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Heart Disease Health Center

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Metabolic Syndrome

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Changing Eating Habits

Diets come and go, but more recently, experts recommend the Mediterranean diet -- one that is rich in "good" fats (olive oil) and contains a reasonable amount of carbohydrates and proteins (such as from fish and chicken).

The Mediterranean diet is palatable and easy to maintain. In addition, recent studies have shown that when compared to a low-fat diet, people on the Mediterranean diet have a greater decrease in body weight and greater improvements in blood pressure, cholesterol levels, and other markers of heart disease, all of which are important in evaluating and treating metabolic syndrome.

Adopting an Exercise Plan

A sustainable exercise program -- for example, 30 minutes a day 5 days a week -- is reasonable as a starting point, providing there is no medical reason you can't. If you have any special concerns in this regard, check with your doctor first. Exercise has a beneficial effect on blood pressure, cholesterol levels, and insulin sensitivity, regardless of whether you lose weight. In itself, exercise is helpful in treating metabolic syndrome.

Cosmetic Surgery to Remove Fat

So, if a large waistline is the problem, why not just have liposuction to remove the fat? It's not so simple. Studies show no benefit in liposuction on insulin sensitivity, blood pressure, or cholesterol. As the saying goes, "If it's too good to be true, it probably is." Diet and exercise are still the preferred first-line treatment of metabolic syndrome.

What if Lifestyle Changes Are Not Enough to Treat Metabolic Syndrome?

What if changes in diet and activity levels do not do the trick? Drugs to control cholesterol and high blood pressure may be considered.

Blood pressure goals are generally set lower than 140/90, and recommendations may change depending on your age. Some blood pressure medications -- ACE inhibitors -- have also been found to reduce levels of insulin resistance and to defer the complications of type 2 diabetes. This is an important consideration when discussing the choice of blood pressure drugs in the metabolic syndrome.

Metformin (Glucophage), usually used to treat type 2 diabetes, also has been found to help prevent the onset of diabetes in people with metabolic syndrome. However, there are currently no established guidelines on treating metabolic syndrome patients with metformin if they do not have a diabetes diagnosis.

WebMD Medical Reference

Reviewed by James Beckerman, MD, FACC on May 16, 2014
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