Dear Dr. Cutler,

I’m a 60-year-old man with a great deal of fat around my waist. From what I’ve read, I’m wondering if I have metabolic syndrome, but I’m not completely clear on what the condition entails. Could you tell me exactly what metabolic syndrome is and what are its symptoms?

—Milford P.

Dear Milford,

Metabolic syndrome is known by several different names including a “pre-diabetic” condition, a “pro-inflammatory state” and “insulin resistance syndrome.” It is actually a cluster of conditions that lead to a greater risk of type 2 diabetes and cardiovascular diseases.

According to the National Cholesterol Education Program guidelines, metabolic syndrome is characterized by three or more of the following:

• Excess body fat around the waist, or visceral adipose tissue (VAT).
• Elevated insulin levels, or insulin resistance.
• High blood pressure, or hypertension.
• Elevated triglycerides, low high-density lipoprotein (HDL)—“good” cholesterol levels—and high low-density lipoprotein (LDL)—“bad” cholesterol levels.
• Glucose intolerance.
• Easy blood clotting.
• Pro-inflammatory state, easily measured as elevate C-reactive protein (CRP) blood levels.
• Limited physical activity, which contributes to VAT.
• Aging.
• Diet of processed, refined foods devoid of nutrients.

Out of all of these conditions, the two main risk factors for metabolic syndrome are excess fat around the waist—which can be prevented and reversed—and insulin resistance—which in most cases can be prevented and reversed.

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