Increasing Number Of Overweight Americans
Suffer From Metabolic Syndrome

Special Report from National Public Radio, December 22, 2003

Health experts say two-thirds of American adults are now considered overweight. An increasing number of them are beginning to suffer from something called metabolic syndrome. It's a collection of five health problems that, taken alone, wouldn't mean much. But when they're added together, they dramatically elevate the risk of heart disease and diabetes. NPR's Patricia Neighmond reports.

PATRICIA NEIGHMOND reporting:
Maybe you've never heard of metabolic syndrome. It's had different names. Not long ago, it was called syndrome X. Its name was changed because all five of the health problems have to do with how the body metabolizes hormones and sugars.

Dr. ROBERT BONOW (Chief of Cardiology, Northwestern University): If you have slightly elevated blood pressure, slightly elevated blood sugar, slightly elevated triglycerides, and your waist circumference is a little bit larger than it ought to be, although each individual factor is relatively minor, the combination is a big deal.

NEIGHMOND: And that's because the problems all interact and exacerbate each other, and it's a big deal, because when taken together, they can push a person's risk for heart disease up by as much as 30 percent. The five health problems considered part of the metabolic syndrome are: slightly high blood pressure; slightly high blood sugar; high triglycerides, which are a form of fat that circulates in the blood; and low levels of the so-called good cholesterol. The fifth factor is how big you measure around the waist.

Dr. BONOW: Individuals who have lots of fat tissue, adipose tissue in their abdomen have a different kind of fat tissue than if you're storing fat in your legs or somewhere else, because that kid of fat tissue is not just a passive storage depot where we put our fat. That particular type of fat tissue is a kind of an organ that secretes hormones, and they're very bad hormones, hormones that can lead to a damage of blood vessels, to high blood pressure, to hardening of the arteries and heart attacks.

NEIGHMOND: People with metabolic syndrome may feel healthy. Bonow says that's why it's so important for the public and doctors to be more aware of this syndrome. Cholesterol, triglycerides, blood sugar, body fat are all easy to measure. And especially as people age, it's more important to measure them, particularly because they can be reversed. A healthy diet and daily exercise can bring down all these risk factors. One recent study in the Journal of the American Medical Association found that fitness in early adulthood can significantly reduce the likelihood of developing metabolic syndrome later in life.

Ms. MERCEDES CARNETHON (Epidemiologist, Northwestern University): There have been plenty of studies to show that people who are physically active are at a lower risk for developing these risk factors. What our study did that went beyond previous research was to show the development of heart disease risk factors over time in young adults.

NEIGHMOND: Carnethon and colleagues looked at young people to see who developed metabolic syndrome in middle age. They looked at over 4,400 young men and women, studying their level of exercise and their health status over 15 years.

Ms. CARNETHON: Those participants who were in low fitness when they were healthy young adults were at an increased risk of developing all of the heart disease risk factors: high blood pressure, diabetes, high cholesterol and the metabolic syndrome.

NEIGHMOND: They were three- to sixfold more likely to develop metabolic syndrome in middle age. So once again, the take-home message is get out and get active.

Ms. CARNETHON: During young adulthood, physical fitness is important. It's not sufficient to assume that waiting until middle age to become physically active to improve fitness is enough. What needs to happen is that young adults need to maintain their levels of physical activity so that they can become more physically fit, thus helping to ward off their risk of developing these heart disease risk factors over time.
NEIGHMOND: Various studies recommend different amounts of exercise, everything from 30 minutes of brisk walking a day to at least one hour a day, but health experts agree that any exercise at all at any age is better than nothing at all.

If you want to learn how your patients can increase their activity then check out the article by our publisher Steve Freed, in this weeks issue.

It’s Not Exercise, It’s Increasing Activity

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