HOW SHOULD WEIGHT LOSS BE BROUGHT ABOUT IN METABOLIC SYNDROME

Weight loss should be attempted in the usual way, starting with diet, exercise and lifestyle changes, with second-line treatments such as pharmacotherapy being used as necessary. However, the dietary guidelines are slightly complicated by the presence of insulin resistance. The diet should be low in fat to induce weight loss but should contain a certain amount of unsaturates and monosaturates, for example from oily fish, to improve the lipid profile. As excess carbohydrate has the potential to increase insulin secretion and overload the system, putting more pressure on the beta cells and worsening all the metabolic effects of the syndrome, the recommendation is to:

• Reduce the fat content of the diet, in particular avoiding saturated fats.
• Maintain or reduce the carbohydrate content of the diet, favouring high-fibre, low-glycaemic-index foods that have a relatively benign effect on the insulin system.
• Reduce dietary intake of salt to avoid aggravating the effect of insulin on the renal system.

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