Metabolic syndrome (sometimes called syndrome X) is a group of risk factors for heart disease. You may have metabolic syndrome if you are overweight and have high blood pressure and high levels of sugar or fats in your blood. Many patients with adult-onset diabetes also have metabolic syndrome.

Why is it important?

With each risk factor you have, your risk for heart disease goes up. If you have all of the risk factors, you are six times as likely to get heart disease. Even if your cholesterol level is normal, you still may be at risk for a heart attack or stroke.

Metabolic syndrome happens when you don't get enough exercise and you eat a diet with too many calories and too much saturated fat. You can lower your risk of heart disease and diabetes by changing some habits, stopping smoking, and losing weight.

How can exercise help reduce the symptoms of metabolic syndrome?

How much exercise and what kind of exercise you should do depends on your fitness level now. Not being active is the biggest risk factor for heart disease. If you don't already exercise, start by walking for five minutes every day. It may be hard at first, so go slowly. If you have a medical problem, talk with your doctor before you start walking.

Once you are walking regularly, you should slowly increase how fast and how far you walk. Eventually you should walk for 30 to 60 minutes at least five days a week. If you already exercise this much, consider adding resistance exercises to build muscle strength.

How do I start exercising?

Many people find it hard to start an exercise program. There are a lot of books, videos, and programs to help. Find a friend to exercise with and get in shape together. Remember that a good exercise program includes three parts: warm-up and stretching, cardiovascular exercise (such as walking and biking), and strength training.

Can my diet reduce the risk of metabolic syndrome?

Yes; what you eat can affect how you feel. See the table on the next page for some healthy food choices. To lower your risk, try to make the following changes to your daily diet:

* Eat fewer calories. Try to eat less at each meal, and skip dessert. Snack on low-calorie foods such as carrot sticks or rice cakes. Try not to eat fried foods. When eating out, ask that gravy, sauces, or salad dressings be served on the side, and use only a little of them. Cut down on the amount of fat added to your starches (for example, don't put butter on a baked potato or a slice of bread). Remove the skin from chicken after cooking and before eating.

* Eat less saturated fat. Change from full-fat dairy products (such as whole milk, cheese, yogurt, cottage cheese) to reduced-fat and then low-fat (or skim) versions. Use only small amounts of butter or use a margarine that has no trans-fatty acids (such as tub or squeeze packages of margarine). Eat smaller portions of red meat (4 to 6 ounces instead of 6 to 8 ounces). Buy leaner cuts of meat. Eat chicken breasts instead of dark meat. Have at least one meatless dinner per week (but do not use eggs or cheese instead of meat in this meal).

* Eat more whole grains. Eat whole wheat bread, brown rice, oatmeal, and puffed-grain cereals. Whole-wheat pasta or pastas made from quinoa (say: keen-wha) or other grains are sold in health food stores and some supermarkets. Eat whole grain crackers and side dishes such as bulgur wheat.

* Eat more fruits and vegetables. We should all eat at least five servings of fruits and vegetables each day. Eat fruit for snacks instead of chips. Count how many fruit and vegetable servings you eat each day. Look for ways to get your "five-a-day" (two servings of fruit and three servings of vegetables).

* Eat fish. Fish has omega-3 fatty acids, which are good for your heart. Adding fish to your diet is healthier than red meat or cheese. Tuna, salmon, whitefish, and mackerel are good choices. Baking, broiling, or poaching fish will help you avoid extra calories from breading and frying.

* Use healthier fats. Olive oil, canola oil, and sesame oil are healthier than corn oil or vegetable shortening. Use only small amounts of lard, pork fat, or vegetable shortening for cooking. Try using the healthier oils in your recipes. These small changes will bring you large health benefits.

This information provides a general overview and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject. Copyright[C] 2004 American Academy of Family Physicians. Permission is granted to reproduce this material for nonprofit educational uses. Written permission is required for all other uses, including electronic uses.

This handout is provided to you by your family doctor and the American Academy of Family Physicians. Other health-related information is available from the AAFP online at http://www.familydoctor.org. 6/04

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