Metabolic Syndrome

Metabolic syndrome often develops unnoticed, but significantly increases the risk of diabetes, heart disease, stroke and fatty liver disease. In this article, we explain the signs, diagnosis, tests, nutrition and treatment options.
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Medical center Patient education Encyclopedia Nutrition and Dietetics Metabolic Syndrome

Metabolic syndrome is a group of several interconnected metabolic and cardiovascular risk factors. It is not a single separate symptom and not one specific disease, but a condition in which several signs appear at the same time: increased waist circumference, high blood pressure, elevated blood glucose, elevated triglycerides and low “good”, or HDL, cholesterol.

Metabolic syndrome is also sometimes referred to as a metabolism syndrome. In everyday language, these terms usually mean the same thing — the body has developed a metabolic state that increases the risk of type 2 diabetes, cardiovascular disease, stroke, fatty liver disease and other chronic health problems.

The most important thing to know is that metabolic syndrome often develops unnoticed. A person may feel relatively well, while blood pressure, glucose, lipids and waist circumference already show that metabolic overload is developing in the body. This is why early recognition of metabolic syndrome is very important — at this stage, many risks can still be significantly reduced.

What is metabolic syndrome?

Metabolic syndrome is a condition in which several cardiometabolic risk factors are present at the same time. “Cardio” refers to the heart and blood vessels, while “metabolic” refers to metabolism — the way the body processes and uses energy from food.

Metabolic syndrome is usually considered when a person has at least three of the five main criteria at the same time:

Criterion What it means
Increased waist circumference Fat accumulation in the abdominal area, especially around the internal organs
Elevated triglycerides A sign of unfavourable fat metabolism
Low HDL cholesterol Reduced level of “good” cholesterol
High blood pressure Greater strain on the heart and blood vessels
Elevated fasting glucose Possible insulin resistance, prediabetes or diabetes risk

These factors often appear together because they share common mechanisms — insulin resistance, abdominal obesity, chronic low-grade inflammation, a sedentary lifestyle, insufficient muscle activity, sleep disorders, hormonal changes, dietary habits and genetic predisposition.

Is metabolic syndrome a disease?

Metabolic syndrome is not a disease in the same sense as, for example, influenza, pneumonia or a disease of one specific organ. It is a group of risk factors showing that metabolism, the vascular system and hormonal regulation are no longer functioning optimally.

However, it is a serious medical condition. Metabolic syndrome means that a person has a higher risk of developing diseases in the future that can significantly affect quality of life and life expectancy.

Simply put, metabolic syndrome is a warning signal. It shows that there is still time to act before type 2 diabetes, heart attack, stroke, fatty liver disease or other complications develop.

Are metabolic syndrome and metabolism syndrome the same?

Yes. In everyday language, the terms metabolic syndrome and metabolism syndrome are usually used as synonyms.

In medical texts, the term metabolic syndrome is most commonly used, while in patient-friendly language “metabolism syndrome” may also be used because it immediately explains that the problem is related to the body’s metabolic regulation.

Why is metabolic syndrome dangerous?

Metabolic syndrome is dangerous not because one indicator is slightly above the normal range, but because several risk factors act at the same time.

If a person has an increased waist circumference, high blood pressure, elevated glucose and an unfavourable cholesterol profile at the same time, the body remains under increased strain for a long period. This affects the blood vessels, heart, liver, pancreas, kidneys and hormonal system.

Metabolic syndrome increases the risk of developing:

Therefore, the aim of treating metabolic syndrome is not only to “lose weight” or “lower sugar”. The aim is to reduce overall cardiometabolic risk — the future likelihood of diabetes, heart disease, stroke and organ damage.

Metabolic syndrome is not an infection

It develops gradually — over months and years. The main role is played by a combination of several factors:

How does metabolic syndrome develop?

The development of metabolic syndrome is usually gradual. Many people notice it only when blood tests already show changes or when a doctor detects high blood pressure, elevated glucose or abnormal cholesterol levels.

The typical development pathway of metabolic syndrome is:

  1. A sedentary lifestyle, dietary overload, sleep disturbances or genetic predisposition

    The body begins to regulate energy use less effectively.

  2. Abdominal fat increases

    Fat accumulates not only under the skin, but also around the internal organs.

  3. Insulin resistance develops

    Cells respond less effectively to insulin, so the pancreas has to produce more insulin.

  4. Glucose and fat metabolism change

    Fasting glucose, triglycerides and blood pressure may increase, while HDL cholesterol may decrease.

