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1. Do I really need to worry about metabolic syndrome?

   While metabolic syndrome itself isn't a disease that will make you sick or kill you, it is a sign that you have a much higher risk of other diseases that will, such as heart disease and diabetes. Think of it as a warning sign that it's time to get serious about things like diet and exercise.

2. My friend's doctor says that metabolic syndrome is very controversial among medical professionals. Why?

   Health care professionals don't always agree on everything, and metabolic syndrome is one of those things. Some health care professionals don't see the value in identifying the syndrome in patients, because it isn't itself a disease; others feel that not identifying it is irresponsible, because it is associated with other diseases, perhaps down the line. Whether or not your health care professional gives you a diagnosis of metabolic syndrome, it is important that you are aware of its components, since any one of the five components can increase your risk of heart disease and/or diabetes.

3. How will I know if I have metabolic syndrome?

   Ask your health care professional to do the following: Measure your blood pressure and your waist circumference, perform a fasting blood glucose test and test your triglyceride and HDL cholesterol levels. If you have any three of the following—a waist measurement more than 34 inches around; a fasting blood glucose test level of 110 mg/dL or higher; a triglyceride level at or above 150 mg/dL; an HDL cholesterol level (the "good" cholesterol) below 50 mg/dL or a blood pressure at or above 130/85 mm Hg—then you have metabolic syndrome.

   Because the markers for metabolic syndrome are so diverse, it's doubtful one medication could address them all. However, medications are available for several of the individual components, including high blood pressure, high triglycerides and low HDL.

4. Why isn't there a single medication to treat metabolic syndrome?

   When you follow a healthy diet and increase your physical activity, nearly every component of metabolic syndrome improves, even if you don't lose weight. Exercise makes your cells more receptive to insulin, the hormone that "unlocks" cells to allow glucose inside; thus your blood glucose levels drop. Exercise also increases HDL cholesterol and reduces triglycerides and can reduce blood pressure. Changing your diet from one high in fat and sugar to one high in vegetables and fruits, along with whole grains and lean protein, also changes levels of blood fats like triglycerides while reducing blood pressure. Finally, both these things—more exercise and a better diet—usually lead to weight loss, even if you're not trying! And weight loss will improve every parameter of metabolic syndrome.

5. Why are women with PCOS so much more likely to have metabolic syndrome?

   We know that women with PCOS, or polycystic ovarian syndrome, a hormone disorder that can lead to infertility and diabetes, are up to 11 times more likely to have metabolic syndrome. What we don't know is whether the components of metabolic syndrome cause the PCOS or vice versa. But women with PCOS tend to be overweight, have insulin resistance, have high levels of fasting blood glucose and, in fact, have a much higher risk overall of cardiovascular disease. The condition affects 10 to 20 percent of U.S. women of childbearing age, and most have one or more of the classic features: irregular or absent menstruation, obesity and hair on the face and other parts of the body where women typically don't have much hair.