The majority of Canadians are struggling to lead a healthy lifestyle. Nearly one quarter adults have high blood pressure¹, over one quarter live with obesity², almost thirty percent of adults have unfavorable cholesterol profiles³, and ten percent of adults have been given a diagnosis of diabetes; although, diabetes often goes undetected for years and the estimate is closer to one third of the population.⁴ The result is a growing percentage of the population who are diagnosed with a chronic disease which unfortunately account the majority of Canadian deaths. Often, one risk factor does not lead to chronic disease, it is the accumulation of risk factors which become dangerous.

What is metabolic syndrome?

Metabolic syndrome is a collection of five specific risk factors which increase the likelihood that an individual will be diagnosed with heart disease, diabetes or stoke later on in life.

The five factors for metabolic syndrome are:

1. High blood pressure – a reading greater than 130/85mmHg
2. Elevated blood sugar levels – ≥ 6.1 mmol/L while fasted
3. Increased fat tissue around the waist- > 102 cm for men and > 88 cm for women
4. Raised triglyceride levels - ≥ 1.7 mmol/L
5. Low levels of ‘good’ cholesterol, called high density lipoprotein or HDL - < 1.03 mmol/L for men and < 1.30 mmol/L for women

In order to be diagnosed with metabolic syndrome, one must have three out of the five risk factors. Although, having just one risk factor still increases the odds of chronic disease. As of 2014, almost one in five Canadian’s met the criteria for metabolic syndrome.⁵ Since this last survey, components of the disorder have risen in the population, therefore the numbers are estimated to be relatively higher in 2022.

What causes metabolic syndrome?

There are both modifiable and unmodifiable risk factors for metabolic syndrome. Unmodifiable risk factors include aspects such as age and family history. These risk factors are out of individual control. However, many factors for metabolic syndrome are modifiable and therefore can prevent and even reverse metabolic syndrome. Modifiable risk factors include insulin resistance, weight gain around the mid-section, and a lack of exercise.

How do you know if you have metabolic syndrome?

Metabolic syndrome can be easily diagnosed with a few measurements and blood tests. Taking a waist circumference, blood pressure reading as well as measuring lipids and glucose in the blood will provide all of the information needed for a screening of metabolic syndrome.

What does a diagnosis of metabolic syndrome mean?

As previously mentioned, metabolic syndrome is a collection of risk factors. This health disorder is used to gauge overall risk. Complications which may result from metabolic syndrome include liver disease, cardiovascular disease, diabetes, or a cardiac event such as stroke or heart attack.⁶

What can you do if you have a diagnosis of metabolic syndrome?

Metabolic syndrome is completely treatable if managed appropriately and within reasonable timing. The treatment for metabolic syndrome will depend on the severity of risk factors, age, personal health history as well as family history. However, nearly everyone with metabolic syndrome can benefit from moving more, adopting a healthy diet, and maintain a healthy weight. Certain supplements and pharmaceuticals can also be used to aid lifestyle changes. 

If you do not have a diagnosis of metabolic syndrome but are looking to prevent metabolic syndrome in the future, the key is to keep each risk factor in check. Maintain a healthy weight, blood pressure, cholesterol levels and blood sugar levels. This can be done exercising regularly and eating a healthy diet.

For both treatment and prevention, the good news is that the action items work for all five risk factors. For example, increasing your daily movement will help to lower high blood sugar levels but also work to decrease blood pressure, cholesterol levels and waist circumference.

Movement

Building muscle can be a powerful tool in lowering blood sugar levels because lean muscle acts as sink for glucose, absorbing glucose from the blood.⁷ Muscle mass can also be helpful in weight loss as muscles require energy, allowing the body to passively burn more calories (increasing the basal metabolic rate). Increasing cardiovascular fitness through aerobic activity can improve heart strength, lower blood pressure and improve circulation of blood in the body. Both aerobic and strength training regularly can decrease the risk of metabolic syndrome as well as complications such as heart disease and stroke.

