Metabolic Syndrome


Triple (or more) Threats


Metabolic syndrome is a group of medical conditions — high blood pressure, high blood sugar, abnormal cholesterol levels — that occur together thus increasing an individual’s risk of heart disease, stroke and diabetes. Consultant Endocrinologist at Pantai Hospital Kuala Lumpur, Dr. Vijay Ananda Paramasvaran, explains metabolic syndrome as, “A combination of various cardiovascular risk factors in an individual. Metabolic syndrome has many definitions and diagnostic criteria but it is widely accepted as defects in glucose and cholesterol level, blood pressure and weight.”


Increased risk for heart disease

Dr. Vijay Ananda says that individuals who are overweight and obese are more susceptible to this condition. It must be said that a person with just one of these conditions does not have metabolic syndrome but is still at risk of developing a serious disease. Thus, the more metabolic risks a person has, the higher the chances of developing heart disease. Also, ‘metabolic’ in this context is the biochemical processes involved in the body’s normal activities.

According to Dr. Vijay Ananda, metabolic syndrome increases the risk of cardiovascular disease but it is also associated with sleep apnoea and other complications of obesity. Other complications of obesity include osteoarthritis, erectile dysfunction in men and fertility problems in women, slow rate of wound healing and cancer.

Gohill, Rosenblum, Coplan and Kral, as cited in PubMed, suggest that chronic stress may contribute to metabolic syndrome by disrupting the hormonal balance in the brain. It will cause high amounts of cortisol  — stress hormones —  to circulate in the body which will raise the levels of glucose and also insulin. High levels of insulin in the body can cause abdominal obesity because of its effects on the adipose tissues (fat tissues). It can also cause insulin resistance and hypertension, another facet of metabolic syndrome.


GP or Endocrinologist?

It is advisable for a person who has elevated blood sugar, blood pressure and who is not at a healthy weight, to get screened for metabolic syndrome. Going to your usual general practitioner and voicing your concerns definitely helps. Dr. Vijay Ananda adds, “A specialist such as an endocrinologist will be able to offer medical expertise when managing multiple disorders present in the syndrome. It is also important to screen for other cardiovascular problems that may be present.”

According to Dr. Vijay Ananda, the doctor will perform tests to ascertain the patient’s glucose, lipids, blood pressure, uric acid, weight and/or Body Mass Index (BMI) and waist circumference in order to properly diagnose them with metabolic syndrome.


Treat the underlying problem

There is no cure-all for metabolic syndrome because it is a cluster of conditions. “We will treat the underlying problem, individual defects and advise weight reduction. Medications that lower cholesterol, anti hypertensive and anti diabetic medications will be prescribed in cases that need it,” says Dr. Vijay Ananda. He also adds that reduction in weight, lifestyle changes such as a regular exercise routine and taking proper medications help greatly.

In the case of the obese (BMI of 40 or greater) who have had no luck in weight reduction despite trying, there is an alternative. Gastric band surgery involves an inflatable silicone device that is surgically placed around the upper portion of the stomach to reduce and slow down the consumption of food. “This surgery is associated with a rapid reduction in weight and restoration of normal parameters of the components of the syndrome,” explains Dr. Vijay Ananda.


Reduce weight, lower blood pressure and sugar

Dr. Vijay Ananda advises, “There is no special diet to go on for this syndrome. Take the appropriate or reduced amount of calories in order to lose weight.”

As it is a group of conditions, it is advisable to tackle all the conditions one by one in order to maintain your health.

It is advisable to avoid food that is high in sodium and to increase your intake of water to lower your blood pressure. Incorporating more fruits and vegetables in order to increase the amount of vitamins, minerals and fibre will also help. Most importantly, exercise! Exercise increases the rate of metabolism which means you will burn calories faster.

Decrease the amount of sugar consumed in order to normalise your blood sugar levels and go for regular blood tests (once a month) in order to gauge your blood glucose levels.

You should also increase the consumption of healthy oils into your diet. By increasing the amount of good cholesterol in your blood, the levels of cholesterol will decrease. Oats are a great source of plant sterols that are considered ‘good cholesterol’ because their molecules are similar to that of ‘bad cholesterol’. Your body will absorb the plant sterols instead of the bad cholesterol, which will then be secreted through waste.

Conclusively, metabolic syndrome is something that can be avoided with a healthy lifestyle. Incorporate healthy habits in order to take care of one ’s self.


Metabolic Syndrome: The Warning Signs

  • Obesity

Body fat concentrated around the middle (apple shaped body)

Waist circumference of 40 inches or more for men and 35 inches or more for women.

  • Increased blood pressure

Systolic (top number) blood pressure of 130 mmHg (millimetres of mercury) or more OR diastolic (bottom number) blood pressure of 85 mmHg

  • High blood sugar level

Fting blood glucose test of 100 mg/dL (milligrams per decilitre) or more

  • High cholesterol,

Triglycerides (blood fat) level of 150 mg/dL or more

Low levels of High-Density Lipoprotein (HDL) cholesterol, ‘good cholesterol’, 40 mg/dL for men or less than 50 mg/dL for women



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