Metabolic syndrome

Question 1

What is metabolic syndrome and what is the criteria for diagnosis?

Answer 1

metabolic syndrome is a cluster of conditions including:

elevated waist circumference: ≥88cm for women; ≥102cm for men

elevated triglycerides: ≥150mg/dL

low HDL cholesterol: <50mg/dL for women; <40mg/dL for men

elevated BP: ≥130 systolic or ≥85 diastolic

elevated fasting glucose: ≥ 100mg/dL

To be diagnosed you need at least 3/5

Question 2

what causes metabolic syndrome?

Answer 2

primarily caused by an unhealthy lifestyle.
- people who too much or consume a lot of sweetened beverages are most at risk of developing metabolic syndrome.
- a lack of exercise can also be a factor

risk factors:
- age: risk of metabolic syndrome increases with age (40% of people over 60yrs have this condition)
- ehtnicity: more common in maori or polynesian
- family history of diabetes
- excess central adiposity
- sedentary lifestyle

Question 3

considerations for exercise testing and prescription

Answer 3

testing:
- apply contraindications for graded exercise testing
- consider CAD risk and glucose status when deciding testing modality
- potential for low exercise capacity
- if obese, consider modality to reduce MSK injury risk
- monitor BP often, given a probable hypertensive response

prescription:
- consider aerobic programs that favour volume over intensity to maximise energy expenditure (EE)
- RT aimed at strength and endurance adaptation to mitigate insulin signalling dysfunction and increase LBM (lean body mass) to increase resting energy expenditure
- mobility training to preserve functional movement and prevent “over use” injuries