Understanding Metabolic Syndrome
Metabolic syndrome is a serious health condition that affects people from all walks of life, especially in countries where obesity and sedentary lifestyles are increasing at an alarming rate. It refers to a cluster of interconnected risk factors that, when present together, substantially increase the likelihood of developing chronic diseases such as type 2 diabetes, cardiovascular disease, stroke, and non-alcoholic fatty liver disease.

The five key risk factors that define metabolic syndrome are¹:

• Abdominal obesity (waist circumference ≥90cm in Asian men or ≥80 cm in Asian women; waist measurement not needed if BMI >30 kg/m²)
• High triglycerides (≥1.7 mmol/L or currently taking medication for elevated triglycerides)
• Low HDL cholesterol (<1.03 mmol/L in men, <1.29 mmol/L in women or currently on treatment)
• Elevated blood pressure (≥130/85 mmHg or on antihypertensive treatment)
• Elevated fasting blood glucose (includes insulin resistance, impaired fasting glucose, impaired glucose tolerance, or on treatment)

A person is diagnosed with metabolic syndrome if they meet three or more of these criteria.

Why You Should Care
Metabolic syndrome significantly increases the risk of long-term health problems. What makes it especially dangerous is its silent progression. Many individuals have no symptoms and remain unaware of the dangers until they experience a major health event, such as a heart attack or stroke. You might feel fine and look fine, but your body could be struggling internally.

Targeting the Core: Why Abdominal Fat Deserves Attention
Central obesity plays a pivotal role in metabolic syndrome. Visceral fat — the fat stored deep inside the abdomen around vital organs — is metabolically active and harmful¹. It releases cytokines and pro-inflammatory hormones that disrupt insulin regulation, blood pressure, and lipid metabolism¹. As a result, a normal weight does not always mean a healthy body — people with hidden visceral fat can still face serious health risks.

Abdominal fat is more than a cosmetic issue — it’s a key contributor to metabolic problems, particularly insulin resistance. Insulin resistance impairs the ability of cells to absorb glucose, leading to high blood sugar levels and forcing the pancreas to produce more insulin to compensate¹. Over time, this overwork can exhaust the pancreas’ beta cells, eventually leading to type 2 diabetes.

Are You Unknowingly at Risk?
Anyone can develop metabolic syndrome. While the risk increases with age, it’s no longer just a problem for older adults. Alarmingly, more cases are now being seen in young adults and even teenagers — largely due to poor lifestyle habits².

You’re more likely to develop metabolic syndrome if you have:

• A family history of type 2 diabetes, high blood pressure, or heart disease
• A sedentary lifestyle (not enough physical activity)
• An unhealthy diet high in calories, sugar, saturated fat, or processed food
• Excess abdominal fat (visceral obesity)

Spotting the Red Flags
Early detection is crucial. Raising awareness about regular health check-ups is essential. These check-ups should include waist circumference, blood pressure, and fasting blood tests to measure glucose and cholesterol levels.

Many people with metabolic syndrome don’t show symptoms, which makes regular screening even more important. Everyone should be encouraged to monitor key health indicators: waist size, blood pressure, blood sugar, and cholesterol. Don’t wait for symptoms — prevention starts with action.

From Risk to Recovery: A Practical Approach
Metabolic syndrome can often be reversed in its early stages through sustained lifestyle changes, especially when it hasn’t yet led to severe complications.

Here are simple, non-medication-based steps to manage and possibly reverse metabolic syndrome:

1. Maintain a Healthy Weight
   Even a modest weight loss of 5–10% of your body weight can improve blood pressure, cholesterol, and insulin sensitivity.
2. Adopt a Balanced Diet
   Eat more fruits, vegetables, whole grains, and lean proteins to support overall health; reduce sugary drinks, refined carbs, processed snacks, and fried foods to improve metabolic balance; and choose natural, unprocessed foods whenever possible to minimise hidden sugars and unhealthy fats.
3. Exercise Regularly
   Aim for at least 150 minutes of exercise per week. Walking, cycling, swimming, and strength training are all helpful. Physical activity burns visceral fat and improves insulin function.
4. Sleep Well
   Lack of quality sleep disrupts hormone balance, raises cortisol levels, and worsens insulin resistance — all of which are linked to weight gain. Individuals should aim for 7–9 hours of restful sleep each night.
5. Manage Stress
   Chronic stress raises cortisol, which increases fat storage and disrupts blood sugar levels. Relaxation techniques like deep breathing and yoga can help restore balance.

