Metabolic syndrome (MetS) is a cluster of diseases including high blood pressure, high blood sugar, abnormal cholesterol or triglyceride levels, and large waist circumference. MetS can significantly increase your risk of cardiovascular disease. MetS is diagnosed if you meet three or more of the following criteria:

• High blood pressure (≥ 130/85 mm Hg, or receiving medication)
• High blood glucose levels (≥ 5.6 mmol/L, or receiving medication)
• High triglycerides (≥ 1.7 mmol/L, or receiving medication)
• Low HDL-Cholesterol (< 1.0 mmol/L in men or < 1.3 mmol/L in women)
• Large waist circumference (≥ 102 cm in men, 88 cm in women; ranges vary according to ethnicity)

A study published in 2014 revealed that 19.1% of Canadians have MetS. That is nearly 1 in 5 Canadians. (link)

As MetS progresses, patients have higher chances of developing chronic diseases such as diabetes, hypertension, heart disease, chronic kidney disease, and dyslipidemia. We need to effectively treat metabolic syndrome to slow the progression of developing these chronic diseases. Effective treatment includes eating a healthy diet, engaging in regular exercise, and losing weight. There are some medications that can also improve insulin resistance, a key component of MetS.

Type 2 diabetes is a chronic disease that is characterized by the way your body metabolizes sugar (glucose). With type 2 diabetes, your body either resists the effects of insulin — a hormone that regulates the movement of sugar into your cells — or doesn't produce enough insulin to maintain normal glucose levels. The management for type 2 diabetes includes losing weight, eating a well-balance diet and exercising. Many times, diet and exercise are not sufficient to manage your blood sugar well, so you may also need diabetes medications or insulin therapy.

Type 1 diabetes is a chronic disease that is characterized by a lack of insulin. Therefore your body requires insulin injection therapy to manage your blood glucose levels. Usually, type 1 diabetes is diagnosed at a young age, but it is possible to be diagnosed later in adulthood as well.

Hypertension is a chronic disease that describes consistently high blood pressure. Your blood pressure fluctuates throughout the day depending on your activities. When your blood pressure is consistently high, you may have hypertension. Normal blood pressure is typically 120/80, however it depends on the individual and their particular medical history.

Symptoms of severe hypertension can include headache, blurry vision, chest pain, or dizziness. Hypertension can also present with no symptoms, and for this reason it is commonly described as the "silent killer." Longstanding high blood pressure can damage your organs, including your kidneys, brain, and heart. This can progress to kidney disease, stroke, heart disease or peripheral vascular disease. Treatment of hypertension involves eating a healthy diet, engaging in regular exercise, maintaining a normal weight and may also involve medication.

Polycystic ovary syndrome (PCOS) is a hormonal disorder in women. Women with PCOS may have irregular menstrual periods or excess male hormone (androgen) levels. The ovaries may develop numerous small collections of fluid (follicles) and fail to regularly release eggs.

The exact cause of PCOS is unknown. However, contributing factors include excess insulin, low grade inflammation, a hereditary component and excess androgen levels. Early diagnosis and treatment along with weight loss may reduce the risk of long-term complications such as type 2 diabetes and heart disease.

Complications of PCOS can include infertility, gestational diabetes, pregnancy-induced high blood pressure, fatty liver (Nonalcoholic steatohepatitis — a severe liver inflammation caused by fat accumulation in the liver), metabolic syndrome, Type 2 diabetes or prediabetes, Sleep apnea, mood disorders, and abnormal uterine bleeding.

Non-alcoholic Fatty liver disease (NAFLD) is a medical condition characterized by buildup of fat in the liver.

Fatty liver disease is the most common type of liver disease in Canada, and the number of people with this condition is increasing in the western world with increasing rate of obesity. In some people, the fat deposition can act as a toxin and lead to inflammation and scaring of the liver called fibrosis. This condition is called Nonalcoholic Steatohepatitis (NASH). This process can progress to permanent liver damage called liver cirrhosis. The cause of NASH is unknown, but it is associated with some chronic conditions such as Metabolic syndrome, obesity, Insulin resistance, Diabetes, Hyperlipidemia, and some drugs and toxins.

The optimal treatment for this condition has not yet been established but the process can be prevented, and the progression can be slowed with the treatment of associated conditions including obesity and metabolic syndrome. There are also many trials currently underway for variety of novel treatments for NAFLD and NASH. 

Thrombosis means formation of blood clots in blood vessels. This can lead to blockage of those vessels and prevent blood flow to vital organs. It can also cause inflammation and damage to the blood vessels themselves.

There are two main types of thrombosis:

• Arterial Thrombosis happens when an artery is blocked by a blood clot. Arteries are blood vessels that carry blood out of the heart. For example, thrombosis in the arteries of the heart can cause heart attack and, in the brain, can cause stroke. 
• Venous thrombosis is when a vein is blocked by a blood clot. Veins are blood vessels that bring the blood back to the heart. For example, blood clot in deep veins of the leg are called Deep Vein Thrombosis or DVT. These clots can travel to the lungs and cause Pulmonary embolism (PE).

There are many causes and risk factors for thrombosis. Some of the risk factors for Arterial thrombosis include diabetes, high blood pressure, high cholesterol, obesity, smoking and family history. Venous thrombosis can be caused by conditions such as immobility, cancer, obesity, and some medications including birth control pills and hormone replacement therapy. Treatment for blood clots depend on the location and extent of the clot as well as underlying cause. They include blood thinners (anticoagulation) to prevent further clots, stent insertion in the blood vessel, and medication to dissolve the clot rapidly. 

All of us, regardless of body size and underlying health conditions, will benefit from adapting well-balanced, healthy eating habits as well as engaging in regular physical activity. For obesity management, the strategy should focus on having a long-term and sustainable plan that includes a modest decrease in calorie intake by improving daily eating pattern, monitoring portion sizes and eating nutritious and balanced meals.

Our lifestyle, preferences, and eating habits are different and therefore it is very important to find an individualized plan that works for you while achieving these goals over long term. Many studies have shown that intense or “Fad” diets are not effective as a strategy to treat obesity as most people cannot continue these extreme diets over long period of time.

Physical activity also plays an important role in overall strategy to treat the obesity and metabolic syndrome. However, the goal should not be solely to burn calories. A regular daily aerobic activity can help to maintain your weight after weight loss, improve your cardiometabolic parameters and your overall fitness. Similar to nutrition, the physical activity you engage in should be long-term, sustainable, and meet your individualized lifestyle and preferences. One strategy is to gradually increase your physical activity so you can gain confidence in your abilities and also to be able to incorporate that in your daily routine.

Finally, it is important to know while having a proper nutrition and exercise plan is very important in the management of obesity, it may not be the only focus of treatment. A comprehensive treatment plan should also include psychological and behavioral interventions as well as consideration for medical and surgical therapy.