METABOLIC SYNDROME
Years ago, we physicians had never heard about this syndrome. We knew about disorders such as diabetes mellitus, heart disease, hypertension, liver disease, kidney disease, stroke and obesity. We were taught that the different diseases affected older people. Currently, the organ-specific thinking has given way to systemic thinking about the health of the patient.
The term metabolic syndrome was coined about 25 years ago by the World Health Organization after recognising that the abnormalities had a commonality resulting from mitochondrial dysfunction and insulin resistance. It was noted that this commonality manifested as high blood pressure/blood sugar levels/ LDL cholesterol, low HDL cholesterol and high triglycerides along with high body mass index (BMI). If a person is found to have at least three of the above parameters, then the person is considered to have metabolic syndrome. This condition is a growing concern globally due to changing lifestyles and dietary habits.
Diagnosis of metabolic syndrome is made by the following measurements:
- Central obesity: Excess fat around the abdominal area, often measured by waist circumference – more than 40 inches for men and 35 inches for women
- Elevated blood pressure: Blood pressure readings consistently above 130/85 mmHg.
- High fasting blood sugar: Fasting glucose levels above 100 mg/dL or HbA1C above 6.0
- High triglycerides: Levels above 150 mg/dL.
- Low HDL cholesterol: Less than 40 mg/dL in men and 50 mg/dL in women.
- High LDL cholesterol above 100 mg/dl.
Several factors contribute to the development of metabolic syndrome, including:
- Genetic predisposition: Family history of diabetes or cardiovascular disease.
- Unhealthy diet: High intake of processed foods, saturated fats, salt and refined sugars.
- Physical inactivity: Sedentary lifestyle with minimal exercise.
- Age: Risk increases as one grows older, especially after 45 years.
- Ethnicity: Certain populations, including South Asians and African Americans are at higher risk due to genetic and lifestyle factors.
Metabolic syndrome does not present with any specific symptoms until very late when an organ dysfunction occurs. Only visible sign may be increased waist circumference. Routine health check-ups, including blood pressure, as well as blood tests are vital for early detection.
If left unmanaged, metabolic syndrome can lead to serious health issues such as:
- Cardiovascular disease, heart attacks and heart failure
- Stroke
- Type 2 diabetes mellitus
- Non-alcoholic fatty liver disease, cirrhosis of liver
- Chronic kidney disease
- Atherosclerosis resulting in blockage of arteries and thromboembolic episodes.
The underlying basic cause for this problem is believed to be mitochondrial dysfunction. Normal mitochondria inside the cells is responsible for energy management with substrate provided, converting glucose to ATP. When it is overloaded with glucose, it is unable to handle it, forcing some to be converted to fat. Moreover, the excess glucose makes the insulin ineffective, leading to insulin resistance. Further sequence of events and inflammation lead to individual organ damages. Metabolic syndrome can be described as a failure of energy management by the mitochondria, caused by excessive overload of substrate and inability to process it.
Managing metabolic syndrome primarily involves lifestyle modifications:
- Dietary changes: Adopting a balanced diet rich in fruits, vegetables, whole grains and lean proteins. Limiting salt, sugar and saturated fat intake is crucial. Ultra processed foods are to be minimised.
- Regular physical activity: Engaging in at least 30 minutes of moderate exercise, such as brisk walking, five days a week.
- Weight management: Achieving and maintaining a healthy body weight.
- Smoking cessation and alcohol moderation: Avoiding tobacco products and limiting alcohol consumption.
- Medication: In some cases, doctors may prescribe medicines to control blood pressure, cholesterol or blood sugar levels. Medications such as Metformin are used to control diabetes mellitus. Effective drugs are also available to control high blood pressure and high cholesterol levels. New class of drugs called as Semaglutides or GLP-1 (Ozempic, Wegovy, Zepbound, Mounjaro) an be useful in reducing body weight and diabetes at same time. They work at the mitochondrial level increasing their number and efficiency, in addition to hormonal effects. Choice of medication will be decided by your physician.
