Prediabetes. Metabolic Syndrome. What Can You Do About It?

October 23, 2016




Prediabetes or Metabolic Syndrome. You've probably heard about it, or even been diagnosed with it.  What is it?


This is a condition when a patient develops insulin resistance, which means the body cannot respond properly to the insulin it makes.  Over time, this causes blood sugar levels to increase, which eventually can lead to development of Type 2 diabetes. 


In 2011-2012, nearly 35% of all U.S. adults and 50% of those 60 years of age or older were estimated to have the metabolic syndrome. (1)


What are the symptoms?

  • A large waistline: This also is called abdominal obesity or "having an apple shape."  Excess fat in the stomach area poses a greater risk factor for heart disease, compared to excess fat in other parts of the body, such as on the hips.

  • A high triglyceride level:  Triglycerides are a type of fat found in the blood.

  • A low HDL cholesterol level:  HDL is sometimes called "good" cholesterol, because it helps to remove cholesterol from the arteries.  A low HDL cholesterol level raises the risk for heart disease.

  • High blood pressure:  Blood pressure is the force of blood pushing against the walls of the arteries, as the heart pumps blood.  If this pressure rises and stays high over time, it can damage the heart and lead to plaque buildup.

  • High fasting blood sugar:  Mildly high blood sugar may be an early sign of diabetes

People who have metabolic syndrome often have two other conditions: excessive blood clotting and constant, low-grade inflammation throughout the body.  Researchers don't know whether these conditions cause metabolic syndrome or worsen it.


Researchers continue to study conditions that may play a role in metabolic syndrome, such as:

  • A fatty liver (excess triglycerides and other fats in the liver)

  • Polycystic ovarian syndrome (a tendency to develop cysts on the ovaries)

  • Gallstones

  • Breathing problems during sleep , like obstructive sleep apnea (2)

What can we do to prevent or stop the progression of metabolic syndrome?


Heart healthy lifestyle changes:


Eat a diet rich in the following:

  • Non-starchy vegetables, such as spinach, collard greens, kale, broccoli, cabbage, and carrots

  • High fiber

  • Fruits such as grapefruit, apples, oranges, pears, grapes, and prunes

  • Berries

  • Whole grains such as plain oatmeal, brown rice, and whole-grain bread or tortillas

  • Dairy foods such as milk, cheese, or yogurt

  • Protein-rich foods:

    • Fish high in omega-3 fatty acids, such as salmon, tuna, and trout, about 8 ounces/week

    • Lean, preferably organic grassfed meats, such as 95% lean beef, pork tenderloin or wild game

    • Poultry such as skinless chicken or turkey

    • Eggs

    • Nuts, seeds, and soy products

    • Legumes such as kidney beans, lentils, chickpeas, black-eyed peas, and lima beans

  • Oils and foods containing high levels of mono-unsaturated and poly-unsaturated fats, which can help to lower blood cholesterol levels and the risk of cardiovascular disease.  Some sources of these oils are:

    • Extra virgin olive, safflower, sesame, sunflower, and soybean oils

    • Nuts such as walnuts, almonds, and pine nuts

    • Salmon and trout

    • Seeds such as sesame, sunflower, pumpkin, or flax

    • Avocados

    • Tofu

    • Green/roasted coffee blend and tea

    • Fermented food , like sauerkraut, kefir, kimchi, organic yogurt with live cultures, yakult

Avoid the following:

  • Low fat diet, as it's been associated with higher incidence of metabolic syndrome (3)

  • Trans and saturated fats

  • Added sugar or artificial sweeteners

Reduce stress: 

  • Restful sleep

  • Meditation and relaxation

  • Stress management

  • Rely on friends, family, and community or religious support systems


  • Perform regular moderate-intensity physical activity for at least 30-minutes continuously at least 5 days/week (ideally, 7 days/week).  Achieving moderate intensity activity for 120 to 150 minutes a week may reduce the risk of developing metabolic syndrome. (4)

  • High intensity exercise for up to 5-10 minutes a day helps to stimulate metabolism even better.


  • Omega 3 fatty acid

  • Vitamin B complex

  • Vitamin D

  • Antioxidants

  • Magnesium

  • Chromium

  • Berberine

  • Green tea extract

  • Ginseng

  • Bitter melon

  • Cinnamon

  • Alpha lipoic acid, and many others

Quit smoking!


There are no pharmaceutical medications that are currently approved specifically to treat the metabolic syndrome.  Some patients may be on medications to lower blood sugar levels, blood pressure and triglycerides and/or to increase HDL.


For more information and specific recomendations for you, please schedule an appointment with Dr. Koganski at 215-750-7000, 



1)  Maria Aguilar, et al. Prevalence of the Metabolic Syndrome in the United States, 2003-2012. JAMA, 2015; 313 (19)


3)  Park S, et al. Very-low-fat diets may be associated with increased risk of metabolic syndrome in the adult population.Clinical Nutrition, 10/16/2015

4)  Department of Health and Human Services, Centers for Disease Control and Prevention. Physical activity and health: the benefits of physical activity.

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