Questions & Answers
1. Why is excess fat around the waist more threatening to a person’s health than excess fat in other parts of the body?
Fat stored around the abdomen and waist is believed to be a better predictor of weight-related diseases like atherosclerotic cardiovascular disease (ASCVD), which results from atherosclerosis, or hardening of the arteries. Central obesity is also associated with increased risk of diabetes and insulin resistance as well as hormonal cancers (e.g. breast cancer), problems with ovulation and obstructive sleep apnea. Exactly why abdominal fat increases the risk of these serious diseases is not yet clear, but the association is well established.
2. Is there a genetic component to metabolic syndrome?
Yes. It is believed that certain individuals are genetically prone to developing insulin resistance. This inherited tendency is then triggered or set off by acquired or environmental factors such as central obesity or physical inactivity.
3. Is it more important to have a high HDL (good cholesterol) than a low LDL (bad cholesterol)?
It is more important to have a low LDL (bad cholesterol) because a high bad cholesterol level is directly associated with atherosclerosis (hardening of the arteries), which leads to stroke and heart attack. Although HDL (good cholesterol) is considered protective, even at high levels it is often not enough to protect against atherosclerosis in patients whose LDL is high. Most doctors would still work on lowering that LDL cholesterol.
4. How does smoking impact metabolic syndrome?
Smoking is a separate environmental factor that significantly increases the risk of atherosclerotic heart disease. So if a person with metabolic syndrome smokes, his or her risk of heart disease is that much higher. Yet smoking by itself is harmful. It increases high blood pressure and lowers HDL, both risk factors for metabolic syndrome.
5. Why does the National Heart, Lung, and Blood Institute suggest that metabolic syndrome may eventually surpass smoking as the leading risk factor for heart disease?
Metabolic syndrome is so closely tied to obesity, and obesity is on the rise in the United States. On the other hand, the percentage of smokers is decreasing.
6. Does the syndrome occur in children, and if so, what can parents do to prevent it?
Yes. Metabolic syndrome has been described in children. Obesity is growing even faster among children, and parents can help prevent metabolic syndrome by modeling and fostering a healthy lifestyle that includes healthy eating and regular physical activity.
7. How can a person tell if she or he has the syndrome?
A person could have several of the risk factors and not know it because except for obesity, metabolic syndrome has few or no symptoms. People should consult with their physician to be checked regularly for high blood pressure and the other risk factors that can result in the syndrome.
8. If a person has metabolic syndrome, does that mean that he or she will get diabetes or cardiovascular disease?
Not necessarily. Metabolic syndrome is a collection of risk factors which increase, but do not guarantee, the likelihood of developing diabetes or cardiovascular disease. There is an opportunity to modify existing risk factors through treatment of the individual conditions and prevention in the form of exercise and weight loss.
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