With urbanisation and changing dietary preferences, the prevalence of metabolic syndrome is on the rise. Public health initiatives aimed at promoting healthier lifestyles and regular screening are essential to address the growing challenge.
Metabolic syndrome is a serious health condition with long-term consequences if not addressed on time. Early detection, lifestyle changes and appropriate medical intervention can significantly reduce the risk of complications. Regular health check-ups and awareness about beneficial living are key to prevention and management.
EYE CARE
New Year, New Eyes: Why 2026 Might Be the Year You Finally See Clearly
By Dr. ARUN GULANI
January is a magical month. Gyms are full. Salads are eaten with enthusiasm. And people everywhere promise themselves things like: “This is the year I’ll finally take care of myself.”
But somewhere between January 12th and the first slice of chocolate cake, many resolutions quietly develop … cataracts. So, let me suggest something different this year. Instead of “New Year, New Me,” how about “New Year, New Vision?”
Because whether you’re 18 or 80, your eyes are working overtime – and most of us don’t realize how much we’re asking of them until they protest. Loudly. With blur.
If your eyes could talk, they would probably say: “Please stop staring at your phone at 11:47 p.m. in a dark room.” “Blink. Just … blink.” “And no, holding the menu at arm’s length doesn’t mean the lighting is bad.”
Our eyes are remarkably polite organs. They tolerate dry air, screens, aging, stress, bad glasses, worse contacts and even decades-old surgeries from the 1980s that nobody wants to talk about anymore. Until one day they say, “Enough.”
Vision myths we all secretly believe: Let’s clear up a few things – pun fully intended.
Myth #1: Glasses mean your eyes are getting worse.
Not true. Glasses don’t weaken eyes. They just reveal the truth – meaning your vision needs help and can be helped with next-generation laser techniques like LaZrPlastique which is a no-blade, no-cuts version of Lasik surgery.
Myth #2: Lasik is only for young people.
Vision today isn’t about age – it’s about individual design. Eyes age differently and there is surgery and technology for every age.
Myth #3: If you’ve had Lasik or cataract surgery and have side effects or bad outcomes, and been told “nothing can be done,” that’s the end of the story.
In my experience, that phrase usually means the question wasn’t finished – not that the answer didn’t exist (Previous Khaasbaat columns of mine explains these concepts and cures ).
So January is actually the best time to think about your vision; here’s a secret most people don’t know: January isn’t just the start of the year – it’s the reset button.
• People are mentally open to change and improvement;
• And eyes that have been “managed” for years finally get examined more thoughtfully.
But more importantly, this month brings clarity – literally and figuratively. When the holiday lights come down and the decorations are packed away, many people suddenly notice: “Why does everything still look sparkly?” Spoiler alert: It’s not the tree.
Vision isn’t just about seeing: It’s about living
I’ve watched patients cry – not because they couldn’t see before, but because they forgot what good vision felt like. Seeing your grandchild’s face clearly. Reading a menu without theatrical lighting. Driving at night without fear. Waking up and seeing the world – without reaching for something on the nightstand.
Vision isn’t vanity. It’s independence. And when vision is approached with patience, customization and respect for each eye’s history, people don’t just see better – they live differently.
A gentle New Year challenge
So here’s my New Year challenge for you: Not a diet. Not a gym membership. Not a complicated resolution you’ll abandon by Valentine’s Day. Just this: Listen to your eyes. If they’re dry, strained, blurry, tired or “just not what they used to be,” don’t ignore them.
Eyes don’t age silently. They whisper first.
And when someone finally listens carefully enough, those whispers often turn into solutions people never thought were possible.
Final Thought (with a wink)
Arun C. Gulani, M.D., M.S., is director and chief surgeon of Gulani Vision Institute in Jacksonville. He can be reached at [email protected] or visit www.gulanivision.com