What is Metabolic Syndrome?
Metabolic syndrome is not a single disorder, rather it is a group of conditions that occur together, including increased blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol and triglyceride levels. A diagnosis of metabolic syndrome requires that a patient has three (or more) of these conditions.
It is estimated that almost 20% – 30% of the middle-aged population are affected by metabolic this syndrome. Most people are unaware of their condition because it is ‘silent’ or impossible to notice without testing, except for the belly weight which is visible externally.
[1] [2]
Metabolic syndrome greatly increases your risks of experiencing cardiovascular disease (CVD), chronic kidney disease, fatty liver disease, and type 2 diabetes. These chronic illnesses account for 43% of all deaths in Canada. [2]
Each of these diseases and conditions happens at a significantly higher rate in patients with metabolic syndrome. For example, the presence of diabetes is estimated to be 2.5 times higher in those with metabolic syndrome compared to those without (18.0% vs. 7.1%). The ten-year risk of a fatal CVD event is five times higher (4.1% vs. 0.8%). [2]
Metabolic Syndrome & Menopause
Postmenopausal women show an increased risk of metabolic syndrome, ranging from 32.6% to 45.7% compared to 25.6% in premenopausal women. In fact, menopause is considered a predictor of metabolic syndrome independent of women’s age. [2] [3] [4]
This is because weight gain, obesity and lowered activity levels largely drive the increased prevalence of metabolic syndrome in postmenopausal women. Perimenopause is associated with significant weight gain (2 to 2.5 kg over 3 years on average) and a change to distribute that weight around the abdomen. At the same time there is often a decrease in activity. [5]
The Study of Women’s Health Across the Nation (SWAN) measured coronary heart disease risk factors, C-reactive protein (a marker of inflammation), and glucose levels to see if changes in these risk factors were associated with menopause or with aging in general. The results showed that cholesterol, LDL and other lipid levels associated with coronary heart disease were more impacted by menopause than by aging. [6]
Lipid Problems and Cardiovascular Disease
Lipid Problems and Cardiovascular Disease
Declining estrogen levels in perimenopause increase the risk of cardiovascular disease risk (CVD). Risk factors include varying lipid levels which are directly impacted by declining estrogen.
Problems with blood lipid levels in menopause are seen when there is an increase in low-density lipoprotein (LDL) cholesterol levels and a decrease in high-density lipoprotein (HDL) cholesterol levels. These changes speed up the development of atherosclerosis (hardening of the arteries). [5]
As well, obese women (with high body mass index (BMI)) are more likely to have high blood pressure as well as high fasting glucose levels, low levels of HDL, all of which are risk factors for CVD. [5]
Insulin Resistance, Diabetes & Obesity
Insulin Resistance, Diabetes & Obesity
The reduction of estrogen in postmenopausal women accelerates the development of insulin resistance (a precursor to Type 2 diabetes). [7] Having insulin resistance and being obese, especially if the extra weight is carried around the abdomen, is associated with oxidative stress, inflammation and a greater risk for blood clots (that can lead to strokes). [3] [8]
Your fat tissue secretes an array of molecules called adipokines that signal key organs to maintain metabolic balance. As well, being obese increases the production of molecules called cytokines that increase inflammation, creating a state of chronic inflammation. [9]
Abdominal fat cells produce a number of substances with an impact on inflammatory responses and insulin resistance. For example, adipokines control energy balance and appetite, influence insulin sensitivity and have a major role in the regulation of fat mass, which then impacts insulin resistance. [5]
Obesity is the expansion of white adipose tissue (WAT), the most effective lipid storage organ in the body. In obese subjects, white adipocytes in WAT increase the release of free fatty acids leading to elevated fatty acid levels in the blood. These extra fatty acids are lipids and have been considered a key reason for obesity driving insulin resistance and fatty liver disease. [9]
Self-care & Natural Remedies
Healthy lifestyle changes can help delay or even prevent serious health problems, such as a heart attack, stroke or diabetes. A recent study concluded that metabolic syndrome may be completely reversed by working in physician-led teams and taking part in a lifestyle modification program that included changes to diet and exercise patterns. [10]
A healthy lifestyle includes:
Regular Physical Activity
Try to get at least 30 minutes of exercise, such as brisk walking, daily. This does not have to happen all at the same time. Parking your car away from entrances (so you have to walk) or taking the stairs instead of the escalator can add up and be included in your 30 minutes.