  5. The criteria for metabolic syndrome develop

    A person may meet at least 3 of the 5 diagnostic criteria for metabolic syndrome.

  6. The risk of complications increases

    Without treatment and lifestyle changes, the risk of type 2 diabetes, heart disease, stroke and fatty liver disease increases.

Main signs that may suggest metabolic syndrome

Metabolic syndrome often does not cause obvious symptoms. However, there are signs that should be taken seriously.

3–5 most common signs

Other possible signs

Important: metabolic syndrome cannot be reliably diagnosed based on how a person feels. A person may feel well even when blood pressure, glucose or lipid levels are already outside the desired range.

Can fatigue after eating indicate insulin resistance?

Fatigue, drowsiness or a drop in energy after a meal may be related to fluctuations in glucose and insulin, especially if the meal was rich in rapidly absorbed carbohydrates — sweets, white bread, sweetened drinks, a large portion of pasta or potatoes without enough protein and vegetables.

However, fatigue after eating is not a specific sign. It may also be related to lack of sleep, overeating, gastrointestinal problems, anaemia, thyroid disorders or other causes.

If fatigue after eating is combined with increased waist circumference, cravings for sweets, high blood pressure or abnormal blood test results, it is worth checking glucose metabolism and metabolic syndrome risk.

Does a large abdomen always mean metabolic syndrome?

No. A large waist circumference alone does not necessarily mean that a person has metabolic syndrome.

However, abdominal obesity is one of the most important warning signs. Fat in the abdominal area, especially around the internal organs, is more metabolically active than fat in other parts of the body. It can promote insulin resistance, inflammation, elevated triglycerides, fatty liver disease and increased blood pressure.

Therefore, waist circumference should be assessed together with:

How to measure waist circumference correctly?

Waist circumference is measured with a measuring tape while the person is standing upright, after a calm exhalation. The tape should be horizontal around the body — neither too tight nor too loose.

In practice, the measurement is often taken at the level of the navel or midway between the lower rib margin and the upper edge of the pelvic bone. The most important thing is to measure consistently in the same place so that changes over time can be compared.

Commonly used threshold values in metabolic syndrome diagnostics:

Sex Waist circumference associated with increased risk
Men 102 cm or more
Women 88 cm or more

Threshold values may differ between guidelines and ethnic groups, so individual risk should always be assessed together with a doctor.

Diagnostic criteria for metabolic syndrome

Metabolic syndrome is usually diagnosed when a person has at least three of the five criteria.

Criterion Commonly used threshold value
Waist circumference Men ≥102 cm, women ≥88 cm
Triglycerides ≥1.7 mmol/L or doctor-prescribed treatment
HDL cholesterol Men <1.0 mmol/L, women <1.2–1.3 mmol/L
Blood pressure ≥130/85 mmHg or blood pressure treatment
Fasting glucose ≥5.6 mmol/L or impaired glucose metabolism

Metabolic syndrome: 5 risk factors

These indicators should be assessed together, not in isolation. For example, a person may have only slightly elevated glucose, but if this is combined with a large waist circumference, high blood pressure and elevated triglycerides, the overall risk is already significantly higher.

What tests should be done if metabolic syndrome is suspected?

If metabolic syndrome is suspected, the doctor usually assesses several groups of indicators.

Basic measurements

Basic blood tests

Additional tests after medical assessment

Metabolic syndrome tests and measurements

Not all patients need all additional tests. They are selected individually — according to symptoms, risk factors, family history and existing medical conditions.

Not only “normal” or “abnormal”: how doctors interpret test results

Test results should not be assessed only by whether they “fall within the laboratory reference range” or “fall outside the laboratory reference range”.

A reference range shows what is considered statistically acceptable in a particular laboratory, but this does not always mean that the level is individually optimal for a person with increased cardiometabolic risk.

For example, in a person with increased waist circumference, a family history of type 2 diabetes, high blood pressure and fatty liver disease, even “borderline normal” glucose or lipid levels may be a signal that the risk should be assessed more broadly.

A doctor or nutrition specialist assesses these indicators together with:

What is insulin resistance?

Insulin is a hormone that helps glucose move from the blood into the cells, where it is used for energy.

Insulin resistance means that the cells no longer respond well enough to the insulin signal. In order for glucose to enter the cells, the pancreas has to produce more insulin.

At first, blood glucose may still remain normal because the body compensates for insulin resistance with higher insulin levels. This is why a person may not know that a metabolic problem is already developing.

