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Metabolic syndrome is an unhealthy metabolism that leads to fatal diseases such as heart attacks, diabetes, and cancer. Moreover, this condition affects more than a fifth of the US population and about a quarter of the European population. Even though its prevalence in South-east Asia is lower, it is still rapidly moving towards the rates of the western world even there. It should be understood that metabolic syndrome is a problem for not only overweight people. So, in 40 out of 70 percent of people with normal weight, doctors diagnose metabolic disorders. This is at least related to an increase in waist circumference or visceral obesity. So what is metabolic syndrome? How do you know if you are at risk? How can lifestyle help prevent this condition and what is the treatment aimed at? This article was last reviewed by Svetlana Baloban, Healsens, on January 24, 2020. This article was last modified on 4 September 2021. What is Metabolic Syndrome? Essentially, metabolic syndrome is the simultaneous presence of several conditions, such as obesity, hyperlipidemia (abnormal levels of cholesterol and / or lipoproteins), diabetes and / or hypertension. This combination was first described back in the late 1960s. Nowadays, medical organizations say that even a few of the risk factors are sufficient. Let’s take a look at which conditions are referred to as metabolic syndrome and which of the factors are more influential. Metabolic Syndrome Criteria The NCEP ATP III panel identified 3 of 5 risks of the next metabolic syndrome criteria: At the same time, the International Diabetes Federation names narrower ranges: IN THIS ARTICLE 1 What is Metabolic Syndrome? 2 What causes metabolic syndrome? 3 Metabolic Syndrome treatment 4 Supplements or Nutraceuticals for Metabolic Syndrome RELATED ARTICLES These are recommendations for the European race. For Chinese, Japanese and South Asians, a waist circumference of ≥90 cm for men is at risk. Note that weight is not taken into account, just the waist circumference. This is no accident. In the next chapter, we will review in detail why so much attention is paid to waist circumference. Other risk factors include the following indicators: 2) elevated triglycerides (≥150 mg/dl);  3) low HDL cholesterol (<40 mg/dl in men, <50 mg/dl in women);  4) hypertension (≥130/≥85 mmHg); and  5) impaired fasting glucose (≥110 mg/dl). The American Heart Association reports a level of risk fasting glucose levels at ≥100 mg / dL. At the same time, the pathophysiology of this syndrome remains a subject of continuing controversy. However, despite the lack of knowledge, researchers have identified visceral obesity and insulin resistance as the most important causative factors. Central obesity or visceral obesity is readily assessed at waist circumference and is independently associated with each of the other components of metabolic syndrome. The second significant factor in the development of this disease is an increase in glucose levels (hyperglycemia). However, even a small increase, both on an empty stomach and after a meal, increases the risk of cardiovascular disease and mortality. In addition, a prospective Quebec study has found that even with no increase in blood sugar, elevated insulin levels (i.e., insulin resistance) are associated with a risk of coronary heart disease. In addition, insulin resistance also contributes to the development of hypertension due to the loss of the vasodilator effect of insulin and vasoconstriction. What causes metabolic syndrome? The pathogenic mechanisms of MetS are complex and yet to be fully elucidated. However, the wide variation in geographic distribution of MetS emphasizes that the consumption of excess calories and lack of physical activity are the major contributors to the development of the disease. Moreover, visceral obesity is the key trigger for most pathways involved in metabolic syndrome. It is worth saying here that visceral fat may not be visible to the naked eye, but it is the fat that envelops the heart, liver and other organs, representing a real threat. By itself, visceral fat behaves very differently from subcutaneous fat. For example, visceral fat deposits contribute to insulin resistance. This is due to the fact that the visceral process of lipolysis leads to an increased supply of free fatty acids (FFAs) to the liver. This, in turn, increases synthesis of triglycerides and production of apolipoprotein B, the carrier of “bad cholesterol”. Ultimately, the “bad” particles become smaller, denser and much more numerous and easily penetrate the vascular endothelium, where they cause irreparable damage. Very high levels of “bad” LDL cholesterol and low levels of “good” cholesterol are indirect effects of insulin resistance. If you add to this an increase in triglycerides (atherogenic dyslipidemia), then even at a normal weight, you will get central obesity with the same high risk of death as obesity. Thus, as you can see, visceral fat, elevated insulin levels, and an unhealthy lipid profile (unhealthy cholesterol levels) are linked to each other. And all this leads to problems with cardiovascular diseases, diabetes, hypertension. It is not a surprise why in Healsens, in addition to monitoring weight, we recommend monitoring waist circumference. Metabolic Syndrome treatment Exercise As previously described, MetS results from increased caloric intake out of proportion to metabolic requirements. That is why lifestyle changes are imperative to manage the main risk factors. The first step in reducing risk factors is maintaining ideal body weight. Accordingly, if BMI is increased, then weight loss is an important preventive and therapeutic strategy. However, weight loss doesn’t have to be a goal by itself. As we wrote above, people whose weight within the normal range may have visceral obesity, which can be measured by checking the circumference of the waist. In this case disease prevention will imply reducing visceral fat without losing weight. The good news is that numerous studies show that it suffice to add physical activity to help the problem. In fact, physical exercise can reduce visceral adipose tissue by 6.1%. Moreover, exercise itself is effective in maintaining muscle mass and facilitating mobility. As for exercise, if there is nAs for exercise, if there is no personal trainer to consult, 30-60 minutes of moderate-intensity exercise per week will