Movement is important in the form of regular exercise as well as movement outside of a planned workout. A large risk factor for metabolic syndrome is the time in the day in which individuals remain sedentary.⁸ This includes time sitting at a desk, watching tv, or laying down. The amount of movement outside of exercise is very important as it brings down the total sedentary time. Aim for at least 10, 000 steps daily to combat the amount of time you spend sitting in a day.

Nutrition

Depending on individual goals, sex, age and health history, an individual diet plan may be helpful to treat or prevent metabolic syndrome. However, nearly all individuals will benefit from a diet which is high in fibre, healthy fats such as monounsaturated fats or omega-3 polyunsaturated fatty acids and low in processed, simple carbohydrates, trans fats and inflammatory oils such as canola oil, safflower oil, or soybean oil.

The timing of eating can also play a role in reducing the risk of metabolic syndrome. Eating for prolonged periods of time, irregular meal patters and misalignment of circadian rhythms with food intake is common in those with metabolic syndrome.⁶ Restoring the circadian rhythm through changing the timing of eating can impact risk factors for metabolic syndrome and may be a possible strategy in both treatment and prevention.⁶

When it comes to nutrition, start simple. What foods or drinks can you eliminate to decrease your sugar intake? Can you switch the oil you are using to a less inflammatory option? What foods can you add in that will increase the amount of fibre you have each day? Are you eating late at night? Are you snacking all day?

Often, individuals who are given a diagnosis of metabolic syndrome or who have some risk factors for the condition are provided exercise and diet prescriptions. On paper, the treatment for metabolic syndrome sounds quite simple, eat well and move more. However, implementing sustainable changes to your health and maintaining these routines can be quite intimidating, time consuming and complex. So, remember to be patient with yourself. Building healthy habits takes time. Remember that consistency is more important than perfection.

Stay tuned for part two of our series where we will take a look at the history of ‘fat free’ and assess which fats can be harmful and which can be healthful for those looking to decrease their risk for metabolic syndrome.  

Note- this is not medical advice. Please see a healthcare practitioner for specific direction pertaining to your individual health.

Dr. Maille Devlin

References

1. Leung et al. Statistics Canada. Risk factors for hypertension in Canada. https://www150.statcan.gc.ca/n1/pub/82-003-x/2019002/article/00001-eng.htm
2. Government of Canada. Health Info Base. Differences in obesity rates between rural communities and urban cities in Canada. https://health-infobase.canada.ca/datalab/canadian-risk-factor-atlas-obesity-blog.html?=undefined&wbdisable=true
3. Statistics Canada. Cholesterol levels of adults in Canada 2016-2019. https://www150.statcan.gc.ca/n1/pub/82-625-x/2021001/article/00003-eng.htm
4. Diabetes Canada. Diabetes in Canada. https://www150.statcan.gc.ca/n1/pub/82-625-x/2021001/article/00003-eng.htm
5. Riediger ND, Clara I. Prevalence of metabolic syndrome in the Canadian adult population. Cmaj. 2011 Oct 18;183(15):E1127-34.
6. Świątkiewicz I, Woźniak A, Taub PR. Time-Restricted Eating and Metabolic Syndrome: Current Status and Future Perspectives. Nutrients. 2021 Jan;13(1):221.
7. Richter EA, Hargreaves M. Exercise, GLUT4, and skeletal muscle glucose uptake. Physiological reviews. 2013 Jul 1.Lavie CJ, Ozemek C, Carbone S, Katzmarzyk PT, Blair SN. Sedentary behavior, exercise, and cardiovascular health. Circulation research. 2019 Mar 1;124(5):799-815.
8. Świątkiewicz I, Woźniak A, Taub PR. Time-Restricted Eating and Metabolic Syndrome: Current Status and Future Perspectives. Nutrients. 2021 Jan;13(1):221.