Metabolic Dysfunction: Overview

What is Metabolic Syndrome?

Metabolic syndrome (MetS) is a collection of pathological conditions associated with metabolic, pro-inflammatory, and prothrombotic states variously defined as having three or more of the following abnormalities:

  • Waist circumference more than 40 inches in men and 35 inches in women (measured at the level of the umbilicus)
  • Elevated triglycerides: 150 milligrams per deciliter of blood (mg/dL) or greater
  • Reduced high-density lipoprotein cholesterol (HDL): less than 40 mg/dL in men or less than 50 mg/dL in women
  • Elevated fasting glucose of l00 mg/dL or greater
  • Blood pressure values of systolic 130 mmHg or higher and/or diastolic 85 mmHg or higher

The underlying abnormality is insulin resistance. This is a significant factor in the majority of chronic diseases that affect us today.

Swarup, Supreeya, Amandeep Goyal, Yulia Grigorova, and Roman Zeltser. “Metabolic Syndrome.” In StatPearls. Treasure Island (FL): StatPearls Publishing, 2020.

metabolic syndrome definition

Stefanadi, Ellie C., Georgios Dimitrakakis, Christos-Konstantinos Antoniou, Dimitrios Challoumas, Nikita Punjabi, Inetzi Aggeliki Dimitrakaki, Sangeeta Punjabi, and Christodoulos I. Stefanadis. “Metabolic Syndrome and the Skin: A More than Superficial Association. Reviewing the Association between Skin Diseases and Metabolic Syndrome and a Clinical Decision Algorithm for High Risk Patients.” Diabetology & Metabolic Syndrome 10, no. 1 (December 2018): 9.

What percentage of adult Americans are metabolically healthy?

A definition of metabolic health was set as having optimal levels of waist circumference (WC <102/88 cm for men/women), glucose (fasting glucose <100 mg/dL and hemoglobin A1c <5.7%), blood pressure (systolic <120 and diastolic <80 mmHg), triglycerides (<150 mg/dL), and high-density lipoprotein cholesterol (≥40/50 mg/dL for men/women), and not taking any related medication. By this definition, according to the National Health and Nutrition Examination Survey of 2009-2016, only 12.2% (95% CI: 10.9-13.6) of Americans were metabolically healthy during this time period.


Araújo, Joana, Jianwen Cai, and June Stevens. “Prevalence of Optimal Metabolic Health in American Adults: National Health and Nutrition Examination Survey 2009–2016.” Metabolic Syndrome and Related Disorders 17, no. 1 (February 2019): 46–52.

What diseases are associated with metabolic disease?

Metabolic dysfunction either directly causes or is associated with a worse outcome for an array of diseases including obesity, diabetes, cardiovascular disease, certain forms of cancer, Alzheimers, fatty liver, polycystic ovary disease, and arthritis. These are often collectively referred to as the ‘Diseases of Civilization’.

Kopp, Wolfgang. “How Western Diet And Lifestyle Drive The Pandemic Of Obesity And Civilization Diseases.” Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, vol. 12, 2019, pp. 2221–36, doi:10.2147/DMSO.S216791.

drugs and environmental toxicants

How is metabolic dysfunction treated?

Metabolic syndrome/insulin resistance and many of its related diseases can often be reversed with simple lifestyle interventions such as reducing sugar intake and/or fasting.

The only primary treatment for the metabolic dysfunction, which is the underlying cause of most of our chronic diseases today, is through lifestyle changes.  Its secondary consequences such as obesity, DM, HTN, dyslipidemia, stroke, dementia, heart disease, and some cancers are treated by conventional medical treatments including drugs, surgery, and radiotherapy. 

original article

Dietary carbohydrate restriction improves metabolic syndrome independent of weight loss. Dietary carbohydrate intolerance (i.e., the inability to process carbs in a healthy manner) rather than obesity per se appears to be a fundamental feature of MetS.


Does carbohydrate restriction work for type II diabetes and metabolic syndrome?

Here is a sample patient who tried it for 18 months. @DietDoctor


I wonder if we should refer to metabolic disease as ‘carbohydrate intolerance’. Similar to lactose intolerance but instead of just getting a little flatulence, you get diabetes, heart disease, Alzheimer’s, and cancer.

There is no biological need for ANY amount of sugar in the diet. (Glucose is required but can be produced by our bodies from the other two macronutrients, fat and protein.)

Dietary sugar and refined carbohydrates is the major cause of metabolic dysfunction linked to diabetes, heart disease, Alzheimer’s disease, and several cancers.