About 47 million Americans (or 25 percent of the population) currently have metabolic syndrome. How did we get ourselves into this metabolic mess, where one-quarter of our population is on a path to type 2 diabetes and at high risk for having a heart attack?

While experts estimate that it’s about 30 percent genetic, the other 70 percent is “our sedentary lifestyle and our high-fat, high-carbohydrate diet,” says Sangeeta Kashyap, MD, of the Cleveland Clinic Lerner College of Medicine.

Move It — and Lose It
The single best thing you can do to combat metabolic syndrome is lose weight, advises Thomas Morledge, MD, of the Center for Integrative Medicine at the Cleveland Clinic. Studies on managing metabolic syndrome through lifestyle modifications show that losing just 7 percent of your body weight can help reduce blood pressure, glucose, triglycerides and cholesterol — in as little as four weeks.

On the other hand, sitting around and doing nothing will literally make you worse: Research shows that six months of inactivity leads to a buildup of inflammation-generating belly fat.

QUIZ: Are You Getting Enough Exercise?

Try This

Start with 15 minutes of walking at a moderate (four miles per hour) pace, and add five minutes a day, five times a week. At the end of just two weeks, your calorie burn will increase from 800 to 1,000 calories per week to 1,600 to 2,000 calories per week.

Dr. Kashyap recommends 150 minutes of aerobic exercise a week, or 30 minutes five times a week. You don’t have to start off with marathon training: Research shows that even modest amounts of exercise (walking 30 to 45 minutes per day, five days a week) can help improve insulin resistance and inflammation in belly fat.

Research has also shown that regular exercise can help raise your HDL cholesterol and lower LDL levels, and along the way, reduces your risk of heart attack and stroke. So what are you waiting for — get moving!

Put Yourself on the Right Path
As important as starting an exercise program is sticking with it. Walking is hard to beat as an entry into exercise: You need minimal equipment (just a pair of good shoes), you can do it anywhere and there are so many different ways you can do it.

Walk in your neighborhood, at the mall, on trails, on a treadmill, with an iPod, with friends, as part of a group — you get the idea. It’s as straightforward as taking a brisk half-hour walk every day. Keep in mind that 30 minutes is your goal for the whole day, so you could take a 15-minute walk at lunch and a 15-minute walk in the evening. With so many options for hitting the pavement, there’s practically no excuse not to walk! 

Walking certainly isn’t the only option. Your walking shoes will forgive you if you see other sports. (Just don’t abandon them for the TV.) You might also try swimming, tennis, running, cross-country skiing, bicycling (or indoor group cycling classes), ballroom dancing or other instructor-led aerobic classes.

 Non-aerobic activities like golf, weight-training and Pilates can also be part of your routine, but do them in addition to your 30 minutes of aerobic activity every day, not as replacements for it. Remember that it’s a good idea to check with your doctor if you’re going to try something new (especially something more strenuous) for the first time.

MORE: As Seen on TV Fitness Gear: Buy or Change the Channel?

Prepare for Success
Exercise will eventually become a habit you look forward to keeping. But at the beginning, you may need more than sheer willpower to keep going strong. Set the stage for success with these strategies:

  • Keep a basic exercise log. It’s easy to overestimate how much exercise you’re doing unless you write it down. This way, you can also track your progress.
  • Surround yourself with supportive people. Find a walking group, for example. Don’t forget about virtual support — joining an online community can also be a good form of support.
  • Find a time that works for you. You’re more likely to stick with an exercise routine if it fits into your schedule.
  • Have a goal. Maybe it’s a local 5K you want to run/walk, or a bicycle ride that you want to be able to take. Once you meet that goal, set a new goal. Make sure your goals are attainable.

A Second Look at Surgery
Researchers are also investigating bariatric surgery as another treatment for metabolic syndrome. “We’re now calling it metabolic surgery,” Dr. Kashyap says. “Conventional wisdom says that you start with lifestyle modification, then drug therapy, then surgery,” she says, but for some people, that might be the wrong sequence. A recent study compared the two approaches among type 2 diabetics who were very overweight.

After two years, the group that got bariatric surgery lost an average of 20 percent of their body weight compared to the lifestyle-modification group, who just lost 1.4 percent. Among the surgery group, 43 percent saw their diabetes go into remission; only 13 percent of the lifestyle-changes group got rid of theirs.

 “We’re trying to find out if surgery is just as effective for people with less degrees of being overweight,” Dr. Kashyap says. Still, lifestyle modification is an incredibly powerful and proactive tool, and surgery is not the solution for everyone — and it requires lifestyle modification following it. Talk to your doctor about the various strategies and settle on those that will work best for you.

by Judi Ketteler