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Among the many benefits of the keto diet are its possible positive effects on metabolic syndrome and associated symptoms and complications. Studies are showing that the keto diet and metabolic benefits may relate to factors ranging from lower body mass index, body fat mass, and similar results. Without reversing symptoms of metabolic syndrome through the keto diet or other means, the complications can become severe or deadly.

What Is Metabolic Syndrome?

Metabolic syndrome is a term for a set of conditions that occur with one another. The conditions that make up metabolic syndrome include:

  • High blood pressure
  • High blood sugar
  • Excess weight around the midsection
  • Abnormal cholesterol or triglyceride levels—this includes a low HDL level, which is considered good cholesterol and a high HDL level, which is referred to as bad cholesterol

If you have one symptom, you don’t necessarily have metabolic syndrome but it puts you at risk of developing it or other complications.

It’s estimated, according to the Mayo Clinic, that up to one-third of adults in the United States have metabolic syndrome.

As obesity rates go up in the U.S. and lifestyles become increasingly technology-driven and sedentary, it’s likely that the prevalence of metabolic syndrome could further increase.  

Metabolic syndrome is closely related to obesity or being overweight and a sedentary lifestyle. It’s also related to insulin resistance. When you eat, your digestive system breaks down food into sugar. Then, your pancreas makes a hormone called insulin that helps your cells use that sugar as fuel.

If you have insulin resistance, your cells don’t respond in a normal way to insulin. Then, glucose doesn’t enter the cells as readily as it should, and your body creates more insulin to try and lower your blood sugar, but your blood sugar levels still go up.

What Are the Causes of Metabolic Syndrome?

Metabolic syndrome and the symptoms it creates are largely the result of lifestyle. If you are inactive and overweight, you are more likely to develop some or all of the symptoms of metabolic syndrome. Some factors can contribute that you can’t control, however, such as aging and genetics.

If you have metabolic syndrome, you may also have chronic, low-grade inflammation throughout your body and excessive blood clotting.

Conditions that may play a role in metabolic syndrome also include a fatty liver, which is a condition where you have excess triglycerides and other fats in your liver, and polycystic ovarian syndrome. Gallstones and breathing problems during sleep are also linked to metabolic syndrome.

With nonalcoholic fatty liver disease, while it’s not one of the five criteria used for the diagnosis of metabolic syndrome, it is often seen in people with this condition. Nonalcoholic fatty liver disease isn’t caused by drugs or alcohol but is instead linked to insulin resistance and oxidative stress.

For someone who has nonalcoholic fatty liver disease as well as metabolic syndrome, weight loss is an important part of treatment.

Risk Factors

As was touched on, there are three main risk factors for metabolic syndrome, which are obesity, particularly in the abdominal area, an inactive lifestyle and insulin resistance. Some people who use certain medicines may also be at greater risk of developing metabolic syndrome because the drugs cause changes in cholesterol, blood sugar levels and blood pressure.

Medications linked to metabolic syndrome are often used to treat inflammation, HIV, depression, and other mental illnesses as well as allergies.

Other risk factors include having a personal or family history of diabetes, and women are at greater risk than men.

Diagnostic Criteria

When making a diagnosis of metabolic syndrome, the following are the cutoff values a doctor may use:

  • A large waistline means you have extra weight, in particular around your waist, and
  • For women, a waist of 35 inches or more is considered a metabolic risk factor.
  • For men, a waist of 40 inches or more is a risk factor. If you have a large waist, you are at a higher risk of heart disease and other health problems as well.
  • Triglycerides are fat in the blood and if you have a level that’s 150 mg/dL or higher, it’s a metabolic risk factor.
  • HDL cholesterol is frequently called good cholesterol, and it helps remove cholesterol from the arteries. If you have less than 50/mL and you’re a woman or less than 40 mg/dL and you’re a man this is considered a risk factor for metabolic syndrome.
  • A blood pressure measurement of 130/85 mmHg or higher is a risk factor. Even if only one of the two numbers is high, it’s still linked to metabolic syndrome.
  • Normal fasting blood sugar should be less than 100 mg/dL. A fasting blood sugar level that falls between 100 and 125 mg/dL is prediabetes, and a fasting blood sugar that’s 126 mg/dL or higher is diabetes. It’s estimated that 85% of people with type 2 diabetes also have metabolic syndrome.

Complications of Metabolic Syndrome

Type 2 diabetes can be considered a complication of metabolic syndrome, and cardiovascular diseases are also serious complications of the condition.

According to the American Heart Association, in addition to the development of Type 2 diabetes, specific complications of the cluster of symptoms that make up metabolic syndrome may include heart conditions.

The arteries that bring blood to the heart can become narrow or blocked by plaque, which is fatty deposits. Then, less blood and oxygen reach the heart, causing coronary heart disease and heart attack. You may also be at greater risk of having a stroke if you have metabolic syndrome.

Type 2 diabetes, if you do develop it, has its own set of serious complications. For example, long-term diabetes complications can include kidney and heart disease, vision loss, and loss of limbs.

How Is Metabolic Syndrome Treated?

The primary way metabolic syndrome is treated is through changes in lifestyle. In some cases, you may need certain types of medicines such as blood pressure medicine, but first and foremost, if you have the symptoms of metabolic syndrome or you’re at risk, your doctor will likely want you to make lifestyle changes related to diet and exercise.

You want to reduce the risk of ischemic heart disease so this means getting your blood pressure and diabetes under control if you already have the condition. If you don’t already have type 2 diabetes, preventing it from developing will be another primary goal.

