Solving Metabolic Syndrome Will Take All of Us

Written By Melissa .

Metabolic syndrome, as we know it now, sits at the intersection of modern life—stress, diet, genetics, sleep, sedentary behavior, and the environments we’ve built around ourselves. It manifests in a related cluster of metabolic dysfunctions that include insulin resistance, high blood pressure, abnormal cholesterol, and increased body fat. In the United States, recent analyses of NHANES data from 2017 through March 2020 estimate that about 45.9% of adults meet diagnostic criteria for metabolic syndrome.

(According to the widely used NCEP ATP III definition, metabolic syndrome is present when three or more of the following five criteria are met:

  • Waist circumference ≥ 102 cm (men) / ≥ 88 cm (women)

  • Triglycerides ≥ 150 mg/dL

  • HDL cholesterol < 40 mg/dL (men) / < 50 mg/dL (women)

  • Blood pressure ≥ 130/85 mmHg

  • Fasting glucose ≥ 100 mg/dL)

The Real Work to Solve Metabolic Syndrome: Collaboration and Curiosity

Our collective obsession with finding the diet or lifestyle that resets the body is understandable. With metabolic health issues and obesity now so prevalent, many people are searching desperately for something that works. But the reality is this: genetics, hormones, microbiome diversity, past stress or trauma, and even the food supply chain likely all play roles too complex for any single plan to solve.

The reality is this: Solving metabolic syndrome will take more than diet books and before-and-after photos. It will take researchers, clinicians, community leaders, and—crucially—people living through it. Lived experience brings insights that data alone can’t.

Population Study

Some of the best data comes from studying populations in the world who have either avoided metabolic syndrome altogether or have seen an increase after some kind of collective lifestyle change.

One example is the Pima/Maycoba studies. Among the Pima people, who share the same ancestry but live in different environments, the contrast is striking. U.S. Pima in Arizona have some of the world’s highest rates of obesity and type 2 diabetes, while their relatives in rural Maycoba, Mexico—living more traditional, physically active lives with minimally processed diets showed far lower rates. PMC+2in.nau.edu+2

This is a textbook example of gene-environment interaction: the Pima had a high genetic predisposition, but the expression of disease varied dramatically depending on environment and lifestyle. Lifestyle factors (physical activity, diet, minimal processed food, manual labour) appear powerful enough to moderate or delay metabolic disease—even in high-risk groups. Environmental shifts (modernization, mechanization, processed food access, reduced physical activity) appear to trigger increases in obesity and diabetes, even in traditionally low-disease communities.

Social Media

Social media, for all its flaws, also offers an enormous opportunity for the kind of “meeting of the minds” that solving metabolic syndrome will take. Never before have we had such a window into the lived experiences of so many others. And people are posting about it. If you are at all interested in health and wellness and search on it, you know that there are gobs of people sharing their experiences with various dietary or fitness interventions and what worked for them—or didn’t. There is so much to learn from people’s honest stories on Facebook, Instagram, TikTok, etc. But alongside that openness comes an overwhelming wave of wellness misinformation.

It can be really hard to be exposed to so much information all the time. Personally, I’m not interested in following advice that isn’t backed by solid, peer-reviewed research. Take diet trends that are commonly shared on social media for example—there’s no shortage of claims that eating a high-fat diet is good for you. But what does the research actually show? Certainly not that. The Dietary Guidelines for Americans (2020–2025) recommend keeping saturated fat <10% of total calories, and the American Heart Association advises replacing saturated fats with unsaturated fats to reduce cardiovascular risk. And while some people do see short-term results on very-low-carb/high-fat approaches (often from appetite suppression and early water/glycogen loss), systematic reviews find little to no long-term advantage over balanced diets for weight loss or cardiometabolic risk when calories are matched. A recent UK Biobank cohort study found that people eating a low-carbohydrate, high-fat (“keto-like”) pattern had higher LDL-C and apoB and about 2× higher risk of major adverse cardiovascular events than matched participants eating a standard diet (adjusted analyses).

Beware of Gatekeepers

If a social media account claims to have the “real answer,” but asks you to pay to learn it—that is a no-go for me. True science evolves in public. The people who have been studying metabolic syndrome and the obesity epidemic for decades know there’s still a lot we don’t understand, and the ones truly invested in helping t solve it know there is more to learn. They share their knowledge freely—whether through peer-reviewed research or through personal stories that are transparent about methods, challenges, and results.

