Ask the Experts: October 2022
Q: What is metabolic syndrome?
A: Metabolic syndrome is a combination of risk factors that greatly multiply your chances for heart disease, diabetes, and stroke. It is diagnosed when you have three or more of the following conditions: abdominal obesity (waist circumference 40 inches or greater [men] or 35 inches or greater [women]); triglyceride level of 150 mg/dL or greater; HDL cholesterol of less than 40 mg/dL in men or less than 50 mg/dL in women; systolic blood pressure (top number) of 130 mmHg or greater, or diastolic blood pressure (bottom number) of 85 mmHg or greater; fasting glucose of 100 mg/dL or greater; insulin resistance or glucose intolerance (the body can’t properly use insulin or blood sugar). When you have these risk factors together, your chances for cardiovascular problems are greater than if you have any one factor presenting alone. For example, having high blood pressure alone is serious, but high blood pressure along with high blood sugar levels and abdominal obesity, a common characteristic of metabolic syndrome, means there is a much greater chance of cardiovascular problems and diabetes because of the combination of risk factors. The underlying causes of metabolic syndrome are poor diet, being overweight or obese, physical inactivity, and genetic factors. Switching to a healthier diet, losing weight, and getting more exercise are the cornerstone treatments. While virtually any healthy diet that helps a person lose weight can improve some features of the metabolic syndrome, researchers are working to sort out which diet works best. The Mediterranean-style diet combined with low-glycemic load foods is often recommended. The Mediterranean diet consists of minimally processed foods, lots of vegetables, fruits, unrefined grains, olive oil, legumes, seafood, fish, and poultry with moderate consumption of red wine, dairy, eggs, and rarely, red, and processed meats. Low-glycemic-index (GI) foods are those that minimize sharp spikes in blood sugar. Generally, the idea is to avoid starchy foods, highly processed foods, and sugary baked goods. Low-GI foods include apples, grapefruits, carrots, broccoli, peppers, whole grains, unsweetened Greek yogurt, and legumes. A registered dietitian can devise the ideal eating plan and behavioral strategies that meet a person’s health needs and dietary preferences.
Q: We recently moved to a new city. Can you provide us with some tips for finding a good hospital?
A: There are several free online grading systems that can help pinpoint specialties valuable to your health-care needs. A 2019 report in the New England Journal of Medicine (NEJM) recommended the U.S. News & World Report (health.usnews.com/best-hospitals). The website provides overviews on national rankings of specialties and performance. For example, UCLA Medical Center in Los Angeles is ranked #3 on the Best Hospitals Honor Roll, the #1 hospital in California & Los Angeles metro area, and nationally ranked in the top 5 in Diabetes & Endocrinology, Gastroenterology & GI Surgery, Geriatrics, Ophthalmology, Orthopedics, Psychiatry, and Pulmonology & Lung Surgery. The NEJM also called out the Centers for Medicare and Medicaid Services (medicare.gov/care-compare), which has a star rating comparison and lots of details on how to find the best hospitals for your needs. The report includes an overall star rating based on how well a hospital performs across different areas of quality, such as treating heart attacks and pneumonia, readmission rates, and safety of care; and a patient survey rating that includes ratings on nurse/physician communications, responsiveness, cleanliness, and noise. Make sure that preferred hospitals as well as physicians are covered by Medicare and your supplement plans. The new federal “No Suprised Act” shields consumers against unexpected bills from out-of-network providers and facilities. For details on the No Surprises Act, go to www.cms.gov/nosurprises.
Finally, let your voice be heard by filling out patient surveys. At UCLA Health PFAC members are a visible and valued part of our care team.
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