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The girth's progress
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Metabolic syndrome can be traced to poor eating habits and a sedentary lifestyle
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THOSE RISKS High BP, diabetes and heart disease have become health burdens for India PHOTO: K.R. DEEPAK
Sadhana has just come back from a complete medical examination. She has been told that she has all the signs of the metabolic syndrome. She is at risk for developing major health problems. She is anxious. What is the metabolic syndrome?
Over the past few decades, India is facing a rapid transition in health problems. The common problems of infection have now been overtaken by chronic health conditions. High blood pressure, diabetes and heart disease have become the major health burdens for India. It has been reported that India suffers the highest loss in potentially productive years of life due to death from heart disease in people aged between 35-64 years. India also has the largest number of people with diabetes.
Heart disease is already the leading cause of death in women and in India this number will soon overtake the number of men dying of heart disease. This is because of metabolic syndrome.
What is the metabolic syndrome?
People with the metabolic syndrome are at an increased risk of coronary heart disease, stroke and type 2 diabetes. The metabolic syndrome is characterised by a group of metabolic risk factors in one person. They include:
Central obesity (excessive fat tissue in and around the abdomen)
Dyslipidemia (abnormal levels of fat in the blood, mainly high triglycerides and low HDL or "good" cholesterol)
Insulin resistance or glucose intolerance
Raised blood pressure (equal to or more than 130/85 mm Hg)
The root cause of most cases of metabolic syndrome can be traced back to poor eating habits and a sedentary lifestyle.
All of the factors associated with metabolic syndrome are interrelated. Obesity and lack of exercise tend to lead to insulin resistance. Insulin resistance has a negative effect on lipid production, increasing VLDL (very low-density lipoprotein), LDL (low-density lipoprotein — the "bad" cholesterol), and triglyceride levels in the bloodstream and decreasing HDL (high-density lipoprotein — the "good" cholesterol). This can lead to fatty plaque deposits in the arteries, which, over time, can lead to heart disease, blood clots and strokes. Insulin resistance also leads to increased insulin and glucose levels in the blood. Excess insulin increases sodium retention by the kidneys, which increases blood pressure and can lead to hypertension. Chronically elevated glucose levels in turn damage blood vessels and organs, such as the kidneys, and may lead to diabetes.
Who has the metabolic syndrome?
The metabolic syndrome has become increasingly common in India. Indians as a race are genetically predisposed to insulin resistance. Acquired factors, such as excess body fat and decreased physical activity, can elicit insulin resistance and the metabolic syndrome in us. Most people with insulin resistance have central obesity.
How is the metabolic syndrome diagnosed?
The metabolic syndrome is identified by the presence of three or more of these components:
Central obesity as measured by waist circumference: Men: greater than 102 cm (40 inches) Women: greater than 88cm (35 inches)
Fasting blood triglycerides greater than or equal to 150 mg/dL
Blood HDL cholesterol: Men: less than 40 mg/dL Women: less than 50 mg/dL
Blood pressure greater than or equal to 130/85 mmHg
Fasting glucose greater than or equal to 110 mg/dL
Waist-hip ratio
Measuring your waist-hip ratio will give you an idea of whether you have central obesity. To find your waist-to-hip ratio, measure the smallest part of your waist with a tape measure. Don't hold in your stomach! Now measure the biggest part of your hips with a tape measure. Measure the part where your buttocks stick out the most. Divide your waist measurement by your hip measurement. The answer is your waist-to-hip ratio. A ratio that is bigger than 1.0 (for men) or 0.8 (for women) shows that you have central (abdominal) obesity.
What can you do to decrease your risk?
To gain the most benefit from modifying multiple metabolic risk factors, the underlying insulin resistant state must become a target of therapy. The safest, most effective and preferred way to reduce insulin resistance is weight loss and increased physical activity.
GITA ARJUN
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