In some cases, medication may be needed to better control blood pressure, blood sugar, or cholesterol. However, it’s important to remember that medication supports — but does not replace — lifestyle changes. A combined approach is key to reducing long-term health risks.

It’s also important to work closely with a healthcare provider to create a personalised health plan that suits your lifestyle and needs.

Final Thoughts
Metabolic syndrome may be common and serious, but it is also largely preventable — and often reversible with timely changes in your lifestyle. Raising awareness is just the start. Taking consistent action is what truly protects your health.

Make your health a priority — now and always.

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¹ International Diabetes Federation. The IDF consensus worldwide definition of the metabolic syndrome [internet]. Brussels: IDF; 2006 [cited 2025 Jun 27]. Available from: https://IDF.org/media/uploads/2023/05/attachments-30.pdf

² Al-Hamad D, Raman V. Metabolic syndrome in children and adolescents. Transl Pediatr. 2017 Oct;6(4):397–407. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5682379/

Dr. Fang possesses a strong passion for internal medicines and demonstrates comprehensive expertise in a broad spectrum of medical and surgical pathologies. Her keen clinical acumen has consistently contributed to accurate diagnoses and effective patient management. Beyond clinical care, Dr. Fang is deeply committed to advancing patient well-being. She actively empowers individuals to take ownership of their health through evidence-based lifestyle interventions, stress management strategies and appropriate pharmacological treatments.

Running as a hobby
Running and cycling have become popular hobbies in the modern post-COVID era, with enthusiasts of all ages taking to the streets, trails, and treadmills. These sports, accessible to almost everyone, offer numerous physical and mental benefits, such as cardiovascular health, weight management, and stress relief. However, like any physical activity, running comes with the risk of injury. Traditionally, rest has been the go-to remedy for sports-related injuries. Modern-day medicine is now promoting active recovery as an alternative to rest for sports injuries.

Since the COVID-19 pandemic, the implementation of social distancing and movement control orders has further popularised running and cycling as hobbies as well as fitness modalities. The factors contributing to the rise of running include:

• Accessibility: Running requires minimal equipment and can be done almost anywhere, making it an appealing option for people with busy schedules.
• Community and Social Aspects: Running clubs, events, and social media groups have fostered a sense of community, providing motivation and support.
• Health and Wellness: With growing awareness of the importance of physical health, many individuals have turned to running as an effective way to stay fit and manage stress.

Common running injuries
Despite its simplicity and health benefits, running can lead to various injuries. Amateur runners often get injured when they neglect the following fundamentals of running:

• Neglecting Proper Warm-Up and Cool-Down: Skipping warm-up exercises can lead to muscle strains and injuries. Similarly, not cooling down can cause muscle stiffness and delayed recovery.
• Inadequate Footwear: Wearing shoes that do not provide adequate support or do not fit properly can lead to a range of injuries, ranging from blisters to stress fractures.
• Ignoring Proper Technique: Poor running form, such as overstriding or improper foot strikes, can cause undue stress on joints and muscles, leading to chronic injuries.
• Underestimating the Importance of Rest: Without adequate rest and recovery, the body does not get a chance to repair itself, increasing the risk of overuse injuries such as tendinitis and shin splints.
• Overtraining: Ignoring pain and training through fatigue can lead to serious injuries.
• Inadequate Strength and Flexibility Training: A lack of strength training, especially for core and leg muscles, can lead to imbalances and injuries. Flexibility exercises are crucial for maintaining a full range of motion and preventing strains.

Traditional approach: Rest
When injuries occur, the conventional advice often involves rest to prevent further damage and allow the body to heal. Rest can reduce inflammation and pain. However, extended periods of inactivity may lead to muscle atrophy, stiffness, and reduced blood circulation, which can ultimately prolong recovery.

Benefits of active recovery
Active recovery, on the other hand, involves gentle movements and exercises that promote healing without placing undue stress on the injured area. Here are the benefits of this approach:

• Maintains Strength and Flexibility: Engaging in controlled, low-impact activities helps maintain muscle strength and flexibility, preventing atrophy and stiffness.
• Improves Circulation: Movement increases blood flow to the affected area, delivering essential nutrients and oxygen for tissue repair.
• Promotes Healing: Gradual, controlled stress on the injured area stimulates the body’s healing processes, encouraging the production of collagen and other vital tissues.
• Prevents Further Injury: Keeping the body active and balanced helps avoid compensatory injuries that can arise from favouring one side of the body.
• Mental Health Benefits: Staying active can improve mood and reduce feelings of frustration.

