Table 1

 

Criteria for Clinical Diagnosis of Metabolic Syndrome

 

Clinical Measure                     WHO (1998)             ATP III (2001) AACE (2003)             IDF (2005)             AHA/NHLBI (2005)

 

Insulin resistance                  IGT, IFG, T2DM,            None                           IGT or IFG                  None                           None

                                                or lowered insulin

                                                Sensitivity                              

                                                plus any 2 of             but any 3 of                     plus any of the                                         but any 3 of the

the following            the following            following based                                                following 5 features

                                    5 features                        on clinical

                                                                                                                        judgment

 

Body Weight                          Men:                            Men:                            BMI  > 25 kg/m2            Increased                  > 102 cm in men

                                                W-H ratio >.90            WC > 102 cm                                               WC (pop.               > 88 cm in women

                                                Women:                     Women                                                          specific)

                                                W-H ratio >.85            WC >88 cm                                                           plus any 2

                                                and/or BMI >                                                                                      of the

                                                30 kg/m2                                                                                     following

 

Lipids                                     TG > 150 mg/dl            TG > 150 mg/dl            TG > 150 mg/dl            TG > 150 mg/dl            TG > 150 mg/dl or

                                                and/or HDL-C            HDL-C<40 mg/dl            and HDL-C < 40            or on TG Rx             on TG Rx

                                                < 35 mg/dl in                       in men or <50             mg/dl in men or            HDL-C < 40                        HDL-C<40 mg/dl in men

                                                men or < 39                mg/dl in women            <50 mg/dl in                     mg/dl in men             HDL-C<50mg/dl in women

                                                mg/dl in women                                            women                      or < 50 mg/dl                     or on HDL-C Rx

                                                                                                                                                            in women or

                                                                                                                                                            or HDL-C Rx

 

Blood Pressure                    > 140/90 mm Hg       > 130/85 mm Hg       > 130/85 mm Hg       > 130/85 mm Hg       > 130/85 mm Hg

                                                                                                                                                            or on BP Rx             or on BP Rx

 

Glucose                                  IGT, IFT, or T2DM            > 110 mg/dl               IGT or IFT                   > 100 mg/dl               > 100 mg/dl              

                                                                                                                                                                                                or BG Rx

 

Other                                       Microalbuminuria                                          Other features

                                                                                                                        of insulin resistance

Adapted from reference 7, Grundy et al, Circulation 2005.

Table 2

 

Nutrition Recommendations for the Risk Factors of Metabolic Syndrome

 

 

                                                                        ADA                                        NCEP                                     JNC-7            

 

Total Fat                                                         Individualize                          25-35%                            Reduced content;

                                                                                                                                                                        Low fat dairy; DASH eating plan

 

Saturated Fat                                                < 10%                                     < 7%                                       Reduced content; DASH eating plan

                                                                        < 7% if LDL>100

 

Trans Fat                                                        Low intake                          Low intake                          Not specified

 

Cholesterol                                                    < 300 mg/dl                           < 200 mg/dl                           Not specified

                                                                        < 200 if LDL>100 mg/dl

 

Monounsaturated Fat (MUFA)                      60-70% (MUFA + CHO)            up to 20%                            Not specified       

 

Polyunsaturated Fat (PUFA)                       ~ 10%                                     up to 10%                            Not specified

                                                                                                                       

Omega-3 Fatty Acids                             2-3 servings of                 increased intake                  Not specified

                                                                        fish/week                                if at risk

 

Carbohydrate (CHO)                         60-70% (CHO + MUFA)            50-60%                            DASH eating plan

 

Fiber                                                               no specific recommend.            20-30 grams                         adopt diet rich in

                                                                        Increased use                                                                      fruits and vegetables

                                                                        encouraged

 

Protein                                                            15-20%                            ~15%                                      Not specified

 

Sodium                                                           reduce salt (NaCl                   Not specified                                reduce salt (NaCl

                                                                        To 6000 mg/day                                                             to 6000 mg/day

 

Alcohol                                                           1 drink/day – women            Not specified                                1 drink/day - women

                                                                                                                                                2 drinks/day – men