Metabolic Syndrome Diet & Lifestyle Recommendations

In 1975, when Nathan Pritikin launched the Pritikin Center to help people with heart disease, he noticed that many had not only high cholesterol but also hypertension, high blood sugar, and belly fat.

The good news, Nathan observed, was that his diet-and-exercise program seemed to help all these problems. But Nathan, ever curious about the workings of the human body, was perplexed. Why, he wondered, did all these things seem to go hand-in-hand? Could they be linked in some way?

What is Metabolic Syndrome?

Metabolic syndrome is a group of five risk factors that increase the risk of developing heart disease, diabetes, and stroke. Increased blood pressure, high blood sugar levels (insulin resistance), excess belly, high triglyceride levels and low levels of good cholesterol, or HDL - are the five risk factors for metabolic syndrome. If you have at least three of them - you may already have the condition.

Today, scientists have answers to Nathan Pritikin’s observations. There is a link, and it’s called the Metabolic Syndrome.

What is the Metabolic Syndrome?

The Metabolic Syndrome is not a disease, per se. It is a cluster of factors indicating a dysfunctional metabolism, and this malfunctioning metabolism often does lead to deadly diseases.

Having the Metabolic Syndrome damages our blood vessels and greatly increases our risk of diabetes, heart attacks, strokes, dementia, kidney disease, fatty liver, vision impairment, and many other woes.

You have the Metabolic Syndrome, according to the National Cholesterol Education Program (NCEP) of the National Institutes of Health, if you have at least three of the following five criteria:

  1. A resting blood pressure of 130/85 or higher (either number), or you’re currently taking blood-pressure-lowering medications.
  2. A waist circumference of greater than 35 inches in women and greater than 40 inches in men. The measurement is typically taken 1 inch above the highest part of the side of your pelvic bone. The circumference around your belly button is a good approximation. NOTE: There are high-risk groups in which the thresholds are lower – 33 inches for women and 37 for men. They include people with a personal or family history of vascular disease (such as heart disease, stroke, and diabetes) as well as specific ethnic groups, including African-Americans, Asians, Native Americans, Indian/Pakistanis, and Latinos.
  3. An HDL “good” cholesterol less than 40 mg/dL in men and less than 50 mg/dL in women, or you’re currently taking HDL-raising medications.
  4. A fasting triglyceride level of 150 mg/dL or higher, or you’re currently taking triglyceride-lowering medications.  NOTE: The American Heart Association has lowered what it considers to be optimal fasting triglycerides to less than 100 mg/dL.
  5. A fasting blood glucose (blood sugar) of 100 mg/dL or higher.


If you have the Metabolic Syndrome, you’re far from alone. This pre-cursor of Type 2 diabetes along with another pre-cursor, pre-diabetes (defined as a fasting glucose between 100 and 125) are now so widespread that scientists estimate that the majority of Americans over age 65 has them. Nearly 50% of Americans over age 40 have the Metabolic Syndrome. And alarmingly, more and more children, especially overweight kids, are being diagnosed with the syndrome.

There’s more troubling news. The Metabolic Syndrome and pre-diabetes increase our risk of heart disease almost as much as Type 2 diabetes does.

Strangely and sadly, it could be argued that you’re lucky if you get to the Type 2 diabetes stage. Far too many people succumb to cardiovascular disease in the earlier stages of diabetes – when they have Metabolic Syndrome or pre-diabetes.


Almost 90 million Americans, more than 25% of our total population, have pre-diabetes, and around 90% aren’t even aware. Warns the Centers for Disease Control and Prevention:  “Without lifestyle changes to improve their health, 15% to 30% of people with pre-diabetes will develop Type 2 diabetes within 5 years.

All this suffering, all this early death, is preventable . They are the direct result of the way we live – by our sedentary habits and our Western-style diets, bereft of whole, fiber-rich foods and full of fast foods and other calorie-dense junk.

How Metabolic Syndrome begins

The Metabolic Syndrome usually begins with insulin resistance. Insulin resistance happens when our cells “resist” insulin.

Here’s what’s going on in our bodies. Normally, we change the sugars and starches we eat into a form of sugar called glucose. The bloodstream carries the glucose to the body’s cells. Insulin, a hormone produced by the pancreas, “ushers” glucose into the cells, where it’s converted to energy. You are insulin resistant if your cells don’t want to “accept” the insulin. Figuratively-speaking, your cells have signs on their doors that say, “Sorry, closed for business. We already have all the glucose we need.”

So the pancreas has to pump out more insulin in an effort to “push” those doors open and keep blood sugar levels from going too high. That’s why the insulin levels of people with Metabolic Syndrome, pre-diabetes, or diabetes are often higher than the insulin levels of others.

In about half of all cases, insulin resistance leads to ever-rising blood sugar levels and Type 2 diabetes (defined as a fasting glucose of 126 or more). Ultimately, the pancreas may give out. For years, it’s been on overdrive, pumping out more and more insulin, trying to break through the cells’ doors. Eventually, it cannot produce enough extra insulin to overcome the insulin resistance. As a result, people who’ve had Type 2 diabetes for many years must often resort to insulin shots.

What causes insulin resistance?

Here’s what we know. Environment is important. The great majority of people with insulin resistance are overweight. But scientists know that genetic susceptibility plays a role as well because some normal-weight people are insulin resistant – and some very obese people are not.

