The cardio metabolic syndrome, also simply called metabolic syndrome (MS), is growing to pandemic proportions in the developing world. While the overall global incidence of MS is around 30 per cent, it is 41 per cent in India, as per a survey. MS is the clustering of cardio metabolic risk factors. Recent research shows that MS is gene related.
According to the International Diabetes Federation, a person is said to have MS, when along with a waist circumference of more than 90 cm (men)/ 80 cm (women), any two of following five conditions exist:
n Triglycerides of more than 150 mg/dl
n HDL cholesterol less than 40 mg (male)/ 50 mg (female)
n Fasting sugar (glucose) of more than 100 mg
n Presence of diabetes
n Hypertension of more than 130 mm Hg systolic or 85 mm Hg diastolic.
Recent study shows certain genetic anomalies in children with MS. A person suffering from MS has three times higher risk for heart attack and stroke; and a five fold more risk of developing type 2 diabetes than a person who does not have MS. What is worse is that Indians are suffering from heart attacks and diabetes much earlier than their Western counterparts. The young Indian male heart is under attack principally due to rise in MS. Metro males are at a greater risk than their non-metro counterparts and their hearts are ageing faster.
Indian diet is rich in saturated fats and has high levels of refined carbohydrates. The level of all the artery-clogging ‘bad’ lipids circulating in the blood, non-HDL cholesterol, is also higher among Indians, predicting higher risk of cardiovascular diseases. In certain communities, women are more affected by MS than men.
The central defect in MS is insulin resistance, which simply put, is a state in which a given level of insulin produces a less than expected biological effect. Indians generally have a higher insulin resistance. But environment and lifestyle also have a huge role to play. Abdominal or central obesity is also common in India. Such a person is typically a “thin fat Indian”, thin on his limbs but fat on the abdomen. As a general guideline, obese children, adolescents, youths and persons above the age 25 should undergo regular screening for MS.
Check in time
Early identification of MS is important. The interventional programme to reduce the prevalence of MS in the community should begin at the secondary school levels. Lifestyle change and weight loss are considered the most important initial steps in treating MS. Parents of adolescents should take equal responsibility in providing a healthy, balanced diet. With both the spouses working in many households, readymade tinned foods and fast foods have entered more than 70 per cent of urban homes. More than 60 per cent of the upper-middle class and affluent do not consume three to five servings of fruits and vegetables per day, even though it is known that their consumption can reduce cardiovascular risk by 25 per cent. Westernised diets are strongly associated with a higher risk of developing MS. Diets rich in fish and cereal grains may be associated with a lower risk of developing MS. Although it looks to be higher among the affluent class, the condition is making its presence felt even in the middle- and lower socio-economic classes. At present, no surgical interventions for MS have been widely accepted. So, our best option is to make lifestyle amends.
(The author is physician, cardiologist &
diabetologist, Sattur Medical Care, Hubballi)
Published 06 November 2015, 16:14 IST