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Metabolic Syndrome

One of the most prominent health problems facing Americans today is metabolic syndrome.  A syndrome is not a disease, but rather a group of diseases that tend to occur together, thus suggesting a common cause.  Individuals are considered to have metabolic syndrome (formerly known as Syndrome X) if they have at least three of the following, before medication:

• Fasting blood sugar of 110 or more
• Waist circumference of 34 inches or more
• Triglycerides levels greater than or equal to 150
• HDL cholesterol less than or equal to 40
• Blood pressure over 130/85

One out of every five Americans, 45% of those in their 60’s, and two-thirds of overweight people have metabolic syndrome.  An astounding 70% of Americans have at least one symptom.  This could lead one to think that these changes are “normal”.  Interestingly, hunter-gatherer cultures virtually never get metabolic syndrome, indicating that there is something in our lifestyle that is causing these changes.

Why should metabolic syndrome be a concern?  Three of the top five causes of death – diabetes, cancer, and cardiovascular disease – are all related to metabolic syndrome.  Metabolic syndrome could also be thought of as “pre-diabetes”.  Of the cancers, prostate and breast cancer are particularly correlated with metabolic syndrome.  And metabolic syndrome will soon overtake cigarette smoking as the number one risk factor for cardiovascular disease.

The fundamental metabolic disturbance that seems to be common in almost all people who have metabolic syndrome is insulin resistance.  Insulin is a hormone that your body uses to move the carbohydrate that you eat into your cells.  If you are insulin resistant, your cells don’t respond well to insulin, and your pancreas has to produce higher amounts in order to keep your blood sugar from going too high.  (Once your pancreas is no longer able to keep up with this increased demand, you become diabetic.)  If you are insulin sensitive, your body is responding well to smaller amounts of insulin.

Fortunately, metabolic syndrome is almost entirely preventable.  Though all the mechanisms behind the metabolic syndrome have not been worked out, the evidence is strong that a combination of several lifestyle strategies are very effective in preventing this condition.

Exercise

Exercise does more than just burn calories or build muscle.  One of the most profound benefits of exercise is its effect on insulin sensitivity.  When insulin is released in response to carbohydrate ingestion, glucose transporters come to the surface of the cell in order to carry the glucose into the cell. In muscles and fat cells this transporter is called Glut-4.  Exercise itself helps Glut-4 to move through the cell membrane to the surface of your muscle cell, causing these cells to be much more insulin sensitive.  Even a single bout of exercise will cause your muscles to respond more effectively to insulin.

Low-glycemic foods

The glycemic index is a measure of how quickly a food raises our blood sugar (see HPL Update Oct 03 – Carbs 101).  The high-glycemic carbohydrates in the American diet are primarily the “white foods” (bread, pasta, rice, white potatoes, and sugar).  These foods cause many of the changes associated with metabolic syndrome, including lower HDL levels, and higher triglycerides.  When a person eats these foods year after year, insulin levels remain chronically high.  The result is that eventually the cells become less responsive to the insulin, in turn leading to increased risk of obesity, hypertension, heart disease, diabetes, and premature death.  Low-glycemic carbohydrates include most fruits and vegetables.  Eating a diet that limits or avoids high-glycemic grains, potatoes, and sugars, and includes more low-glycemic fruits and vegetables, fish, and lean meat can dramatically improve your insulin sensitivity.

The right fat

We’ve talked in previous issues about the seemingly miraculous health benefits of fish oil.  Fish oil improves insulin sensitivity.  Eskimos, who consume high quantities of fish oil, rarely experience diabetes, even though they are often overweight.  Though the mechanism by which fish oil works isn’t yet understood, many researchers believe that fish oil makes the cell membrane more “fluid”, enabling the Glut-4 transporters to more easily move to the surface of the cell in response to insulin.  Everyone who does not eat fish on a regular basis should consider taking a high-quality fish oil.

Saturated fats and trans-fats, in contrast, make the cell membrane more stiff and inflexible, and also reduce insulin sensitivity.  Saturated fats are found primarily in beef, pork, and dairy products and trans-fats are found in processed foods.  Saturated fats should be minimized, and trans-fats should ideally be completely eliminated from the diet.

Lose weight

If you’re overweight, nothing will improve your insulin sensitivity faster than losing some weight.  In fact, weight loss significantly improves all aspects of metabolic syndrome.  Following the three recommendations above should accelerate the process.

Take action

Remember, just reading newsletters has never made anyone any healthier.  Though there are drugs available to treat some of the symptoms, doctors have no pharmaceutical cure for metabolic syndrome, and almost all individuals become more insulin resistant as they age.  It is the lifestyle choices and the actions that you take today to improve your insulin sensitivity that will have a powerful impact on the length and quality of your life.  As always, let me know if you have any questions.

Go Long,

Wiley