Screening and management of Metabolic Syndrome.

Severe obesity leads to high mortality, morbidity and psychological problems; and has nega-tive effects on quality of life. Beneficial effects of risk reduction through changing life style and pharmacological therapy have been documented. Environmental factors play a role in development of the metabolic syndrome and are recommended to be the subject of targeting screening for disease preventing in partners of people with the metabolic syndrome. An overweight child or adolescent may have several risk factors and should be carefully evalu-ated regarding each risk factor through screening. Clinical management of metabolic syn-drome aims to reduce atherosclerosis risk at first and then to reduce development of diabetes mellitus risk; therefore, clinical management of metabolic syndrome starts with reducing major risk factors such as cessation of smoking, controlling LDL and triglycerides level, in-creasing HDL level, and controlling blood pressure and glucose levels. Treatment of lipid and non-lipid risk factors should be started after lifestyle changes. Body weight should be reduced 7-10 % during first year of therapy. A major component of life style changes is reaching the energy balance. The goal for physical activity is to be at least 30 minutes of exercise per day; however, the level of activity needs to be adjusted regarding the individuals ’ age. Metabolic syndrome is accompanied by several complications and affects social health in childhood and adolescence; therefore, we recommend the establishment of a screening guideline for risk factor reduction in metabolic syndrome that includes a diet and physical activity program, and pharmacological treatment