In recent years, the prevalence of metabolic syndrome has increased, affecting over 25% of individuals in the United States. (4) Obesity and common modern lifestyle factors may impair metabolic health and result in metabolic syndrome. It’s essential to address metabolic syndrome, as it increases the risk of developing other diseases, including type 2 diabetes and cardiovascular disease. (15) Fortunately, research has shown that certain dietary and lifestyle interventions may prevent or reverse the condition. Read on to learn more about metabolic syndrome and evidence-based approaches to address it.

What is metabolic syndrome?

Metabolic syndrome, also referred to as insulin resistance syndrome, obesity syndrome, and syndrome X, (9) is a group of metabolic abnormalities or disorders. (14)(15) The condition is characterized by the presence of any three of the following metabolic risk factors:

• A large waistline: greater than 40 inches in men and 35 inches in women
• Elevated triglyceride levels: 150 milligrams per deciliter of blood (mg per dL) or greater
• Reduced high-density lipoprotein (HDL) cholesterol: less than 40 mg per dL in men or less than 50 mg per dL in women
• Elevated fasting blood glucose (blood sugar): 100 mg per dL or greater
• Elevated blood pressure: systolic 130 mmHg or higher and/or diastolic 85 mmHg or higher (15)

Metabolic syndrome is largely preventable and modifiable using dietary and lifestyle interventions.

Signs and symptoms of metabolic syndrome

Individuals with MetS demonstrate at least three of the metabolic risk factors listed above. Certain irregularities, such as elevated triglycerides and reduced HDL cholesterol, can only be detected through blood tests. Physical symptoms of high blood pressure may include dizziness, headaches, and nose bleeds. High fasting blood glucose may be associated with symptoms such as blurred vision, increased thirst, increased urination, and fatigue. (10)

Medical conditions related to metabolic syndrome

There are concurrent (co-occurring) health conditions that may be seen in individuals with MetS, such as low-grade systemic inflammation and increased blood clotting. (10) Having MetS increases an individual’s risk of insulin resistance, cardiovascular disease (CVD), and type 2 diabetes. (15) Additionally, complications that may arise include neurological and vascular conditions, such as a cerebrovascular accident (stroke). (15)

Causes and risk factors for metabolic syndrome

In individuals where metabolism is impaired as a result of genetics or lifestyle, metabolic syndrome (MetS) may occur. Several causes and risk factors for MetS have been identified, including:

• Age: risk is greater with increasing age (10)
• Certain health conditions (e.g., gallstones, fatty liver disease, polycystic ovarian syndrome (PCOS), sleep apnea) (10)
• Dietary intake of saturated fat, trans fat, and sugar (8)
• Gender: increased risk in females (10)
• Genetic abnormalities which may increase the risk of insulin resistance (10)
• Nutrient deficiencies (e.g., carotenoids, vitamin B, vitamin D, vitamin E) (9)
• Overweight or obesity (10)
• Personal or family history of diabetes (10)
• Sedentary lifestyle (10)

Insulin resistance may also increase the risk of developing MetS. Insulin is a hormone that facilitates the transport of glucose into our cells for energy. Insulin resistance occurs when your cell’s responsiveness to insulin decreases. (11) Insulin resistance is associated with high blood glucose and being overweight or obese, (10) and may develop into prediabetes or type 2 diabetes. (11) Inflammation is involved in the development of cardiovascular disease and may be a contributor to MetS. Several inflammatory markers are elevated in individuals with MetS, including C-reactive protein, interleukin 6 (IL-6), and tumor necrosis factor-alpha (TNF-α). This systemic inflammation may result in the symptoms seen in individuals with MetS. (14)

Metabolic syndrome treatment

The treatment of MetS may vary depending on the metabolic risk factors present. Pharmaceutical medications commonly used include antihypertensives (blood pressure-lowering drugs), metformin (a blood glucose-lowering drug), and statins (cholesterol-lowering drugs). One goal of treatment is to reduce weight to achieve an ideal body weight. (14) Lifestyle interventions to assist with weight loss and improve metabolic risk factors include dietary modifications, dietary supplements, physical activity, and adequate sleep.

