Experts step up work against metabolic syndrome with new definition

International expert agreement on a definition of the metabolic
syndrome, a collection of risk factors for heart disease and
diabetes, will help doctors and the food industry better target
prevention of disease, writes Dominique Patton.

The International Diabetes Federation​ (IDF), which presented the global consensus statement yesterday, said having one definition of the condition would lead to earlier detection and increased reduction of heart disease and diabetes.

Dietary changes, such as higher intake of wholegrains and fibre, and weight loss are among the most widely recommended approaches to metabolic syndrome and a number of health ingredient makers are targeting this condition. But the new definition demonstrates global scientific recognition of the relatively new term and will support long-term input from industry in this area.

Experts in the fields of diabetes, cardiology, lipidology, public health, epidemiology, genetics, metabolism and nutrition from six continents contributed to the definition.

Professor Sir George Alberti, past president of IDF and co-chairman of the consensus group, said: "With a single, universally accepted diagnostic tool, clinicians can now more quickly identify patients with the metabolic syndrome in the practice setting. Put simply, we have the potential to stop the cardiovascular disease time bomb."

People with metabolic syndrome are twice as likely to die from, and three times as likely to have a heart attack or stroke compared to people without the syndrome. This puts metabolic syndrome and diabetes way ahead of HIV/AIDS in morbidity and mortality terms yet the problem is not as well recognised, said the IDF.

People with metabolic syndrome also have a fivefold greater risk of developing type 2 diabetes, if it is not already present.

The new definition, which builds on earlier ones put forward by the WHO and NCEP ATP III, requires that a person has central obesity, plus two of four additional factors: raised triglycerides, reduced HDL cholesterol, raised blood pressure, or raised fasting plasma glucose level.

The use of different definitions up until now has made it difficult to estimate the prevalence of metabolic syndrome and make comparisons between nations but recent data from Australia and the US provides a broad estimate of 20-25 per cent of the adult population.

Professor Paul Zimmet, director of the International Diabetes Institute and co-author of the consensus statement said that lifestyle changes, for example changes in diet and an increase in exercise, form the underlying strategy of treatment for the condition. There are also new therapies on the horizon, which may address several of the risk factors concurrently.

As well as the diagnostic tool, the new IDF consensus statement includes recommendations for additional criteria to be included in research and epidemiological studies of the metabolic syndrome.

The consensus definition process was supported by an educational grant from AstraZeneca Pharmaceuticals.

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