OBJECTIVES: (1) To compare risks posed by the metabolic syndrome (MetS) diagnosed with four different criteria and cardiovascular risk factors in the development of diabetes mellitus 2 (T2D), cardiovascular disorders and other chronic disorders. (2) To determine if modification should be made to existing MetS definitions and standards of diagnosis of high risk patients. METHODS: A combination of NHANES 2009-2010 and 2010-2011 databases formed our study cohort. MetS criteria included harmonized 2009 World Health Organization definition, criteria from National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III), International Diabetes Federation (IDF) and European Group for Study of Insulin Resistance (EGIR). Individual cardiovascular risk factors included smoking, alcoholism, albuminurea, elevated C-reactive protein levels and heredity of diabetes and cardiovascular disorders. Risk prediction was carried out for chronic disorders such as diabetes, cardiovascular disorders, arthritis, asthma, emphysema, bronchitis, cancer and AIDs. Adjusted relative risk (RRs) using Poisson regression was calculated for each criteria and individual risk factors.   RESULTS: MetS failed to predict risk for cardiovascular disorders. However albuminurea (RR=2.25), smoking (RR=2.16) and heredity (RR=1.52) posed a risk for cardiovascular disorders. All except smoking (0.32) demonstrated high risk for asthma. Smoking (RR=4.15) along with all the MetS criteria (RR with WHO=2.63; NCEP=3.16; IDF=5.67) except European criteria (RR=0.67) predicted risk for emphysema. MetS (RR with WHO=2.24; Europe=5.43; NCEP=3.31; IDF=2.66) and albuminurea (RR=1.49) were good predictors of kidney conditions.  Similarly MetS (RR with WHO=3.67; Europe=6.33; NCEP=4.24; IDF=1.89), albuminurea (RR=2.94), alcoholism (RR=3.08) and heredity (RR=3.74) were associated with risk for liver conditions. No MetS criteria and individual risk factors showed an association with risk for AIDS. CONCLUSIONS: Overall European MetS criteria emerged as the strongest risk predictor for chronic conditions. The RRs of individual risk factors depict significant chronic disease predicting ability. Recommendations may be made to policy makers to alter or make additions to the current MetS definition.