Focus on lifestyle change and the metabolic syndrome

This article has attempted to provide the groundwork for understanding the basis and nonpharmacologic management of the metabolic syndrome. Weight loss can greatly reduce insulin resistance and all of the manifestations of the metabolic syndrome. Physicians' endorsement of eating and exercise behaviors that lead to a healthier waistline and improved BMI, lower blood pressure, improved HDL-C and TGs, and lower blood sugars along with a reduced CRP carries the promise of improved long-term outcomes. While clinicians await further research into behavioral science, adipocytes, hormones, and the mechanistic link between insulin resistance and other important factors that will help them identify new targets for therapy, they can do much by promoting improved lifestyles for all individuals. The findings of the NHANES III (1988-1994) that perhaps 4% of adolescents and nearly 30% of overweight adolescents in the United States meet criteria for the metabolic syndrome suggest that a national focus on lifestyle change needs to start now [52].