Dr Dulcy on the scourge of metabolic syndrome
METABOLIC SYNDROME: 50% IN SA ARE OBESE, WHICH HIKES THEIR RISK OF DEVELOPING IT
It brings increased blood pressure and blood sugar, excess waist fat and abnormal cholesterol or triglyceride levels.
Metabolic syndrome is a clustering of several heart disease risk factors. The prevalence in Africa is increasing, and it tends to increase with age.
This increase in the prevalence of metabolic syndrome in the continent is thought to be due to departure from traditional African to western lifestyles. In Africa, it is not limited to adults but is also becoming common among the young ones.
Obesity and dyslipidemia seem to be the most commonly occurring components. While obesity appears more commonly in females, hypertension tends to be more predominant in males. Insulin resistance is the most important underlying cause.
One in every two South Africans suffers from obesity, which increases the individual’s risk of developing metabolic syndrome. In fact, it is estimated that one in every four South Africans already suffer from it.
You have metabolic syndrome when you have the following cluster of conditions; increased blood pressure, high blood sugar, excess body fat around the waist and abnormal cholesterol or triglyceride levels. When these occur together, you are at increased risk of developing heart disease, stroke and diabetes.
If you have metabolic syndrome or any of its components, aggressive lifestyle changes can delay or even prevent the development of the serious health problems.
Your risk for heart disease, diabetes and stroke increases with the number of metabolic risk factors you have. The risk of having metabolic syndrome is closely linked to being overweight or obese and a lack of physical activity. Metabolic syndrome is becoming more common due to a rise in obesity rates among adults. In the future, metabolic syndrome may overtake smoking as the leading risk factor for heart disease.
Symptoms
A large waist circumference (pot belly, mkhaba) is the most obvious symptom, otherwise you might appear to be symptomless. Also if your blood sugar is very high, you might have signs and symptoms of diabetes, including increased thirst and urination, fatigue, and blurred vision.
Causes
The most obvious cause is being overweight and obese, and lack of physical activity. Insulin resistance is also closely linked to metabolic syndrome. Insulin is a hormone made by your pancreas that helps break down the sugar that you take in to be used as fuel by the cells. In people with insulin resistance, cells don’t respond normally to insulin, and glucose can’t enter the cells as easily. As a result, glucose levels in your blood rise.
Risk factors The following factors increase your chances of having metabolic syndrome:
Age: risk increases with age.
Obesity: carrying too much weight, especially in your abdomen.
Diabetes: you’re more likely to have metabolic syndrome if you had diabetes during pregnancy (gestational diabetes) or if you have a family history of type 2 diabetes.
Other diseases: your risk of metabolic syndrome is higher if you’ve ever had cardiovascular disease, nonalcoholic fatty liver disease or polycystic ovary syndrome.
Complications The complications are very serious and chronic and they include:
Hardening of the arteries (atherosclerosis).
Diabetes mellitus.
Heart attack.
Kidney disease.
Stroke.
Nonalcoholic fatty liver disease.
Peripheral artery disease.
Cardiovascular disease.
Further complications may occur from having diabetes mellitus, and they include:
Eye damage (retinopathy).
Nerve damage (neuropathy).
Kidney disease.
Amputation of limbs.
Diagnosis According to guidelines used by the National Institutes of Health, you have metabolic syndrome if you have three or more of these conditions:
Large waist circumference: a waistline of more than 90cm for women and 102cm for men.
High triglyceride level: fat levels more than 1.7 mmol/L in blood.
Reduced high-density lipoprotein (HDL) cholesterol: this is the good cholesterol found in blood tests.
Increased blood pressure: blood pressure more than 140/90 mmHg.
Elevated fasting blood sugar: blood sugar of more than 6mmol/l tested in the morning before you have anything to eat.
Treatment
Most important treatment is aggressive lifestyle changes such as diet and exercise.
Speak to your dietician and physician to prescribe the best combination for you.
Your doctor will recommend lifestyle changes that may include losing between seven and 10% of your current weight and getting at least 30 minutes of moderate to intense exercise five to seven days a week.
In situations where there is already increased blood pressure, blood sugar and cholesterol ab- normalities, medical treatment will have to be included.
If you stick to the prescribed lifestyle changes, you will see a reduction in dosages of medication required and even be able to stop treatment.
A healthy lifestyle is a lifelong commitment. Successfully controlling metabolic syndrome requires long-term effort and teamwork with your health care providers.
Prevention
Preventing metabolic syndrome is very possible. Maintaining a healthy waist circumference, healthy blood pressure levels and healthy cholesterol levels reduce your risk. In particular, eat a healthy diet that is very low in carbohydrates and sugars. Be careful of the hidden sugars in fruit and juices, cereals, condiments.
You should also get moving. Regular physical activity will reduce your blood pressure, blood sugar levels and cholesterol levels. The key is to try to maintain a healthy weight.
Talk to your healthcare providers before beginning an exercise programme or radically changing your diet. Prevention of metabolic syndrome will also require regular physical exams. Get your blood pressure, sugar and cholesterol checked, measure your waist and discuss your diet with a doctor.
Prevention of metabolic syndrome will also require regular physical exams.