Eat a Healthy, Well-Balanced Diet
Information on starting and maintaining healthy-eating plans, such as the Dietary Approaches to Stop Hypertension (DASH) diet and the Mediterranean diet, are easily available online or from your healthcare provider. Healthy eating plans emphasize eating vegetables, fruits, high-fibre whole grains and lean protein while cutting back on alcohol, salt, sugar and fats, especially saturated fats and trans fats. Omega fatty acids, found in fish oils and some nuts and seeds, can help lower blood triglycerides.
Losing Weight
Losing and maintaining the loss of just 7% of your body weight can reduce insulin resistance, lower blood pressure and decrease your risk of type 2 diabetes.
Reducing or Managing Stress
Physical activity, meditation, yoga, and other wellness techniques can help you handle stress and improve your emotional and physical health.
High-Quality Sleep
Get adequate amounts of high-quality sleep. Seven to 9 hours a night are recommended for most adults.
Stop Smoking
Therapy & Treatments for Metabolic Syndrome
Metabolic syndrome is a silent condition that is often diagnosed by a healthcare provider following a routine checkup with bloodwork. If healthy lifestyle changes alone do not work for you, you may need certain types of medicines. These medicines are often used together with healthy lifestyle changes. There are risks with some of the following medications, so make sure to tell your healthcare provider as much information as possible when making up a treatment plan.
Reduce Blood Pressure
Medicines to lower your blood pressure.
Medicines to lower your blood pressure. These include ACE inhibitors, angiotensin receptor blockers, diuretics, and beta blockers. Be aware that some diuretics and beta blockers can raise the risk of type 2 diabetes in people who have metabolic syndrome.
Control Blood Lipid Levels
Medicines to control lipid (fat) levels in your blood.
These include statins and niacin that can help lower triglyceride and LDL cholesterol levels while raising your levels of “good” HDL cholesterol. Be aware that some statins can raise the risk of type 2 diabetes in people who have metabolic syndrome.
Lower Blood Sugar
Medicines to lower blood sugar levels.
These include insulin sensitizers such as thiazolidinediones. [11]
Hormone-Replacement Therapy
Hormone Replacement Therapy
HRT has been shown to reduce abdominal obesity, reduce insulin resistance and new-onset diabetes, lower lipids (fats), and lower blood pressure in women without diabetes. In women with diabetes, HRT can reduce insulin resistance and fasting glucose levels. This is in addition to the other benefits and risks associated with HRT. [7][12]
The Science
Metabolic syndrome greatly increases the risk of many chronic illnesses. The diagnostic criteria for metabolic syndrome includes three of the following:
- ▢ High blood pressure (≥ 130/85 mm Hg, or receiving medication)
▢ High blood glucose levels (≥ 5.6 mmol/L, or receiving medication)
▢ High triglycerides (≥ 1.7 mmol/L, or receiving medication)
▢ Low HDL-Cholesterol (< 1.3 mmol/L in women)
▢ Large waist circumference (88 cm in women; ranges vary according to ethnicity) [2]
| Name | Function |
|---|---|
| lipids | fatty, waxy, or oily compounds, including fats and oils (triglycerides) |
| lipoproteins | particles made of fat (lipids) and proteins that travel in your bloodstream to cells throughout your body; cholesterol and triglycerides are two types of lipids found in lipoproteins |
| insulin | a naturally occurring hormone made in your pancreas needed to let your body to use sugar (glucose) as an energy source |
| low-density lipoprotein (LDL) or LDL cholesterol | a lipoprotein known as bad cholesterol because it can build up the walls of your blood vessels |
| high-density lipoprotein (HDL) or HDL cholesterol | a lipoprotein known as good cholesterol because it carries lipoproteins (cholesterol) through the body back to your liver, where it is removed from your body |
