Metabolic syndrome: one man's story
Sydney man Stephen Cowie has metabolic syndrome. myDrtalked to him about how he found out and the changes he’s made to his lifestyle since he was diagnosed.
It was only a month ago that Sydney man Stephen Cowie first heard the label ‘metabolic syndrome’ applied to the cluster of conditions that he had been diagnosed with over the past 5 years.
Deadly quartet
Having high blood pressure, type 2 diabetes and carrying a bit more weight round the middle than is healthy, Stephen suffers from 3 of the health problems that are part of the so-called ‘deadly quartet’ of metabolic syndrome.
Stephen is not alone, for more than half of Australian adults have at least one component of metabolic syndrome - unofficially dubbed beer gut syndrome – and also known as syndrome X.
Australian Vascular Initiative steering committee member Dr Greg Fulcher said: ‘People with this disorder are likely to have a large gut that sits around the middle of their body, with one or a number of other risk factors, including high blood pressure, abnormal levels of fat in the blood and high blood sugar levels.’
Having abnormal levels of fat in the blood means that you may have a high level of ‘bad’ cholesterol (LDL cholesterol) or a low level of ‘good’ cholesterol (HDL cholesterol) in your blood or high levels of another type of fat substance in the blood called triglycerides. Having high levels of ‘bad’ cholesterol or triglycerides is a risk factor for coronary heart disease. Having high blood sugar levels can be an indication of diabetes.
Blood pressure
Stephen is married, with 2 adult children, and works as an insurance investigator so naturally is under a certain amount of stress during the day.
He said: ‘I’ve known that I had high blood pressure for some time – probably about 5 years – and I’ve been taking medication for that, but then my doctor suggested that I might have type 2 diabetes.
Type 2 diabetes is a type of diabetes where the body cells can’t use insulin properly and glucose (sugar) accumulates in the bloodstream. Type 2 diabetes is promoted by lifestyle factors such as an unhealthy diet and lack of exercise contributing to obesity. It is commonly diagnosed in people over the age of 50, but recently is being increasingly identified in younger Australians.
‘I went and got tested and found out that I did have diabetes. My doctor said the combination of the diabetes and high blood pressure, plus being overweight, could develop into metabolic syndrome. And from there on you can develop other problems.’
Dr Greg Fulcher agrees: ‘Having this syndrome in its full-blown form will increase the risk of coronary heart disease and stroke by roughly 3 times. It will increase the likelihood of dying from coronary heart disease by about 5 to 6 times.’
Metabolic syndrome may be caused by a combination of genes and lifestyle factors, including overeating and lack of exercise.
Lifestyle changes
Stephen is aware of the lifestyle changes he needs to make to improve his health outlook.
He said: ‘Since discovering that I have type 2 diabetes I have attempted to moderate my lifestyle and to change my diet habits. Over the years I’ve probably been on most diets that are around, including WeightWatchers and Jenny Craig. With all of them I’ve lost weight, but eventually I’ve put all that weight back on, plus additional weight.
‘So, I’m not prepared really to go on a straight out diet. I’ve done that too many times and always just increased my weight. What I have done is change some of the things I eat. I eat a lot more fruit and cut out the good things in life like cakes and chocolate. I generally try to be more healthy about the things I eat. I avoid fast foods, perhaps take a sandwich to work - of wholemeal bread - things like that. And I generally feel better as a result of that, even though I haven’t lost any weight – but I haven’t put any weight on, which is the main thing.’
Exercise
Stephen is also incorporating exercise into his life to help offset the risks of metabolic syndrome.
He said: ‘I think increasing exercise is a major factor and I’ve attempted to do that by walking several days a week. I’ve only been doing that for 2 mornings in the week but I intend to increase that to every day.’
Stephen takes the dog with him on his hour-long walks and sometimes at the weekend his wife accompanies him too.
‘I don’t mind doing that – you can just walk – it’s a good long walk for an hour but you don’t feel any physical strain as a result of it. I’m hoping to get to the stage where I might be able to jog for part of it, or perhaps jog for all of it,’ he added.
Balance
Stephen hasn’t allowed metabolic syndrome to affect his day to day life.
‘I play drums in a rock and roll band sometimes on the weekends and recently climbed over the Harbour Bridge with no problem at all. Until recently I was a member of the State Emergency Services, and I would still be involved. It’s only pressure of work that’s stopped me continuing with that,’ he said.
Support
Stephen is grateful to have a good doctor who has recognised his conditions and has educated Stephen about metabolic syndrome and been very supportive.
‘He’s one of those doctors who’ll always go out of his way to find the best solution to your problem,’ Stephen said.
Australia’s growing obesity problem, combined with our high incidence of diabetes, means that Australian doctors are taking metabolic syndrome very seriously. So seriously that a new national screening programme called the Australian Vascular Initiative (AVI) was launched in May 2002.
Screening programme
The programme aims to target 60,000 Australians. Local doctors are being asked to measure their patients around the middle (abdominal circumference) to identify those at risk of developing metabolic syndrome.
Abdominal girth measurement
Men with an abdominal circumference of more than 94 cm and women with an abdominal circumference of more than 80 cm are being checked for other risk factors and then offered healthy lifestyle advice, as well as any relevant advice specific to managing blood pressure, diabetes and/or high cholesterol or lipids, said Dr Fulcher, who is on the AVI steering committee. The respective numbers for Asians are 90 cm for men and 80 cm for women.
Stephen fully supports the initiative though, as he says, it’s a little bit late for him.
‘Certainly too late to have prevented diabetes, because once you’ve got it you can’t get rid of it.
‘However, anybody who is at risk from various diseases such as I am should consult with their GP and get on to the programme earlier because they may be able to avoid getting diabetes,’ Stephen urged.
The Australian Vascular Initiative is being implemented nationally by General Practitioners. The programme has been developed in partnership with Sydney Diabetes, Royal North Shore Hospital and with support from the National Vascular Disease Prevention Partnership, which is a partnership of the Australian Kidney Foundation, Diabetes Australia, National Heart Foundation and the National Stroke Foundation.
Last Reviewed: 23 May 2002
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