The present day food consumption patterns have shifted leading to several adverse effects on human health. Modern food habits, regular consumption of fast food and the unhealthy lifestyles of people cause weight gain and increase the risk of developing 03 sisters of chronic diseases named diabetes, hypertension and increased blood lipids. The harmony of these metabolic disorders is associated with the metabolic syndrome. Metabolic syndrome is not a disease, but indicates the health risk.

According to some research studies, metabolic syndrome is a growing epidemic worldwide where the prevalence reaches 25-50% in some urban areas of South Asia. This may be due to unhealthy eating habits and lifestyles.

Dietician and Nutritionist Wasundara Rathnaweera spoke about metabolic syndrome and highlighted the following information related to this topic.

Metabolic Syndrome (MetS)
“MetS also known as cardio-metabolic syndrome, is a cluster of conditions, comprising abnormal glucose metabolism, abnormal lipid metabolism, abdominal obesity and high blood pressure,” explained Rathnaweera.

MetS is strongly associated with developing cardiovascular diseases (CVD) and Type 2 diabetes mellitus.

Risk factors
Rathnaweera mentioned the causes of MetS. “There are two major factors. The first involves significant factors including insulin resistance, abdominal obesity (modifiable risk factors), physical inactivity, age, gender and genetic. Second involves insignificant factors which include hormonal changes and people with specific medication (ex: medication for mental disorders),” she explained.

Symptoms
Rathnaweera spoke about the symptoms of MetS. “Most of the metabolic risk factors except large waist circumference have no signs or symptoms until the condition becomes serious. However, sometimes people with high blood glucose levels, especially Type 2 diabetes mellitus may experience frequent urination, increased thirst, tiredness, sweating and blurred vision.

Sometimes high blood pressure may be indicative by headaches; but most of the time patients with this condition do not show any symptoms.

Diagnosis
According to the latest definition of International Diabetes Federation (IDF), for a person to be identified with MetS, that person should have;

Large waist circumference - a waistline that measures ≥ 90cm for men and ≥ 80 cm for
Women (For South Asians including 

Sri Lankans)
Plus any two of followings,
1. High triglyceride levels - ≥150 mg / dL or specific treatment for this lipid abnormality
2. Reduced high density lipoproteins (HDL) cholesterol levels - less than 40 mg/dL (1.03 mmol/L) in men or less than 50 mg/dL (1.29 mmol/L) in women of this “good” cholesterol.
3. High blood pressure - 130/85 millimeters of mercury (mm Hg) or higher.
4. Elevated fasting plasma glucose levels (FPG) - ≥ 100 mg/ dL or previously diagnosed type 2 diabetes.

Treatment
In terms of treatment Rathnaweera proposes two interventions; Primary management of MetS is achieving a healthy lifestyle with moderate calorie restriction (aiming for a healthy weight), moderate increase in physical activity, change in dietary composition and other lifestyle changes such as managing stress, smoking cessation.

Next intervention is drug therapy or medicine.Recommendations
Rathnaweera opined that prevention is better than cure. Therefore, if you are a person prone to this risk, you should aim at avoiding complications or at least to delay the emergence. If you have already developed the conditions or any, still you should try to minimize the complications as first line treatment.

She has recommended changes in lifestyle, including a healthy diet and increasing physical activity. Because, a small weight reduction would greatly help to increase the insulin sensitivity, select healthy types of carbohydrates and fats, limit simple sugars as sweets, sugar and refined carbohydrates (Ex; polished rice, flour preparations), have a healthy blend of dietary fats and limit or avoid saturated fat intake. (Ex; red meat, fast food), incorporate healthy fat sources (Ex; nuts) into your diet, limit salt intake, cut down excess calorie intake, have a variety in food, engage in physical activity (Ex; walking, jogging), stop smoking, and manage stress by engaging in activities such as meditation and yoga.

In conclusion, metabolic syndrome puts you in a higher risk of developing type 2 diabetes mellitus and cardiovascular diseases and also increases the risk of mortality due to cardiovascular diseases. Therefore, it is very important to be away from risk factors that you can control to live a healthy life.