Implementing active recovery safely
To ensure safe and effective active recovery, consider the following guidelines:

• Consult a Professional: Seek advice from your healthcare professional to rule out serious injuries and to develop a personalised recovery plan.
• Start Slowly: Begin with gentle exercises that do not cause pain, gradually increasing the intensity as healing progresses.
• Listen to Your Body: Pay attention to your body’s responses and discuss them with your healthcare professional.
• Integrate Other Treatments: Combine active recovery with other treatments such as physical therapy, massage, and appropriate medications for optimal results.

While rest has been the traditional approach to recovery, active recovery is gaining recognition for its ability to promote healing while maintaining strength and flexibility. By incorporating controlled, gentle activities and consulting with professionals, runners can effectively manage their injuries and return to their beloved sport more swiftly and safely. Embracing active recovery not only supports physical rehabilitation but also fosters mental resilience, ensuring a holistic approach to managing running injuries. Movement is intrinsic to life, embodying vitality, growth, and progress. After an injury, the instinct might be to halt all activity, yet this can lead to further physical decline and emotional distress. Instead, adapting to active recovery can sustain muscle strength, maintains flexibility, and boosts circulation, accelerating the healing process. Furthermore, continuing to participate in sports, albeit at a modified pace, helps preserve the athlete’s sense of identity and purpose, fostering a positive mindset. Embracing movement, even post-injury, ensures that life’s dynamism is never lost, turning setbacks into comebacks and challenges into opportunities for growth.

Dr. Edwin Ong Kean Siong is a sports enthusiast and a keen proponent of active living. As an avid badminton player himself, he is passionate in treating sports injuries. He emphasises early treatment for all his patients to achieve the best clinical outcomes. With extensive experience in various treatment modalities, ranging from non-operative methods to minimally invasive arthroscopic surgeries, he believes that individualised treatment and utmost care can help any injured sports player, regardless of age or level of play, return to an active lifestyle.

by Dr. Evylne Chin Oi Lian
General Dental Practitioner

Myth #1 Sugar Is the Sole Culprit of Cavities
While sugar plays a significant role in cavity formation, it is not the sole culprit. Cavities develop due to a combination of factors, including oral bacteria, time, susceptible tooth surfaces, and fermentable carbohydrates.

When we consume foods or drinks containing sugar, the bacteria in our mouths—especially Streptococcus mutans—use that sugar as an energy source, producing acid as a byproduct. This acid weakens and demineralises enamel over time, leading to cavities. However, cavities can also be influenced by other factors, such as:

A. Bacterial Presence and Plaque Build-Up:
Plaque, a sticky biofilm of bacteria, adheres to teeth and feeds on more than just sugar. Simple carbohydrates found in bread, pasta, and fruit can also be broken down into sugars, which bacteria consume and convert into acids. A study published in the Journal of Dental Research found that starchy foods increase cavity risk, especially when oral hygiene is poor.

B. Oral pH Levels and Acidic Foods:
Acidic foods and drinks, such as citrus fruits, soda, and vinegar, lower the pH in your mouth, softening enamel and making teeth more vulnerable to decay. Saliva helps neutralise acid, but consistently high acid levels accelerate enamel erosion regardless of sugar intake. A study in the Journal of Clinical Periodontology highlights the importance of pH levels in maintaining healthy enamel, showing how acidic diets amplify the impact of sugar on tooth decay.

C. Oral Hygiene Habits:
Neglecting regular brushing and flossing allows plaque to build up, creating an environment where acids can attack the enamel. Proper oral hygiene is crucial to minimising cavity risk—avoiding sugar alone isn’t enough.

D. Genetic Factors and Enamel Quality:
Some people are more prone to cavities due to inherited factors, such as weaker enamel or differences in saliva composition, which affect how well it neutralises acids.

While limiting sugar intake is important, a holistic approach to oral care—including a balanced diet, regular brushing and flossing, and routine dental checkups—provides the best defence against cavities.

Myth #2 You Should Brush Your Teeth Right After Eating
Brushing your teeth immediately after eating is not always recommended, especially after consuming acidic foods and drinks like coffee, citrus fruits, or soda.

Research from the American Dental Association highlights that brushing your teeth right after consuming acidic items can harm enamel due to acid exposure. Acidic substances temporarily soften enamel, making it more susceptible to wear when brushed. Over time, enamel thinning exposes the yellowish dentin layer underneath, leading to the appearance of yellow teeth and heightened sensitivity.