In addition to being overweight and having a genetic tendency, other factors that contribute to insulin resistance are:

  • Poor diet: Even in normal-weight people, a diet high in fats and highly refined, processed foods like sugars, white breads, and dry cereals is associated with greater risk of developing insulin resistance and all other aspects of the Metabolic Syndrome.
  • Inactivity
  • Smoking
  • Aging

How do you prevent or reverse the Metabolic Syndrome?

There is no one magic pill that erases the syndrome. Pharmaceutically, it is treated in piecemeal fashion. People take one type of drug, usually statins, to control cholesterol, another to lower blood pressure, another to lower triglycerides, and still others to treat high blood sugar. To date, no drugs have been approved for insulin resistance.

The far better approach – one that treats the overall problem – is the more natural way: a healthy diet and regular exercise. It is also the most effective way, argue experts like Dr. Paul Ridker of the Center for Cardiovascular Disease Prevention at Brigham and Women’s Hospital in Boston, because it targets what are often the roots of the problem: poor diet, lack of physical activity, and excess body fat, especially in the belly.

Oh, what that spare tire can do!

Excess belly fat is problematic because it is not just a dormant roll of flab. Those fat cells, wrapped around organs like the liver and pancreas, are very active. They pump out hormones and other chemicals that raise blood pressure, worsen cholesterol levels, slow down our metabolism (so yes, we end up gaining even more weight), and foul up the delicate system by which insulin works, causing insulin resistance.

The chemicals that belly fat secrete also trigger inflammation throughout the body. That’s bad news because high levels of inflammation are increasingly linked with higher risk of heart attacks, strokes, osteoarthritis, and even Alzheimer’s disease.

A bulging belly, in short, is deadly, and it appears so even if you aren’t overweight or obese by other measures, according to research.  Reporting in the Archives of Internal Medicine, , scientists analyzed data from more than 100,000 people who were followed for a decade and found that men and women with big waistlines had double, and more, the risk of dying compared to those with trimmer waistlines, and these conclusions held true for people whose overall weight, measured by BMI (body mass index), was normal.

Cleaning up a metabolic mess

Now for the good news. With lifestyle-change programs like Pritikin, the problems that make up the Metabolic Syndrome start to fade quickly and simultaneously. Over the past 40 years, studies published in peer-reviewed journals like Diabetes Care and the New England Journal of Medicine have shown that the Pritikin Program lowers blood pressure, dramatically improves cholesterol and triglyceride profiles, sheds body fat, and normalizes blood sugar levels.

The good news, too, is that just a small amount of weight loss – about 5% of body weight – can help restore insulin sensitivity. In fact, just getting started on the Pritikin Diet and Exercise Program can reverse the Metabolic Syndrome.

Metabolic Syndrome diet and lifestyle | Benefits

Within three weeks, researchers at UCLA documented in the Journal of Applied Physiology, the majority of people who arrived at the Pritikin Longevity Center with the syndrome were able to improve their cholesterol levels, blood pressure, triglycerides, and blood sugars so much that they no longer met the three-risk-factor criteria for the syndrome.

Additionally, after two weeks on the Pritikin Program, research by scientists at Washington University found that 67 adults with Type 2 diabetes and/or the Metabolic Syndrome achieved major improvements in multiple cardiovascular risk factors. Blood glucose, LDL cholesterol, and systolic and diastolic blood pressure were lowered on average 10% to 15%; triglycerides decreased 36%; body mass index fell 3%; and 37% of subjects no longer met National Cholesterol Education Program criteria for the Metabolic Syndrome.

“The results of these studies show that dramatic changes in diet and activity levels can quickly and favorably alter most of the metabolic abnormalities seen in people with the Metabolic Syndrome,” notes Kimberly Gomer, MS, RD, LDN, Director of Nutrition at the Pritikin Longevity Center.

Children benefit, too. In an investigation on overweight kids (ages 8 to 17) attending the Pritikin Program with their parents, scientists found that the children with Metabolic Syndrome left Pritikin’s two-week healthy-living program free of the syndrome.

Research has also found that the Pritikin Program is effective in curbing inflammatory factors related to the Metabolic Syndrome and excess weight. Studying overweight/obese children in the two-week Family Health Camp at Pritikin, UCLA scientists reported significantly improved markers of not only metabolic health but also chronic inflammation.

A key factor in curbing inflammation, the authors concluded, was the Pritikin Eating Plan’s dramatic decrease in saturated fat intake.

Science is also learning that reducing the factors that make up the Metabolic Syndrome may also reduce the risk of prostate cancer.

Bottom Line

The optimal approach for preventing the Metabolic Syndrome is to lose excess weight with regular exercise and a diet, like the Pritikin Eating Plan, that focuses on foods that are low in calorie density and naturally high in fiber and nutrients, including whole-grain foods like hot cereals, corn, whole-wheat pasta, and brown rice; generous amounts of fruits, vegetables, and starchy foods like potatoes, yams, beans, lentils, and peas; and modest amounts of nonfat dairy products, seafood, and lean poultry and meat.

As more than 100 studies in leading peer-reviewed medical journals have proven, and as Nathan Pritikin observed four decades ago, this simple but powerful diet-and-exercise approach acts like a one-two punch on the Metabolic Syndrome, and, in doing so, helps prevent and control the leading causes of death and disability in the United States, including cardiovascular disease, Type 2 diabetes, hypertension, and stroke.

“If ever there were a magic bullet for reversing the Metabolic Syndrome and building long-term health, the Pritikin Program is it,” sums up Gomer.

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Originally published in in 2013. Edited in 2019 by Kell Wynn

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