| triglycerides | the most common type of fat (lipid) that circulates in your blood; they come from foods, especially butter, oils, and other fats |
| cholesterol | cholesterol is a wax-like substance that helps your body make cell membranes, many hormones, and vitamin D, but too much can cause damage throughout the body; your cholesterol comes from two sources: the foods you eat and your liver, although your liver makes all the cholesterol you need; HDL and LDL lipoproteins are types of cholesterol |
| fibrinogen | a protein produced by the liver that helps blood clots form |
| C-reactive protein | a marker of inflammation, so the more inflammation you have the more C-reactive proteins you’ll have |
| glucose | glucose is sugar, carried by your blood to all of your body’s cells to use for energy |
| adipocytokines | active molecules produced by adipocytes, which may affect the functioning and the structural integrity of other tissues |
| adipocytes | fat cells – the major energy storage sites in the body, that also produce hormones |
| adipokines | molecules (cytokines) that send signals to other cells and produced by the adipose tissue; they play functional roles in metabolism, inflammation, obesity, |
| leptin | A type of adipokine |
| resistin | A type of adipokine |
| adiponectin | A type of adipokine |
| ghrelin | ghrelin is a hormone produced by your stomach known as the “hunger hormone” because it tells your brain you’re hungry |
| free fatty acids | fatty acids are a major source of fuel in the body and play an important role in cell signaling; free fatty acids are released into the blood by the breakdown of triglycerides |
| saturated fats | a type of dietary fat that is one of the unhealthy fats, (along with trans fat); These fats are most often solid at room temperature. Foods like butter, palm and coconut oils, cheese, and red meat have high amounts of saturated fat. |
| trans fats (trans-fatty acids (TFA)) | trans fat is considered the worst type of fat to eat, because they raise bad LDL cholesterol and also lowers good HDL cholesterol; they are found in margarine, vegetable shortening, ghee, fried foods, and industrially produced baked goods such as crackers, biscuits and pies |
[13][14][15][16][17][18][19][20][21][22][23]
Using medications to help treat metabolic syndrome is the second choice, after lifestyle interventions. The keys are to decrease your weight, eat a healthy balanced diet, exercise more frequently, and manage your stress levels. A recent study shows that metabolic syndrome can be completely reversed using a ‘team’ approach to lifestyle improvements. This makes changing your lifestyle more enjoyable and social, as well as providing accountability. [2]
Gaining just 10 pounds can increase insulin resistance and blood pressure as well as your risk of type 2 diabetes. If you do gain weight, try to increase your activity levels and work to reduce the extra weight with a healthy, well-balanced diet.
References
[1] https://www.mayoclinic.org/diseases-conditions/metabolic-syndrome/symptoms-causes/syc-20351916
[2] https://www.metabolicsyndromecanada.ca/
[3] Patni R, Mahajan A. The Metabolic Syndrome and Menopause. J Midlife Health. 2018 Jul-Sep;9(3):111-112. doi: 10.4103/0976-7800.241951. PMID: 30294180; PMCID: PMC6166423.
[4] Ben Ali S, Belfki-Benali H, Aounallah-Skhiri H, et al. Menopause and metabolic syndrome in tunisian women. Biomed Res Int. 2014;2014:457131. doi: 10.1155/2014/457131.
[5] Stachowiak G, Pertyński T, Pertyńska-Marczewska M. Metabolic disorders in menopause. Prz Menopauzalny. 2015 Mar;14(1):59-64. doi: 10.5114/pm.2015.50000. Epub 2015 Mar 25. PMID: 26327890; PMCID: PMC4440199.
[6] Karen A. Matthews, Sybil L. Crawford, Claudia U. Chae, Susan A. Everson-Rose, Mary Fran Sowers, Barbara Sternfeld, Kim Sutton-Tyrrell, Are Changes in Cardiovascular Disease Risk Factors in Midlife Women Due to Chronological Aging or to the Menopausal Transition?, Journal of the American College of Cardiology, Volume 54, Issue 25,
2009, Pages 2366-2373, ISSN 0735-1097, https://doi.org/10.1016/j.jacc.2009.10.009.
