WASHINGTON, May 31 (UPI) -- We've all heard about the dangers of cardiovascular disease and diabetes. But there's another reason to get off that couch: metabolic syndrome, a cluster of traits including elevated LDL cholesterol, elevated blood pressure, abdominal obesity and insulin resistance that often leads to serious health problems. An estimated 50 million Americans have the syndrome, and many don't know they have it. Dr. Molly Carr, a Northwestern University professor and endocrinologist affiliated with The Endrocrine Society, spoke with United Press International about how to combat this little-known condition.
Q. What's the history of metabolic syndrome?
A. For decades, a constellation of closely related risk factors has been studied. People noticed at the beginning of the 19th century that obesity, elevated cholesterol, diabetes and hypertension traveled together. Finally, in early 2001, there was a consensus by the World Health Organization and the National Cholesterol Education Program (NCEP) to call it metabolic syndrome.
Q. How is it diagnosed?
A. If you have three or more of the following criteria:
-- Abdominal obesity, a measure of waist circumference, is greater than 40 inches for men or 35 for women.
-- Triglycerides are greater than 150 milligrams per deciliter.
-- HDL (healthy cholesterol) is less than 40 mg/dl for men or less than 50 mg/dl for women.
-- Blood pressure is greater than 130/85.
-- Fasting glucose is greater than 100 mg/dl.
Q. Is the public aware of this?
A. People don't know much about it. I lecture a lot to physicians, and they are still struggling how to figure it out. One of the advantages of actually defining metabolic syndrome is it's a way for physicians to identify people at risk for the future. These people were flying under the radar screen for a long time.
Q. So having metabolic syndrome definitely sets you up for heart problems later on, right?
A. Usually the risk of cardiovascular disease (for metabolic syndrome patients) is quoted at about 1.5 to 4 times than healthy people. Even if the physician says, 'I'm not going to put you on lipid-lowering therapy,' you're still someone to keep a close eye on. Really, it's a wakeup call to lose weight.
Q. But we've all heard to exercise and eat right, and people don't seem to listen. What can we do?
A. It's frustrating and difficult to change one's lifestyle. What I try to do is give people helpful hints. If you cut out 500 calories a day from your diet, that's 3,500 calories per week, or one pound, and soon you're talking about four pounds a month. When you lose weight you need to focus on slow and steady. If you make drastic changes to your diet, you can't maintain it. Also, you don't have to go to the gym to get aerobic exercise. Get out at your lunch hour and walk 20 minutes, or get off the bus or train a few stops before and walk.
Q. Is this syndrome reversible? Can we turn around the damage?
A. All physicians have seen patients who lost a lot of weight (and become completely healthy). People don't realize how much lifestyle is a factor in cardiovascular risk. You don't need to lose 25 percent of your weight to get metabolic benefits. You can get improved lipid and glucose levels by losing just 5 or 10 percent of your body weight.
Q. The incidence of metabolic syndrome seems to be rising.
A. Yes, it affects 20 percent of Americans. Over the age of 60, 45 percent of Americans have it -- really an incredible amount. This is data that was collected in early 1990s. Metabolic syndrome increased 86 percent in women between 20 and 39 between 1990 and 2000. When you think about cardiovascular disease, it's a lifelong process that develops over decades. At some point, you have to wake up and say, this is about my quality of life.
Q. How do we turn the tide?
A. This is going to be a public-health issue that requires education at the population level. No one single change is going to have a major effect.
For more information: americanheart.org/presenter.jhtml?identifier=4756