The Takeaway

Healing from metabolic syndrome and/or obesity is challenging in the current environment — there just isn’t a one-size fits all method or even consensus from the ‘experts’ on the right approach. In my view, those truly invested in finding widespread solutions should focus on building a culture of curiosity, collaboration, and transparency.

We might not be scientists or physicians, but here are some ways that I believe we all can participate in this fight for health:

  • Learn what it takes to keep your body metabolically healthy or to improve your current health. This includes understanding:

    • what a nutritious diet looks like

    • how much physical activity you should strive for

    • the importance of sleep

    • proper hydration

    • managing psychological and physiological stress

  • If you have found ways to improve your health, be willing to share your story openly and in full.

  • Support social media accounts that share their methods and results transparently.

  • Read or listen to ALL things online with a healthy dose of skepticism, and always come back to what the science supports.

The real solutions will come with our collective willingness to keep learning, together.

References

Grundy, S. M., Brewer, H. B., Jr., Cleeman, J. I., Smith, S. C., Jr., & Lenfant, C. (2004). Definition of metabolic syndrome: Report of the National Heart, Lung, and Blood Institute/American Heart Association conference on scientific issues related to definition. Circulation, 109(3), 433–438. https://doi.org/10.1161/01.CIR.0000111245.75752.C6

Alberti, K. G. M. M., Eckel, R. H., Grundy, S. M., Zimmet, P. Z., Cleeman, J. I., Donato, K. A., Fruchart, J.-C., James, W. P. T., Loria, C. M., & Smith, S. C., Jr. (2009). Harmonizing the metabolic syndrome: A Joint Interim Statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation, 120(16), 1640–1645. https://doi.org/10.1161/CIRCULATIONAHA.109.192644

Liang, X., Or, B., Tsoi, M. F., Cheung, C. L., & Cheung, B. M. Y. (2023). Prevalence of metabolic syndrome in the United States, 2011–2018: NHANES data analysis. Postgraduate Medical Journal, 99(1175), 985–992. https://doi.org/10.1093/postmj/qgad008

Kim, Y. J., Kim, S., Seo, J. H., & Cho, S. K. (2024). Prevalence and associations between metabolic syndrome components and hyperuricemia by race: Findings from US population, 2011 – 2020. Arthritis Care & Research (Hoboken), 76(8), 1195-1202. https://doi.org/10.1002/acr.25338

Sacks, F. M., Lichtenstein, A. H., Wu, J. H. Y., Appel, L. J., Creager, M. A., Kris-Etherton, P. M., Miller, M., Rimm, E. B., Rudel, L. L., Robinson, J. G., Stone, N. J., & Van Horn, L. V. (2017). Dietary fats and cardiovascular disease: A Presidential Advisory from the American Heart Association. Circulation, 136(3), e1–e23. https://doi.org/10.1161/CIR.0000000000000510 American Heart Association Journals+1

U.S. Department of Agriculture & U.S. Department of Health and Human Services. (2020). Dietary Guidelines for Americans, 2020–2025 (9th ed.). https://www.dietaryguidelines.gov/ (see saturated fat <10% recommendation). Dietary Guidelines+2Dietary Guidelines+2

Naudé, C. E., Schoonees, A., Senekal, M., Young, T., Garner, P., & Volmink, J. (2022). Low-carbohydrate versus balanced-carbohydrate diets for reducing weight and cardiovascular risk. Cochrane Database of Systematic Reviews, 1, CD013334. https://doi.org/10.1002/14651858.CD013334.pub2 (Conclusion: little to no difference in weight loss and CVD risk up to 1–2 years). Cochrane Library+2PubMed+2

Hall, K. D., & Guo, J. (2017). Body weight regulation and the effects of diet composition. Gastroenterology, 152(7), 1718–1727. https://doi.org/10.1053/j.gastro.2017.01.056 (Mechanisms: appetite effects of ketosis; early weight loss from glycogen/water). Gastro Journal+1

Iatan, I., Raiker, R., Hussain, M., Bellissimo, M. P., Shahid, I., Ahmed, S. B., … Brunham, L. R. (2024). Association of a low-carbohydrate high-fat diet with plasma lipid levels and incident cardiovascular events in the UK Biobank. JACC: Advances. https://doi.org/10.1016/j.jacadv.2024.100924 JACC

Melissa .
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