[7] Yan H, Yang W, Zhou F, Li X, Pan Q, Shen Z, Han G, Newell-Fugate A, Tian Y, Majeti R, Liu W, Xu Y, Wu C, Allred K, Allred C, Sun Y, Guo S. Estrogen Improves Insulin Sensitivity and Suppresses Gluconeogenesis via the Transcription Factor Foxo1. Diabetes. 2019 Feb;68(2):291-304. doi: 10.2337/db18-0638. Epub 2018 Nov 28. PMID: 30487265; PMCID: PMC6341301.
[8] https://bestpractice.bmj.com/topics/en-us/889
[9] Cao H. Adipocytokines in obesity and metabolic disease. J Endocrinol. 2014 Jan 8;220(2):T47-59. doi: 10.1530/JOE-13-0339. PMID: 24403378; PMCID: PMC3887367.
[10] Khursheed Jeejeebhoy, Rupinder Dhaliwal, Daren K. Heyland, Roger Leung, Andrew G. Day, Paula Brauer, Dawna Royall, Angelo Tremblay, David M. Mutch, Lew Pliamm, Caroline Rhéaume and Doug Klein. Family physician-led, team-based, lifestyle intervention in patients with metabolic syndrome: results of a multicentre feasibility project
March 14, 2017 5 (1) E229-E236; DOI: https://doi.org/10.9778/cmajo.20160101
[11] https://www.nhlbi.nih.gov/health/metabolic-syndrome/treatment
[12] Salpeter SR, Walsh JM, Ormiston TM, Greyber E, Buckley NS, Salpeter EE. Meta-analysis: effect of hormone-replacement therapy on components of the metabolic syndrome in postmenopausal women. Diabetes Obes Metab 2006;8:538–554 https://doi.org/10.1111/j.1463-1326.2005.00545.x
[13] Maximus PS, Al Achkar Z, Hamid PF, Hasnain SS, Peralta CA. Adipocytokines: Are they the Theory of Everything? Cytokine. 2020 Sep;133:155144. doi: 10.1016/j.cyto.2020.155144. Epub 2020 Jun 16. PMID: 32559663; PMCID: PMC7297161.
[14] Mercedes Gil-Campos, Ramón Cañete, Angel Gil, Adiponectin, the missing link in insulin resistance and obesity, Clinical Nutrition, Volume 23, Issue 5, 2004, Pages 963-974, ISSN 0261-5614, https://doi.org/10.1016/j.clnu.2004.04.010.
[15] https://my.clevelandclinic.org/health/articles/23229-lipoprotein
[16] https://my.clevelandclinic.org/health/body/22601-insulin
[17] https://www.webmd.com/heart-disease/ldl-cholesterol-the-bad-cholesterol
[18] https://www.hopkinsmedicine.org/health/conditions-and-diseases/high-cholesterol/cholesterol-in-the-blood
[19] https://my.clevelandclinic.org/health/diagnostics/12363-blood-glucose-test
[20] https://www.umassmed.edu/guertinlab/research/adipocytes
[20] https://my.clevelandclinic.org/health/body/22804-ghrelin
[21] Arabi YM, Tamimi W, Jones G, Jawdat D, Tamim H, Al-Dorzi HM, Sadat M, Afesh L, Sakhija M, Al-Dawood A. Free Fatty Acids’ Level and Nutrition in Critically Ill Patients and Association with Outcomes: A Prospective Sub-Study of PermiT Trial. Nutrients. 2019 Feb 13;11(2):384. doi: 10.3390/nu11020384. PMID: 30781774; PMCID: PMC6412238.
[22] https://medlineplus.gov/ency/patientinstructions/000838.htm
[23] https://www.who.int/news-room/fact-sheets/detail/trans-fat
Original content, last updated February 3, 2025.
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