Metabolic Syndrome

Metabolic syndrome is a cluster of related conditions that together significantly raise the risk of type 2 diabetes, heart disease, stroke, and fatty liver disease. It's very common in Indians — and because South Asians often have central (belly) obesity at relatively lower body weight, metabolic syndrome can appear at what would otherwise look like normal BMI.

What defines metabolic syndrome

You have metabolic syndrome if you have 3 or more of the following (specific cut-offs for South Asians):

• Central obesity — waist circumference ≥90cm in men or ≥80cm in women (South Asian cut-offs)
• Raised blood pressure — 130/85 mmHg or higher, or on BP treatment
• Raised blood sugar — fasting ≥100 mg/dL, or on diabetes treatment
• Raised triglycerides — ≥150 mg/dL, or on treatment
• Low HDL ("good") cholesterol — <40 mg/dL in men or <50 mg/dL in women, or on treatment

Why it matters

• 2-3x higher risk of heart disease
• 5x higher risk of developing type 2 diabetes
• Increased risk of stroke, fatty liver disease, PCOS, sleep apnoea, and certain cancers
• Each additional component adds to the risk
• The underlying issue is usually insulin resistance

Causes and risk factors

• Excess abdominal (belly) fat
• Physical inactivity
• Diet high in refined carbs, added sugars, saturated and trans fats
• Insulin resistance — often genetic, more common in Indians and other South Asians
• Family history
• Age
• PCOS in women
• Some medicines (steroids, some antipsychotics)
• Sleep apnoea
• Smoking

Treatment

The same lifestyle changes help all of the components — and can reverse metabolic syndrome in many people:

• Lose 5-10% of body weight — often dramatically improves all components
• Cut refined carbs and added sugars — sweets, biscuits, maida-based foods, soft drinks, fruit juices
• More whole foods — whole grains, millets, pulses, vegetables, fruits, nuts, seeds
• 150+ minutes of moderate exercise per week — walking, yoga, swimming, cycling
• Strength training 2-3 times a week
• Sleep well — 7-8 hours; address sleep apnoea if suspected
• Stop smoking
• Limit alcohol
• Medicines — to manage specific components (BP, glucose, lipids) as needed; the diagnosis of metabolic syndrome often prompts earlier medication consideration

Metabolic syndrome is a warning sign that your body is heading toward serious disease — but also an opportunity, because lifestyle changes can substantially reverse it if made early.