How Is Metabolic Syndrome Treated?

Healthy lifestyle changes are the first line of treatment for metabolic syndrome. Lifestyle changes include weight loss, increased physical activity, an improved diet, and quitting smoking.

Medicines are the next line of treatment. They’re used to treat and control individual risk factors such as high blood pressure, high triglycerides, low HDL cholesterol (high-density lipoprotein cholesterol), and high blood sugar. Medicines such as aspirin also may be used to reduce the risk of blood clots, a condition that often occurs with metabolic syndrome.

Goals of Treatment

The major goal of treating metabolic syndrome is to reduce a person’s risk for heart disease. Treatment is directed first at reducing LDL cholesterol (low-density lipoprotein cholesterol), high blood pressure, and diabetes (if these conditions are present).

The second goal of treatment is to prevent the onset of type 2 diabetes (if it hasn’t already developed). Long-term complications of diabetes often include heart and kidney disease, vision loss, and foot or leg amputation. If diabetes is present, the goal of treatment is to reduce the increased risk for heart disease by controlling all of the risk factors.

The main emphasis in the treatment of metabolic syndrome is to lessen the effects of the underlying risk factors that can be controlled, such as overweight, lack of physical activity, and an unhealthy diet.

Specific Types of Treatment

Weight Loss

In general, people with metabolic syndrome who are overweight or obese are urged to reduce their weight by 7 to 10 percent during the first year of treatment. For example, a person weighing 250 pounds should try to lose 18 to 25 pounds. A person weighing 300 pounds should try to lose 21 to 30 pounds.

After the first year, people are urged to continue to lose weight to the extent possible, with a long-range target of lowering their body mass index (BMI) to less than 25. BMI measures your weight in relation to your height and gives an estimate of your total body fat. A BMI between 25 and 29.9 is considered overweight. A BMI of 30 or more is considered obese. A BMI of less than 25 is the goal for prevention and treatment of metabolic syndrome.

You can calculate your BMI using the National Heart, Lung, and Blood Institute’s (NHLBI’s) online calculator, or your health care provider can calculate your BMI. For more information on losing and maintaining your weight, see the Diseases and Conditions Index article on Overweight and Obesity.

Healthy Eating Plan

For a healthy eating plan, go to the NHLBI’s Aim for a Healthy Weight Web site and the NHLBI’s “Your Guide to Lowering Cholesterol With TLC.” This booklet describes the Therapeutic Lifestyle Changes (TLC) diet.

With the TLC diet, less than 7 percent of your daily calories should come from saturated fat, and no more than 25 to 35 percent of your daily calories should come from all fats, including saturated, trans, monounsaturated, and polyunsaturated fats. You also should consume less than 200 mg a day of cholesterol. The amounts of fat and cholesterol in prepared foods can be found on the food’s nutritional label.

Foods high in soluble fiber also are part of a healthy eating plan. These foods include:

• Whole grain cereals such as oatmeal and oat bran
• Fruits such as apples, bananas, oranges, pears, and prunes
• Legumes such as kidney beans, lentils, chick peas, black-eyed peas, and lima beans

Fish are an important part of a heart healthy diet. Fish are a good source of omega-3 fatty acids, which may help protect the heart from blood clots and inflammation and reduce the risk for heart attack.

You also should try to limit the amount of sodium and salt that you eat. This means choosing low-sodium and low-salt foods and “no added salt” foods and seasonings at the table or when cooking. The nutritional label on food packaging shows the amount of sodium in the item.

Try to limit alcoholic beverages. Too much alcohol will raise your blood pressure and triglyceride level. It will also add extra calories, which will cause weight gain. Men should have no more than two drinks containing alcohol a day. Women should have no more than one drink containing alcohol a day.

Increased Physical Activity

In general, people with metabolic syndrome are urged to keep up a moderate level of activity, such as brisk walking for at least 30 minutes at least 5 days of the week. This activity can be broken into shorter periods as needed—for example, three 10-minutes sessions.

The ultimate goal is for people to maintain a moderate level of physical activity 60 minutes a day for 5 days a week, but preferably daily. You should talk with your doctor about the best kind of physical activity for you before starting any kind of program.

Smoking

If you smoke, quitting is important. Among other known harmful effects on your heart, smoking will raise your triglyceride level and lower your HDL cholesterol.

Medicines

Your doctor may recommend medicines to help treat unhealthy cholesterol levels, high blood pressure, and high blood sugar. Unhealthy cholesterol levels are treated by one or more cholesterol-lowering medicines such as statins, fibrates, or nicotinic acid.

High blood pressure is treated by one or more antihypertensive medicines such as diuretics or angiotensin-converting enzyme (ACE) inhibitors. High blood sugar is treated with oral medicines (such as metformin), insulin injections, or both. Low-dose aspirin can help reduce the risk of forming blood clots, especially for people at high risk for heart disease.