Over time, the body’s ability to compensate may decrease. Then blood glucose begins to rise, prediabetes may develop and later type 2 diabetes may occur.

Insulin resistance can affect:

Muscles are very important for glucose use, which is why physical activity, especially strength exercises and regular walking, helps improve insulin sensitivity.

Insulin resistance and abdominal obesity: the vicious cycle

At the centre of metabolic syndrome there is often a vicious cycle: visceral obesity promotes insulin resistance, while insulin resistance in turn promotes weight gain and worsening metabolism.

This process can be explained as follows:

  1. Abdominal fat increases.
  2. Fat tissue becomes metabolically active.
  3. Chronic low-grade inflammation increases.
  4. Cells respond less effectively to insulin.
  5. The pancreas produces more insulin.
  6. The metabolic load of glucose and fat metabolism increases.
  7. Triglycerides, blood pressure and fat accumulation in the liver may increase.
  8. Weight loss becomes more difficult.

Insulin resistance vicious cycle

This cycle is not irreversible. Regular physical activity, gradual weight loss, sufficient protein intake, fibre, improved sleep and doctor-guided treatment of risk factors can significantly improve metabolic indicators.

What causes metabolic syndrome?

Metabolic syndrome is usually not caused by one single factor. It develops through the interaction of several factors.

Main risk factors

Is diet the only cause?

No. Diet plays a very important role, but metabolic syndrome is not only the result of “unhealthy eating”.

Genetics, hormones, sleep, stress, physical activity, body fat distribution, medications and comorbidities also contribute to its development.

However, diet is one of the factors that can be changed most effectively. This is why the involvement of a nutrition specialist can be very important in the treatment of metabolic syndrome.

Who should check their risk of metabolic syndrome?

The risk of metabolic syndrome should be checked in people who have one or more of the following factors:

Screening is especially important if several of these factors appear at the same time.

Metabolic syndrome in women

In women, the risk of metabolic syndrome may increase at several life stages and in several situations.

Particular attention should be paid if there is:

After menopause, the hormonal environment and body fat distribution change. In some women, fat begins to accumulate more in the abdominal area, and this increases the risk of insulin resistance, high blood pressure and lipid disorders.

In PMOS, insulin resistance is particularly common. This does not mean that every woman with PMOS will develop metabolic syndrome, but it does mean that glucose, lipid and blood pressure control should receive greater attention.

Metabolic syndrome in men

In men, metabolic syndrome is often accompanied by abdominal obesity, high blood pressure, elevated triglycerides and low HDL cholesterol.

In men, metabolic disorders may also be associated with:

Erectile dysfunction may be an early signal of vascular health problems. If it appears together with abdominal obesity, high blood pressure or abnormal test results, not only hormones should be assessed, but also glucose metabolism, lipids, cardiovascular risk and sleep quality.

Metabolic syndrome in children and adolescents

Metabolic syndrome can also develop in children and adolescents, especially if there is:

Diagnostic criteria in children differ from adult criteria. Therefore, assessment in children should involve a paediatrician or paediatric endocrinologist.

For children and adolescents, the main goal is not a strict “diet”, but a change in family habits:

Can a thin person have metabolic syndrome?

Yes. Although the risk of metabolic syndrome is more often associated with excess weight and abdominal obesity, it can also occur in people with a normal body mass index.

In some people, fat accumulates more around the internal organs rather than under the skin. Externally, the person may not appear significantly overweight, but metabolic risk may still be increased.

Therefore, it is important to assess not only body weight, but also:

Metabolic syndrome and type 2 diabetes

Metabolic syndrome is not the same as diabetes. However, it significantly increases the risk of type 2 diabetes.

Insulin resistance can exist for a long time before glucose levels reach the diagnostic threshold for diabetes. At first, the body tries to compensate for insulin resistance with higher insulin levels. Later, this compensatory capacity may decrease, and blood glucose begins to rise.

The development pathway often looks like this:

  1. Abdominal fat increases.
  2. Insulin resistance develops.
  3. Insulin levels increase.
  4. Fasting glucose becomes higher.
  5. Prediabetes develops.
  6. Some people develop type 2 diabetes.

This process can be slowed down or, in some cases, stopped if diet is changed in time, physical activity is increased, body weight is reduced and other risk factors are controlled.

Metabolic syndrome and cardiovascular disease

Metabolic syndrome increases the risk of cardiovascular disease because several factors damage blood vessels at the same time.