General lifestyle modifications that can help reduce the symptoms of metabolic syndrome include changing your diet, maintaining a healthy weight, quitting smoking, getting physical activity, and managing your stress.

As far as exercise, even if you don’t see that you’re losing weight on the scale, it’s a critical part of lowering blood pressure and improving insulin resistance. Incorporating even small amounts of physical activity can help slow or stop the signs of metabolic syndrome.

Losing weight can help too, and changing your diet is a critical part of reversing metabolic syndrome.

So what about the keto diet for metabolic syndrome?

What Is the Keto Diet?

There is some research currently available, as well as other research in progress that looks at metabolic syndrome and keto. Some feel the keto diet for metabolic syndrome might be one of the best changes you can make.

The ketogenic diet is a high-fat, moderate-protein diet. It limits carbohydrates, sugars, and processed foods. Most keto diets keep carbs below 20 grams a day and often people who follow this way of eating won’t have any breads, cereals or grains.

Typically, when we don’t follow the keto diet, and particularly if we follow a primarily processed and low-nutrient Standard American Diet, the body uses carbs as our primary source of energy.

When carbs aren’t available for energy, our body instead breaks fat down into ketones that then become the body’s primary energy source. The body also uses ketones as an alternative energy source to fuel our brain.

In many ways, the keto diet is similar to fasting because when you fast, your body doesn’t have a source of energy. However, fasting can cause the body to break down lean muscle mass, but with the keto diet your body is using the ketones as its source of energy so you can maintain your lean muscle mass.

The keto diet has been used for more than 100 years to manage epilepsy, which is a seizure disorder, and more recently, it’s been looked at as a diet to help with both obesity and diabetes.

The keto diet has also shown benefits in terms of preventing or helping slow the development of many chronic diseases such as Alzheimer’s and cancer.

How Does the Keto Diet Help with Metabolic Syndrome?

If you’re considering following the keto diet for metabolic syndrome, there is strong evidence suggesting this could be a good idea. Since the keto diet is low in carbs and high in fat, it can lower insulin levels. Carbohydrates and processed foods can cause insulin levels to spike on the other hand.

There was a study done at Bethel University, and it compared to the health of three groups of adults diagnosed with metabolic syndrome.

One group followed the keto diet without exercise, the second group followed the Standard American Diet and didn’t exercise and the third group followed the Standard American Diet and did 30 minutes or more of exercise three to five times a week.

The findings were that the keto diet without exercise was significantly more effective than the other two groups for weight loss, lowering body fat percentage, and decreasing HbA1c, which is a measure of blood glucose control.

Keto Diet and Type 2 Diabetes

One of the best ways to understand the positive links between the keto diet and metabolic syndrome reversal or prevention is by looking at insulin resistance and type 2 diabetes.

When you follow the keto diet, as was touched on, you aren’t converting sugar to energy—instead, you’re converting fat to energy. It’s not uncommon, even outside of the keto diet, for people with type 2 diabetes to be told to reduce their carbohydrate intake because carbs turn to sugar and cause blood sugar spikes.

In 2008, there was a 24-week study looking at the effects of a low-carb diet on people with type 2 diabetes and obesity. The participants who followed the keto diet saw more improvements in both glycemic control and medication reduction compared to following a low-glycemic diet.

There was also a 2013 review that found the keto diet paved the way for more improvements in blood sugar control, weight loss, A1C, and insulin requirements.

Weight Loss

Losing weight is a good way to reduce all symptoms of metabolic syndrome. Weight loss is another reason the keto diet for metabolic syndrome is worth exploring. When you follow the keto diet, you’re using stored fat as energy, although to achieve that you need to ensure you’re limiting your carb intake to no more than 20 to 50 grams a day, depending on your body size.

Being in a state of ketosis can also help you feel less hungry and maintain your muscles.


Metabolic syndrome is associated with inflammation, although researchers don’t know if one causes the other and if so, which typically comes first. Regardless, chronic low-grade and widespread inflammation is a key symptom of metabolic syndrome.

The keto diet and metabolic syndrome may have beneficial effects on one another as far as this inflammation goes as well.

The keto diet is known to impact the mechanisms in our body linked to chronic inflammation. When you’re in a ketogenic state, and you’re burning fat rather than sugar, these ketones being produced by your body fight inflammation. For example, there is a ketone known as BHB that inhibits inflammatory pathways.

Heart Health

With the keto diet, there may be effects on cardiovascular health stemming from the other benefits of the diet. For example, when you’re able to lower your blood sugar and control or reverse type 2 diabetes, it improves your heart health.

People with diabetes, even without other symptoms of metabolic syndrome are more likely to develop heart disease and have other health-related issues because high blood glucose can damage the blood vessels and nerves controlling the heart.

The longer you have diabetes, the more likely it is that you’ll develop heart disease.

Being overweight also puts you at a greater risk of developing cardiovascular disease, so if the keto diet helps you lose weight, it could also help reduce your risk of heart-related complications.

Summing Up—What to Know About Metabolic Syndrome and Keto

There is a lot of positive information relating to metabolic syndrome and keto, and the ways in which following the keto diet and consuming nutrient-rich fats and proteins can help you reverse unhealthy metabolic syndromes.

From weight loss to blood sugar control, the keto diet and metabolic syndrome are two concepts worth looking into if you want to improve your health and longevity and reduce your risk of complications like heart attack and stroke stemming from metabolic symptoms.



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