At our centre, we regularly come across individuals with multiple health problems, particularly those related to heart disease. Very often, they need robust prevention and rehabilitation programs to help improve their physical, physiological and psychosocial wellbeing.
One such condition which we encounter commonly these days is “Metabolic Syndrome”. As the name suggests it is a combination of multiple risk factors of heart disease such as abdominal obesity, high blood pressure, increased blood sugar level and abnormal cholesterol level. This condition is growing in number day by day in India and expected to grow exponentially across the globe. The fact that several risk factors are present in the same individuals puts them at a very high risk of heart attack and stroke.
Based on multiple research findings, the rise in the incidence of obesity and diabetes was found to be the main reason behind the increase in metabolic syndrome. Also, the younger population, that is individuals between 25 and 35 years of age, are most affected suggesting that it is high time the youngsters take note of it!
The criteria for diagnosing Metabolic Syndrome as per the International Diabetes Federation guidelines in 2006 are:
- Higher waist circumference – more than 102cm for men; more than 88 cm for women & higher BMI
- Increased blood sugar level – more than 100 mg/dL
- Abnormal cholesterol levels – increased triglycerides and decreased High-Density Lipoprotein
- Increased blood pressure – more than 130/85 mmHg
The unhealthy lifestyle choices of our people such as
- Physical inactivity
- Unhealthy diet
- Chronic stress
- Disturbed sleep pattern
- Increase in tobacco and alcohol consumption
are the culprits causing this sudden surge in metabolic syndrome.
One important fact to be highlighted here is that all the above risk factors are interrelated which means that the occurrence of any one of the risk factors could pave way for the others as well.
If an individual has been diagnosed with metabolic syndrome, the following management should be initiated at the earliest:
1. Intensive lifestyle modification
An intensive lifestyle modification program is the first and only step in fighting metabolic syndrome, especially in individuals who are young, whose blood pressure, blood sugar and cholesterol levels are borderline elevated and who are free of organ damage. The program typically consists of health education about the condition and its effect on the body, tailor-made exercise training which focuses on controlling blood pressure, lowering blood sugar and cholesterol levels and education about the importance of exercise, along with personalized dietary guidance. Psychosocial counselling to help individuals cope better with their mental stress and emotional problems is also included in the program.
Importance of Exercise Training in Metabolic Syndrome
Exercise training is the cornerstone in the lifestyle program because of its multiple benefits:
Aerobic Training
- Helps to improve endurance and stamina
- Results in fat and carbs being used up as calories
- Lowers blood sugar, normalises cholesterol level and also controls blood pressure
- Aids in weight loss
If you are wondering how much aerobic exercise is adequate, here is my recommendation:
| Frequency | Intensity | Duration | Type |
| 5-7 days/week | Mild to moderate Intensity | 30-60 minutes/day | walking, jogging, cycling, swimming, hiking, treadmill, EFX |
Strength Training
- Helps to improve muscle strength and power
- Aids in calorie expenditure and weight loss
- Increases muscle mass and reduces fat mass
- Can be done with the help of equipment or use of bodyweight too
Guidelines for strength training:
| Frequency | Intensity | Duration | Type |
| 2-3 days/week | Mild to moderate Intensity | 20-30 minutes/day | Bodyweight (push-ups, pull-ups, squats), dumbbells, barbells, machine-based |
Other types of exercise training such as flexibility training, interval training and circuit training can be incorporated in the exercise program as per the individuals’ needs and health goals.
2. Medications
In individuals with advanced metabolic syndrome, that is high levels of blood sugar, abnormal cholesterol and uncontrolled blood pressure, medications such as anti-diabetic drugs, anti-hypertensive drugs and cholesterol-lowering drugs should be initiated along with the lifestyle intervention.
3. Surgery
Fat-reduction surgery or bariatric surgery is sometimes needed to address severe obesity especially if it does not respond to lifestyle changes and medications.
As metabolic syndrome is on the rise and so is the incidence of heart attack and stroke, we need to adopt a healthy lifestyle that includes regular exercise, balanced diet, well-managed stress and adequate sleep, along with regular medical checks. It is never too early and never too late to make a change that will improve your health and your overall wellbeing.