Understanding Metabolic Syndrome: What You Need to Know

Metabolic syndrome is a term you might have heard from your doctor or seen in health articles. But what exactly is it, and why should you care? It's often referred to as "pre-diabetes (type 2)." If you fall into this group, then it is worth reading on and taking action. In the future, you will thank yourself for it.

What is Metabolic Syndrome?

Metabolic syndrome is a group of conditions that occur together and significantly increase your risk of heart disease, stroke, and type 2 diabetes. If you meet three of the main criteria research has shown that your health is at risk- it's time to make some healthy changes.

The Five Key Components

There are five main conditions that make up metabolic syndrome. You need to have at least three of these to be diagnosed with it:

  1. Increased Waist Circumference (see below on how to measure this properly):
    • This means having extra fat around your belly. A waist measurement over 40 inches for men and over 35 inches for women is a red flag.
  2. High Triglycerides:
    • Triglycerides are a type of fat found in your blood. Levels above 1.7 mmol/L can increase your risk.
  3. Low HDL Cholesterol:
    • HDL is known as the "good" cholesterol because it helps remove bad cholesterol from your bloodstream. Low levels (below 1.0 mmol/L for men and 1.3 mmol/L for women) can be problematic.
  4. High Blood Pressure:
    • Blood pressure readings of 130/85 mmHg or higher, or taking medication for high blood pressure, are concerning.
  5. High Fasting Glucose:
    • High blood sugar levels, especially a fasting glucose level of 5.6 mmol/L or more, indicate that your body is not using insulin properly.

Why Should You Care?

Having metabolic syndrome increases your risk of serious health problems, including:

  • Heart Disease: Conditions that affect your heart and blood vessels.
  • Stroke: A serious condition where the blood supply to part of your brain is cut off.
  • Type 2 Diabetes: A chronic condition that affects the way your body processes blood sugar (glucose).

What Causes Metabolic Syndrome?

Several factors can contribute to the development of metabolic syndrome, including:

  • Obesity: Carrying extra weight, especially around the abdomen.
  • Physical Inactivity: Not getting enough exercise.
  • Insulin Resistance: Your body’s inability to use insulin effectively.
  • Unhealthy Diet: Eating too much sugar, unhealthy fats, and not enough fruits and vegetables.

How Can You Prevent or Manage It?

The good news is that you can take steps to prevent or manage metabolic syndrome. Here are some tips:

  1. Adopt a Healthy Diet:
    • Focus on eating more fruits, vegetables, whole grains, and lean proteins. Reduce your intake of sugar, salt, and unhealthy fats.
    • Intermittent fasting, especially if stop fast from early evening, has a profound impact on lipid profiles.
    • Ketogenic diets can also have a strong impact on proflies
    • See our blog on The Cholesterol lowering diet from Dr Dean Ornish
  2. Exercise Regularly:
    • Aim for at least 30 minutes of moderate exercise, like brisk walking, most days of the week.
    • Aerobic exercise is best for improving and increasing HDL-C, and resistance training is best for lowering LDL-C; therefore, a combination of both is best.
  3. Lose Weight:
    • Even losing a small amount of weight can make a big difference in reducing your risk.
    • If you afford to work with a nutritionist this is ideal, we learn eating patterns from a young age and sometimes need to educate and get support in changing this. It can also be highly rewarding to introduce new interesting foods into your diet instead of eating the same old all the time. 
    • Get a DNA test, we all react to foods differently. Check out our blog on genes that affect weight: 
  4. Quit Smoking:
    • If you smoke, seek help to quit. Smoking increases the risk of heart disease and other health issues.
  5. Monitor Your Health:
    • Checking your progress regularly can help with motivation and can help you keep track of your blood pressure, cholesterol levels, and blood sugar levels.

How to Measure Waist Circumference

Measuring your waist circumference is a simple way to assess your risk for health conditions related to obesity, such as metabolic syndrome.

Waist circumference is a strong indicator of visceral fat, the fat stored within the abdominal cavity and around important internal organs. This type of fat is more metabolically active and can increase the risk of health problems more than subcutaneous fat (fat stored under the skin)

Often I see patients trying to cheat and "sucking in" when doing this measurements, don't you are only lying to yourself. This article from Harvard Education Waist Size Matters does a good job of explaining it in more detail.

Here's a step-by-step guide:

  1. Get a Measuring Tape:

    • Use a flexible, non-stretchable measuring tape.
  2. Find the Right Spot:

    • Stand up straight and locate the top of your hip bones and the bottom of your rib cage. The measuring tape should be placed halfway between these points, typically around your belly button.
  3. Prepare for Measurement:

    • Ensure you are standing relaxed and breathing out gently. Do not suck in your stomach.
  4. Wrap the Tape Around Your Waist:

    • Wrap the tape measure around your waist at the identified spot, keeping it parallel to the floor. Make sure the tape is snug but not compressing the skin.
  5. Read the Measurement:

    • Look at the measurement on the tape at the point where the tape meets itself. Record the measurement in inches or centimeters.
  6. Compare to Guidelines:

    • For men, a waist circumference over 40 inches (102 cm) indicates an increased health risk.
    • For women, a waist circumference over 35 inches (88 cm) indicates an increased health risk.

It's a really useful measurement, by regularly measuring your waist circumference, you can monitor changes in your abdominal fat and take steps to reduce your risk of obesity-related health issues.


Metabolic syndrome might sound scary, but it’s actually a helpful wake-up call. It gives you the chance to make changes that can improve your health and reduce your risk of serious diseases. By adopting a healthier lifestyle, you can take control of your health and enjoy a better quality of life.

Lifestyle and dietary changes are fundamental to improving lipid profiles, yes medication can help but they do have side effects. If you are in this position it is worth discussing all of the above with your Doctor.


1. Mottillo S, Filion KB, Genest J, et al. The metabolic syndrome and cardiovascular risk a systematic review and meta-analysisJ Am Coll Cardiol. 2010;56(14):1113-1132.

2. Saklayen MG. The Global Epidemic of the Metabolic Syndrome. Curr Hypertens Rep. 2018;20(2):12. Published 2018 Feb 26. ]

3. Zhou C, Wang M, Liang J, He G, Chen N. Ketogenic Diet Benefits to Weight Loss, Glycemic Control, and Lipid Profiles in Overweight Patients with Type 2 Diabetes Mellitus: A Meta-Analysis of Randomized Controlled Trails. Int J Environ Res Public Health. 2022;19(16):10429. Published 2022 Aug 22. 29

4. Liang M, Pan Y, Zhong T, Zeng Y, Cheng ASK. Effects of aerobic, resistance, and combined exercise on metabolic syndrome parameters and cardiovascular risk factors: a systematic review and network meta-analysis. Rev Cardiovasc Med. 2021;22(4):1523-1533.

5. Safaei M, Sundararajan EA, Driss M, Boulila W, Shapi'i A. A systematic literature review on obesity: Understanding the causes & consequences of obesity and reviewing various machine learning approaches used to predict obesity. Comput Biol Med. 2021;136:104754. 

Harvard Education Waist Size Matters 

Assessing Your Weight and Health Risk NIH


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