For more than 40 million American adults these days, X -- as in Syndrome X -- ominously marks the spot.

Also known as metabolic syndrome, the condition is characterized by obesity, high cholesterol and blood lipids, and insulin resistance (inability to effectively metabolize carbohydrates and sugars). It’s believed to be a major risk factor for serious illnesses such as coronary artery disease, stroke, and diabetes.

While people with high blood pressure are often given medications to lower it, some of these drugs can actually worsen other factors associated with metabolic syndrome. But recent Duke research shows that lifestyle interventions can be as beneficial as drugs while avoiding those adverse effects. Published last fall, the study, led by Duke medical Psychophysiologist Lana Watkins, PhD, indicated that exercising and losing weight can significantly reduce the overproduction of insulin and lower the blood pressure of patients with Syndrome X.

So if you want to remove the X rating from your health profile, where do you start? First, consult with your doctor; then, consider seeking professional guidance and support from nutritionists and exercise physiologists like those at Duke’s Center for Living (for sample tips from Center experts, see below).

The challenge of changing sedentary, high-calorie habits is well worth it, says Fred, a Duke patient who lost 73 pounds and dramatically reduced his blood pressure and cholesterol levels over the course of a year. “I took a very methodical approach to burning more calories than I took in, day by day,” he recalls. “Now I feel better, I breathe better, and I’m much more able to do the things I want to do.”

Easing Into Exercise

Do something you enjoy. If you choose an activity you like to do, whether it's walking, swimming, or even dancing, you'll be more likely to stick with it.

Start with mini-workouts. Try squeezing in just five or ten minutes of exercise several times throughout the day. Walking from your car to the office and active home chores count; even giving up the remote control and walking to the TV to change the channel can add up to a few miles per week.

Challenge yourself -- but slowly. Once you’ve established a more active lifestyle, add a regular walk to your routine, gradually adding minutes and increasing your pace. Building up to a regular routine could take anywhere from eight weeks to four months; listen to your body and don't feel pressured to go too fast.

Add strength training as time permits. Strength training helps your body metabolize nutrients more efficiently and burn more calories even at rest. Work up to doing strengthening exercises with weights for 15 to 20 minutes two to three times a week.

Shedding Those Extra Pounds

Lose the sweet tooth: Avoid refined sugar, which adds lots of "empty" (low-nutrition) calories to your diet. Include ample protein to help your metabolism work efficiently.

H2O to go: Drink plenty of water, as hunger and thirst are often confused. Adequate water is also essential to keep body systems functioning efficiently.

Find your balance: While the Duke Center for Living’s Diet and Fitness Center now offers the Atkins diet due to the success many people have had with it, most studies still favor a balanced, low-fat, low-cholesterol, low-calorie diet with plenty of fruits and vegetables. Don't, however, restrict calories to fewer than 1,000 a day; this will actually lower your metabolism and slow your weight loss.

Don’t phase out all fat: High-quality fats (such as canola, peanut, and olive oils) in your diet help prevent hunger and bingeing. Just keep the calories they provide to no more than about 15-20 percent of your total daily calories.