What Is Metabolic Syndrome?

Metabolic syndrome? What is that? In this article, you will find everything you need to know about metabolic syndrome and how to treat it. 

Metabolic syndrome has been defined by the World Health Organization as a pathological condition characterised by hypertension, hyperlipidemia, insulin resistance, and obesity. In other words, it is a group of medical conditions including high blood sugar, abnormal cholesterol levels, high blood pressure, and excess body fat around the waist. 

What does this mean though? Is it dangerous? Should you worry? This article will answer all your questions.


Over the years, multiple definitions have been proposed for metabolic syndrome. In the late 20th century, metabolic syndrome was identified as Syndrome X that had originated from Insulin Resistance. In the early 21st century, metabolic syndrome had been defined by several names and it was characterised by abdominal obesity, insulin resistance, cardiovascular disease, prothrombotic state, pro-inflammatory state, and hypertension.1 It is now considered a constellation of risk factors for cardiovascular disease, stroke, and type 2 diabetes rather than a single disease.2

Over the last few years, the incidence of metabolic syndrome has increased but fortunately also has our understanding of the biology of the disease. Approximately 25% of adults worldwide have metabolic syndrome. Therefore, it is an important global health challenge.3 The gut microbiome (the community of bacteria that live in our gut) has been extensively studied and is an important asset of human health and biology. A healthy gut microbiome can prevent several diseases such as metabolic syndrome, and cardiovascular diseases.4 Furthermore, there are many biological mechanisms discovered that can have therapeutic implications for metabolic syndrome. But before looking at prevention and therapy, you should first be informed about some of the causes of metabolic disease.5

Causes of metabolic syndrome

As previously mentioned, metabolic syndrome is a cluster of health conditions that can increase the risk of type 2 diabetes and cardiovascular disease. The following risk factors increase the probability of developing metabolic syndrome:

  • Genetics: Genetic factors could influence the syndrome itself and individual components of the syndrome. A family history of insulin resistance, obesity, or type 2 diabetes significantly increases the probability of someone developing metabolic syndrome. Research has shown some candidate genes for metabolic syndrome, and theseinclude LDLR, GBE1, IL1R1, TGFB, IL6, COL5A2, SELE, and LIPC.6
  • Poor diet: The chief environmental factor that plays a role in the expression of genes that are involved in metabolic syndrome is probably nutrition. A poor diet includes refined carbs such as snacks with sugar, white flour, and beverages. These are low in nutrients and should be avoided as they cause spikes in blood sugar levels.7
  • Increased age: As we get older, the prevalence of metabolic syndrome increases.1
  • Excess weight (particularly abdominal obesity): People who progressively gain weight increase the risk of developing metabolic syndrome. Moreover, metabolic syndrome is highly associated with obesity. A body mass index (BMI) is a measure of your body’s percentage of fat based on your weight and height. A BMI greater than 25 is considered overweight and increases the risk of developing metabolic syndrome. A BMI greater than 30 falls within the obese range.1 The prevalence of obesity has increased over the past years, especially in countries with low socio-economic indexes. Although obesity is a risk factor for metabolic syndrome, they are not synonymous. There are healthy-obese individuals that do not suffer from hypertension or hyperlipidemia.8 However, obesity is responsible for excessive fatty acid, proinflammatory products, and cytokines release. This can lead to insulin resistance, dyslipidemia, and hypertension.1
  • Physical inactivity: Sedentary lifestyle and the lack of moderate exercise have been shown to be critical risk factors for metabolic syndrome. Studies have indicated that reducing sedentary time can have significant benefits for older people.9
  • Sleep disorders: Human health is highly benefited by obtaining an adequate amount of sleep each night. Over the last few years, research has suggested that inadequate sleep plays an important role in cardiometabolic factors such as hypertension, obesity, dyslipidemia, and hyperglycemia, which are all risk factors for metabolic syndrome.10
  • Chronic stress: Environmental influences like chronic stress has emerged as a contributor to metabolic syndrome development.11
  • Certain medications: Using certain medications may increase the risk of metabolic syndrome by altering glucose/lipid metabolism or promoting weight gain. Such medications include antidepressants, antiepileptic medications, immunosuppressive medications, antipsychotics, protease inhibitors, oral contraceptives, thiazolidinedione agents, niacin, beta-blockers, and thiazide diuretics.12

Signs and symptoms of metabolic syndrome

The International Diabetes Federation (IDF) has formatted a diagnostic criteria for metabolic syndrome. Patients can be diagnosed If they have at least 3 out of 5 characteristics. These characteristics include:1

  1. Abdominal obesity (large waist circumference): Greater than 102cm for men and 88cm for women13
  2. High blood pressure: Higher than 130/85 mmHg2
  3. High blood glucose levels: Higher than 5.6 mmol/L
  4. High levels of triglycerides: Higher than 1.7 mmol/L2
  5. Low levels of high-density lipoprotein (HDL) cholesterol: lower than 1.0 mmol/L in men and lower than 1.3 mmol/L in women2

