Are you heading for an early heart attack or stroke? You might be if you have metabolic syndrome. Managing your lifestyle can make all the difference.

A few years ago Alfred King* (49), a TV-show producer, was seriously overweight. His blood pressure was sky high, his cholesterol level worried him, he struggled with gout, he felt dead tired and his sleep apnoea was so bad he couldn’t go to bed without linking himself to a machine that prevented his breathing from ceasing completely. He weighed 120kg and had tried every diet you can think of – even resorting to slimming injections – to no avail.

Then he consulted an endocrinologist, a visit that could be described as life-saving.

By then Alfred was so obese he was a candidate for stomach clamping or stomach bypass surgery. The risk of a heart attack or heart failure was high. He was taking handfuls of medication every day to lower his blood pressure and cholesterol and keep his gout under control. As a child he’d never been overweight but as an adult his lifestyle of too much fast or fatty food and too little exercise led to weight gain and deteriorating health.

Alfred didn’t want a stomach op so he decided to change his lifestyle. His doctor prescribed a low-fat diet, with an emphasis on reducing animal fats. He also had to limit his alcohol intake, eat frequent small meals and exercise regularly. It wasn’t easy but he persisted and shed about 25kg in the first seven months.

Alfred works long, irregular hours. To change his eating habits and avoid the temptation of fast food at work he orders pre-packed meals from a company specialising in providing healthier options for office workers. “I choose food and snacks that fit into my new eating plan and it has definitely helped to change my bad habits to good ones.”

He has cut out almost all bread, sugar and yeast and now eats lots of vegetables.

Alfred didn’t know he was suffering from metabolic syndrome, a condition also sometimes described as “syndrome X”. Although he turned out not to be insulin-resistant, he had the other symptoms typical of metabolic syndrome: obesity, high blood pressure and dangerously high blood cholesterol and blood fat levels.

Like many other patients with metabolic syndrome he reduced the many risk factors as he lost weight. Not only is Alfred now fitter but his blood pressure and cholesterol levels are lower, his gout and sleep apnoea have diminished and he’s not so fatigued. Best of all, his risk of having a heart attack is now significantly lower than it was before he took action.

What is metabolic syndrome?

Metabolic syndrome is a condition that alarmingly increases your chance of a premature death. It’s a collective name for a group of five conditions – obesity, high blood pressure, high cholesterol, high blood fat and insulin resistance – which combined put serious pressure on your heart and blood vessels. In addition, insulin resistance is a forerunner of diabetes.

Each of these conditions is life-threatening in itself. Doctors say if you have three or more of the five you have metabolic syndrome, which means your risk of premature death is even higher. For example, the chance you’ll have a fatal heart attack leaps by 300%.

It’s a domino effect, says Dr Magda Conradie, a specialist at Stellenbosch University in South Africa’s endocrinology department and metabolic unit.

Doctors can’t agree if metabolic syndrome itself should be regarded as a disease but the concept does help them to hasten the diagnosis of patients at high risk of heart disease and stroke, Dr Conradie says.

“These patients’ separate health problems must be treated much more aggressively to try to prevent premature death. The irony is almost every case of metabolic syndrome could have been prevented by the patient,” she adds.

If you have a fat belly or are apple-shaped, the chances are good you’re on the road to metabolic syndrome or you have it already. In most cases excessive fat around the tummy is the root of the problem.

Because most people with tummy fat are also overweight all overweight people should get themselves tested for metabolic syndrome. And if your waist circumference is more than 88cm if you’re a woman or 10cm if you’re a man, a test is essential.

In Australia more than 5 million people are already so overweight they’re fast developing metabolic syndrome – and putting themselves at risk of a stroke or heart attack.

What can you do?

The good news is you can prevent metabolic syndrome simply by changing your lifestyle.

If you already have metabolic syndrome, lifestyle changes and medication can diminish your risk factors to such an extent that you will no longer suffer from this condition. If you’re overweight, you need actively to slim down. And if your blood pressure is high, your weight-loss programme must be monitored very carefully.

These practical steps will help…

Start exercising today

It’s a preventive effort and an essential treatment along with the right medication for people with the syndrome. Walk, cycle, jog, swim, dance, row, skate – do whatever you enjoy for at least 120 minutes a week. Start slowly but exercise at least three times a week and establish a routine. If you can’t walk for 30 continuous minutes, start with three sessions of 10 minutes each.

Keep exercising even if the scale doesn’t show you’re losing weight because exercise destroys tummy fat and builds stronger and heavier muscles. Exercise also reduces the chances of insulin resistance.

Stop smoking

Smoking markedly increases the risk of a heart attack for people with metabolic syndrome.

Eat healthily

This is an essential preventive part of the treatment. If you’re overweight, it’s important to shed the weight at a rate of between 500g and 1kg a week by following a high-fibre, low-GI and low-fat eating plan.

How do you do this?

    • Replace refined carbohydrates with complex carbohydrates – swap white bread for coarse bread, white rice for basmati or brown rice, white pasta for full-grain pasta.

    • Eat less sugar and fewer sweets, biscuits and pastries.

    • Eat more fresh vegetables and fruit.

    • Choose fish, lean meat and skinless chicken.

    • Avoid creamy food.

    • Sauté or grill food using only a little oil rather than deep frying.

    • Eat fresh fruit or small portions of dried fruit and nuts rather than sweets and crisps.

    • Replace white bread and jam with wholegrain bread and ham.

    • Swap fizzy cooldrink for flavoured milk or yoghurt. A study has found people who drink artificially sweetened cooldrink stand a greater chance of developing metabolic syndrome, although researchers aren’t yet sure why.

    • Use less salt, even if your blood pressure is normal, and teach your children from an early age not to add salt to their food. Research indicates that if you eat just 1g less salt a day, you can make a dramatic difference to your chances of survival by lowering your blood pressure. Most of this we get from processed and prepacked food.

* Not his real name.