Metabolic Syndrome and Diet

26% of Australian adults are obese. 1 in 3 Australians over the age of 25 have metabolic syndrome, a group of risk factors that can contribute to the development of cardiovascular disease and diabetes. Clinical dietitian Dr Catherine Itsiopoulos discusses ways to identify if you have metabolic syndrome, ways to prevent it, and tips on healthy eating.

Hi, I’m Dr Catherine Itsiopoulos, I’m an Accredited Practising Dietician and I have a research position at the University of Melbourne, and also with the Dietician’s Association of Australia. I’m here to talk to you today about a major problem in Australia: Obesity and the Metabolic Syndrome.

You may have seen a recent government report that shows that we are now officially the fattest nation in the world. 26% of Australian adults are obese compared to 25% of the Americans, so we’ve actually taken over the Americans. Nine million people in Australia are overweight or obese and this is a major problem.

The metabolic syndrome is a group of risk factors that greatly increase your chances of developing heart disease and diabetes. Approximately 1 in 3 Australians over the age of 25 are estimated to have the Metabolic Syndrome, and that is a very young age. What we’re finding is that diabetes is developing in younger and younger people, which is alarming, and we believe that obesity is a major contributing factor to this.

Risk Factors

If you answer yes to any of the following risk factors then you are likely to have a Metabolic Syndrome.

Firstly, if you have an abdominal waist that is bigger than an ideal cut off, for men that is 94cm and for women it’s 80cm, and the measurement is taken at your bellybutton.

Secondly, if you have raised blood fat levels (and these fats are called triglycerides), if your levels are above 1.7 then that is a risk factor for the Metabolic Syndrome. If you have reduced HDL cholesterol levels, that is the protective cholesterol, if you’re a man and your levels are under 1 or if you’re a woman and your levels are under 1.29 then that is another risk factor for the Metabolic Syndrome. If you have high blood pressure, that is a risk factor, and if you have high fasting glucose levels, that is, blood sugar levels that are above the level of 5.6 when you’re fasting, then that is another risk factor for the metabolic syndrome. So if you have a large abdominal waist and any 2 of the other 3, then that classifies as you as having a Metabolic Syndrome.

The good news is that the Metabolic Syndrome is preventable so, although you are at increased risk of developing heart disease and diabetes, if you change your diet lifestyle you can actually prevent this diabetes and heart disease from developing:

Firstly, if you’re overweight, you need to be losing weight and achieve a healthy weight, within your healthy weight range. Now, a way to monitor weight loss is to measure your waist girth and if you remember the cut off, for men it’s 94cm and for women under 80cm, and that will show you whether you’re progressing in losing weight.

Secondly, increase your daily physical activity and look for opportunities to be more active through the day. So, incorporate 30 minutes of brisk walking into your day and use the stairs, or walk wherever you can so that you become more physically active.

And thirdly, follow a healthy diet that is nutritionally balanced, that is low in saturated or animal fats, low in simple sugars and salt, and high in fibre. It’s very important that you spread your meals evenly through the day and not to skip meals. And make sure you don’t have long periods of time through the day where you’re not eating anything and then having a big meal at night because metabolically that’s not favourable, you should spread your meals evenly.

Healthy diet to prevent the metabolic syndrome

Now, a healthy diet to prevent the Metabolic Syndrome should include the following guidelines:

1. Use olive oil as your main added fat. That is olive oil in cooking or in your salads, or on vegetables, rather than animal fats.
2. Eat more vegetables and include leafy greens and tomatoes. You should try to have at least 2.5 cups of vegetables per day and 1 cup of that is leafy green vegetables, and include some tomato.
3. More legumes. Legumes could be incorporated such as baked beans or bean soups or bean salads, but include legumes at least twice a week in your meals.
4. More fish. Include fish at least twice a week, try and have at least a 100 gram serve twice a week, either in your lunch or dinner, and that could even include tinned fish. Try to include salmon, which is high in fish oils and very beneficial for your heart. And when you’re having fish, prefer fish that is grilled or that is baked, or barbequed, rather than deep fried and battered because that really takes away any of the benefits, it adds more fat.
5. Try to have less meat and have lean pieces of meat and smaller portions. That is the key. Meat maybe a couple of times a week but keep the portions small, about 120-150 grams, for most of us that is the size of the palm of our hand not our whole hand. So keep the portions small and make sure you grill meats or bake them in the oven or stew them. But remove all the fat before eating the meat.
6. Eat fruit everyday. Fresh fruit preferably and avoid too many fruit juices, which are concentrated in fruit sugar. So have fresh fruit: eat the skin wherever possible, try to include at least a couple of pieces of fruit each day, and fruits make perfect snacks so eat fruit in between meals.
7. Try to have yogurt everyday – preferably natural low-fat yogurt. But if you’re going to have fruit yogurt, choose low-fat fruit yogurt and low in sugar as well. Yogurt is very beneficial for calcium intake and it’s also a terrific snack – and it has probiotic properties, which means that they help maintain a healthy gut.
8. Include whole-grain breads and cereals. So when you eat bread or breakfast cereal make sure it’s high in fibre. Your breads should be whole grain, preferably including the seeds, and try not to spread high-fat spreads on your bread – use low-fat spreads if you’re going to use spreads at all. And limit the quantity of bread overall. So for breakfast, for lunch in a sandwich, but if you’ve got a big meal you probably don’t need bread as well. With a breakfast cereal, choose a cereal that is high in fibre and low in sugar. So do check the labels. A little bit of fruit sugar is ok but not added sugars. Cereals are a terrific breakfast, they get you going, lots of energy and then you have low fat milk with the cereal, so it’s a terrific breakfast option.
9. Now, you may ask about alcohol. Alcohol can be part of a healthy diet if you drink alcohol in moderation. If you drink alcohol, then 1-2 glasses – preferably wine, and there’s more evidence for red wine than any other alcohol in terms of benefits for your heart. So include a glass of wine with your meal, preferably not without a meal, don’t drink on an empty stomach and try not to exceed a couple of glasses a day. A little bit less for women, so 1 glass for women, 2 glasses for men. If you’re going to have beer choose one that is low in carbohydrate because beer has alcohol PLUS sugar. So choose one of the many beers that are low in carbohydrate.
10. And finally, sweets or sweet drinks should only be for special occasions. Your drinks should mainly be water, or calorie-free drinks, or plain mineral water, soda water, but generally plain water is the best to hydrate yourself. Limit sweet drinks to special occasions. And cakes and sweets should only be had on special occasions and in small quantities, not on a daily basis.

Thank you for listening. This is Dr Catherine Itsiopoulis, Clinical Dietitian. If you have any questions about the metabolic syndrome or your own personal risk please consult your health professional, which would include your local doctor, your dietician, physiotherapist, a specialist nurse or any other health professional that you can consult in the community.

More information on Obesity and the Metabolic Syndrome