Back in the 1970s, high blood pressure was called "the silent killer." But a study from Florida Atlantic University says that for the 21st century, the new silent killer is metabolic syndrome, a combination of several risk factors that include abdominal obesity, high triglycerides, high blood pressure, abnormal lipids, and insulin resistance, a precursor of Type 2 diabetes. In short, the study warns, your love handles can kill you.

Extra pounds, the researchers say, contribute to metabolic syndrome, which affects 1 in 3 adults and about 40 percent of adults aged 40 and older. In the past, health experts have evaluated each of the major risk factors that contribute to metabolic syndrome independently. But evidence shows that some risk factors carry more "weight" than others.

 "The major factor accelerating the pathway to metabolic syndrome is overweight and obesity," the researchers warn. "Obesity is overtaking smoking as the leading avoidable cause of premature death in the U.S. and worldwide."

A man's waist should measure less than 40 inches and a woman's should be less than 35 for optimal health. Visceral fat present in extra abdominal fat leads to insulin resistance. It also spurs the release of non-esterified free fatty acids from body fat, which accumulate in the liver and muscle and further increase the risk of insulin resistance.

In addition, the extra abdominal fat may produce  adipokines, which are cytokines (cell signaling proteins) that may also influence insulin resistance and risk factors for cardiovascular disease.

The authors warn that people with metabolic syndrome usually have no symptoms, but have a 16 to 18 percent risk of having a first coronary event during the next 10 years. The risk is almost as high as a patient who already had a heart attack or other coronary event. In addition, they say that metabolic syndrome is both underdiagnosed and undertreated.

People can have excess abdominal fat and still have a normal body mass index (BMI). Waist circumference is becoming a better indicator of cardiac risk."There are patients who have a normal body mass index yet are at high risk," said senior author Dr. Dawn Sherling.
"These patients represent an important population for clinicians to screen for metabolic syndrome."

"The pandemic of obesity, which begins in childhood, is deeply concerning," said Parvathi Perumareddi, D.O. "Adolescents today are more obese and less physically active than their parents and already have higher rates of type 2 diabetes. It is likely that the current generation of children and adolescents in the U.S. will be the first since 1960 to have higher mortality rates than their parents due mainly to cardiovascular disease, including coronary heart disease and stroke."

According to the U.S. National Institutes of Health, approximately two-thirds of adults age 20 or older are overweight or obese with BMIs greater than 25, and nearly one-third have BMIs greater than 30. Less than one-third of them are at a healthy weight with a BMI of 18.5 to 24.9.

The American Heart Association says that cardiovascular diseases account for one out of every three deaths in the U.S.