The importance of managing the metabolic syndrome has been emphasised in the prevention of cardiovascular disease. Experts also warn that the risk for heart disease, diabetes and stroke increases with the number of metabolic risk factors one has. But what is metabolic syndrome?

Dr Menelas Nkeshimana, an internal medic at University Teaching Hospital of Kigali (CHUK) describes metabolic syndrome as a cluster of diseases, where if any three of them occur together, they gravely increase cardiovascular risk.

"Metabolic syndrome is a cluster of conditions such as increased blood pressure, high blood sugar, excess body fat around the waist and abnormal cholesterol or triglyceride levels that occur together, increasing your risk of heart disease, stroke and diabetes,” he says.

Nkeshimana further explains that one does not need to have all of the characteristics to have metabolic syndrome. However, a person with one characteristic is more likely to have others.

"Having just one of these conditions doesn’t mean you have metabolic syndrome. However, any of these conditions increase your risk of serious disease. Having more than one of these might increase your risk even more,” he explains.

The risk of having metabolic syndrome is closely linked to overweight, obesity and a lack of physical activity.

Nkeshimana says having at least three of these five traits, that is, excess abdominal fat, high blood triglycerides, low HDL (which is the good cholesterol), high blood pressure and impaired glucose tolerance increase the risk of metabolic syndrome.

"Insulin resistance also may increase your risk for metabolic syndrome. Insulin resistance is a condition in which the body can’t use its insulin properly. Insulin is a hormone that helps move blood sugar into cells where it’s used for energy. Insulin resistance can lead to high blood sugar levels, and it’s closely linked to overweight and obesity,” he explains.

According to Rachna Pande, a specialist in internal medic at Butaro Hospital, the exact mechanism behind metabolic syndrome is not known but it is postulated to be due to increased atherosclerosis (deposition of fat over inner lining of blood vessels).

"This causes damage to the lining of blood vessels and subsequent inflammation. It may be due to high blood pressure causing kidney damage and increasing susceptibility for stone formation. The condition can also be a result of a complex interplay between genetic, physiological and biochemical factors,” she explains.

Most of the disorders associated with metabolic syndrome have no symptoms, although the prevalence increases with age and a large waist circumference is a visible sign.

Dr Jose Nyamusore, the division manager of Epidemic Surveillance and Response Division at Rwanda Biomedical Centre, reveals that the risk factors that contribute to metabolic syndrome have no symptoms until severe organic damage occurs which is why people need to go for regular check-ups to know their health status. He further explains that the increasing cases of metabolic syndrome are attributed to physical inactivity, behavioural change and even genetic factors. ManagementNyamusore says if you have metabolic syndrome or any of its components, aggressive lifestyle changes can delay or even prevent the development of serious health problems.

"Prevent occurrence by tackling specific risk factors. It is possible to prevent or delay metabolic syndrome, mainly with lifestyle changes. A healthy lifestyle is a lifelong commitment. Successfully controlling metabolic syndrome requires long-term effort and teamwork with your healthcare providers. Seek medical attention and advice if necessary.

"Treat cardiovascular risk factors, such as high blood pressure and cholesterol. If these problems persist despite losing weight and exercising, management of the metabolic syndrome usually includes losing weight and becoming more active,” he says

Nkeshimana advises that diet should be low in fat and cholesterol as these are big contributors towards developing metabolic syndrome.

"High levels of low-density lipoprotein (LDL) (bad) cholesterol increase the risk of coronary artery disease. In people with metabolic syndrome, an LDL level of less than 80 to 100 mg/dL is recommended,” he says.

"Keeping your blood pressure in a healthy range is an important goal, especially in people with the metabolic syndrome. If your blood sugar is very high, you might have signs and symptoms of diabetes,” he adds.

According to Nkeshimana, trimming your waistline reduces one of the metabolic syndrome traits.