Syndrome X (also known as the metabolic syndrome ) is a constellation of cardiovascular risk factors including high cholesterol , increased weight, elevated blood pressure , and insulin resistance (a reduced sensitivity to insulin, which eventually leads to diabetes if left untreated.) Unfortunately, as with obesity and diabetes, the prevalence of syndrome X in the U.S. is on the rise. It is estimated that as many as 40 million (that’s almost one out of every six) adults have the syndrome, whether they know it or not.

Although each individual component of syndrome X has been shown to increase the risk of coronary heart disease (CHD), insulin resistance, and it’s resultant hyperinsulinemia (excess insulin in the blood) is now believed to be the most important one. The one risk factor, however, most commonly recognized and treated with medications is high blood pressure. Unfortunately, some syndrome X patients treated with anti-hypertensive medications alone experience a worsening of their cholesterol levels and insulin resistance.

In an effort to address this problem, a group of researchers set out to identify a non-pharmacologic approach to treating syndrome X. The results of this study were published in the September 8, 2003 issue of the Archives of Internal Medicine. The researchers found that a treatment plan combining exercise and weight loss can effectively lower both hyperinsulinemia and blood pressure in patients with syndrome X.

About the study

A total of 53 men and women with syndrome X were randomly assigned to one of three groups: exercise only, exercise plus a weight loss plan, or a control group. The participants in the exercise group were instructed to exercise three to four times per week for 26 weeks. The exercise consisted of 10 minutes of warm up exercises, 35 minutes of aerobic activity (cycling, walking, or jogging), and 10 minutes of cool down exercises.

The participants in the exercise plus weight loss group followed the same exercise program as the exercise only group. They also participated in a weight management program based on the LEARN manual, which focuses on five elements of weight loss: lifestyle, exercise, attitudes, relationships, and nutrition.

The control group was asked to make no changes to their usual dietary and exercise habits.

Each participant’s blood pressure, cholesterol level, aerobic fitness, body composition, and glucose tolerance (a measure of insulin resistance) was assessed both before and after receiving treatment.

The findings

The researchers found that the patients in the exercise and weight loss group lost the most weight and reduced their level of insulin overproduction (hyperinsulinemia) by as much as 47%. Those in the exercise only group lost less weight and reduced their level of hyperinsulinemia by only 27%. Participants who showed the greatest weight loss also showed the greatest reduction in their level of hyperinsulinemia. Additionally, the blood pressure levels of those in the exercise and weight loss group were also significantly reduced compared to the control group.

How does this affect you?

The results of the study suggest that exercise plus weight loss is an effective treatment for hyperinsulinemia and high blood pressure in patients with syndrome X.

It also emphasizes the importance of weight loss in improving the cardiac risk factors associated with syndrome X. Although exercise alone resulted in decreased levels of hyperinsulinemia in this study, this decrease was significantly larger when a more comprehensive weight management program was added.

While drug therapy is often a necessary part of the treatment for syndrome X, medications are risky and they do not cure this condition. This study, and other like it, continue to remind us that the cure for syndrome X will not be found on your doctors prescription pad or in your local pharmacy, but rather in your motivation to change your style of living.