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ISSA, International Sports Sciences Association, Certified Personal Trainer, ISSAonline, Metabolic Syndrome: What It Is & How Exercise Helps

Metabolic Syndrome: What It Is & How Exercise Helps

Reading Time: 5 minutes


DATE: 2022-11-18

Some medical conditions are highly prevalent. This means that your likelihood of working with a client who has them is almost a given. Metabolic syndrome is a condition that falls into this category.

One in three adult Americans has metabolic syndrome. (1) That makes it important for personal trainers to know what this condition is. You also need to know how exercise can help. We’ll get into all of that here.

What Is Metabolic Syndrome?

Metabolic syndrome is a group of risk factors. When combined, these factors increase a person’s risk of developing a serious health problem. Related conditions include heart disease, diabetes, and stroke

To be diagnosed with metabolic syndrome, three or more of the following risk factors must be present:

  • high fasting blood sugar

  • high blood pressure

  • high triglyceride levels

  • low HDL cholesterol levels (a.k.a. the “good cholesterol”)

  • abdominal obesity

Metabolic syndrome is also sometimes called insulin resistance syndrome. With insulin resistance, the body doesn’t respond as it should to the hormone insulin. This makes it harder to control blood sugar levels. 

Insulin resistance can lead to hyperglycemia. Hyperglycemia is a condition in which blood glucose levels are elevated. If these levels remain high over time, type 2 diabetes may develop.

Metabolic Syndrome Causes and Risk Factors

There is no singular cause for metabolic syndrome. Instead, this condition is generally a result of several causes working together. The National Library of Medicine(NLM) reports that its causes include (2):

  • obesity or being overweight

  • having a sedentary lifestyle

  • insulin resistance

  • being older

  • having a genetic predisposition to this syndrome

The NLM adds that certain factors can lead to an increased risk of developing metabolic syndrome. Among them are:

  • being from a racial or ethnic group with a higher risk (the risk is highest for Mexican Americans)

  • having diabetes, or having a parent or sibling with diabetes

  • having polycystic ovary syndrome (PCOS)

  • taking medications that lead to weight gain

  • taking medications that change one’s blood pressure, cholesterol, or blood sugar level

Johns Hopkins shares a few more factors that can increase the risk of developing this syndrome. They include smoking, heavy drinking, and stress. (3)

Diagnosing Metabolic Syndrome

How does one know whether they have metabolic syndrome? Many of these risk factors can occur without any noticeable symptoms. The only one that is more obvious is abdominal obesity. If your client has a large waist circumference, they already have one of the risks.

They may also show signs of some of the other factors, even if they’re subtle. Do they feel tired and have an increased need to urinate? They may have prediabetes or diabetes. Do they get severe headaches, chest pains, or have an irregular heartbeat? They may have high blood pressure.

A healthcare professional can run tests to see if the person meets the requirements for a diagnosis. This requires testing each risk factor individually as there is no one “metabolic syndrome test.” Here are the measurements for each:

  • Abdominal Obesity: a waist measurement of 35+ inches for women or 40+ inches for men

  • High Triglyceride Level: 150 mg/dL or higher

  • Low HDL Cholesterol Level: <50 mg/dL for women or <40 mg/dL for men

  • High Blood Pressure: 130/85 mmHg or higher

  • High Fasting Blood Sugar: 100 mg/dL or higher

Typically, these measurements are recorded as part of an annual physical. However, if your client is concerned, they can request that their healthcare provider run them at any time. 

How This Metabolic Disease is Treated

Each metabolic risk factor may need to be treated on its own. Medication may be required to lower blood pressure or cholesterol. Insulin may be needed to manage type 2 diabetes.

Otherwise, metabolic syndrome is often treated with healthy lifestyle changes. If the person is overweight, weight loss is key. This requires following a healthy diet. This diet should be high in fruits, veggies, whole grains, and lean protein. It’s also low in saturated fat and processed foods.

Other diet changes can positively impact the individual metabolic syndrome risks. Reducing salt intake, for example, can help ease high blood pressure. Avoiding trans fat can lower one’s cholesterol level. Watching sugar intake can make it easier to manage one’s blood sugar. 

