how to diagnose it, and how to intervene

Article by SoLongevity Research
One in 4 Italians - and one in 2 among those over 50 - suffers from metabolic syndrome. Here's how to diagnose it and how to intervene to reduce the risk of metabolic and vascular diseases

What this article is about

  • Metabolic syndrome is a complex clinical condition that includes at least 3 different risk factors for vascular disease
  • The prevalence of metabolic syndrome in Italy is estimated at 1 in 4 people and appears ready to increase
  • Metabolic syndrome can be effectively prevented and countered by lifestyle

What is metabolic syndrome

We all know that an unregulated diet and little physical activity damage health. It is difficult, however, to be aware of the possible consequences. These include some conditions that, when present at the same time, take on a very specific name: metabolic syndrome. Few people know exactly what it is, which is curious as almost half of the Italian population aged 50 and over (one in 4 people overall, according to the Istituto Superiore di Sanità), suffer from it. And its prevalence seems likely to increase.

The 5 criteria for the diagnosis of metabolic syndrome

Metabolic syndrome is a complex clinical picture given by the combination of multiple risk factors for the cardiovascular system. International scientific societies have identified 5 criteria for diagnosing metabolic syndrome, which we list below. It should be noted that there are slight differences between the values given by different societies, particularly between the US, European and World Health Organization.

  1. High abdominal circumference, obesity index: equal to or greater than 102 cm for men (94 cm if European) and 88 cm for women. The WHO, on the other hand, considers the waist-to-hip ratio (there is visceral obesity when it exceeds 0.9 in males and 0.85 in females) and/or a body mass index (BMI) greater than 30.
  2. Hypertension: ≥130/85 mm Hg (or 140/90 mm Hg according to the European Insulin Resistance Study Group; or ≥160/90 mm Hg or taking antihypertensive drugs, according to WHO).
  3. HDL cholesterol (the so-called “good” cholesterol) less than 40 mg/dl in men and 50 mg/dl in women (or 39 mg/dl according to European guidelines; or 35 mg/dl in males and 39 mg/dl in females according to the WHO).
  4. Elevated triglycerides: ≥ 150 mg/dl (also according to WHO, or ≥ 115 mg/dl according to European guidelines).
  5. Impaired fasting blood glucose: ≥ 110 mg/dl (or between 110 and 126 mg/dl according to European guidelines.

In general, three of these altered parameters must coexist for the diagnosis of metabolic syndrome. According to the WHO, more specifically, there must be impaired blood sugar (insulin resistance and two other altered parameters, among which it adds the presence of trace amounts of albumin in the urine (microalbuminuria >20μg/min or albumin/creatinine ratio >20mg/g).

In Italy, metabolic syndrome is estimated to affect nearly half of the population over the age of 50

But beyond the scientific quarrel over where to draw the line, the concept (simplifying) is clear: abdominal obesity, insulin resistance, and hypertension are not only individually risk factors for vascular health, but are interconnected and, together, amplify it.

Metabolic syndrome identifies a set of conditions that predispose a person to the development of diseases such as diabetes and cardiovascular events

Excess visceral (or abdominal) body fat can result in altered fat and sugar(glucose) metabolism and activation of the process of chronic inflammation, which in turn can result in insulin resistance. The malfunctioning of beta cells in the pancreas, which produce insulin, a hormone critical to maintaining normal blood glucose levels, promotes the onset of diabetes. If visceral fat increases, it also causes inflammation that leads to atherosclerosis in blood vessels, thus promoting cardiovascular disease, strokes, and heart attacks.

Preventing not curing

Among the useful actions to counter metabolic syndrome, regular physical activity tops the list because it “burns” visceral fat first, facilitates the action of insulin (and thus the reduction of blood sugar), reduces triglycerides and increases HDL cholesterol, as well as decreases blood pressure. Therefore, if you are accustomed to a sedentary lifestyle, you need to change your habits. Try walking up stairs, getting around by foot or bicycle, parking your car a little far from your destination, and avoiding spending too long a time sitting. A person with high abdominal circumference, but who is physically active, has a high chance of not developing diabetes or metabolic syndrome.

Regular physical activity and a balanced diet are the first guard against metabolic syndrome

Especially after the age of 50, it is essential to maintain an active lifestyle

A balanced diet and a balanced distribution of meals throughout the day are particularly important, as they regulate the glycemic spikes caused by simple carbohydrate intake. Ideally, therefore, divide the “food day” into three meals and two snacks, one mid-morning and the other mid-afternoon. In those at risk for diabetes mellitus, a strategy based on more than 5 percent reduction in body weight, a fat percentage of no more than 30 percent of total daily calories, with saturated fat restriction, increased fiber consumption, and physical activity for at least at 4 hours per week has been shown to be effective in reducing the incidence of the disease.

That is why it is important to periodically check one’s weight, waist circumference, blood pressure and perform targeted blood tests (blood glucose, total cholesterol, HDL, triglycerides). If your blood sugar, weight, or blood pressure rises, the first thing to do is to see your doctor. It should be mentioned that in addition to poor lifestyle habits, there is also a genetic predisposition to insulin resistance that needs to be carefully monitored.

SoLongevity has put together a quick metabolic check up (available at participating pharmacies) that allows you to know, in just 15 minutes, your Metabolic Syndrome Coefficient: an easy-to-read value (on a scale of 0 to 5) that indicates the risk of metabolic syndrome which can be discussed with the physician.


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