Metabolic Syndrome

By Stephen T. Sinatra, M.D., F.A.C.C., F.A.C.N., C.N.S., C.B.T.

Metabolic syndrome, also known as insulin resistance, is a major and escalating worldwide health problem that doubles the risk of developing cardiovascular disease and quintuples the risk of diabetes. It is a symptom-less and progressive destroyer of your circulatory system − the vast network of arteries, veins, and capillaries that circulates blood throughout your body.

According to the International Diabetes Foundation, a quarter of the world’s adults have metabolic syndrome! Think for a moment about that mind-blowing statistic. “Earlier diagnosis is needed to stop this global time bomb,” the federation says.

The incidence has risen steeply in the United States and Europe, and is increasing rapidly as well in the developing countries of Asia, South America, and East Europe. The cause: an excess consumption of calories, sedentary life habits, and increasing obesity.

Metabolic Syndrome is defined by a combination of several interconnected physiological, biochemical, and metabolic factors, unhealthy body measurements and abnormal laboratory test results. They are as follows:

  • Waist girth more than 35 inches (88 cm) for a woman and more than 40 inches (102 cm) for a male.
  • Fasting blood sugar over 110 mg/dl.
  • Triglycerides (blood fats) over 150 mg/dl
  • So-called “good” cholesterol (HDL) less than 50 mg/dl for a woman and less than 40 mg/dl for a man.
  • Blood pressure over 130/85 or someone requiring a blood pressure medication.

You are at clear risk if you have any three of the five characteristics listed above.

The two most significant components of metabolic syndrome are insulin resistance and central adiposity (a fancy name for “belly fat”).

Overconsumption of refined carbohydrates causes a situation in which the body cannot use its insulin properly. Insulin is a hormone that moves blood sugar (the breakdown of carbohydrates) into cells where it’s used for energy. When the cells become insensitive to insulin, because of chronic high insulin production, high blood sugar levels occur, leading to diabetes. This situation is closely linked to an increase in triglycerides (a blood fat), overweight and obesity, and creates a heightened state of inflammation in the body.

It takes blood tests to determine your insulin and blood sugar status. If you test positive for metabolic syndrome, then you need to keep a close eye on your glucose, hemoglobin A1c (a long-term glucose level), and triglyceride levels. Cardiovascular disease is an inflammatory disease and these factors are indicators of inflammatory status in your body.

The most obvious characteristic of metabolic syndrome is a waist circumference measuring over 35 inches for a woman and 40 inches for a man. You can easily check it yourself with a cloth tape measure. Wrap the tape around your abdomen, just above the level of the hip bone. Keep the tape snug and measure your circumference while breathing out, with your abdomen relaxed.

Are you over the top? A bit too much flab around the middle?  If so, that’s a real indicator that you need a doctor to check out the other indicators.

Research (see Elks) has revealed that excess belly fat is not just embarrassing, it’s also harmful. The fat secretes a steady stream of chemicals that kindle inflammation throughout the body. This onslaught appears to damage the thin endothelial lining and underlying matrix of arterial walls, including the coronary arteries and blood vessels in the kidneys.

The Sinatra Spin

Prevention is always worth a pound, and even a kilo, of cure. I always told that to my patients. To keep yourself from falling into the metabolic syndrome class, or to get yourself out of it, you must start paying attention to lifestyle.

Lifestyle modification remains the initial intervention of choice. Researchers link metabolic syndrome to lifestyle, and in particular to the combination of overeating and insufficient physical activity.

You can start getting yourself back on a healthier track simply by learning to eat to the point of satisfaction and not to fullness. Overeating is a common habit that can even ensnare even conscientious, health-minded folks. Food choices are critical here as well. I highly recommend a Mediterranean-type diet. Research (see Whayne) shows that eating this kind of a diet, high in fruits, vegetables, fish, and healthy fats (like from extra virgin olive oil), reduces metabolic syndrome, as well as coronary heart disease and diabetes.

As far as exercise is concerned, even a little physical activity, like daily walking, goes a long way and can actually help neutralize and shrink visceral fat. Conversely, overdosing on the couch is hazardous to health. A 2011 Harvard study (see Grøntved) reveals that every two hours spent watching TV daily increases the risk of diabetes by 20 percent and cardiovascular disease by 15 percent.

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