METABOLIC SYNDROME

RISK FACTORS LINKED TO CARDIO VASCULAR DISEASE

DIETARY MANAGEMENT
Arsiniati M.Brata-Arbai
Email: arsiniati2006@yahoo.co.id
HP 0818522463

Cardio Vascular Disease (CVD)

- disease of the heart & blood vesels
- disease of the arteries of the heart is called:
coronary heart diseaese (CHD)
- atherosclerosis
hardening of the arteries
root forms of CVD

CHD
- is a major public health problem
- a contrubutor to mortality and morbidity
in westernised countries as well as in countries
undergoing economic transition (Yogiantoro,
2005).
Prevalence of CVD
- USA 61 million men & women
- Indonesia CVD main cause of death
ranked
1972
11
1986
3
1992
1

METABOLIC SYNDROME (THE METS)

WHO, 1998: Metabolic Syndrome (MetS):
are cluster of risk factors linked to CVD
ATP ( Adult Treatment Panel) III, 2001 :
1. Abdominal obesity (central obesity)
2. Atherogenic dislipidemia
3. Raised blood pressure
4. Insuline resistance
5. Proinflammatory state
6. Protrombic state

Beyond these components, individuals with MetS are

suspectable to other conditions
7. Vascular abnormalities
8. Hyperuricaemia
9. Adrenal incidentaloma (increase cortisol secretion)
10.Fatty liver ( fatty disposition)
(Askandar, 2005)

OBESITY
a state in which an excess of fat accumulate
Grade I : Their overweight does not affected their
health, they are able to lead their normal life
Grade II : reduced exercise tolerance, shorteness of
breath on exertion

At increase risk of of one or more of the disorders

Grade III
- these are pathetic patients
- their activities are restricted by their enormous
mass
- have serious psychological disturbances
- suffering from many of of the disorders *
- life expectation is low

Diabetes Mellitus, hypertension,gall blader disease, fatty liver,

gout, pulmonary disorders,osteoarthritis,hernias,
varicouse veins, dermatitis.

Abdominal obesity (central obesity)

Elevated waist circumference
Obesity:

Apple shape , Android ( more in men)

Pear shape , Gynoid ( more in women)

Europids
South Asian

Waist Circumference (cm)

Male
Female
94
80
90
80

CRITERIA FOR CLINICAL DIAGNOSIS OF METS

(Grundy et al , 2005)
3 out of 5 diagnostic:
1.Abdominal obesity: Men
> 90 cm
Women > 80 cm
2. Serum Trigliceride 150 mg/dl
3. Serum HDL Cholesterol: Men
< 40 mg/dl
Women < 50 mg/dl
4. Blood pressure 130 / 85
5. Fasting Glucose 110 mg/dl

THERAPEUTIC INTERVENTION FOR METS

Weight management
BMI = weight (kg) / height (m2)
< 18.5 underweight
18.5 24.9 healthy/low health risk
> 25 overweight/ increase risk of disease
> 30 obese (class 1) increase risk of disease
> 35 obese (class II) higher risk of disease
> 40 extremely or morbidly obese (class III)
(Sareen, 2005)

I. Dietary approach
normal healthy adult consume 2000 kcal / day
- Very low Calorie Diet
800 kcal/day
- Moderateay Low calorie Balanced Diet
1000 kcal / day
protein 65 gram, fat 35 gram
adequate in all other nutrients

Sample of daily menu

Breakfast:

- small glass unsweetened fruit juice

- 1 egg boiled/scrambled or grill

bacon
- 20 gram unsweeted cereal or
120 poridge with milk or
- 20 gram bread with butter
- coffee or tea without sugar with milk
Mid morning: coffee or tea no sugar , milk from
allowance

Midday meal: - clear soup, - 2 slied of bread

- 60 gram chicken or tuna,
- small salad / vegetable
- 1 serving of fruit
Mid afternoon : coffee or tea no sugar
Evening meal : - 60 gram chicken or tuna,
- 2 small boiled potatoes
- salad / vegetable
Allowances: - 300 ml skim milk
- 15 gram butter

These group of food contain

1. 175 kcal, 4 gram protein, 40 gram carbohydrate
100 gram of rice , 70 gram of white bread
210 gram potatoes
2. 50 kcal, 7 gram of protein ,2 gram fat
40 gram chicken, 40 gram meat
35 gram fish, 15 gram salty fish
3. 75 kcal,7 gram protein, 5 gram fat
55 gram chicken egg, 50 gram duck egg

II PHYSICAL ACTIVITY
Physical activity provides the
advantages of
- cardio vascular condition
- insuline sensitivity.
- mantaning muscle mass
- bone density
Aerobic exercises
- walking
- swimming
- bycycling
20 minutes several times a week

Aerobic exercises
- walking
- swimming
- bycycling
20 minutes several times a week

III. Behavioral Modification and

Psychological support
1. Focus on method of acquiring new
behavior
2. Self monitoring
3. Guidelines for maintaning weight loss

CONCLUSSION
METS MANAGEMENT:
1.DIET
2. PHYSICAL ACTIVITY
3.BEHAVIORAL MODIFICATION