You know this kind of morning—you’re rushed to get ready for work, grabbing at outfits, yet everything you try on feels a little too tight around the middle. Mid-cycle bloat? Possibly, but an expanding waistline may be a warning sign for women at risk for diabetes and heart disease. If you’re plump around the middle, have high blood pressure, abnormal cholesterol, slothlike habits, and a tendency toward high blood sugar, you might have metabolic syndrome. Almost one in four adult Americans (22%) have metabolic syndrome, estimates the Centers for Disease Control and Prevention. As Americans grow more obese, the incidence of the condition is increasing.

Call it love handles, a spare tire, or spillover, a big belly is shaping up to be a big risk factor for the deadliest health concerns. Sometimes called insulin resistant syndrome, syndrome X, pre-diabetes, or the deadly quartet, metabolic syndrome isn’t a disease—it’s a cluster of related signs and symptoms that increases diabetes risk by up to fivefold, and hardening of the arteries (atherosclerotic cardiovascular disease) by as much as three times. Women account for a quarter of those with metabolic syndrome.

There’s more than one cause of metabolic syndrome, and its seriousness varies from person to person. Generally, the more components of the syndrome that you have, the greater the risks to your health. Researchers are debating whether metabolic syndrome is an actual medical condition or if more understanding is needed before it can be diagnosed and treated, although the criteria proposed by the National Heart, Lung and Blood Institute and the American Heart Association are widely accepted by many scientists and health care providers.

Although most women who are insulin resistant are also obese, this is not always the case in women of South Asian ethnicity or in women who have a family history of diabetes. Metabolic syndrome is also more common among blacks and Hispanics.


Even your body shape can put you at risk for metabolic syndrome if you carry extra fat around the middle, leading experts to suggest that body-fat distribution (having an apple-shaped figure instead of a pear-shaped figure) plays an important role in the syndrome. Lifestyle factors play a huge role in whether you will develop metabolic syndrome, as do genetics. Inactivity and consuming foods high in saturated fats and cholesterol put you at risk.

Your risk for metabolic syndrome also increases as you age. More than half of people ages 60 and older fit the parameters for having the syndrome. Research published in Science shows that the body’s 24-hour internal clock, which regulates sleep and hunger, plays an important role in the struggle to maintain healthy weight. The research team, led by an endocrinologist and a circadian-rhythms expert, has shown that a faulty or misaligned body clock can wreak havoc on the body and its metabolism, increasing the propensity for obesity and diabetes and putting a person with a healthy diet at risk for metabolic syndrome.

If you don’t have any of the components of metabolic syndrome, make sure you never develop them. If you have only one or two components, eliminate them and prevent the development of additional ones. The best prevention is a healthy lifestyle, including adequate physical activity and a healthy diet.

If you have metabolic syndrome, it’s not too late to make changes to reverse or diminish its effects on your health. Your main goal should be to prevent type 2 diabetes or cardiovascular disease. Reduce your risks by changing your lifestyle. In a recent Diabetes Prevention Program study, almost half of those with metabolic syndrome who adopted a healthier lifestyle no longer had it by the study’s end. Prescription drugs are available that can further reduce risks.

Thirty minutes of moderately intense activity like brisk walking most days of the week helps, but strive for 60 minutes each day. Talk to your care provider before starting an exercise program. Even small weight losses of 7% to 10% over a year will improve your health. Eat foods low in saturated fats, trans fats, cholesterol, sodium and sugar. If you smoke, stop. Smoking has been shown to increase insulin resistance and worsen the impact of metabolic syndrome.

Your care provider might recommend using drugs in addition to lifestyle changes, depending on your risk factor: If you have high cholesterol, she might recommend a statin. If you have high blood pressure, anti-hypertensives such as diuretics, angiotensin converting enzyme (ACE) inhibitors, calcium channel blockers, and beta blockers can be used. You might be asked to take lowdose aspirin daily to reduce clot formations. Thiazolidinediones and metformin, which are used in people with pre-diabetes and diabetes, decrease insulin resistance. Ongoing research is assessing whether these drugs can also be used to lessen insulin resistance in people with metabolic syndrome.

• Waist size of 35 inches or more for women
• Blood-pressure reading of 130/85 MMHG or more
• Fasting blood level of 150 MG/DL or more
• Fasting blood sugar of 100 MG/DL or more