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Metabolic Syndrome: The Missing Diagnosis (Blog Series, Part I)

Written by Courtney Baird and Dr. Jennifer Coomes



This blog series goes right along with the Metabolic Syndrome (MetS) online class by Dr. Jennifer Coomes, Courtney Baird, and Cassidy Schukar to help educate the general public about the hidden impacts of MetS on the US population because we rarely talk about it in medical terms and it is rarely diagnosed with patients even though there is increasing levels of research indicating that it can be the root of many chronic diseases and metal health conditions. We have chosen to do a blog series to break down these very important topics so that you have the information you need to consider making an appointment at Essence Health & Research with a Doctor of Clinical Nutrition (DCN) and your PCP to get further assessed.


The first topic we are going to talk about (with Courtney leading the way) is the definition and criteria of Metabolic Syndrome (MetS).




What is Metabolic Syndrome?

Metabolic syndrome, (MetS), also known as Syndrome X or dysmetabolic syndrome (2). Although Metabolic Syndrome is not a disease, it can indicate risk for disease. Metabolic syndrome is classified as a syndrome because it is exactly that. A syndrome, by definition, is “A set of symptoms or conditions that occur together and suggest the presence of a certain disease or an increased chance of developing the disease (1).


Metabolic syndrome may not be in the awareness of many people in our society. One in every three people in the United States have Metabolic Syndrome (5). The good news is that MetS is lifestyle related. No, that does not mean the presence of metabolic syndrome is the individual’s fault. It can, however, create hope to learn that MetS can be prevented or reduced by lifestyle interventions including physical activity, diet, and cessation of smoking tobacco (3).


What are the Criteria to be diagnosed with MetS?



Must have 3 or more of the following:

1. Increased abdominal fat

>35 inches in women or >40 inches in men


This is determined by measuring the circumference around a person’s waist. The concern is not necessarily about having stored fat, but the concern is regarding where the fat is located. When fat is stored in the abdomen, it is typically visceral fat, or fat that surrounds the internal organs. This is different from subcutaneous fat, or fat the is just beneath the skin. Visceral fat can impair the function of the vital organs they surround. The concern is that visceral fat can lead to many chronic conditions and is harder to get rid of than subcutaneous fat.


2. Hyperglycemia/High fasting blood sugar (glucose)

100 mg/dl or higher

To test fasting blood glucose, a person is asked to not each or drink for twelve hours prior to the blood sample. Since our blood sugar rises after we have eaten a meal containing carbohydrates, it is important to get this text done after many hours without eating to get a more accurate idea of how well the body can regulate the blood glucose. If blood sugar is considered high after many hours of fasting, this may indicate that the body is having issues regulating blood sugar, which may mean there is insulin resistance.


Insulin is a hormone that is produced by the pancreas in order to regulate blood sugar. When everything is working as it should, insulin signals for the cells of the body to take glucose in for energy, while also reducing blood sugar. Insulin resistance is when the body’s cells are unable to respond to insulin. Think of this like the lock in a door stops working for the key that is supposed to unlock it.



3. High level of fat (lipids/triglycerides) in the blood

150 mg/dl or higher


This is a measured of the lipids, or fats, that circulate in our blood. Triglycerides are also measured by a blood sample that is taken while fasting. Blood lipid levels are impacted by the foods we eat. For the same reason as for testing blood glucose, it is best to examine blood while someone has not eaten anything for several hours to get an idea of what their blood lipids are like unrelated to anything they might have recently consumed.


4. Low levels of “good” cholesterol (<HDL)

50 mg/dl or lower for women or 40 mg/dl or lower for men


First, I think it is important to distinguish between the “good” and the “bad” cholesterol that is produced in the liver of animals. It is produced in your body and is also consumed through the diet. Cholesterol often gets a bad reputation, but it is essential for cell membranes, hormone production, and it makes vitamin D from sun exposure. There can be too much of a good thing, however. too much cholesterol circulating in the blood can lead to blockages in the arteries resulting in a heart attack or stroke.


At this point, most people have heard reference of “good” or “bad” in regards to types of cholesterol. What people are referring to are high-density lipoproteins (HDLs) or low-density lipoproteins (LDLs). Lipoproteins are the transportation method for cholesterol to travel around in the blood. LDLs are considered the “bad” cholesterol because they are the main risk factor for cardiovascular disease and are related to plaque buildup in arteries (4). HDLs are referred to as the “good” cholesterol because they scavenge around the blood and bring cholesterol back to the liver to be processed. Low HDL cholesterol, related to total cholesterol, could indicate that the amount of LDL cholesterol is high, increasing risk of health complications.


5. High blood pressure (hypertension)

130/80 mmHg of higher


Most people have had their blood pressure taken whenever they visit a medical facility or even at the pharmacy area of many supermarkets. It can be taken by hand of the medical professional or by using an automated machine. This is a measure of how hard the heart is having to work to get blood throughout the body and the pressure that is exerted in the arteries, blood vessels leaving the heart. The systolic number, or top number, measures the maximum pressure that is present when the heart pumps. The diastolic number, or the bottom number, measures the pressure in the artery when the heart is resting (3). The measure of a person’s blood pressure can indicate their overall health status and their risk of having future health issues.



Next Steps...Make an Appointment with EH&R!


You can continue to read this MetS blog series and then, you are greatly encouraged to reach out to Dr. Jennifer Coomes to ask more questions and make an appointment for your clinical nutrition initial evaluation for you or a family member. It's so important to catch these signs early and get more of a natural approach with nutrition so that you do not have to be reliant on medications.


You can make an appointment at EH&R by reaching out to Dr. Jennifer Coomes by email at jennifer@essencehealthandresearch.com or by calling 425.505.3090.


References:


(1): NCI Dictionary of Cancer terms. National Cancer Institute. (n.d.). https://www.cancer.gov/publications/dictionaries/cancer-terms/def/syndrome 


(2): Samson, S. L., & Garber, A. J. (2014). Metabolic syndrome. Endocrinology and metabolism clinics of North America, 43(1), 1–23. https://doi.org/10.1016/j.ecl.2013.09.009


(3): Edlin, G., & Golanty, E. (2016). Health & Wellness. Jones & Bartlett Learning. 


(4): Hartley, A., Haskard, D., & Khamis, R. (2019). Oxidized LDL and anti-oxidized LDL antibodies in atherosclerosis - Novel insights and future directions in diagnosis and therapy. Trends in cardiovascular medicine, 29(1), 22–26. https://doi.org/10.1016/j.tcm.2018.05.010


(5): U.S. Department of Health and Human Services. (2022). What is metabolic syndrome?. National Heart Lung and Blood Institute. https://www.nhlbi.nih.gov/health/metabolic-syndrome#:~:text=Metabolic%20syndrome%20is%20common%20in,health%20problems%20it%20can%20cause

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