Waiting at least 30 minutes to an hour after consuming acidic foods or drinks allows saliva to neutralise acids and remineralise enamel, reducing the risk of abrasion caused by brushing. Rinsing your mouth with water or drinking milk after acidic intake can also help. Using a soft-bristled toothbrush with fluoride toothpaste provides additional protection. Chewing sugar-free gum stimulates saliva production, aiding in pH restoration. These approaches minimise enamel erosion and help maintain the natural whiteness of your teeth.

Myth #3: Probiotics for Oral Health – Are They Really Helpful?
Probiotics are live bacteria that are good for your health, especially your gut. Recently, they’ve also been considered for oral health, as they might help with things like tooth decay, gum disease, and bad breath.

For probiotics to work in your mouth, they need to stick to your teeth and gums. Some types of probiotics, like those found in yogurt, have shown promise in helping with oral health. However, the effects are usually temporary, meaning they won’t stay in your mouth long unless you keep using them regularly. Certain probiotics can help fight harmful bacteria that cause dental problems, but you’ll need to keep taking them to maintain any benefits.

While probiotics may help support oral health in the short term, they shouldn’t replace regular brushing, flossing, and dental checkups. They can be a helpful addition, but a healthy mouth still depends on good daily care and routine dental visits.

Potential Benefits of Probiotics in Oral Health:

• Dental Caries: Certain probiotics inhibit cariogenic bacteria like Streptococcus mutans, reducing cavity formation.
• Periodontal Disease: Probiotics may help reduce inflammation and pathogenic bacteria, promoting a healthier balance in the oral microbiota.
• Halitosis: Some strains reduce volatile sulphur compounds responsible for bad breath.

Current Challenges and Evidence:
While laboratory and preliminary clinical studies highlight potential benefits, challenges remain:

• Limited high-quality, long-term clinical trials.
• Variability in probiotic strains and their effectiveness.
• Difficulty ensuring probiotics survive and colonise the oral environment.

Conclusion:
Probiotics hold promise for oral health, particularly as an adjunct to traditional therapies. However, robust research is needed to establish clear guidelines. For now, probiotics should be viewed as complementary to, rather than a replacement for, established oral care practices like brushing, flossing, and professional dental care.

Summary Box:

• Probiotics are living microorganisms that are safe for human consumption and have health benefits.
• Probiotic therapy is being explored for oral health applications, particularly against antibiotic-resistant bacteria.
• Probiotics in dairy products neutralise acidic conditions in the mouth and interfere with cariogenic bacteria.
• Patients with periodontal disease who used probiotic-containing chewing gum or lozenges saw improvements in periodontal status.
• Probiotics in gargling solutions or gum inhibit the production of volatile sulphur compounds that contribute to bad breath. 

Myth #4: Whitening toothpaste works just like professional whitening

Understanding Whitening Toothpaste vs. Professional Whitening

Many people believe that whitening toothpaste works just as well as professional whitening treatments, but is that really true? Let’s break it down:

A. Mechanism of Action:
Whitening toothpaste typically contains mild abrasives and certain chemical agents (such as) hydrogen peroxide or carbamide peroxide that help remove surface stains caused by food, beverages, or smoking. However, these products primarily act on the enamel surface rather than penetrating deeper into the tooth structure to address intrinsic stains.

B. Effectiveness:
Research published in the Journal of the American Dental Association found that whitening toothpaste can result in a slight increase in tooth brightness but often falls short of achieving the more significant, long-lasting results provided by professional whitening treatments. In contrast, professional whitening products often contain higher concentrations of bleaching agents that penetrate the enamel and dentin, yielding more dramatic results.

C. Duration of Results:
Studies indicate that the effects of professional whitening treatments tend to last significantly longer than those achieved with whitening toothpaste. For example, a clinical trial in the Journal of Dentistry demonstrated that professionally applied whitening treatments maintained brightness for several months, whereas over-the-counter whitening toothpaste had minimal effects.

D. Potential for Sensitivity:
Some patients experience tooth sensitivity when using professional whitening products, especially those with a high concentration of bleaching agents. Whitening toothpaste typically has a lower risk of causing sensitivity, but results may be less noticeable. A study in Operative Dentistry emphasised the need for patients to consider sensitivity when choosing whitening treatments.

A systematic review in the British Dental Journal compared the efficacy of whitening toothpaste with professional treatments. The review concluded that while whitening toothpaste can remove some surface stains and provide minor whitening effects, it is not a substitute for professional whitening, which offers more substantial and longer-lasting results. Patients should be aware that while whitening toothpaste may improve the appearance of their teeth by removing surface stains, it cannot achieve the same level of whitening as professional treatments. For significant whitening results, individuals should consider consulting a dentist for personalised professional whitening options. 

All images by LohGuanLye Specialists Centre