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Eighty-five percent of Americans have never heard of metabolic syndrome or don’t know it’s a cluster of risk factors for heart attack, stroke and type 2 diabetes, a national health survey reported. And of the nearly 250,000 people polled, only 0.6% thought they had this pre-diabetic condition themselves. While that may make it sound as if metabolic syndrome is very rare, actually it affects 26% of adults – nearly 50 million Americans.

Here’s why you need to know if you have metabolic syndrome: it triples your risk for heart attack and stroke, and quadruples it for type 2 diabetes. This cluster of cardiovascular risk factors that often strike in tandem is so easy to detect that you can even diagnose yourself, using a few basic numbers that every patient should know. And if you do have it, all of the risk factors are highly treatable, with simple steps advised by the BaleDoneen Method.

A Gang of Five Cardiovascular Villains

Do you have metabolic syndrome? Making the call is a bit like baseball: three strikes and you’re out. If you have three or more of these diagnostic criteria then you have metabolic syndrome —and therefore, you also have insulin resistance, the root cause of 70% of heart attacks and almost all cases of type 2 diabetes.

  • A large waist. Fifty-three percent of people with the syndrome are saddled with excessive belly fat, a study by the Centers for Disease Control found. A waist measurement above 35 inches for a woman, or above 40 inches for a man, is one “strike” for most people. However, for Asians, the abnormal numbers are 31 inches and 35 inches respectively for women and men.
    BaleDoneen recommendation: Combine aerobic exercise, such as walking, jogging, cycling or swimming, with muscle strengthening activities, such as lifting weights or resistance training. Both types of exercise help dieters avoid regaining belly fat after weight loss, suggesting that regular workouts are essential for maintaining a healthy weight – and waistline. We advise at least 30 minutes of exercise daily. Check with your healthcare provider before starting a new fitness regime to make sure it’s right for you.
  • High blood pressure. Also called hypertension, high blood pressure affects one in three Americans and ranks as the leading risk factor for stroke. If your pressure is 130/85 mmHg or higher, you have a strike. Decades of data show this level of pressure (or higher) damages arteries, raising your risk for heart attacks, strokes and kidney failure.
    BaleDoneen recommendation: Have your blood pressure checked regularly and talk to your healthcare provider if even one of your numbers is abnormal (a reading of 120/80 or higher). Treatments for high blood pressure typically include lifestyle and dietary changes and in many cases, medication.
  • Low HDL cholesterol. HDL (high-density lipoprotein) is the “good” cholesterol. A HDL level below 50 mg/dL for women, and under 40 mg/dL for men, is another strike for metabolic syndrome. Many people who are headed for arterial disease and diabetes will run low HDL levels. If you are being treated for low HDL, you have a strike even if the levels are above 50 and 40 mg/dL.
    BaleDoneen recommendation: if you use tobacco in any form, here’s yet another reason to kick this deadly habit: Several studies link quitting to a rise in HDL levels. Eating oily fish (such as salmon, tuna and sardines) or other foods that are high in omega-3 fatty acids helps boost levels of good cholesterol, while reducing inflammation.
  • High triglycerides. Like cholesterol, triglycerides are a type of fat (lipid) found in your blood. If your triglyceride level is 150 mg/dL or above, you have acquired another strike. If you are being treated for high triglycerides, it is a strike even if the level is below 150 mg/dL.
    BaleDoneen recommendation: If you’re overweight, losing 5% to 10% of your body weight (10 to 20 pounds if you weigh 200) can lower your triglycerides by 20%, according to a scientific statement from the American Heart Association. Limiting or avoiding sugar, and increasing the fiber in your diet, also are helpful.
  • High fasting blood sugar. Fasting means you have not consumed anything with calories for at least ten hours. A level of 100 mg/dL or higher counts as a strike. Fasting blood sugar levels of 100 mg/dL to 125 mg/dL indicate that you’re prediabetic, while a level above 125 mg/dL indicates diabetes.
    BaleDoneen recommendation: To prevent or reverse prediabetes, the treatment that trumps all others is regular exercise. Working out 30 minutes daily, five or more times a week, has been proven to prevent prediabetes from progressing to full-blown diabetes 60% of the time, while the success rate rises to 70% if regular exercise is combined with moderate weight loss (5% to 7% of your body weight), large studies report.