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Got a 40-inch waistline? Beware!

By Ehtasham Khan
Last updated on: June 16, 2005 16:41 IST
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You are a man. Your waistline is above 40 inches.


You are a woman. Your waistline is above 34 inches.

We have news for you: Beware!

The big round belly may be a reservoir of metabolic risk factors and make you susceptible to various health disorders.

In medical terminology, this condition is known as Metabolic Syndrome/ Syndrome X/ Dysmetabolic Syndrome or Insulin Resistance Syndrome.

It can be defined as a cluster of problems, like abdominal obesity, high blood pressure, elevated blood sugar levels and unhealthy cholesterol levels that set the stage for:

  • Type 2 diabetes
  • Heart disease
  • Stroke
  • Cancers of the breast, uterus, prostate, colon
  • Alzheimer's Disease
  • Sudden Cardiac Death

Dr Balbir Singh, Senior Consultant and Interventional Cardiologist of New Delhi's Escorts Heart Centre, tells us more about this disease.

What is Metabolic Syndrome?

Earlier, Syndrome X was a disease for people aged between 70 and 80.

Today, our sedentary lifestyles could trigger MS at 15 or 20. Sometimes, even earlier.

Early stages of the Syndrome begin when there is a series of biochemical changes (genetic or lifestyle-related) in the body.

When we eat anything, our digestive system usually converts carbohydrates into simple sugar, ie glucose. The presence of glucose in the blood signals the pancreas to make insulin. This helps the muscles, fat and other cells take glucose from the blood. Which, in turn, leads to a decrease in blood sugar levels.

Hence, insulin production by the pancreas also decreases, since there is no sugar to act on.

This system can go haphazard if you are overweight.

Our body considers excess fat, especially belly fat, as an intruder. Hence, the immune system goes into overdrive to protect our body by producing a covering of disease fighting cells around it.

These cells send chemical messengers, called cytokines, in the bloodstream. These interfere with insulin's ability to open up the cells and muscles to absorb sugar, and attach themselves with the insulin receptors.

The sugar level in the blood then rises since the cells can't take it up themselves. This rise signals the pancreas to secrete more insulin.

When insulin levels rise, the cells take up sugar and help keep the sugar level normal or only slightly elevated for some time. After many years, though, the insulin producing capacity of pancreas reduces due to the overload of work on its insulin-producing islets.

Hence, the result: Type 2 diabetes. The insulin levels fall and the blood sugar levels rise.

Over time, these changes lead to the development of one or more associated medical conditions, like heart disease, stroke, high blood pressure. That is what Syndrome X is all about.

Research has shown that one in four people with Syndrome X will develop Type 2 diabetes.

The most frightening aspect is that the rest of us may not have any warning signal for many years till we face a major health setback due to Syndrome X.

Risk Factors

A thorough diagnosis with your doctor is a must if you have three or four of the below symptoms:

1. Apple-shaped bodies

'Apple' and 'pear' are the terms to describe your body shape.

An apple-shaped body tends to have fat above the waist and a pear-shaped body has fat below the waist.

If you have an apple-shaped body and if your waist measures 40 inches (for men), and 35 inches (for women), you may well be among the victims of Syndrome X.

2. If you cross these figures

i. Blood pressure is 130/85 mm Hg or higher.
ii. Triglyceride level is above 150mg/dl.
iii. The fasting blood glucose (sugar) level is greater than 100 mg/dl.
iv. The fasting blood High Density Lipoprotein level is less than 40 mg/dl (men) or under 50 mg/dl (women).

3. In your genes

People who have a genetic disorder, known as Insulin Resistance, are more susceptible to MS. This disorder inhibits the efficient use of insulin by the body.

That is why Metabolic Syndrome is also called Insulin Resistance Syndrome.

4. Diabetes

People who are diabetic who cannot maintain a proper level of glucose (glucose intolerance).

5. High blood pressure

People who are not diabetic, but who have high blood pressure and secrete large amounts of insulin (hyperinsulinaemia) to maintain blood glucose levels.

6. History of heart attack

Heart attack survivors who have hyperinsulinaemia and who are not glucose intolerant.

The medical problems associated with MS develop over a period of time. This is the main reason why people don't know they are suffering from MS until they experience major health setbacks, like sudden heart attack, stroke, etc.

The real culprit is high insulin levels, not high blood sugar levels.

Since insulin levels can not be measured with a simple laboratory test, you might be more ignorant of the disease.

What causes Metabolic Syndrome?

1. Apple-shaped belly

The body's immune system goes into overdrive when there is excess fat. This interfers in the process of insulin production and sugar absorption.

2. Physical inactivity

Physical activity leads to muscle contractions that help absorb sugar regardless of your insulin resistance level.

But lack of physical exercise makes you more dependent on insulin to absorb sugar. This means your pancrease will be overworked and will use up all the insulin producing islets.

3. Genetic predisposition

Your genetic make-up also plays a very important role in acting as the cause of MS.

4. Age factor

The risk of MS increases with age, affecting over 40 percent of the people in their 60s and 70s.

5. Family history

A family or personal history of Type 2 diabetes, high blood pressure or cardiovascular disease.

6. Stress and depression

If you are depressed, you are more likely to engage in unhealthy behaviours, like smoking, eating an unhealthy diet, leading a sedentary lifestyle, and not comply with medical treatment.

This increases your risk of developing MS. Also, depression may lead to body changes that predispose you to MS.

Next: How you can prevent MS!

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Ehtasham Khan