Metabolic syndrome, also called syndrome X, may sound like a super-secret plan in a spy movie. It’s actually more dangerous. The syndrome is a set of risk factors that can trigger a trio of life-threatening diseases. “Metabolic" refers to natural processes key to the body's healthy function. If you have metabolic syndrome, your body doesn’t work the way it should.

Abdominal obesity (belly fat), high blood pressure, high blood sugar, low HDL ("good") cholesterol and high triglycerides (blood fat) all boost your chance for heart disease, Type 2 diabetes and stroke.

Syndrome X can contribute to other life-long health conditions, too. It’s been linked to brain changes and mental deficits in adults and teens.

More than three million cases of metabolic syndrome are diagnosed in the United States each year. You are more likely to have metabolic syndrome if you are overweight or don’t get enough exercise.

People with metabolic syndrome often have one or more other factors tied to the health issue. These include:

• Greater risk of blood clotting
• Higher inflammation throughout the body
• Small amounts of a protein (albumin) in the urine

Do the Math

There are five risk factors with metabolic syndrome. Risk factors are traits, conditions or habits that raise your chance of getting a disease. All are linked to too much belly fat and problems metabolizing fat and sugar in your diet.

While having any of the risk factors can mean trouble for your health, you need to have three or more to meet the definition of metabolic syndrome.

Do you have these risk factors?

Extra weight in your middle. A waistline of 35 inches for women and 40 inches or more for men is a risk factor.

Low HDL. HDL (“good”) cholesterol less than 40 mg/dL for men and less than 50 mg/dL in women is a risk factor.

High triglycerides. Triglycerides are a type of fat in the blood. Fasting triglycerides of 150 mg/dL or higher is a risk factor.

High blood pressure. Blood pressure of 130/85 or higher is a risk factor.

High fasting blood glucose. Fasting blood glucose of 100 mg/dL or higher is a risk factor.

How many risk factors do you have? Three or more means there is a good chance you have metabolic syndrome.

Fending Off Metabolic Syndrome

If you have metabolic syndrome, or any of its risk factors, here’s some good news: There is a lot you can do to get it under control.

While you can’t change inherited risk factors such as genetics or family history, you have control over many others. When you make healthy choices in key areas, you may be able to reverse or better manage metabolic syndrome.

Start with these steps.

• Lose weight. Losing just three to five percent of your current weight can make a difference. Losing more weight can help cut all five risk factors.
• Eat a heart healthy diet. Ask your doctor to suggest one. You can start by curbing and avoiding saturated and trans fats, coconut and palm oils, sugary foods and drinks, foods with added salt, alcohol and red meat.
• Get active. Aim to get at least 150 minutes of physical activity each week. This can be as easy as brisk walking.
• Quit smoking. Ask your doctor to suggest products and programs that can help.
• Take your medicine. If your doctor orders medicine to keep your HDL, triglycerides, blood pressure or blood glucose under control, take it as directed.

Are you at risk for metabolic syndrome? Talk to your doctor about making healthy lifestyle changes.

Source: Metabolic Syndrome,  National Heart, Lung, and Blood Institute, National Institutes of Health, 2022

Originally published 8/25/2016; Revised 2021, 2023