The following are the symptoms of metabolic syndrome:14,15

  1. Fatigue
  2. Increased hunger or thirst
  3. Blurred vision
  4. Numbness or tingling in the hands or feet

Management and treatment for metabolic syndrome

Metabolic syndrome can be managed and treated through lifestyle changes and medications. Some of the lifestyle changes are listed below:

  • Physical activity: Exercise is a key component of energy balance and expenditure, the benefits of exercise in metabolic syndrome are not limited to calorie expenditure, but also in the increase of muscles and secretion of hormones that are beneficial metabolically.16 It is proposed that you engage in moderate-intensity aerobic exercise for at least 150 minutes per week.14,15 A reasonable start for a sustainable exercise program would be 30 minutes per day for 5 days a week. Exercise has a beneficial effect on cholesterol levels, blood pressure, and insulin sensitivity and therefore, in treating metabolic syndrome1
  • Stress management: You can also practise stress-reducing techniques such as yoga, meditation, tai chi, qigong, and breathing17
  • Healthy diet: A variety of dietary factors are known to aid the prevention of metabolic syndrome. Among these are capsaicin, curcumin, olive oil, cinnamon, luteolin, rosemary, etc. You should consume a diet that is high in vegetables, whole grains, fruits, and lean protein and low in saturated fats, added sugars, and sodium. Studies have provided evidence of the beneficial role of the Mediterranean diet. This diet is characterised by a balanced consumption of “good” fats (olive oil), reasonable amounts of proteins (chicken/fish), and carbohydrates. This diet also includes reduced meat and dairy consumption1,7,18
  • Quit smoking: Smoking is a major risk factor for metabolic syndrome. If you are a smoker, quitting can reduce the risk of stroke and heart disease and improve your overall health19

Some of the medications are listed below:14,15

  • Diabetes medications: These are used to lower blood sugar levels and improve insulin sensitivity
  • Blood pressure-lowering medications: These are used to lower blood pressure
  • Cholesterol-lowering medications: These are used to decrease levels of triglycerides and cholesterol 


How is metabolic syndrome diagnosed?

Metabolic syndrome is normally diagnosed by a physical examination where the doctor would measure the waist circumference of the patient as well as their blood pressure. The doctor would additionally check for any signs of diabetes or insulin resistance. Moreover, the doctor would need to assess the patient’s medical history by asking them about their physical activity level, their diet, and any family history that is relevant. Ultimately, diagnostic and laboratory tests would be commonly used to diagnose metabolic syndrome. Such tests include blood tests to measure the patient’s cholesterol, triglycerides, high-density lipoprotein (HDL), and glucose levels, oral glucose tolerance tests to assess the patient’s bodily ability to process glucose, and fasting glucose tests to measure the patient’s blood sugar levels after an overnight fast.14,15

How can I prevent metabolic syndrome?

Metabolic syndrome can be mainly prevented by making lifestyle changes. As mentioned before, it is extremely important to have a healthy diet that includes many fruits, vegetables, whole grains, and lean protein. Try to avoid consuming added sugars, sodium, and saturated fats. Equally important is to engage in regular physical activity of at least 150 minutes per week. Generally, it is ideal to maintain a healthy weight and manage stress by practising stress-reducing techniques. Finally, it is critical to follow the suggested sleep hour of 7-9 hours of sleep per night. 

Who is at risk of metabolic syndrome?

Since metabolic syndrome consists of several risk factors for cardiovascular disease, people with these risk factors are at increased risk of developing metabolic syndrome. 

When should I see a doctor?

Should you be worried? It is recommended to visit a doctor if you have: abdominal obesity, high blood sugar levels, high blood pressure, high triglyceride levels, low HDL cholesterol levels, fatigue, blurred vision, increased hunger or thirst, numbness or tingling in the hands or feet.14,15

Early diagnosis and treatment can aid in the prevention of developing more serious health problems such as heart disease, type 2 diabetes, and stroke. 


In conclusion, metabolic syndrome is a serious health condition that increases the risk of developing other health diseases. It is a complex pathophysiologic state that is primarily caused by an imbalance in energy expenditure and caloric intake. However, it can also be affected by genetics and environmental factors such as a sedentary lifestyle. It is critical to identify and manage the risk factors associated with metabolic syndrome through early diagnosis, treatment, and lifestyle changes. 

By making healthy lifestyle choices, such as increased physical activity, a healthy and balanced diet, and stress management, people can decrease the risk of metabolic syndrome development and improve their overall health and well-being. If you have any of the aforementioned risk factors for metabolic syndrome, it is important to see a doctor for proper management of the condition. A good idea would be to target the younger population and aim for the prevention of metabolic syndrome rather than targeting it after it happens. This could be done through several ways such as cooking classes in school, government restricting unhealthy food, a better understanding of the biology of the disease, and increasing investment in finding the right medications.18


