With so much focus on obesity, it’s easy to forget that we’re facing another epidemic that goes with obesity – metabolic syndrome. You don’t hear as much about this disorder as you do obesity but it’s no less problematic. In fact, metabolic syndrome is the main reason that people who are obese face the health risks that they do. So, what is it?
Metabolic syndrome is a group of health factors that increase the risk of developing heart disease and type 2 diabetes. How would you know if you have metabolic syndrome? Doctors use a set of 5 criteria. If you have 3 out of the 5, you’re considered to have metabolic syndrome. These criteria include:
Abdominal obesity, for women, a waist size greater than 35 inches
Low HDL cholesterol, also referred to as “good” cholesterol”
High blood pressure
High fasting blood sugar
Metabolic syndrome and obesity often go hand in hand. As the incidence of obesity has risen, so has the number of people with metabolic syndrome. Experts now say that metabolic syndrome may soon overtake smoking as the leading cause of heart disease. The risk of developing metabolic syndrome increases as you get older. This happens as your cells become less sensitive to the hormone insulin, partially due to loss of muscle mass and weight gain. Reduced insulin sensitivity is also known as insulin resistance, another way of describing metabolic syndrome.
How does insulin resistance contribute to heart disease? When you have insulin resistance, you have a higher circulating level of insulin. Research suggests that insulin can directly damage the interior wall of blood vessels, including those that carry blood and oxygen to your heart and ones that carry oxygen and blood to the brain. When these vessels are damaged, it increases the risk of a heart disease and stroke respectively. So, you don’t want lots of insulin circulating in your blood stream.
Would You Know if You’re Insulin Resistant?
You can have metabolic syndrome and insulin resistance and not know it. What’s disturbing is recent research shows a growing number of normal weight and only slightly overweight people have metabolic syndrome and all of the risks that go with it. Shockingly, in one study, 24% of the population meet the criteria for metabolic syndrome. So, regardless of your age or weight, keep an eye on the five criteria above. It only takes three of them to greatly increase your risk for health problems.
Tackling the Problem of Metabolic Syndrome and Insulin Resistance
What happens if you develop metabolic syndrome? If you’re overweight or obese, the first priority should be to lose weight. Some doctors prescribe a prescription medication called metformin to treat metabolic syndrome. Metformin is a medication that improves insulin sensitivity, how sensitive cells are to the hormone insulin, and lowers blood sugar. Although metformin is effective, a study showed that lifestyle changes are even better.
How effective are lifestyle changes? In one study, researchers divided 3,234 men and women with metabolic syndrome into two groups. One group took the medication metformin and a second took a placebo. A third group took a lifestyle approach to treating their metabolic syndrome. This group adopted an eating plan that emphasized fiber-rich whole grains, fruit, vegetables and lean protein. In addition, they did at least 2.5 hours of moderate physical activity each week.
The results? The incidence of metabolic syndrome dropped to 17% in the metformin group while the lifestyle group experienced a 41% reduction in metabolic syndrome. Lifestyle was more effective than the best medication available for treating metabolic syndrome. These results are consistent with previous research showing lifestyle to be more effective than medications for treating metabolic syndrome.
Exercise for Insulin Resistance and Metabolic Syndrome
Exercise is one of the most powerful natural treatments for metabolic syndrome. Remember, metabolic syndrome is a disorder marked by insulin resistance. Exercise has a dramatic effect on insulin sensitivity. Even a single exercise session improves the way your cells respond to insulin for up to 16 hours afterward. More intense exercise may boost insulin sensitivity for up to 2 days after a workout. So, it’s not surprising that exercise plays an important role in reversing metabolic syndrome.
Although exercise AND diet is the best approach to reversing metabolic syndrome but exercise alone has significant benefits. In one study, adults who were insulin resistant exercised 30 minutes daily by walking at a moderate pace at least 3 times a week. These adults were able to reverse insulin resistance without changing their diet and without losing weight.
Both aerobic and resistance training improves insulin sensitivity. When you increase muscle mass, you have more metabolically-active tissue. This improves insulin sensitivity and aids in fat loss. A healthier body composition, more muscle and less fat, is the key to improving your metabolic health. Although aerobic exercise is more effective at increasing insulin sensitivity short-term, resistance training may offer greater benefits longer term.
Exercise, Diet, and Sleep for Metabolic Syndrome
Although exercise alone improves insulin sensitivity, you’ll get the most benefits if you combine it with a healthy diet and adequate sleep. Even one night of too little sleep decreases insulin sensitivity. On average, most adults need around 7 hours of sleep a night for optimal metabolic health. In terms of diet, a Mediterranean diet that’s heavy on plant-based foods, fruits, vegetables, nuts, and whole grains, reduces insulin resistance.
On the other hand, refined carbohydrates and sugar fuel insulin resistance and metabolic syndrome. There’s also evidence that eating a diet high in saturated fat worsens insulin sensitivity. Sugar isn’t the only culprit. Some research suggests that high-fructose corn syrup, found in many processed foods, promotes insulin resistance and is more damaging to metabolic health than even sugar. So, choose whole, unprocessed foods and avoid adding sugar to your diet.
The Bottom Line
Exercise is a powerful weapon for reversing metabolic syndrome but it’s also important to modify the diet you eat and your sleep habits if you have metabolic syndrome. Metabolic syndrome truly is a lifestyle disease and one that you can reverse through lifestyle modifications.
Can Fam Physician. 2007 Jul; 53(7): 1203–1205.
Int J Sports Med. 2000 Jan;21(1):1-12.
Sports Med. 2004;34(6):371-418.
National Heart, Lung, and Blood Institute. “What is Metabolic Syndrome?
Medscape Multispecialty. “Metabolic Syndrome in Normal-Weight Americans”
Diabetes Care 2003 Mar; 26(3): 944-945. http://dx.doi.org/10.2337/diacare.26.3.944.
Clin Nutr. 2004 Aug;23(4):447-56.
Diabetes Self-Care. “Increasing Insulin Sensitivity”
Medscape Multispecialty “Resistance Training Benefits Type 2 Diabetics”
Int J Med Sci. 2007; 4(1): 19–27. Published online 2006 Dec 18.
Medscape Multispecialty. “Insulin Sensitivity Improved With Mediterranean-Style Diet”
Today’s Dietitian, Vol. 15 No. 7 P. 42. July 2013.