Consume the best diet for metabolic syndrome

Dietary patterns that may help reduce metabolic risk factors and improve health in individuals with MetS include the Mediterranean diet (MD), the Dietary Approaches to Stop Hypertension (DASH) diet, and a vegetarian diet. While a vegetarian diet doesn’t necessarily specify the quality or nutrient-density of foods consumed, both of these diets include a reduction in animal products, specifically processed meat on the MD. (7) Foods to limit when addressing metabolic syndrome include:

• Diet sodas, which are associated with an increased risk of MetS components and type 2 diabetes when consumed daily (12)
• Refined carbohydrates, particularly sweetened beverages, which increase the risk of MetS when consumed daily (8)
• Saturated and trans fats (e.g., fried foods, margarine, shortening, palm oil), which can impair metabolic health and may increase the risk of MetS and CVD (7)(8)

Dietary components to increase when addressing metabolic syndrome include:

• Monounsaturated fatty acids (e.g., avocados, nuts, seeds, olives), which improve metabolic parameters such as blood pressure and lipid levels (8)
• Polyunsaturated fatty acids (e.g., oily fish, walnuts, flax seeds), which similarly improve metabolic parameters (8)
• Vegetables and fruit, low intake of which has been found to be a risk factor for MetS (7)
• Herbs (e.g., cinnamon, garlic, turmeric), which have antioxidant and anti-inflammatory properties (14)
• Whole grains, which provide dietary fiber, shown to improve insulin sensitivity and reduce the risk of diabetes (8)
• Protein, which may improve cardiometabolic risk factors and help manage weight when consumed at amounts of 1.2 to 1.6 grams of protein per kilogram of body weight per day (8)

Consider dietary supplements

There are several dietary supplements that have been shown to improve metabolic health, including bioflavonoids, berberine, chromium, and omega-3 fatty acids.

Bioflavonoids

Bioflavonoids, such as resveratrol and quercetin, are a group of polyphenol compounds found in plants. Resveratrol is found in foods such as grapes, nuts, and red wine, and is commonly used as an isolate in dietary supplements. (14) A randomized controlled trial of individuals with MetS found that resveratrol supplementation improved total weight, body mass index (BMI), fat mass, waist circumference, and total insulin secretion. (5) Quercetin, an antioxidant, is found in a variety of dietary sources including berries, onions, and tea, and also commonly isolated for supplement use. (14) In a study of healthy males, an eight-week protocol of quercetin supplementation was found to improve metabolic markers such as waist circumference, HDL levels, triglycerides following a meal, and systolic blood pressure following a meal. (13)

Berberine

Berberine is an alkaloid that is extracted from certain botanical herbs, including barberry, goldenseal, and Oregon grape. (2) In clinical trials, berberine supplementation has been shown to lower lipid levels and improve insulin resistance. Additionally, berberine supplementation may support cardiometabolic health by reducing inflammation and improving vascular health. (2)

Chromium

Chromium is a trace mineral essential for metabolizing carbohydrates and lipids (fats). As chromium supports the signaling function of insulin, deficiency of the mineral may play a role in insulin resistance. (1) A supplemental form known as chromium picolinate has been shown to improve body composition and help manage weight. (16)

Omega-3 fatty acids

The omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are long-chain polyunsaturated fats found in high amounts in oily fish (e.g., herring, mackerel, salmon, sardines). Consuming these fatty acids has been shown to inhibit fat storage in the body and regulate the expression of certain genes involved in the metabolism of fatty acids in the liver and fat tissue. (14) Omega-3 supplements derived from fish oil have demonstrated similar effects to non-steroidal anti-inflammatory drug (NSAID) medications, exerting potent anti-inflammatory and cardioprotective effects. (3)

Address metabolic syndrome with exercise

Physical activity is another modifiable risk factor for MetS. High-intensity interval training (HIIT) is any form of cardiovascular exercise that alternates between high-intensity exercise and low-intensity exercise or rest. HIIT has been shown to improve MetS and cardiorespiratory fitness. One study examined the effects of HIIT three times per week for 16 weeks in men and women with MetS. Both genders had improvements in blood pressure and waist circumference following the exercise intervention. (6)

Optimize your sleep

As sleep deprivation and sleep apnea have been associated with the development of metabolic syndrome, improving your sleep habits is an important step. Research suggests that three months of treatment with a continuous positive airway pressure (CPAP) machine may improve irregularities associated with metabolic syndrome, including blood pressure, in individuals with moderate to severe sleep apnea. (15)

The bottom line

Metabolic syndrome is a group of metabolic factors that may be prevented or addressed with dietary and lifestyle modifications. A healthy dietary pattern, certain supplements, HIIT exercise, and improved sleep have been shown to benefit individuals with MetS. Work with your integrative healthcare provider to develop a wellness plan that supports your metabolic health and prevents the development of Metabolic syndrome.