Metabolic syndrome, also called syndrome X, is a poorly understood condition in which several cardiovascular disease risk factors develop in a single person. These include:

  • Abdominal obesity (excessive fat tissue in and around the abdomen.)
  • Unhealthy cholesterol profile (some elements of the following: low HDL ("good") cholesterol, high LDL ("bad") cholesterol, and high triglycerides)
  • High blood pressure
  • Insulin resistance (either frank type 2 diabetes or pre-diabetes)
  • Prothrombotic state (increased risk of blood clots)
  • Proinflammatory state (elevated levels of c-reactive protein, associated with increased rate of hardening of the arteries)

All of these risk factors are separately associated with an increased rate of atherosclerosis, leading to angina, heart attacks, strokes, intermittent claudication, and related conditions. When they occur together, the risk is even higher. Metabolic syndrome has become increasingly common in the United States; according to the American Heart Association, as many as 50 million Americans may have it.1 Although its causes are not clear, researchers believe that abdominal obesity plays a primary role. Abdominal obesity leads directly to high blood pressure. Perhaps more importantly, it also appears to cause insulin resistance, a condition in which the body does not respond properly to its own insulin. The first signs of insulin resistance include high levels of insulin in the body, impaired glucose tolerance, and disturbances incholesterol profile. In time, frankdiabetes of the type 2 variety can develop. Other elements of the metabolic syndrome may follow.

Exercise and weight losscan reduce insulin resistance; therefore, these two lifestyle "treatments" are the most important for addressing metabolic syndrome. Evidence does suggest that deliberate weight loss through dietary change, accompanied by increased levels of exercise, can in fact help control metabolic syndrome.4While any diet that effectively reducing weight would presumably work, there is some evidence that a Mediterranean-style diet—low in refined carbohydrates, high in fiber, moderately high in vegetable proteins and high in unsaturated fats—is particularly well suited for patients with this condition.6Beyond diet, the surgical treatment for obesity (eg, bypass surgery) has also been shown to effectively treat metabolic syndrome.6 The approaches described in the articles on Hypertension, High Cholesterol, andHigh Triglycerides may also be helpful.

It has also been suggested that deficiency of the mineral chromiummay play a role in the development of metabolic syndrome, and that supplementation may help. However, a study of 63 obese, nondiabetic adults with metabolic syndrome found that 16 weeks of supplementation with 1,000 mg chromium picolinate did not improve their insulin sensitivity, glucose metabolism, body weight, serum lipids or inflammatory state.8 One preliminary placebo-controlled trail suggests that a cinnamonextract may modestly lower blood sugar and blood pressure and raise lean body weight in patients with metabolic syndrome.7 However, the reliability of these results must be questioned since, even at much higher doses, cinnamon has not been consistently shown to lower blood sugar in diabetics, and there is no other evidence of its favorable effects in high blood pressure.

Another preliminary placebo-controlled study tested a proprietary extract of freshwater algae in 60 people with the syndrome and found some evidence of overall benefit.3In addition, a proprietary formulation of nopal cactus tested on 59 overweight women showed some benefit for their metabolic syndrome.5

One study failed to find that the supplement conjugated linoleic acid (CLA)was helpful for metabolic syndrome.2