The metabolic syndrome is a group of risk factors that can make you more likely to develop certain health conditions, including heart disease, stroke, and diabetes. If you have at least three of the following risk factors, you are considered to have the metabolic syndrome: Abdominal obesity. Excess fat around the belly is more likely to increase your risk for heart disease and other illnesses than excess fat elsewhere. It typically means a waist measurement of more than 40 inches in men or 35 inches in women. Elevated triglycerides. Another risk factor is having a higher-than-normal level of triglycerides—a type of fat in the blood—or being on medicine for that problem. It’s defined as a triglyceride level of 150 mg/dl or higher. Low HDL cholesterol or being on medicine to treat low HDL. HDL is considered the “good” form of cholesterol because it reduces the chance of developing heart disease. A low HDL level is defined as lower than 40 mg/dl in men or lower than 50 mg/dl in women. Elevated blood pressure. This means having higher-than-normal blood pressure or being on blood pressure-lowering medicine. It’s defined as a systolic pressure (the first number) of 130 mm Hg or higher and/or a diastolic pressure (the second number) of 85 mm Hg or higher. Elevated blood sugar or being on medicine to treat high blood sugar. A blood sugar level that is higher than normal is an early warning sign that the body can’t use insulin or glucose properly. You meet the criteria for this risk factor if the level of sugar (glucose) in your blood after fasting is 100 mg/dl or higher or if you take medicine to control high blood sugar. A level between 100 and 125 mg/dl is considered pre-diabetes. Higher than that is considered diabetes. Obesity, physical inactivity, and genetics can play a role in whether someone develops the metabolic syndrome. The same factors also contribute to heart disease. Other risk factors closely associated with the metabolic syndrome include older age, smoking, heavy drinking, and having a body mass index (BMI) higher than 25. BMI is a measure of body fat compared with height and weight. Diagnosis Your doctor will perform a physical exam and order several blood and urine tests to help determine if you have the metabolic syndrome. Treatment Because the metabolic syndrome increases the risk for more serious, chronic conditions such as heart disease and type 2 diabetes, treatment is important. Consider it a 'final warning' before irreversible changes impact your health. Making certain lifestyle changes can help you prevent or control the metabolic syndrome. Get more exercise. On at least five days of the week, aim for at least 30 minutes of moderate-intensity activity. This includes brisk walking, moderate biking, and swimming. Ask your doctor what type of and how much activity is best for you. Lose excess pounds. Burning more calories through exercise is half the battle. The other half is taking in fewer calories from foods. Avoid diets that ban certain foods or call for very small portions. Instead, keep portion sizes moderate. Focus on fruits, vegetables, whole grains, and nonfat or low-fat milk and dairy products. Eat foods full of protein. This includes foods such as lean meat, poultry, fish, beans, eggs, and nuts. Take prescribed medicine. Medication might be needed to help control your triglycerides, cholesterol, blood pressure, or blood glucose. With a combination of healthy lifestyle practices and medicine, you can help head off a number of complex medical problems and preserve your good health.