Metabolic syndrome (MetS), a compilation of interrelated subclinical conditions, is an increasing problem worldwide. Through holistic care, integrative medicine can help patients make lifestyle changes that reduce the risk for MetS while increasing overall quality of life.
In this article:
- What is Metabolic Syndrome (MetS)?
- How is MetS Diagnosed?
- Common Causes of MetS
- Why Integrative and Holistic Care is Essential for Prevention and Management of MetS?
- Prevention and Management with Integrative Medicine
- Further Exploration of MetS
Although metabolic syndrome (MetS) is becoming an increasing problem worldwide, the average individual is still typically unaware of this health problem. Data collected from the 2003-2006 National Health and Nutrition Examination Survey (NHANES) suggests that approximately 34% of adults in the United States have MetS .
MetS is a combination of interrelated subclinical conditions, including pre-central obesity and hypertension, pre-diabetes, high blood cholesterol and triglycerides (dyslipidemia). These metabolic risk factors increases the chances for the development of type 2 diabetes, cardiovascular disease and stroke. According to the International Diabetes Federation (IDF) consensus, "people with metabolic syndrome have a five-fold greater risk of developing type 2 diabetes mellitus and are twice as likely to die from, and three times as likely to have a heart attack or stroke compared with people without."
According to the American Heart Association, the National Heart, Lung, and Blood Institute, and the International Diabetes Federation, a person has MetS when three or more of the following are present: 
- Abdominal obesity (waist circumference):
Men: 40 in (102 cm) or more
Women: 35 in (88 cm) or more
- Triglyceride level of 150 mg/dL or higher
- Low high-density lipoprotein (HDL) ("good" cholesterol):
Men: less than 40 mg/dL
Women: less than 50 mg/dL
- Blood pressure equal to or greater than 130/85 mmHg
- Fasting blood sugar (glucose) equal to or greater than 100 mg/dL
Many factors can contribute to the development of MetS. However, the major risk factors are abdominal (visceral) obesity and insulin resistance.
Having extra fat around the waist is an extreme health concern. A 2002 study in the Archives of Internal Medicine analyzed the National Health and Nutrition Examination Survey and found that in every weight category (normal, overweight, obese), individuals who had larger waist circumferences typically had higher blood pressures, cholesterol levels, and inflammation [3,4].
Insulin resistance is a condition in which the body does not respond normally to insulin and cannot use it efficiently. Consequently, the body overproduces insulin, which leads to negative effects including increased blood free fatty acids.
Other associated risk factors for MetS include the following:
- Unhealthy diet
- Sedentary lifestyle
- Certain medications (e.g. steroids, tricyclic agents, certain diabetic medications, oral contraceptives, etc.)
- Mood disorders
- Sleep disorder
- Hormonal changes (e.g. menopause, polycystic ovarian disease, hypothyroidism, etc.)
- Genetic predisposition to type 2 diabetes, hypertension, obesity, and heart disease
Western medicine has limited treatments for subclinical conditions which are manifested in MetS. On the other hand, the core of integrative medicine centers on prevention by analyzing the whole person and his/her psychosocial environment and lifestyles. This holistic approach has the ability to retard the progression of developing chronic diseases as well as improve the patient's overall quality of life.
Prevention or management of subclinical conditions, such as MetS, requires analysis of your personal lifestyle and understanding of how daily choices can make a major impact on your overall health.
- Diet/Nutrition: The foods you eat play a critical role in maintaining your health. Suzie Seoyang Lee, PhD, FNP, LAc, nurse practitioner and acupuncturist at the UCLA Center for East-West Medicine recommends a Mediterranean and low glycemic index diet and foods that are high in fiber and essential fatty acids (e.g. salmon, flaxseeds, walnuts, avocados, olives). On the other hand, she suggests minimizing the consumption of dairy products and cold, raw, spicy, or processed foods.
- Exercise: Lack of physical activity can have immediate detrimental effects on your body, such as reduced energy levels. Long-term consequences of maintaining a sedentary lifestyle include increased risk of obesity and chronic diseases. Getting active can have immediate benefits. Just a small amount of exercise can improve your mood, increase your energy level, and confer protection against many diseases. Make an effort to incorporate more physical activity into your daily routine. You do not have to make a big commitment to the gym to gain the benefits associated with exercise. Start out small. For example, take the stairs instead of the elevator. If possible, walk or bike to get around rather than drive your car. When parking, avoid looking for the closest spot and instead, park further away from the office or store.
- Stress management: Constant high levels of stress negatively impacts major organs throughout the body including the brain, muscles, heart, stomach, pancreas, intestines, and reproductive system. According to Dr. Esther Sternberg, director of the Integrative Neural Immune Program at NIH's National Institute of Mental Health, autoimmune diseases such as rheumatoid arthritis and lupus can result from continuous high levels of stress hormones activating the immune system. Additionally, studies have found that individuals under high levels of stress have compromised immune systems, weight gain, as well as a higher risk for developing cancer and heart disease. Consider tai chi, yoga, meditation, and breathing exercises as possible outlets for your stress.
- Sleep hygiene: According to the National Sleep Foundation, adults should sleep 7 to 9 hours a night . Current research suggests that getting enough sleep is important for memory consolidation, proper functioning of the immune system, metabolism, weight control, cardiovascular health, and maintaining a pleasant mood .
To improve your sleep hygiene and both your quality and quantity of sleep:
- avoid watching T.V., using the computer, or reading in bed.
- maintain a regular sleeping schedule.
- avoid consuming caffeinated products at least 8 hours before bedtime.
Counseling and integrative medicine services: Visit UCLA Center for East-West Medicine's website for more information on integrative and holistic care plus resources on how to make lifestyle changes to achieve optimal health.
- Esposito K & Giugliano D (2010). Mediterranean diet and the metabolic syndrome: the end of the beginning. Metab Syndr Relat Disord. 8(3):197-200.
- PubMed Health. Metabolic Syndrome. National Center for Biotechnology Information, U.S. National Library of Medicine. Accessed at http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0004546/ on August 25, 2011.
- Healthful Life Project. Waist Circumference (Abdominal Girth) and Health: It is more than just risk of stroke. New Jersey Medical School. Accessed at http://njms2.umdnj.edu/hwmedweb/archives/waist_archive.htm on August 25, 2011.
- Janssen, I, Katzmarzyk, P, Ross, R. Body Mass Index, Waist Circumference, and Health Risk. Archives of Internal Medicine. 2002;162:2074-2079.
- Centers for Disease Control and Prevention (CDC) Features. Sleep and Sleep Disorders. CDC. Accessed at http://www.cdc.gov/features/sleep/ on August 25, 2011.
- Harvard Health Publications. Importance of Sleep: Six reasons not to scrimp on sleep. Harvard University. Accessed at http://www.health.harvard.edu/press_releases/importance_of_sleep_and_health on August 25, 2011.