For many years, institutional medicine didn’t recognize metabolic syndrome as a disease entity, nor discuss how it affected our heart. Thankfully, that’s changed. It is now recognized by the World Health Organization (WHO) and the American Society of Endocrinology as a global epidemic and major health hazard; meaning, we can start receiving funding and research to help reverse the trajectory of this disease.
Metabolic syndrome is defined as a breakdown in metabolism, the process by which our bodies convert food, or fuel, into energy. Marked by insulin resistance, elevated fasting blood sugar, dyslipidemia, hypertension, low LDL (good cholesterol), use of cholesterol medication, and abdominal obesity (belly fat measuring 40 inches or more for men and 35 inches or more for women), the syndrome is a major risk factor for cardiovascular health and heart disease.
So why cardiometabolic syndrome? Because anyone with this combination of metabolic dysfunctions has twice the risk of dying from heart disease, three times the risk of having a heart attack or stroke, and five times the risk of developing diabetes. And it’s not a small number of people who are affected—the American College of Cardiology estimates that approximately 47 million Americans have cardiometabolic disorders, and the problem is growing and extends globally.
Am I At Risk?
There are a number of things that create a higher risk of developing cardiometabolic syndrome, including:
- elevated triglycerides
- chronic inflammation
- low level of physical activity
- poor dietary choices
- certain health conditions
- high blood sugar
- thyroid problems
There are telltale symptoms of cardiometabolic syndrome like high blood sugar, insulin resistance, and high blood pressure that can be felt when the patient is attuned to the signs, but most often these are overlooked as nuisance concerns. And while a diagnosis of metabolic syndrome is formally made by a doctor who identifies two or more risk factors, most patients resist a change in lifestyle.
It’s no wonder. Although the most common trait in patients at risk is obesity, not all clinically obese people are at risk; alternatively, about 20 percent of people who are not obese do have metabolic syndrome and are at risk for heart disease or stroke. It feels random!
To be sure, there are risks, predispositions and warning signs:
- chronic stress
- chronic inflammation
- schizophrenia when treated with clozapine
- polycystic ovary syndrome (PCOS)
- celiac disease (for patients who replace gluten with an increase in dietary sugars, calories and
- unhealthy fats)
- gestational diabetes
- unhealthy gut microbiome
Does gender make a difference?
For both genders, the risk of developing metabolic syndrome increases with age. However, new research published by the National Institutes of Health states that there are differences between the sexes when it comes to metabolic and cardiovascular traits, such as gut microbiota, fat distribution, insulin signaling, and more. The hope is that these differences will lead to new insights.
Researchers are taking a look at how emotions like anger, tension, anxiety, depression, and stress, increase the likelihood of disease. A study published in the Journal of Clinical Endocrinology & Metabolism (JCEM) of 3,003 women in midlife found that physically active study participants had a 26-62 percent lower risk of metabolic syndrome than those who were not physically active.
For men with cardiometabolic syndrome, a study in The Lancet showed that mortality rates were “substantially higher” in those who experienced job stress than in men who did not. This mortality difference was comparable to the risk from smoking and was even greater than the mortality rate due to high blood pressure, high alcohol intake, a sedentary lifestyle, and obesity.
Reversal, Prevention, and Improvement
Positive lifestyle changes help! Small tweaks sustained over a time are shown to prevent, reverse, and improve many risk factors, which in turn lower the risk of developing CMS. Improvements in diet and physical activity—modifiable behaviors like quitting smoking, monitoring sodium, creating mindfulness, implementing relaxation techniques, and so on—were associated with recovery from and a decreased risk of metabolic syndrome.
The path to alleviate risk can be pinpointed by a good functional medicine practitioner who wants to investigate systemic imbalances in the gastrointestinal tract and gut microbiome. To work together and look at sluggish detoxification that contributes to fatty liver, and so on. And who will take a deep-dive into the testing, really get to know important factors about history, family, lifestyle and diet—and create a targeted, individualized approach for patients.