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.

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 Li Chen

Consultant Physician

MD (UNIMAS), MRCP (UK)

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.

by Dr. Tan Jin Aun – Consultant Orthopaedic & Spine Surgeon and Dr. Deepak A/L Ajit Singh – Consultant Orthopaedic Surgeon (Spine Surgery and Interventional Pain Management)

When people talk about leadership strength, they usually mean qualities such as resilience, vision, or discipline. Yet for senior executives, policymakers, and business leaders, strength also has a literal dimension. The spine is not simply a biological structure. It is the central column that supports the physical demands of leadership, from long flights and boardroom hours to the continuous pace of decision-making.

Spinal health often becomes a concern only when pain begins to interfere with performance. In our years of treating leaders, the same pattern appears repeatedly. The drive that fuels success frequently comes at the expense of personal well-being. Hours spent in static postures, frequent travel, high stress, and irregular exercise gradually accumulate, leading to back and neck conditions that may begin as minor discomfort but eventually affect both health and performance.

The consequences extend beyond physical pain. Research consistently identifies musculoskeletal disorders, particularly those involving the spine, as leading causes of lost workdays among professionals over 40. Pain not only limits movement but also reduces energy, slows decision-making, and disrupts sleep. Over time, these effects erode the clarity, stamina, and focus that leaders rely on. In Malaysia, spinal disorders remain one of the most common causes of workplace absence, with implications that affect not just the individual but also teams, departments, and organisational outcomes.

By the time symptoms are disruptive enough to require treatment, the underlying problem has often been present for months or even years. The encouraging reality is that many of these conditions are preventable or manageable if detected and addressed early.

The most effective leaders take the same approach to their health as they do to their organisations: regular monitoring, timely adjustments, and preventive action. For the spine, this can be as simple as reviewing office ergonomics, incorporating short breaks for movement during meetings, or practising stretches that counteract the strain of prolonged sitting. Most importantly, it involves undergoing periodic spine health screenings, a structural audit that can identify issues before they become serious.

The comparison is clear. The spine is the body’s core infrastructure. Just as no company can operate without monitoring its essential systems, no leader should expect their spine to perform indefinitely without care. A healthy spine not only prevents pain but also sustains posture, energy, and concentration, all of which form the physical foundation for effective leadership.

Standing tall is more than a figure of speech. It reflects the structure that supports you in every sense. Prioritising spinal health is not indulgence; it is a strategic investment. In the long game of business and governance, one of the greatest assets a leader can protect is the one that allows them to stay upright and perform at their best.

by Dr. Mohamad Imran bin Idris – Consultant Neurologist

Dementia isn’t just forgetfulness—it’s about slowly losing the essence of who you are. In Malaysia, this silent epidemic is growing faster than most realise, driven by an ageing population and widespread chronic illnesses like diabetes and high blood pressure. Globally, dementia affects more than 55 million people, and the World Health Organization (WHO) predicts this number will reach 78 million by 2030. Local studies suggest over 200,000 Malaysians are living with dementia, and the figure is likely underestimated due to low awareness and limited screening.

Consultant Neurologist at Sunway Medical Centre, Sunway City, Dr. Mohamad Imran bin Idris, explained that while slower memory and reduced mental agility can come with age, dementia is different. “The hallmark of dementia isn’t just forgetfulness,” he said. “It is when thinking skills interfere with daily life—language, judgement, even recognising familiar faces. That is when it is time to get help.”

Vascular dementia caused by impaired blood flow to the brain, often after a stroke or due to chronic conditions like high blood pressure, is very common in Malaysia.

Conditions such as hypertension, high cholesterol, smoking and diabetes are key contributors to vascular dementia, he said.

“We’ve seen people in their 40s and even 30s developing early signs after strokes or years of unmanaged chronic illness,” Dr. Mohamad Imran shared. The damage builds silently over decades; when symptoms show, the brain may already be severely affected.

While diet and exercise are known brain boosters, one often overlooked factor is sleep. “Poor sleep affects brain health more than we realise,” said Dr. Mohamad Imran.

Socialising also plays a powerful role. Talking with friends, engaging in conversation — these spontaneous, unpredictable interactions challenge the brain and help preserve cognitive function, he explained. “Repetitive digital games may feel mentally stimulating but offer little long-term benefit. The brain needs novelty,” he said.

While dementia has long been seen as a hopeless diagnosis, science is now catching up. “Two years ago, I’d have said nothing can be done,” Dr. Mohamad Imran said. “But now we have medicines that can slow its progression. We’re entering a new era of treatment.”

Screening tools—from digital cognitive assessments to blood tests that detect early brain changes—are becoming more accessible.

His advice is to start thinking seriously about brain health at the age of 40s and 50s. “Control your blood pressure, stay socially engaged, sleep well, and eat a balanced diet.

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

Consultant Orthopaedic & Trauma Surgeon

MBBS (UM), MS Ortho. (UM), CMIA (NIOSH), Fellowship in Adult Reconstruction and Sports Medicine (S. Korea) 

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.