The metabolic syndrome is not a disease but a group of factors — increased blood pressure, high blood sugar, excess body fat around the waist and abnormal cholesterol or triglyceride levels — that occur together, increasing your risk of heart disease, stroke and diabetes. The prevalence of obesity and the metabolic syndrome is rapidly increasing in India and other South Asian countries, leading to increased mortality and morbidity. The main cause of the metabolic syndrome is closely related to being overweight or obesity and inactivity. It is also linked to insulin resistance.   Who is at risk of the metabolic syndrome? Age: Your risk of the metabolic syndrome increases with age. Race: In the United States, Mexican-Americans appear to be at the greatest risk of developing the metabolic syndrome. Close behind them are Asian Indians, Caucasians and South Asians. Obesity: Carrying too much weight, especially in your abdomen, increases your risk of the metabolic syndrome. Abdominal fat is just the beginning. Diabetes: You're more likely to have the metabolic syndrome if you had diabetes during pregnancy (gestational diabetes) or if you have a family history of type-2 diabetes. Other diseases: Your risk of the metabolic syndrome is higher if you've ever had cardiovascular disease, non-alcoholic fatty liver disease or polycystic ovary syndrome.   Diagnostic criteria for Asian Indians:

• Central obesity: Increased waist circumference (males: ≥90 cm and for females: ≥80 cm)

• High blood pressure: Elevated blood pressure (systolic blood pressure ≥130 mmHg and/or diastolic blood pressure ≥85 mmHg or drug treatment for hypertension)

• High triglycerides: Hypertriglyceredimia ≥150 mg/dl

• Low HDL cholesterol: (Males <40 mg/dl (1 mmol/l) and for females <50 mg/dl

• Insulin resistance: Elevated blood sugar (fasting blood sugar ≥100 mg/ dl or drug treatment for diabetes mellitus)

Three out of five cardiovascular risk factors have to be abnormal for the identification of the metabolic syndrome.   Treatment Dietary modification:

• Avoid intake of sugar, saturated fats, trans fat, refined carbohydrates and sweetened beverages.
• Increase dietary fibre by including green leafy vegetables and fruits to help prevent obesity.
• Reduce high-sodium foods such as table salt, pickles, papads and processed foods.
• Include foods with healthy MUFA fats such as avocado, fatty fishes such as salmon, tuna, mackerel, olive and canola oil.
• Avoid alcohol and smoking.

  Behavioral modification:

• It is essential to identify maladaptive behaviour related to eating habits and rewards, especially in children and younger adults.
• Habits are difficult to change in older individuals. It is essential that corrective measures continue even after the achievement of a healthy lifestyle.
• Reduce stress by engaging in deep breathing and meditation.

    Pharmacological intervention: Drugs can be prescribed by your doctor to help control your blood pressure, cholesterol levels and blood glucose.         Physical activity:

• Regular exercise should be promoted to increase energy expenditure and achieve weight loss and increase insulin sensitivity.
• Exercise is also known to reduce blood pressure, increase HDL cholesterol and lower triglyceride levels.

  Prevention with lifestyle changes: It is possible to prevent or delay the metabolic syndrome, mainly with lifestyle changes. A healthy lifestyle is a lifelong commitment. Successfully controlling the metabolic syndrome requires long-term effort and teamwork with your healthcare providers. The metabolic syndrome is now becoming more common owing to a rise in obesity rates among adults. In the future, the metabolic syndrome may overtake smoking as the leading risk factor for heart disease.     Download the Grow Fit app on Google Play or App Store today for a specialised diet plan.

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