Metabolic syndrome can lead to multiple chronic diseases, one of which seems to contribute to the others. Belly fat and metabolic syndrome are closely related. Dr. Howard LeWine explains.
Question: What’s the origin of the term “metabolic syndrome,” and what seems to be the major driver?
Answer: More than a century ago, scientists began to recognize that a variety of abnormal health measures appeared to cluster together in some people. In the 1970s, the term “metabolic syndrome” was coined to describe this collection of interrelated conditions. The term evolved into a more formal definition based on meeting at least three of the five following criteria:
- Have abdominal obesity (the accumulation of fat inside the belly), defined as a waist size of 40 inches or greater in men or 35 inches or more in women.
- Blood triglyceride level of 150 milligrams per deciliter (mg/dL) or greater, or you’re taking medication to lower triglycerides.
- Blood pressure is 130/85 millimeters of mercury (mm Hg) or higher, or you’re taking medication for high blood pressure.
- Fasting blood sugar level of 100 mg/dL or higher, or you’ve been diagnosed with type 2 diabetes, or you’re taking diabetes medication.
- A low blood HDL cholesterol level (below 40 mg/dL in men or below 50 mg/dL in women).
These factors interact in a complex web that drives the progression of multiple chronic diseases. Besides significantly increasing your risk for cardiovascular disease, metabolic syndrome means you are much more likely to develop diabetes, kidney disease, fatty liver disease, and sleep apnea. Studies also have found that metabolic syndrome can double the risk of erectile dysfunction.
Having just one of these metabolic factors is bad enough, but having multiple ones makes the likelihood of bad health outcomes even greater. So, people should take action when they gain an extra five to 10 pounds; need a bigger pants waist size; or show rising blood pressure, cholesterol, or sugar levels.”
The epicenter: Belly fat and metabolic syndrome
While each metabolic syndrome factor is problematic, the epicenter is abdominal obesity. Excess visceral fat, which surrounds our internal organs and builds up in our liver, is a driver of most of the other components of metabolic syndrome. This metabolically active fat is tightly linked to insulin resistance, which leads to higher blood sugar, and is associated with increased triglyceride levels and elevated blood pressure.
Shrinking your waistline to help reduce visceral fat can have the biggest across-the-board impact. Managing your weight can improve most everything related to metabolic syndrome. The best way to reduce excess fat is the standard formula for overall good health: weight management, aerobic exercise, strength training, and a plant-based diet. But keep in mind that visceral fat can be slow to come off. When you put on extra pounds, you tend to add visceral fat before you gain subcutaneous fat. But when you lose weight, the visceral fat is slower to come off.
In addition to diet and exercise, some people may also benefit from taking a GLP-1 receptor agonist to help with weight loss to manage belly fat and metabolic syndrome.
Howard LeWine, M.D., is an internist at Brigham and Women’s Hospital in Boston and assistant professor at Harvard Medical School. For additional consumer health information, please visit www.health.harvard.edu.
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