The term "metabolic syndrome" may not be on the tip of the collective tongue, so to speak, but it makes sense to at least be aware of the existence of this cluster of risk factors that increases the chance of heart attack, stroke, diabetes and death.

You are diagnosed with metabolic syndrome if you have three or more of the following:

* A large amount of abdominal body fat, as indicated by a waist measurement of more than 100 cm for men, and more than 85 cm for women.

* Low HDL (good) cholesterol, of less than 40 mg/dl for men, and less than 50 mg/dl for women.

* High triglycerides, of 150 mg/dl or more.

* High blood pressure, of 135/85 mmHg or more; or if you are currently on medication to reduce blood pressure.

* High blood sugar, being fasting blood glucose of 110 mg/dl or more.

Even if the level of each risk factor is not itself very bad, your condition becomes much more serious when they are combined, causing cholesterol-rich atherosclerotic change in the blood vessels, which leads to them becoming obstructed.

Also, even though there is a tendency for these risk factors to occur in combination in the same individual, the exact cause of metabolic syndrome is not yet known. What is known, is that genetic factors, excess body fat (especially in the waist area) and lack of exercise contribute to the development of the condition.

Having three or more of these risk factors is a sign that the body is resistant to insulin, a hormone that is important in the control of the levels of blood sugar produced by the pancreas. This resistance to insulin means that more of the hormone than normal is needed to keep blood sugar at a healthy level.

Currently, one in five people in the United States have metabolic syndrome and, although the incidence is lower in Japan, it is on the rise.

While this condition is known to run in families, and is more likely to afflict people who are overweight and those who don't take much exercise, the chances of developing metabolic syndrome rise as you get older.

What is of particular concern here, though, is the fact that most people who have metabolic syndrome feel healthy and may not have any symptoms. Consequently, they do not generally seek medical care until very late, even though they are at risk of developing life-threatening conditions like diabetes and heart disease.

So, how can metabolic syndrome be prevented and treated?

Increasing your level of physical activity, eating a well-balanced diet and losing weight are the best ways to manage your metabolic condition. By losing weight, you can lower your cholesterol level and become more sensitive to insulin, which leads to a lowering of the blood sugar level.

Medications can also be used to treat risk factors such as high blood pressure and high blood-sugar and cholesterol levels if they cannot be controled by exercise and diet alone.

If you think you may have risk factors for metabolic syndrome, don't hesitate to consult a doctor. But remember, a healthy lifestyle, good dietary habits and regular physical activity are the best ways to prevent and manage the condition -- so be sure to take advantage of Japan's healthy cuisine and walking culture!