The National Heart, Lung, and Blood Institute has additional recommendations. They include:

  • managing stress

  • quitting smoking

  • getting enough quality sleep

Another important lifestyle change is getting more exercise. In fact, there is a strong connection between metabolic syndrome and physical activity. (4)

The Connection Between Metabolic Syndrome and Exercise

Research indicates that physical activity can help prevent metabolic syndrome. For those who already have this condition, increasing physical activity can also reduce its effects—even impacting the person’s health outcomes. (5)

This isn’t exactly groundbreaking information since exercise has long been known to positively impact each of the syndrome’s risk factors. It can help reduce blood pressure and cholesterol, for instance. But what is of interest is that this particular research goes on to say that, despite exercise being an effective prevention and treatment remedy for metabolic syndrome, it is underutilized for this purpose.  

A 2018 review adds that regular exercise is so important for treating metabolic syndrome that it should have the same status as medicine and “be prescribed as such.” One of the ways it helps the most, according to this review’s authors, is by reducing abdominal obesity. This is critical because obesity in the abdominal area is considered the biggest risk factor for metabolic syndrome. (6)

Yet, the idea of using exercise as treatment also presents some challenges. The main one is figuring out how to motivate people with this condition to participate in and stick with an exercise program. 

Working with Clients Who Have Metabolic Syndrome

If your client has metabolic syndrome, getting approval to exercise is the first step. Their healthcare provider may have guidelines based on their condition. Or they may want to run some tests. If their cholesterol is high or they have heart disease, they may be required to do a stress test. This can help reduce the risk of a heart attack during exercise.

Once approval is received, you can start to create an exercise program. The American Heart Association recommends that people with metabolic syndrome get at least 150 minutes of exercise per week. And it should be moderate intensity. If they’re new to exercise, they can start by walking. Walking is also a good starting point for people with obesity. Once their fitness progresses, they move to other activities to get their heart rate up. (7)

Other actions may be needed to keep the exercise safe. Clients with blood sugar issues should check their levels before and after working out. This can keep it from getting too high or low. They may need to adjust their insulin to help with this. If the client has high blood pressure, start with a lower intensity. This can keep their blood pressure from spiking too high. Warming up and cooling down are important too. 

Working out regularly can positively impact many of the metabolic syndrome risks. So, work with the client to keep them motivated. If they’re losing weight, this can help. Point out how exercise can help with blood pressure and cholesterol as well. 

Clients can face a variety of physical and mental challenges when trying to achieve a healthy weight. Learn how to help them overcome these roadblocks as a Certified Health Coach. This ISSA teaches you how to work with clients who have chronic health conditions, helping them make positive lifestyle changes.

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ISSA | Certified Health Coach

ISSA's Health Coach certification is for personal trainers and other health professionals who want to help clients overcome physical and mental health barriers to achieve their optimal wellness.


  1. U.S. Department of Health and Human Services. (2022, May 18). What is metabolic syndrome? National Heart Lung and Blood Institute. Retrieved November 8, 2022, from https://www.nhlbi.nih.gov/health/metabolic-syndrome 

  2. U.S. National Library of Medicine. (2020, January 17). Metabolic syndrome. MedlinePlus. Retrieved November 8, 2022, from https://medlineplus.gov/metabolicsyndrome.html 

  3. Metabolic syndrome. Metabolic Syndrome | Johns Hopkins Medicine. (2021, August 8). Retrieved November 8, 2022, from https://www.hopkinsmedicine.org/health/conditions-and-diseases/metabolic-syndrome 

  4. U.S. Department of Health and Human Services. (2022, May 27). Treatment. National Heart Lung and Blood Institute. Retrieved November 8, 2022, from https://www.nhlbi.nih.gov/health/metabolic-syndrome/treatment 

  5. Myers, J., Kokkinos, P., & Nyelin, E. (2019). Physical activity, cardiorespiratory fitness, and the metabolic syndrome. Nutrients, 11(7), 1652. https://doi.org/10.3390/nu11071652 

  6. Paley, C. A., & Johnson, M. I. (2018). Abdominal obesity and metabolic syndrome: Exercise as medicine? BMC Sports Science, Medicine and Rehabilitation, 10(1). https://doi.org/10.1186/s13102-018-0097-1 

  7. Prevention and treatment of metabolic syndrome. www.heart.org. (2022, June 29). Retrieved November 8, 2022, from https://www.heart.org/en/health-topics/metabolic-syndrome/prevention-and-treatment-of-metabolic-syndrome 

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