Along with the rapidly rising increase in the number of people who are overweight or obese, a related condition called metabolic syndrome is raising the concerns of health care professionals.

A combination of medical criteria comprise this syndrome, but an expanding waistline may be the first indicator of metabolic syndrome and the increased risk of serious long-term health consequences.

Question: What criteria distinguish between simply being too fat and having metabolic syndrome?

Answer: This syndrome is diagnosed when a person has any three of the five following criteria:

» Elevated waist circumference (varies by gender and race)

» High blood triglycerides (over 150 mg/dl)

» Low HDL cholesterol (below 40 mg/dl in men and under 50 mg/dl in women)

» Increased blood pressure (greater than 130/85)

» Increased fasting blood glucose (over 100 mg/dl)

Each of these indicators alone is typically not considered to pose a significant health risk. However, when these criteria exist together, they indicate substantially increased risk of associated health problems.

Q: What health problems are associated with metabolic syndrome?

A: There is a substantially increased risk of cardiovascular disease and diabetes. The syndrome also is linked with greater risk of developing polycystic ovarian syndrome, nonalcoholic fatty liver disease, obstructive sleep apnea, gallstones and cancer of the prostate, breast or colon.

Q: What can be done to prevent metabolic syndrome?

A: The key elements for prevention include maintaining a regular habit of daily physical activity and consuming a balanced diet in moderation. As part of the balanced diet, it seems to be especially important to consume only moderate amounts of carbohydrate, mostly by avoiding excessive amounts of foods high in sugar.

Q: What can be done to reverse metabolic syndrome?

A: Dr. James Koski of Oregon State University Student Health Services spoke on this topic last week at the Pacific Coast College Health Association annual meeting. He identified a number of things a person can do to help reverse the syndrome. Depending on the severity of the various specific elements of the syndrome, drug treatment may be recommended. However, whether drugs are needed, the elements of treatment are similar to those of prevention:

» Maintain a moderate level of calorie intake that will promote gradual weight loss.

» Moderate carbohydrate in the diet, especially in the form of sugar. This is where reading food labels can really help increase awareness of sugar added to foods or naturally present in foods.

» Incorporate in the diet more low-fat foods with higher protein to replace high carbohydrate foods.

» Gradually increase physical activity to incorporate exercise as a daily part of lifestyle.

Q: How much exercise is recommended?

A: To maintain health, the adult "Physical Activity Guidelines for Americans" recommend aiming to obtain 150 minutes of moderate-intensity exercise each week or 75 minutes a week of vigorous-intensity aerobic exercise or a combination of the two. The guidelines suggest aiming for 300 minutes of moderate exercise or 150 minutes of vigorous intensity exercise.

Remember, prevention of metabolic syndrome is likely easier than reversing it.

Joannie Dobbs, Ph.D., C.N.S., and Alan Titchenal, Ph.D., C.N.S., are nutritionists in the Department of Human Nutrition, Food and Animal Sciences, College of Tropical Agriculture and Human Resources, University of Hawaii-Manoa. Dobbs also works with University Health Services.