Metabolic Syndrome: A New Hope

A long time ago, in a galaxy far, far away, disaster was about to strike the Death Star. The catastrophe wasn’t due to a single problem but combined effects of several: imperial overconfidence, weak defenses against small threats, and -famously- an unshielded exhaust port leading straight to the central reactor. Any one of these issues could have been dangerous, but together they spelled the end of the Death Star.

The tragedy of the Death Star is quite like Metabolic Syndrome in this regard. Metabolic Syndrome, also called by several other names (MetS, Syndrome X, etc.) is a group of health problems that together increase your risk of serious diseases. It is defined as three or more of the following:

• Obesity around the waist (apple-shaped, not pear-shaped)
• High blood pressure
• High blood sugar, indicating insulin resistance
• High triglycerides, a type of fat
• Low HDL, “good cholesterol,” another type of fat

Just like the Death Star, trouble is not caused by one issue—it’s the combination of factors that causes the real damage. 

On their own, each of these is a problem that should be addressed. Together, these issues build on each other to form an existential threat to a person that can lead to diabetes, kidney problems, mental issues, and cardiovascular disease, including heart attack and stroke. Metabolic syndrome is very common, affecting somewhere around ⅓ of Americans. The exact causes are difficult to pinpoint, but several risk factors have been identified. These risks include:

• Obesity
• Inactive lifestyle
• Stress
• Aging
• Type 2 Diabetes
• Dyslipidemia (fat-in-blood disorders)
• Rheumatoid arthritis and psoriasis
• Chronic obstructive pulmonary disease (COPD)
• Genetics
• Some types of heart disease

These risks alter how our fat cells function, cause chronic inflammation, and change how our body processes food and drink. This may sound like we’re doomed to a starry grave, but there’s A New Hope! Ok, maybe it’s not new, but we had to throw in another Star Wars reference here.

The key to metabolic syndrome management is a healthy lifestyle, which includes:

• Eating healthy
• Physical activity
• Sleep
• Lowering stress
• Support
• Avoiding dangerous substances

This list includes some of the most challenging and vital changes a person can make. The prime objective in many cases is weight loss. Bariatric surgery shows evidence of reversing metabolic syndrome but is not usually the first choice. Lowering carbohydrates, including sugary drinks, seems to be effective. Specific diets like the Mediterranean or ketogenic diets may provide a good outline. A healthy diet may also help balance microbiome irregularities, which play a yet undetermined role in metabolic syndrome. A healthy diet is even more effective when combined with exercise. Overall, clinical research shows that losing as little as 3% of body weight leads to improvement. A 10% drop can help reduce blood sugar. Weight loss may be a goal, but it is easier to achieve when other lifestyle measures are improved.

Support comes from a lot of places. Friends, family, medical professionals, social agencies, and support groups, just to name a few. A walking or gardening club can encourage physical activity. A social media group can help generate healthy meal ideas. Patient-centered care and interventions can ensure that a holistic approach to health is taken. Cell phone apps may help with support, though limiting cell phone use may help improve sleep. Lowering stress, improving sleep, and avoiding drugs, alcohol, and tobacco are all easier with support. Even just knowing there are other people (a LOT of other people) struggling with metabolic syndrome may help someone know they aren’t dealing with this alone.

A healthy lifestyle is like ensuring the Galactic Empire is replaced with the New Galactic Republic: it’s a big step and necessary for long-term stability. In the short term, though, something’s gotta be done about that exhaust port. The best medical approach to metabolic syndrome currently is to treat the comorbidities - other conditions that occur simultaneously. Your doctor may prescribe one or more specific medications to treat high blood sugar, high blood pressure, and/or cholesterol issues. Blood sugar can be lowered with metformin, DPP4 inhibitors, GLP-1 agonists, and/or SGLT2 inhibitors. The latter few also help with weight and may give cardiovascular and kidney benefits. High blood pressure may be treated with low-dose aspirin, ACE inhibitors, or angiotensin-converting receptor blockers. Dyslipidemia - abnormal fat levels in the blood - may be treated with statins. There are also several new medications and combination medications which are in clinical trials and research phases currently. More help is needed, and that’s where volunteer participants like yourself can get involved. If you have any of the conditions mentioned above, ask about joining a research study today. Fighting metabolic syndrome is a long-term affair, but with support, a healthy lifestyle, and the right medicines, sufferers can make sure the Empire doesn’t Strike Back!

Staff Writer / Editor Benton Lowey-Ball, BS, BFA

Click Below for ENCORE Research Group's Enrolling Studies

References:

Aguilar-Salinas, C. A., & Viveros-Ruiz, T. (2019). Recent advances in managing/understanding the metabolic syndrome. F1000Research, 8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6449786/

Ambroselli, D., Masciulli, F., Romano, E., Catanzaro, G., Besharat, Z. M., Massari, M. C., ... & Mannina, L. (2023). New advances in metabolic syndrome, from prevention to treatment: the role of diet and food. Nutrients, 15(3), 640.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9921449/

Kadowaki, T., Maegawa, H., Watada, H., Yabe, D., Node, K., Murohara, T., & Wada, J. (2022). Interconnection between cardiovascular, renal and metabolic disorders: A narrative review with a focus on Japan. Diabetes, Obesity and Metabolism, 24(12), 2283-2296. https://dom-pubs.pericles-prod.literatumonline.com/doi/10.1111/dom.14829

McCracken, E., Monaghan, M., & Sreenivasan, S. (2018). Pathophysiology of the metabolic syndrome. Clinics in dermatology, 36(1), 14-20.https://www.sciencedirect.com/science/article/pii/S0738081X1730158X

Tobias, D. K., Chen, M., Manson, J. E., Ludwig, D. S., Willett, W., & Hu, F. B. (2015). Effect of low-fat diet interventions versus other diet interventions on long-term weight change in adults: a systematic review and meta-analysis. The lancet Diabetes & endocrinology, 3(12), 968-979. https://www.thelancet.com/journals/landia/article/PIIS2213-8587(15)00367-8