High blood pressure strains the arteries and the heart. An unfavourable lipid profile promotes the formation of atherosclerotic plaques. Insulin resistance and chronic low-grade inflammation impair vascular function.

In the long term, this can increase the risk of:

Therefore, in the treatment of metabolic syndrome it is important not only to reduce weight, but also to control blood pressure, lipids, glucose and the effects of smoking.

Metabolic syndrome and fatty liver disease

Metabolic syndrome is closely associated with metabolic dysfunction-associated fatty liver disease. This is a situation in which fat accumulates in the liver and the process is linked to cardiometabolic risk factors such as obesity, insulin resistance, elevated glucose or dyslipidaemia.

Fatty liver disease may occur without symptoms. It is often detected through elevated liver enzymes or ultrasound examination.

Liver involvement may be suggested by:

In some people, fatty liver disease may progress to inflammation, fibrosis or cirrhosis, so liver health should be assessed together with overall metabolic risk.

Angļu valodā:

Metabolic syndrome and sleep apnoea

Sleep apnoea is a condition in which breathing repeatedly stops or decreases during sleep. It is more common in people with excess weight, abdominal obesity and high blood pressure.

Sleep apnoea may be suggested by:

Sleep apnoea can worsen glucose metabolism, blood pressure and cardiovascular risk. If sleep apnoea is suspected, a doctor’s consultation and sleep studies are needed.

How is metabolic syndrome treated?

Treatment of metabolic syndrome is individual. There is no single universal tablet or one diet that works for everyone.

The aim of treatment is to reduce several risks at the same time:

Treatment usually includes:

Does metabolic syndrome always require medication?

Not always. In the early stage, lifestyle changes and regular medical follow-up may sometimes be sufficient.

However, medication may be needed if:

In such cases, the doctor may prescribe medication to treat specific risk factors. The choice of medication is individual, and it should not be started or stopped without a doctor’s instructions.

The role of a nutrition specialist in treating metabolic syndrome

In metabolic syndrome, a nutrition specialist helps not simply to “put a person on a diet”, but to develop a long-term nutrition strategy.

This is important because short-term diets often give short-term results. In metabolic syndrome, the aim is to improve metabolic flexibility and efficiency — the ability to better regulate glucose, fat metabolism, satiety, energy use and body weight control.

A nutrition specialist helps assess:

A good nutrition plan is not a punishment. It should be practical, sufficiently filling and sustainable in the long term.

Lifestyle therapy for metabolic syndrome

Nutrition in metabolic syndrome

Nutrition is one of the most important parts of treating metabolic syndrome.

The aim is not a short-term, very strict diet. The aim is a dietary pattern that helps:

Recommended nutrition principles

Does the Mediterranean diet help in metabolic syndrome?

A Mediterranean-style dietary pattern is often suitable for people with metabolic syndrome. It should not be understood as a precise “southern diet”, but as a set of nutrition principles. In Latvia, this eating pattern corresponds well to the Nordic diet.

This means:

Such a dietary pattern can help improve glucose control, lipid profile, blood pressure and weight regulation.

Do bread, potatoes and pasta have to be avoided?

Not necessarily. In metabolic syndrome, it is not automatically necessary to avoid all carbohydrates.

The quality, amount and combination of carbohydrates with other foods are more important.

Better choices include:

It is usually better to limit:

Does sugar worsen metabolic syndrome?

Excessive intake of sugar and sweetened drinks can contribute to weight gain, elevated triglycerides, fat accumulation in the liver and glucose fluctuations.

Sweetened drinks are especially problematic because they provide a lot of energy but create poor satiety. A person can consume many calories without feeling full. This is a major problem in adolescents and children and can contribute to metabolic dysfunction-associated fatty liver disease and metabolic syndrome.

This does not mean that a person can never eat dessert. However, in metabolic syndrome, sweets and sweetened drinks should not be part of the everyday diet.

How important is fibre?

Fibre helps:

Good sources of fibre include:

In metabolic syndrome, fibre is one of the most practically important elements of nutrition.

Physical activity in metabolic syndrome

Physical activity improves insulin sensitivity, helps muscles use glucose, lowers blood pressure, improves the lipid profile and supports weight control.

A practical goal for adults is:

Moderate activity includes, for example:

Is walking enough?

Walking is a very good start, especially for people who have previously been sedentary.

However, in the long term it is advisable to add strength exercises as well, because muscle mass plays an important role in glucose metabolism. The better muscles can use glucose, the easier it is for the body to regulate blood sugar levels.

