Lifestyle Interventions That Help Treat Metabolic Syndrome

Metabolic syndrome, characterized by abdominal obesity, insulin resistance, hypertension, and hyperlipidemia, is now considered a major health hazard¹ and has even been called a “global pandemic.”² Researchers suggest that an increase in high-calorie, low-fiber fast food, an increase in sedentary lifestyles, and a decrease in physical activity contribute to the rising incidence of metabolic syndrome.¹

Patients with metabolic syndrome are five times more likely to develop diabetes.³ In fact, data show that the incidence of metabolic syndrome often parallels the incidence of obesity and type 2 diabetes.¹ Between 1988-2010, the average BMI in the US increased by 0.37% per year in both men and women.¹ CDC data published in 2017 found that about 30.2 million adults aged 18 years and older (12.2% of US adults) had type 2 diabetes; the prevalence of prediabetes or metabolic syndrome was about three times more—suggesting that about one third of US adults have metabolic syndrome.¹

But metabolic syndrome isn’t only affected by diet and exercise; stress levels, economics, and the health of the microbiota can also play a part. A 2018 cross-sectional analysis suggests that the psychosocial stressors associated with shift work may contribute to higher metabolic syndrome incidence.⁴ The Whitehall II study conducted on 10,308 British civil service men and women who were followed for an average of 14 years revealed that employees under chronic work-related stress had an odds ratio of 2.25 for developing cardiometabolic syndrome compared to those without work-related stress.² Among women, depressive symptoms, stressful life events, intense anger, and feeling tense increase the likelihood of developing cardiometabolic syndrome.² A 2018 study suggests that the epidemic of metabolic syndrome is also associated with economic development, lifestyle transition, and dysbiosis of gut microbiota.⁵

Research suggests that early intervention can help prevent metabolic syndrome. Before ordering lab tests, screening for metabolic syndrome can be as simple as conducting a brief physical exam for visceral adiposity and acanthosis nigricans.^6,7,8 Specifically, a simple waist-to-hip ratio may indicate an increased risk for diabetes, heart disease, and other complications.^9,10

Dietary interventions have also been shown to be effective in helping to prevent or control metabolic syndrome. 2018 epidemiologic evidence suggests that novel trimethylated (betainized) compounds associated with glucose metabolism in humans are associated with diets rich in whole grains, and they improve insulin resistance and insulin secretion.¹¹ Data from a cross-sectional analysis in adults suggests that a higher quality diet, assessed using the Dietary Approaches to Stop Hypertension (DASH) dietary quality score, is associated with improved adiposity measures and a less insulin-resistant, proinflammatory, pro-thrombotic, and pro-atherogenic cardiometabolic profile, which may impact central obesity and metabolic syndrome risk.¹²