Metabolic syndrome

The National Institutes of Health guidelines define metabolic syndrome as having three or more of the following traits, including traits for which you may be taking medication to control:

• Large waist — A waistline that measures at least 35 inches (89 centimeters) for women and 40 inches (102 centimeters) for men
• High triglyceride level — 150 milligrams per deciliter (mg/dL), or 1.7 millimoles per liter (mmol/L), or higher of this type of fat found in blood
• Reduced "good" or high-density lipoprotein (HDL) cholesterol — Less than 40 milligrams per deciliter (mg/dL) (1.04 millimoles per liter (mmol/L)) in men or less than 50 mg/dL (1.3 mmol/L) in women of high-density lipoprotein (HDL) cholesterol
• Increased blood pressure — 130/85 millimeters of mercury (mm Hg) or higher
• Elevated fasting blood sugar — 100 mg/dL (5.6 mmol/L) or higher

If aggressive lifestyle changes such as diet and exercise aren't enough, your doctor might suggest medications to help control your blood pressure, cholesterol and blood sugar levels.

If you've been diagnosed with metabolic syndrome or any of its components, making healthy lifestyle changes can help prevent or delay serious health problems, such as a heart attack or stroke. A healthy lifestyle includes:

• Regular physical activity. Health experts recommend getting at least 30 minutes of exercise, such as brisk walking, daily. But you don't have to do that activity all at once. Look for ways to increase activity any chance you get, such as walking instead of driving and using the stairs instead of an elevator.
• Weight loss. Losing 7% of your body weight can reduce insulin resistance and blood pressure and decrease your risk of diabetes. In fact, any amount of weight loss is beneficial. It's also important to maintain your weight loss. If you're struggling with losing weight and keeping it off, talk to your doctor about what options might be available to help you, such as medications or weight-loss surgery.
• Healthy diet. Healthy-eating plans, such as the Dietary Approaches to Stop Hypertension (DASH) diet and the Mediterranean diet, emphasize eating vegetables, fruits, high-fiber whole grains and lean protein. Healthy-eating plans tend to recommend limiting sugar-sweetened beverages, alcohol, salt, sugar and fat, especially saturated fat and trans fat.
• Stopping smoking. Giving up cigarettes greatly improves your overall health. Talk to your doctor if you need help quitting.
• Reducing or managing stress. Physical activity, meditation, yoga and other programs can help you handle stress and improve your emotional and physical health.

You're likely to start by seeing your primary care provider. He or she may then refer you to a doctor who specializes in diabetes and other endocrine disorders (endocrinologist) or one who specializes in heart disease (cardiologist).

What you can do

When you make the appointment, ask if there's anything you need to do in advance, such as fasting for a specific test. Make a list of:

• Your symptoms, including any that seem unrelated to the reason for your appointment
• Key personal information, including major stresses, recent life changes and family medical history
• All medications, vitamins or other supplements you take, including the doses
• Questions to ask your doctor

Take a family member or friend with you if possible, to help you remember the information you're given.

For metabolic syndrome, basic questions to ask your doctor include:

• What conditions are causing metabolic syndrome for me?
• How can I reduce the risk of other health conditions caused by metabolic syndrome?
• Will losing weight help my condition? What about exercise?
• Do I need any additional tests?
• I have other health conditions. How can I best manage them together?
• Should I see a specialist?
• Are there brochures or other printed material I can have? What websites do you recommend?

Don't hesitate to ask other questions.

What to expect from your doctor

Your doctor is likely to ask about your diet, exercise and other lifestyle habits.