  1. Marc J. Genetic Susceptibility to Metabolic syndrome. EJFCC; 2007. 18(1): 7-14.
  2. Alberti KGMM, Eckel, RH, Grundy SM, Zimmet PZ, Cleeman JI, Donato KA, Fruchart JC, James WPT, Loria CM, Smith JR SC; International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; International Association for the study of obesity. Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute, American Heart Association; World Federation; International Atherosclerosis Society and International Association for the Study of Obesity. Circulation; 2009. 120(16): 1640-1650.
  3. International Diabetes Federation. The IDF Consensus Worldwide Definition of the Metabolic Syndrome. 2015. Available at https://www.idf.org/e-library/consensus-statements/60-idfconsensus-worldwide-definitionof-the-metabolic-syndrome.html. Accessed on 2 Feb 2023. 
  4. Everanrd A, Belzer C, Geurts L, Ouwerkerk JP, Druart C, Bindels LB, Guiot Y, Derrien M, Muccioli GG, Delzenne NM, de Vos WM, Cani PD. Cross-talk between Akkermansia muciniphila and intestinal epithelium controls diet-induced obesity. Proc Natl Acad Sci U S A; 2013. 110(22): 9066-9071.
  5. Kopec AK, Abrahams SR, Thornton S, Palumbo JS, Mullins ES, Divanovic S, Weiler H, Owerns 3rd AP, Mackman N, Goss A, van Ryn J, Luyendyk JP, Flick MJ. Thrombin promotes diet-induced obesity through fibrin-driven inflammation. J Clin Invest; 2017. 127(8): 3152-3166.
  6. Kissebah AH, Sonnenberg GE, Myklebust J, Goldstein M, Broman K, James RG, Marks JA, Krakower GR, Jacob HJ, Weber J, Martin L, Blangero J, Comuzzie AG. Quantitative trait loci on chromosome 3 and 17 influence phenotypes of the metabolic syndrome. Proc Natl Acad Sci U S A; 2000. 97(26): 14478-14483.
  7. Di Daniele N, Noce A, Vidiri MF, Moriconi E, Marrone G, Annicchiarico-Petruzzelli M, D’Urso G, Tesauro M, Rovella V, De Lorenzo A. Impact of Mediterranean diet on metabolic syndrome, cancer, and longevity. Oncotarget; 2017. 8(5): 8947-8979.
  8. Wildman RP, Muntmer P, Reynolds. K, McGinn AP, Rajpathak S, Wylie-Rosett J, Sowers MFR. The obese without cardiometabolic risk factor clustering and the normal weight with cardiometabolic risk factor clustering: prevalence and correlates of 2 phenotypes among the US population (NHANES 1999-2004). Arch Intern Med; 2008. 168(15): 1617-1624.
  9. Bankoski A, Harris TB, McClain JJ, Brychta RJ, Caserotti P, Chen KY, Berrigan D, Troiano RP, Koster A. Sedentary activity associated with metabolic syndrome independent of physical activity. Diabetes Care; 2011. 34(2): 497-503. 
  10. Chasens ER, Imes CC, Kariuki JK, Luyster FS, Morris JL, DiNardo MM, Godzik C, Jeon B, Yang K. Sleep and metabolic syndrome. Nurs Clin North Am; 2022. 56(2): 203-217. 
  11. Tamashiro KL, Sakai RR, Shively CA, Karatsoreos IN, Reagan LP. Chronic stress, metabolism, and metabolic syndrome. The International Journal on the Biology of Stress; 2011. 14: 468-474.
  12. Wofford MR, King DS, Harrell TK. Drug-induced metabolic syndrome. J Clin Hypertens (Greenwhich); 2006. 8(2): 114-119. 
  13. Bosetti C, Gallus S, Trichopoulou A, Talamini R, Franceschi S, Negri E, La Vecchia C. Influence of the Mediterranean diet on the risk of cancers of the upper aerodigestive tract. Cancer Epidemiol Biomerkers Prev; 2003. 12(10): 1091-1104. 
  14. American Heart Association. 2021. Metabolic Syndrome. Available at https://www.heart.org/en/health-topics/metabolic-syndrome/about-metabolic-syndrome. Accessed on 2 Feb 2023.  
  15. Mayo Clinic. 2021. Metabolic Syndrome. Available at https://www.mayoclinic.org/diseases-conditions/metabolic-syndrome/symptoms-causes/syc-20351916. Accessed on 2 Feb 2023.  
  16. Hofmann T, Elbert U, Stengel A. Irisin as a muscle-derived hormone stimulating thermogenesis—a critical update. Peptides; 2014. 54: 89-100. 
  17. Anderson JG, Taylor AG. The metabolic syndrome and mind-body therapies: a systematic review. J Nutr Metab; 2011. 276419.
  18. Saklayen MG. The global epidemic of the metabolic syndrome. Curr Hypertens Rep; 2018. 20(2): 12.
  19. Cena H, Fonte ML, Turconi G. Relationship between smoking and metabolic syndrome. Nutrition Reviews. 69: 745-753. 
This content is purely informational and isn’t medical guidance. It shouldn’t replace professional medical counsel. Always consult your physician regarding treatment risks and benefits. See our editorial standards for more details.

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My name is Athina Servi, and I am a young professional with a strong academic background
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