Eat Well : Addressing metabolic syndrome

Learn to cut back on salt. 

METABOLIC syndrome refers to a group of symptoms that occur together where you have three or more of these health issues:

* A waist measurement of more than 102cm in men and more than 89cm in women

* High blood pressure — more than 130mm Hg systolic (upper level) or more than 85mm Hg diastolic (lower number)

* High level of triglycerides

* Low level of good cholesterol HDL

* High fasting blood sugar level — more than 6.2 mmol/L     

Statistics show that people with metabolic syndrome are five times more likely to end up with type 2 diabetes and twice as likely to develop cardiovascular disease.

Genetics plays a role in whether you will get metabolic syndrome, but a large contributing risk factor is lifestyle-related, such as poor food choices, lack of exercise and smoking. All these will just make the condition worse.

Here’s what you can do to stack the odds in your favour:


Most people with metabolic syndrome are told instantly to lose weight. Maybe you could have even heard that from your doctor. Body fat around your waist constitutes a high amount of abdominal fat. Research shows that high abdominal fat increases your risk for high triglyceride, cholesterol and hypertension.

But in your eagerness to lose weight, don’t fall for diet gimmicks and supplements that promise extremely fast results with hardly any lifestyle changes on your part.

Advertisements and promises can sound very convincing, especially if you are desperate to lose weight. Always be mindful that these fad diets and slimming pills can worsen your condition if you already have metabolic syndrome.

A healthier, more sustainable approach is to learn to have a positive relationship with food; your dietitian can be of great help. At the end of the day, you can’t get rid of all the foods that tempt you, but you can learn about nutrition and gain the skills to help you make better food choices to manage your condition.


Excessive sugar can raise blood glucose levels and cause weight gain. High sugar foods are often called empty calories because they do not have substantial nutrients.

The World Health Organization recommends that no more than 10 per cent of your daily calories be from sugar. For an average adult who consumes about 2,000 calories that works out to approximately 10 teaspoons of sugar.

The best way to control your sugar intake is to familiarise yourself with nutrition labels on your food and drinks. The manufacturer will state the amount of sugar in grammes; for example, one piece of Cookie brand XYZ may have 10g of sugar.

Just remember that one teaspoon of sugar is equivalent to 5g. So, one piece of Cookie brand XYZ has two teaspoons of sugar (10g sugar divided by 5g = two teaspoon).


If you are like the majority of Malaysians who eat out at least two meals in a day, it is prudent to be aware of oily foods. This is because oily foods are higher in fat.

Too much fat in your diet can raise your cholesterol and triglyceride levels. In the long run, this high fat intake can potentially be a risk factor for a heart attack as high cholesterol and triglyceride levels turn to plaque that clogs up important blood vessels.

If you eat out a lot, steer clear of deep-fried foods. Instead, look for dishes that are steamed, braised, lightly stir-fried, broiled or grilled. Complement your dishes with light ones such as salads, clear soups, ulam or kerabu.


Salt comes in many common processed foods such as instant noodles, sausages, cold cut meats, canned foods, soya sauce, marinades, seasoning powders, frozen foods, and carbonated drinks.

A diet high in salt can make your high blood pressure soar. If you have a history of heart disease and stroke, you should not consume more than 2,000mg of sodium per day. If you also have high blood pressure, aim for 1,500mg sodium per day.

Table salt (sodium chloride) is the main contributor of sodium in our diet. Salt, like fat, makes our food tasty.

You don’t have to go absolutely salt-free, but every little reduction here and there makes a big impact in your overall average intake over the week. Eat more fresh produce instead of processed foods. Fresh foods have no added salt, unlike processed foods. Use natural herbs and spices to add robust flavour to your foods instead of relying on sauces and seasoning powders.

A tip to remember when cooking — foods get saltier once they have cooled down. So don’t be so quick to add too much salt while cooking. Always add it in the very last step.



* One plate (662g) of Cantonese fried kway teow (kung foo chow) — 49.6g of fat

* One bowl (410g) of curry mee — 36.9g of fat

* One plate (300g) of fried kway teow with kerang (cockles) — 36.4g of fat

* One plate (330g) of rojak (mamak style) — 51.2g of fat

* One plate (392g) of fried rice — 51.2g of fat

* One plate (300g) of mutton curry — 36.4g of fat

* Five pieces (355g) of cekodok pisang (traditional Malay kuih) — 22.5g of fat 

Be mindful of sugar in your diet.


* One (325ml) carbonated drink — seven to 10 teaspoons of sugar

* One piece (110g) of chocolate cake — 15 teaspoons of sugar

* One cup cake (110g) — six teaspoons of sugar

* One kuih koci (50g piece) — 2 1/4 teaspoons of sugar

* One bingka ubi (80g piece) – 4 1/4 teaspoons of sugar

*Cookies (three pieces approximately 34g) — two teaspoons of sugar


Each of these items have a sodium content of more than 480mg

* One tablespoon dark soya sauce

* 1/4 teaspoon light soya sauce

* One tablespoon salted Chinese cabbage (hum choy)

* 1/4 cup dried ikan bilis (anchovies)

* One piece (25g) salted fish

* 1/2 tablespoon oyster sauce

* 1/2 teaspoon fermented shrimp paste (cencaluk)

* 1/4 tablespoon fish (budu)

* One piece (about 3cm) belacan

* Indra Balaratnam is a consultant dietitian who believes in simple, practical ways to eating well and living healthy. She can be reached at


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