As winter approaches, we may be tempted to slow down, hibernate and gobble up comfort foods. It might be a better idea to get out the hiking boots, walk the dog, join the gym and become a regular at the salad bar.

A high-fat diet and inactive lifestyle not only lead to feeling sluggish, but may damage your cardiovascular system and potentially compromise your cognitive function later in life.

The National Cholesterol Education Program has identified metabolic syndrome as a cluster of risk factors that are highly predictive of heart disease and diabetes.

Women with metabolic syndrome have a three times higher risk of dying from a heart attack or stroke compared with women who do not have the syndrome.

Metabolic syndrome may also influence the mental abilities of women as they age. A recent large study at the University of California found that post-menopausal women with metabolic syndrome had a 66 percent increase in the risk of developing cognitive impairment than women who did not have the syndrome (Archives of Neurology, March 2009).

Almost 45 percent of American adults between 60 and 70 years old have metabolic syndrome. Metabolic syndrome is diagnosed when people have at least three of the following traits:

• Large waist size: greater than 40 inches in men and 35 inches in women.
• High triglycerides: greater than 150 mg/dl or the use of cholesterol-lowering medication.
• Low HDL, or "good," cholesterol: less than 40 mg/dl for men and 50 mg/dl for women, or the use of cholesterol-lowering medication.
• High blood pressure: greater than 130/85 or use of high blood pressure medication.
• High fasting glucose level: higher than 100 mg/dl.

The worst combination seems to be an enlarged waist and high triglycerides. Women with a large waist measurement and high triglyceride levels have five times the risk of dying of a heart attack or stroke compared with women with normal measurements.

Researchers have concluded that metabolic syndrome is essentially a cluster of complications resulting from obesity. Therefore, the primary target of therapy is reduction of obesity through weight loss and increased physical activity.

If you meet several of the criteria for metabolic syndrome, you should see your health care provider for a physical exam and lab testing. If you are diagnosed with metabolic syndrome, there are several things you can do to treat or even reverse the condition.

Another opportunity to consider: many employers now offer wellness screening and incentives for participation in risk reduction programs. Take advantage of these employer-sponsored programs.

As a general rule, if you are overweight, the American Heart Association recommends losing 7 percent to 10 percent of your starting weight over a period of six months to a year.

A low-fat, low-cholesterol, low-sodium diet that includes plenty of fruits, vegetables and whole grains will help to control your weight, reduce your cholesterol and improve your body's use of glucose.

Supplements or medication may also be necessary to improve your cholesterol level. Fish oil supplements and niacin are commonly used prior to prescription medications.

Recent studies have shown that calcium and vitamin D, found in dairy products, may also help to prevent metabolic syndrome and diabetes (Diabetes Care 28, 2005).

Finally, get moving and keep moving! Start with at least 30 minutes per day of brisk walking or other vigorous activity, then take the stairs or add in bicycling, swimming and treadmill use. Beginning some weight-bearing exercise will also help to prevent osteoporosis.

Mary Huddle is the nurse care manager of Making Waves. St. Patrick Hospital sponsors this free cardiometabolic risk reduction program as a benefit for its employees.