By
Roy M. Arnold, MD
Metabolic syndrome is the name for a group of risk factors that raises your risk for heart disease and other health problems, such as diabetes and stroke. The term “metabolic” refers to the biochemical processes involved in the body’s normal functioning. Risk factors are traits, conditions, or habits that increase your chance of developing a disease.
The five conditions described below are metabolic risk factors. You can have any one of these risk factors by itself, but they tend to occur together. You must have at least three metabolic risk factors to be diagnosed with metabolic syndrome.
* A large waistline. This also is called abdominal obesity or “having an apple shape.” Excess fat in the stomach area is a greater risk factor for heart disease than excess fat in other parts of the body, such as on the hips. Men should have a waist less than 40 inches, Women less than 35 inches.
* A high triglyceride level (or you’re on medicine to treat high triglycerides). Triglycerides are a type of fat found in the blood. Triglycerides greater than 150 mg/dl are considered elevated.
* A low HDL cholesterol level (or you’re on medicine to treat low HDL cholesterol). HDL sometimes is called “good” cholesterol. This is because it helps remove cholesterol from your arteries. A low HDL cholesterol level raises your risk for heart disease. Men should have an HDL Level greater than 40mg/dl and women should be greater than 50.
* High blood pressure (or you’re on medicine to treat high blood pressure). Blood pressure is the force of blood pushing against the walls of your arteries as your heart pumps blood. If this pressure rises and stays high over time, it can damage your heart and lead to plaque buildup.
* High fasting blood sugar (or you’re on medicine to treat high blood sugar). Mildly high blood sugar may be an early sign of diabetes. Fasting blood sugar greater than 100 is considered elevated.
The exact mechanisms of the complex pathways of metabolic syndrome are under investigation. The pathophysiology is very complex and has been only partially elucidated. Most patients are older, obese, sedentary, and have a degree of insulin resistance. Stress can also be a contributing factor. The most important factors are genetics, aging, diet (particularly sugar-sweetened beverage consumption), sedentary behavior or low physical activity, disrupted chronobiology/sleep, mood disorders/psychotropic medication use, and excessive alcohol use. There is debate regarding whether obesity or insulin resistance is the cause of the metabolic syndrome or if they are consequences of a more far-reaching metabolic derangement.
Other risk factors for the syndrome include stress, obesity, sedentary lifestyle, and aging. Metabolic Syndrome increases the risk of developing Type 2 diabetes fivefold. About half of patients with coronary artery disease also have metabolic syndrome and many of those have premature coronary disease occurring prior to age 45.
Other complications than Diabetes and increased risk of cardiovascular disease can develop. Most dangerous is Non-Alcoholic Fatty Liver Disease or NALFD. Over time fat deposits build up in the liver and can ultimately lead to liver failure. In these instances the only treatment may be liver transplant.
Metabolic syndrome can largely be prevented by increased physical activity and a healthy, reduced calorie diet. The first line of treatment is weight reduction through a low carbohydrate diet and physical exercise. If this doesn’t improve the lipid profile and lead to weight loss, lipid lowering agents and antihypertensives should be added. The use of insulin sensitizing drugs such as metformin is controversial but has shown some improvement in a few studies.
Once metabolic syndrome is present, fairly drastic lifestyle modifications must be made in order to reverse the damage. For many people, this becomes an almost impossible task. Nevertheless, the only known method to reverse the damage is through aggressive treatment. To learn more about metabolic syndrome go to http://www.nhlbi.nih.gov/health/health-topics/topics/ms/ or consult with your personal healthcare provider.
A reduced calorie diet is often the cause of metabolic syndrome. What happens when you reduce calories? Your metabolism slows down. Reducing calories is not sustainable and leads to cravings and binge eating. What happens when you resume eating normally with a slowed metabolism? You re-gain any weight you lost while dieting plus maybe a few extra pounds. Yo-yo dieting makes metabolic syndrome even worse. Women who eat 1200 and men who eat 1800 calories per day (or less) in an effort to lose weight are doing themselves more harm than good. If you can’t see yourself sustaining any diet for the rest of your life, it isn’t worth doing. The answer is to quit eating processed and sugary foods as well as foods with industrial seed oils and instead Eat Real Food and move your body. This will fuel you body with nutrients and increase your metabolism. You will feel better, lose weigh, and keep it off. The food-like products that are sold in our grocery stores these days are full of fat, salt and sugar, but lack fiber and nutrients are poisoning us and putting us on a fast track to type 2 diabetes. Stay out of the isles (the isles are where the processed stuff is sold) and buy most of your food from the perimeter of the store. Buy fresh local produce when possible and if you can afford it, eat free-range poultry and grass-fed beef rather than grain-fed feed lot crap.
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