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 that occur simultaneously: excess abdominal fat, a disrupted glucose metabolism (insulin resistance or elevated blood sugar), high blood pressure, and abnormal blood lipids (elevated triglycerides, low 'good' HDL cholesterol). When these factors occur together, they substantially raise the risk of cardiovascular disease and type 2 diabetes. There is still no single universally agreed definition of exactly when someone has metabolic syndrome, which makes comparing studies difficult.

The health risks are considerable. Metabolic syndrome not only raises the risk of heart attack and stroke, but has also been linked to a higher likelihood of at least 13 types of cancer, including colorectal, pancreatic, breast and bladder cancer. Notably, this elevated cancer risk appears to be present even in people with a normal body weight who have metabolic dysfunction. People with excess weight but no metabolic signs ('metabolically healthy obesity') appear to face lower risk in the short term, but research shows that this state typically progresses over time into an unhealthy metabolic condition with increased cardiac risk.

The cornerstone of treatment and prevention is lifestyle modification: a healthier diet and more physical activity. This applies to both adults and children. Medication or surgery is not the first choice for most people. The exact magnitude of the effect of lifestyle changes varies from person to person and from study to study, but the underlying principle is firmly supported by evidence.

Children and adolescents form a particularly vulnerable risk group. Depending on how metabolic syndrome is defined, between 6 and 39 percent of obese children and teenagers already show signs of metabolic syndrome. Early intervention is important to prevent lasting organ damage. In a small, carefully selected group of severely obese young people with dangerous co-existing conditions (such as type 2 diabetes, sleep apnoea or severe fatty liver disease), bariatric surgery can be safe and effective, but this is explicitly not recommended for most children.

In practical terms: anyone who wants to prevent or address metabolic syndrome would be wise to focus on weight reduction (especially abdominal fat), physical activity, and a dietary pattern with fewer heavily processed products, sugars and saturated fats. Consulting a doctor is sensible, because depending on severity, additional steps such as medication may be necessary. Do not wait until symptoms appear: the syndrome often progresses for years without clear signs.