Metabolic syndrome and obesity

What is metabolic syndrome? 

Metabolic syndrome is a combination of impaired carbohydrate metabolism, abdominal obesity, dyslipidemia and hypertension, and is associated with the development of type 2 diabetes and cardiovascular diseases.

In order to confirm the presence of a metabolic syndrome, a person must have at least 3 of these 5 syndromes:

1) Abdominal obesity. Doctors use the term "obese" for people who have a "body mass index" of 30 or more. The waist size in abdominal obesity in men is more than 94 cm, in women-more than 80 cm.

2) Increased blood pressure. When measuring blood pressure, 2 numbers are determined. For example, your doctor may say that your blood pressure is "140 by 90 mmHg." The upper number is the pressure inside the arteries as the heart contracts. The lower number is the pressure inside the arteries when the heart relaxes. You have hypertension if:

  • Upper digits 140 or higher
  • Lower digits 90 or higher
  • Treatment with drugs for high blood pressure

3) High blood sugar. In order for all the cells of your body to work normally, glucose is necessary. Sugar enters the cells with the help of the hormone insulin. If there is not enough insulin, or if the body stops responding to insulin, glucose accumulates in the blood. A violation of sugar metabolism in the body is considered to be an empty-stomach blood glucose level of more than 5.6 mmol/l, or treatment with hypoglycemic drugs.

4) High triglyceride levels (impaired lipid metabolism). Triglycerides are fat-like substances in the blood. You have a high level of triglycerides if they are higher than 1.7 mmol / l.

5) Low levels of HDL in the blood (high-density lipoproteins). High-density lipoproteins are "Good Cholesterol" because they reduce the risk of heart attacks and other health problems. You are considered to have a low HDL level if they are less than 1.0 mmol/l in men, and less than 1.2 mmol/L in women.

Some doctors do not use the term "metabolic syndrome" for the totality of these syndromes. This is because the treatment of the metabolic syndrome is not different from the treatment of each of the syndromes. Thus, there is no need to allocate a special name for this problem. The best and safest way to treat this problem is to lose weight, eat less food. Losing weight will help reduce your waist size, your triglyceride levels, and hypertension.

How is the metabolic syndrome diagnosed? 

As part of the examination, the doctor:

1) Measures blood pressure

2) Measures your height and weight to determine your BMI

3) Measures the widest part of your stomach with a tape measure. This measurement is called "waist circumference".

You also take a blood test to determine your blood sugar and lipids.  Blood lipids include indicators such as triglycerides and cholesterol. People who have high triglyceride levels often have high cholesterol, too.

Is it possible to prevent metabolic syndrome? 

You can reduce the chances of acquiring metabolic syndrome if:

1) lose weight, if you are overweight;

2) eat a lot of fruits and vegetables, low-fat dairy products, little meat or fatty foods;

3) walk a lot or do physical activity daily;

4) quit smoking if you smoke.

How is the metabolic syndrome treated? 

Treatment includes:

Diet. Among the healthy diets that will help you lose weight are:

  • The Mediterranean diet is a diet high in fruits, vegetables, nuts, whole grains, and olive oil. It can help reduce weight, blood pressure, lipids, and blood sugar levels.
  • The DASH Diet (Dietary Approaches to Prevention-Hypertension). This is a diet low in salt and fat. It includes 4 to 5 servings of fruits and vegetables, and 2 to 3 servings of low-fat dairy products per day. This diet can lower blood pressure, weight, lipids, and blood sugar levels.

Exercises. It is recommended to exercise at least 30 minutes a day 5 or more days a week. If you can't exercise for 30 minutes at a time, try exercising for 10 minutes 3 or 4 times a day. Brisk walking is a good choice in such a situation.

Medications.  It is recommended to take medications to reduce blood pressure, lipids and blood sugar.

In the event that conservative methods of treating morbid obesity and other manifestations of metabolic syndrome are ineffective, patients may be shown surgical treatment aimed at reducing the volume of the stomach and reducing the absorption of food in the intestine. This is called bariatric surgery.

Diagnosis and treatment of morbid obesity and diseases associated with metabolic syndrome should take place in a specialized department with the participation of an endocrinologist, gastroenterologist, nutritionist and bariatric surgeon.

GBUZ Moscow Clinical Scientific Center named after Loginov MHD