How To Treat Metabolic Syndrome

Medically reviewed by Dr. Stacy Hengisman MD and Felice Ramallo MSRD.

Metabolic syndrome is characterized by a cluster of symptoms that collectively raise one’s risk for long-term health implications such as coronary heart disease, diabetes, and stroke. If the term ‘metabolic syndrome’ doesn’t sound familiar, don’t worry, it can also be referred to as insulin resistance syndrome, and despite how common it is - 1 in 3 adults in the US have metabolic syndrome - the term is not part and parcel of our daily vernacular. Fortunately, despite how serious metabolic syndrome is (and how common), it is also thought to be largely preventable, according to the National Institute of Health. In this article we’ll be diving into how metabolic syndrome’s symptoms may develop, as well as what steps are available in order to treat metabolic syndrome. 

How does metabolic syndrome develop? 

So what causes metabolic syndrome?

Experts aren’t exactly sure what causes metabolic syndrome to manifest in some people versus in others, though there are “several factors [that] are interconnected.” Johns Hopkins Medicine reports that it appears obesity as well as a sedentary lifestyle contribute to risk factors for metabolic syndrome (which may include high cholesterol, insulin resistance, and high blood pressure). 

There is also belief by some medical providers that insulin resistance may be a causal factor of metabolic syndrome, although “they have not found a direct link between the two conditions” as of yet, while others believe hormonal changes - triggered by chronic stress - may be an exacerbating factor, if not a driving cause, of some cases of abdominal obesity, insulin resistance, and higher blood lipids. 

All in all? The jury is still out on the root cause behind this condition. That being said, according to the National Institute of Health, there are several factors within one’s control, as well as several outside of it, that can increase the likelihood of developing metabolic syndrome.

Risk factors for metabolic syndrome 

The following behaviors have been associated with an increased risk of developing metabolic syndrome. Researchers have characterized these factors as mostly within an individual’s control. 

• Being inactive 

• A meta-analysis published in 2012 found that greater time spent sedentary “increased the odds of metabolic syndrome by 73%.” As a result, researchers tentatively suggest that less time be spent engaging in sedentary activities that are mostly optional, such as watching TV. It’s important to note, however, that researchers point out they are not drawing a causal link; instead, robust longitudinal studies and intervention studies are necessary to “clarify the nature of any casual relationship between sedentary behavior and metabolic syndrome.” 

• Eating an unhealthy diet

• In at least one study, high consumption of ultra-processed foods was associated with increased prevalence of metabolic syndrome.  

• Not getting high quality sleep

• One report found that “there is a U-shaped associated between sleep duration and health outcomes” with individuals with short sleep duration (less than 5 hours) or long sleep duration (more than 9 hours) showing “higher risk for metabolic syndrome than those with normal sleep duration” which was categorized as 7-8 hours of sleep a day. 
• This same report also found that insomnia is a risk factor for the development of metabolic syndrome.

• Working hours that align with your circadian clock 

• Circadian rhythms are defined as physical, mental, and behavioral changes that follow a 24 hour clock. Circadian rhythm is driven by responses “primarily to light and dark” and this process is known to “affect most living things, including animals, plants, and microbes” - as well as humans! For instance, feeling tired when the sun starts to go down: that is likely a sign of your circadian rhythm. 
• A recent review published in 2020 strove to “summarize the recent advancements in the circadian clock regulation of nutrient metabolism and [discuss] the current understanding of the metabolic feedback signals that link energy metabolism with the circadian clock.” 

Some risk factors that may place you at increased risk for metabolic syndrome, but that the NIH points out are largely outside of one’s control, include: 

• Age

• As you age, your likelihood of metabolic syndrome increases.  

• Environment

• The National Institute of Health reports that those with low socioeconomic status are more likely to have problems with sleep, accessing healthy food, and are more likely to lead an inactive lifestyle.  

• Your genes

• Family history can impact your likelihood of developing metabolic syndrome; if you have a family member who has had diabetes, diabetes, or some of its risk factors, you may also be at increased risk. 

• Other medical conditions

• PCOS, certain cancer treatments that affect your immune system, and medicines used to treat allergies and a number of mental health conditions (like bipolar disorder, depression, and schizophrenia) are also thought to increase your risk. 

• Sex

• Likely because of hormonal changes after menopause, women have a higher risk of metabolic syndrome than men in older adults. 

Treating metabolic syndrome 

The National Institute of Health puts forward several treatment options for metabolic syndrome, typically revolving around protecting your heart health by consuming a healthy diet, engaging in physical activity, and leading a balanced life, if possible. 

Notice that the risk factors for metabolic syndrome - when turned on their head - can be useful in reducing one’s likelihood of developing metabolic syndrome, and potentially helping reverse it if you have been diagnosed. So let’s walk through the evidence behind how certain changes to lifestyle may be able to help. 

• Consume healthy foods

Once again, we’re talking about the Mediterranean diet!

One study published in 2020 that examined how dietary strategies impact metabolic syndrome found that “the scientific evidence supports the use of the MedDiet (mediterranean diet) as the new paradigm for metabolic syndrome prevention and treatment” since the nutritional distribution and quality of the diet allows health professionals to provide easy to follow dietary advice to people, without imposing challenging restrictions.

• Engage in regular physical activity 

According to a review published in 2019, “recent meta-analyses suggest that exercise training improve factors that underlie metabolic syndrome” and that in many subjects who met the criteria for metabolic syndrome, health outcomes were “significantly improved by aerobic or resistance training, or their combination.” 

So why is physical activity potentially so beneficial? Researchers suggest that there are numerous factors that contribute, but likely exercise impacts insulin resistance, adipose fuel metabolism, inflammation, and epigenetic factors.

• Manage and reduce stress

Ongoing stress has been related to an increased risk of metabolic disease, cardiovascular disease, and type 2 diabetes. 

Unfortunately, we know that reducing stress is easier said than done. Consider the following - if at all possible - to potentially help lower daily stress levels: 

• Reducing time with people in your life (be it family members, friends, or coworkers) that you feel drained after engaging with; 
• Changing jobs or reducing your hours at work if your manager, coworkers, or your work itself are a major source of stress
• Taking a certain amount of time each day (hopefully an hour, but even 15 minutes would be helpful) to do something that you truly enjoy just for the sake of it. It could be a walk, listening to a favorite podcast, journaling, or whatever makes you feel energized, relaxed, or at peace.
• Try setting up an appointment with a licensed therapist (if you have insurance, you can find a therapist that is in network, and if you don’t have insurance, ask about a sliding scale fee, which most therapists have - this means a lower fee based on income). Your therapist can teach you evidence-based skills to reduce stress and increase mindfulness in your life, while also acting as a soundboard for all those problems you find difficult to shoulder - a good therapist can help you carry them.