HealthCert Blog

Metabolic Syndrome (MetS) is a major contributor to morbidity and mortality worldwide, and its global prevalence is estimated to be around 20-25% in the adult population [1].

For further information on this topic, you may be interested to learn more about the HealthCert Professional Diploma program in Medical Nutrition Management.

MetS is defined by the World Health Organisation as a group of individual risk factors, whose main purpose is to identify individuals with increased risk of developing heart disease, diabetes, stroke and other health problems [2].

MetS is diagnosed when someone has three or more of these risk factors:

• Elevated waist circumference: population- and country-specific cut-off points
• Blood pressure: systolic > 130 and/or diastolic > 85 mmHg
• Fasting glucose: >100 mg/dL (5.6 mmol/L)
• Triglycerides: >150 mg/dL (1.7 mmol/L)
• High-density lipoprotein (HDL)-cholesterol: <40 mg/dL (1 mmol/L) (male) or <50 mg/dL (1.3 mmol/L) (female)

Patients who fulfil the criteria of MetS have a two-fold increased risk of CVD, 1.5-fold increased risk of all-cause mortality, and three-fold increased risk of diabetes [3, 4]. These estimates may differ slightly depending on the criteria set used and the population where they are applied.

Two forces driving the global spread of MetS are sedentary lifestyles and increased availability and consumption of high-energy, nutrient poor foods. Therefore, the primary approach to treatment of MetS begins with therapeutic lifestyle changes, including the acquisition of healthful dietary habits [5].

The beneficial effect of diet has already been highlighted in many clinical and epidemiological studies [6-8], with recommendations including:

• Weight management primarily focusing on a low fat, high fibre diet to reduce energy intake by 2142–4184 kJ/day (500–1000 kcal/day). The main goal is to provide a 7–10% reduction of body weight over a 6–12-month period and achieve an ideal BMI <25 kg/m².
• Adopting healthful dietary patterns shown to lower the risk of MetS. These are characterised by high consumption of fibre-rich fruits, vegetables, wholegrains, and fatty fish; and low consumption of foods high in added sugar and refined carbohydrates. For example, the Mediterranean diet is strongly linked to beneficial cardiovascular profiles.
• Intermittent fasting, also known as time-restricted eating, has shown beneficial effects for metabolic disturbances, cardiovascular disease, type 2 diabetes, and cancer, mainly due to the daily caloric restriction involved [9]. The main cardiovascular effects observed after a fasting intervention are improvements in insulin resistance, dyslipidaemia, blood pressure, and inflammation. However, application of this strategy is complex and trained health care providers (such as qualified dietitians) are needed to avoid side effects.

Primary care physicians should provide guidance around the ideal combination of diet, physical activity recommendations, and behaviour changes, while remembering that no one size or treatment fits all.

Learn more about metabolic syndrome with the online HealthCert Professional Diploma program in Medical Nutrition Management.

– Lynette Law, Accredited Practising Dietitian

Read another article like this one: Nutrition management in cancer

References

1. Saklayen, M.G., The Global Epidemic of the Metabolic Syndrome. Current hypertensionreports, 2018. 20(2): p. 12-12.
2. Huang, P.L., A comprehensive definition for metabolic syndrome. Disease models & mechanisms, 2009. 2(5-6): p. 231-237.
3. Ford, E.S., Risks for all-cause mortality, cardiovascular disease, and diabetes associated with the metabolic syndrome: a summary of the evidence. Diabetes Care, 2005. 28(7): p. 1769-78.
4. Mottillo, S., et al., The metabolic syndrome and cardiovascular risk a systematic review and meta-analysis. J Am Coll Cardiol, 2010. 56(14): p. 1113-32.
5. Pitsavos, C., et al., Diet, exercise and the metabolic syndrome. The review of diabetic studies : RDS, 2006. 3(3): p. 118-126.
6. Dragusha, G., et al., Treatment benefits on metabolic syndrome with diet and physical activity. Bosnian journal of basic medical sciences, 2010. 10(2): p. 169-176.
7. Zujko, M.E., M. Rożniata, and K. Zujko, Individual Diet Modification Reduces the Metabolic Syndrome in Patients Before Pharmacological Treatment. Nutrients, 2021. 13(6): p. 2102.
8. Kastorini, C.-M., et al., The Effect of Mediterranean Diet on Metabolic Syndrome and its Components. Journal of the American College of Cardiology, 2011. 57(11): p. 1299-1313.
9. Manoogian, E.N.C., et al., Time-restricted Eating for the Prevention and Management of Metabolic Diseases. Endocrine Reviews, 2022. 43(2): p. 405-436.