How Bad Is a Little Bad?

By Karen Collins, MS, RD, CDN

Someone recently asked me, “If my blood sugar and blood pressure are only a little high, not high enough to be diagnosed as diabetes or hypertension, does it really matter?” This person acknowledged that he’d been gaining weight over the last ten years and asked (with a reluctant look in his eyes), “Do I really need to go on a diet now?”

This is metabolic syndrome, and one in every three American adults has it. It doesn’t only change your risk of heart disease, it also affects your risk of cancer and other diseases. Fortunately, you can do something about it. More on that in just a minute…

Even Initial Signs of Diabetes and Hypertension
May Be Indicators of Metabolic Syndrome

What is metabolic syndrome? Major health organizations have now agreed on criteria for diagnosing the disease. Factors include:

• Fasting blood sugar of 100 mg/dl or more
• Blood pressure of 130/85 or higher (or already being treated for high blood pressure)
• Low HDL (“good”) cholesterol (less than 40 mg/dl in men, less than 50 mg/dl in women)
• High blood triglycerides (150 mg/dl or more)
• Increased waist size (40 inches or more in men, 35 inches or more in women)

If you meet at least three of these criteria, you’ve got metabolic syndrome.

The biggest concern involves waist size: Other systems use tighter standards for waist at 37½ inches for men and 32 inches for women (36 inches and 32 inches, respectively, for Asian populations), and some researchers say this better identifies risk for Americans, too.

Whether or not someone is actually defined as overweight, excess body fat – particularly the fat that settles around the waist – is often at the heart of these metabolic changes. Excess body fat releases substances that travel throughout the body, promoting chronic, low-grade inflammation. It also disturbs normal insulin function, often for years before your body can’t keep up any more and you see blood sugars creeping up.

Here’s the thing: Although these criteria may not seem far from normal, they are a sign that the overall environment within your body is not healthy. Initial research found that for people with metabolic syndrome were twice as much at risk for heart disease and five times more for type 2 diabetes.

In recent years, studies show the impact is much wider: The risk of non-alcoholic fatty liver disease is 4 to 5 times higher. The risk of certain cancers, such as colon, endometrial and postmenopausal breast cancers, increases by 25 to more than 200 percent.

Increased cancer risk seems to stem from insulin resistance, leading to high levels of insulin in the body that can promote cancer growth, changes in cancer-promoting and cancer-protective hormones, inflammation, and increased estrogen levels in women after menopause with high levels of body fat.

So how did I answer the man’s question? Actually, I don’t recommend that you go on a diet. For most people, that involves restrictions they can’t live with. Now is the time to work on healthy changes for keeps. I urged him to try out some small steps he would be able to continue long-term, choosing changes laser-targeted to have the biggest impact.

No single food or nutrient change can do for metabolic syndrome what you get from an overall healthy eating pattern at a calorie level that helps you reach and maintain a healthy weight.

Prevalence data on metabolic syndrome comes from the NHANES study as well as a study by McNeill in “Diabetes Care,” February 2005, showing 23 percent of those without diabetes or cardiovascular disease at baseline developed metabolic syndrome during 11 years of follow-up.

Karen Collins, MS, RD, CDN is a Registered Dietitian who promotes healthy eating as a syndicated nutrition news columnist, speaker and consultant, bringing special expertise in cancer prevention and how it fits within overall wellness efforts. Karen can be contacted about speaking engagements at For more information, please visit

The articles written by guest contributors are the sole responsibility of the individual writers in terms of factual accuracy and opinion and do not necessarily reflect the views of the publisher of this blog.

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