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Older people who are normal-weight can have the metabolic syndrome--also known as insulin resistance syndrome or Syndrome X--if their fat is stored in the wrong places.

You have the metabolic syndrome if you have at least three of five symptoms: low HDL ("good") cholesterol, a large waist, and elevated (but not necessarily high) blood pressure, blood sugar, and triglycerides. People with the syndrome have a higher risk of diabetes and heart disease (see Oct. 2004, p. 5).

Researchers used CT scans to measure fat deposits in the waist and thighs of more than 3,000 men and women aged 70 to 79. As expected, the metabolic syndrome was more common in the obese and overweight than in people who were normal-weight.

However, when the researchers looked at people within the same weight category, those with the metabolic syndrome had the same (or less) total body fat than those without the syndrome. The difference: people with the metabolic syndrome had more fat deep in the abdomen (visceral fat) and inside the thigh muscles than did people without the syndrome.

What to do: Remind your doctor that even normal-weight people can have the metabolic syndrome.

Archives of Internal Medicine 165: 777, 2005.

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