Strength exercises do not necessarily mean going to a gym. They can include:

Is weight loss always the main goal?

If a person has excess weight or abdominal obesity, weight loss is very important. Even moderate weight loss can improve glucose, blood pressure, triglycerides and liver markers.

However, the goal is not only the number on the scale. It is also important to:

A person may become healthier even if weight decreases gradually, as long as movement, nutrition, blood pressure and blood tests improve significantly.

Alcohol and metabolic syndrome

Alcohol can worsen several components of metabolic syndrome. It can:

In metabolic syndrome, alcohol consumption should be limited. In people with elevated triglycerides, fatty liver disease, high blood pressure or diabetes, a doctor may recommend avoiding alcohol completely.

Smoking and metabolic syndrome

Smoking itself significantly increases the risk of cardiovascular disease. If it is combined with metabolic syndrome, the risk becomes even higher.

Smoking worsens blood vessel function, promotes inflammation and increases the risk of atherosclerosis. Therefore, smoking cessation is one of the most important steps in preventing complications of metabolic syndrome. It should be noted that when smoking is stopped, the effect of nicotine on metabolism decreases and the risk of excess weight may increase. Therefore, weight gain prevention should be started proactively — with additional physical activity and dietary adjustment.

Common mistakes when trying to treat metabolic syndrome on your own

Many people try to address metabolic syndrome with short-term or overly one-sided methods.

Common mistakes include:

Metabolic syndrome usually requires a systematic approach. The best results are achieved when a person works together with a general practitioner, a nutrition specialist and, if necessary, an endocrinologist or cardiologist.

When should you see a doctor?

You should see a doctor if there is:

A general practitioner can perform the initial assessment, prescribe tests and determine the next steps.

When should you see an endocrinologist?

An endocrinologist’s consultation is especially recommended if there is:

When should you see a cardiologist?

A cardiologist’s consultation is needed if there is:

When should you see a nutrition specialist?

A nutrition specialist’s consultation is especially useful if:

Can metabolic syndrome be prevented?

In many cases, metabolic syndrome can be prevented or significantly delayed. Prevention is based on the same principles as treatment:

The earlier risk factors are detected, the greater the chance of preventing serious complications.

Is metabolic syndrome reversible?

In many cases — yes. If changes are detected early, the components of metabolic syndrome can be significantly improved.

The most common improvements are seen in:

However, “reversible” does not mean that after the indicators improve, a person can return to previous habits. Metabolic syndrome is often a long-term tendency that needs to be managed. To maintain the result, it is necessary to keep a strategy for nutrition, movement, sleep and medical monitoring.

What is clear in medicine today, and what is still being studied?

It is well established in medicine that metabolic syndrome is associated with an increased risk of type 2 diabetes and cardiovascular disease.

It is also clear that lifestyle changes — weight reduction, physical activity, improved nutrition quality, smoking cessation and blood pressure/lipid control — reduce risks and improve metabolic indicators.

Active areas of research include:

Disclaimer

The information provided in this article is intended for informational and educational purposes only. It does not replace a doctor’s consultation, diagnosis or an individually tailored treatment plan. Metabolic syndrome may be associated with an increased risk of diabetes, cardiovascular disease, fatty liver disease and other complications, so self-diagnosis and self-treatment may be inaccurate and dangerous. If you have increased waist circumference, high blood pressure, abnormal glucose or cholesterol test results, fatigue after eating, rapid weight changes or other risk factors mentioned in this article, consult a general practitioner, endocrinologist, cardiologist or nutrition specialist. If chest pain, sudden shortness of breath, weakness on one side of the body, speech disturbances, impaired consciousness or other severe and rapidly worsening symptoms occur, emergency medical help should be called immediately.

References and authoritative sources

Content author

Guna Havensone, physician and nutrition specialist.

Frequently Asked Questions

Additional questions for a nutrition specialist or dietitian about metabolic syndrome

1. What is metabolic syndrome?

Metabolic syndrome is a cluster of risk factors — increased waist circumference, elevated blood pressure, elevated glucose, elevated triglycerides and low HDL cholesterol. It increases the risk of diabetes, heart attack and stroke.

2. Are metabolic syndrome and metabolism syndrome the same thing?

Yes. In everyday use these terms are generally used as synonyms.

3. Is metabolic syndrome a disease?

It is not a single isolated disease, but a cluster of several metabolic and cardiovascular risk factors. However, it is a serious medical condition.

