What is metabolic syndrome and how do I get rid of it?

Metabolic syndrome is not a single disease but a cluster of risk factors occurring at the same time: excess abdominal fat, a disrupted sugar metabolism (insulin resistance or elevated blood sugar), high blood pressure, and abnormal blood lipids (triglycerides that are too high, 'good' HDL cholesterol that is too low). When these occur together, your risk of cardiovascular disease and type 2 diabetes rises sharply. Exact threshold values have not yet been defined consistently worldwide, which makes comparing studies difficult.

The consequences reach beyond the heart and blood vessels. Metabolic syndrome is associated with an increased risk of at least 13 types of cancer, including colorectal, pancreatic, breast, and bladder cancer. Notably, that risk also applies to people of normal weight who have metabolic problems. People who are overweight without metabolic problems face lower short-term risk, but research shows that this 'metabolically healthy overweight' often shifts over the years into an unhealthy metabolic state carrying a higher cardiac risk.

The cornerstone of treatment and prevention is lifestyle change: eating more healthily and moving more. This applies to both adults and children and is firmly supported by multiple human studies. Medication or surgery is not the first choice for most people.

Children and adolescents are a particular at-risk group. Depending on the definition used, between 6 and 39 percent of obese children already show signs of metabolic syndrome. Early intervention helps prevent lasting organ damage. Bariatric surgery can be safe and effective for a small, carefully selected group of severely obese young people with dangerous co-existing conditions such as type 2 diabetes or sleep apnoea. But that is explicitly not the route for the vast majority.

Do you want to tackle or prevent the syndrome? Start by reducing abdominal fat, moving more, and eating fewer heavily processed products, added sugars, and saturated fats. Depending on the severity, additional medication may be needed; discuss this with a doctor. And do so in good time: the syndrome can persist for years without obvious symptoms.