4. Can metabolic syndrome be asymptomatic?

Yes. Many people have no obvious symptoms, which is why it is important to regularly measure blood pressure, waist circumference and carry out blood tests.

5. What are the symptoms of metabolic syndrome?

The most common signs are increased waist circumference, fatigue after eating, cravings for sweets, difficulty losing weight, elevated blood pressure and abnormal test results.

6. Does a large belly always mean metabolic syndrome?

No. However, increased waist circumference is one of the most significant risk signals.

7. How is metabolic syndrome diagnosed?

It is usually diagnosed when a person meets at least three of five criteria: increased waist circumference, elevated triglycerides, low HDL, elevated blood pressure and elevated glucose.

8. What tests are needed?

Tests usually include fasting glucose, HbA1c, lipid profile, liver and kidney markers. If needed, a doctor may order insulin levels, the HOMA index or additional tests.

9. What is the HOMA index?

The HOMA index is a calculation that uses fasting glucose and insulin levels to indirectly assess insulin resistance.

10. Does metabolic syndrome mean diabetes?

No. It is not the same as diabetes, but it significantly increases the risk of type 2 diabetes.

11. Can metabolic syndrome be cured?

In many cases the indicators can be significantly improved. For some people they no longer meet the criteria for metabolic syndrome if the changes are maintained long-term.

12. Is metabolic syndrome reversible?

Often yes, especially at an early stage. Diet, physical activity, weight loss and treatment of risk factors can significantly change the situation.

13. What causes metabolic syndrome?

It is caused by a combination of factors: insulin resistance, abdominal obesity, genetics, physical inactivity, lack of sleep, stress, hormonal changes and dietary habits.

14. Does heredity play a role?

Yes. If there is type 2 diabetes, early heart disease or fatty liver disease in the family, the risk may be higher.

15. Do stress and lack of sleep affect metabolism?

Yes. They can impair appetite regulation, glucose metabolism, blood pressure and weight control.

16. Does alcohol increase the risk of metabolic syndrome?

Excessive alcohol can raise triglycerides, promote fatty liver disease, increase blood pressure and contribute to weight gain.

17. Does smoking worsen the consequences of metabolic syndrome?

Yes. Smoking significantly increases the risk of cardiovascular disease, especially in combination with metabolic syndrome.

18. Does menopause increase the risk?

Yes. After menopause the hormonal environment and fat distribution change, which can increase cardiometabolic risk.

19. Is PCOS associated with metabolic syndrome?

Yes. PCOS is often associated with insulin resistance and an increased risk of metabolic syndrome.

20. Can metabolic syndrome cause fatty liver disease?

It is closely associated with fatty liver disease. Abdominal obesity, insulin resistance and elevated triglycerides increase the risk of fat accumulation in the liver.

21. How is metabolic syndrome treated?

Treatment includes dietary changes, physical activity, weight loss, improving sleep, reducing alcohol and smoking risk, as well as doctor-prescribed therapy where needed.

22. Does treatment always require medication?

Not always. At an early stage lifestyle changes are sometimes sufficient. However, medication may be needed to treat blood pressure, glucose, cholesterol or obesity-related complications.

23. What to eat with metabolic syndrome?

A diet rich in vegetables, legumes, wholegrains, protein, fish and unsaturated fats is recommended. Sugary drinks, sweets, fast food, alcohol and ultra-processed products should be limited.

24. Do you need to give up carbohydrates?

It is not necessary to give up all carbohydrates. What matters more is the quality, quantity and combination of carbohydrates with protein and vegetables.

25. Does the Mediterranean diet help?

Yes, the Mediterranean-type diet is often suitable for metabolic syndrome, as it emphasises vegetables, legumes, wholegrains, fish and quality fats.

26. Is coffee allowed?

Most people can consume coffee in moderation, as long as it does not worsen blood pressure, sleep, palpitations or stomach complaints.

27. What physical activities help the most?

Aerobic activities such as brisk walking, swimming or cycling, combined with strength exercises, are beneficial.

28. Is walking enough?

Walking is a good start, but in the long term it is advisable to add strength exercises as well.

29. Can children have metabolic syndrome?

Yes, especially children with obesity, a sedentary lifestyle and a family history of type 2 diabetes.

30. When should you see a doctor?

See a doctor if you have an increased waist circumference, elevated blood pressure, abnormal glucose or cholesterol, excess weight, fatty liver disease or a family history of diabetes or heart disease.

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