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Metabolic Syndrome


What Is It?

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The metabolic syndrome is identified as a group of metabolic abnormalities that, when present together, may lead to the development of cardiovascular disease or type 2 diabetes. In short, a person will present with abdominal fat, along with two other diagnostic markers. The additional markers are high blood sugar, blood fats, or blood pressure. 

Until recently, metabolic syndrome was thought to be an adult disease. Due to the increase in childhood obesity, however, the metabolic syndrome is now seen in children. In overweight adolescents, almost seven percent are affected. In obese adolescents, the rate increases to 29 percent. In severely obese children, 50 percent are affected by the metabolic syndrome. What follows is that more and more children are getting diabetes, and are being put on medications that were once reserved for adults in the hopes that they won’t develop heart disease at shockingly young ages.

The definition of the metabolic syndrome has not always been completely agreed upon, but, recently, the International Diabetes Federation created a definition for international use. This should eliminate some of the confusion when it comes to diagnosis and research.

Specifically, for a person to be identified as having the metabolic syndrome, he or she will have:

• Central obesity (abdominal fat) plus any two of the following:

• Raised triglyceride levels (≥ 150 mg/dL)

• Reduced HDL cholesterol (< 40 mg/dL in males, < 50 mg/dL in females)

• Raised blood pressure (systolic BP ≥ 130 or diastolic BP ≥ 85 mm Hg)

• Raised fasting plasma glucose (≥ 100 mg/dL)

Some consider inflammation as playing a part in the metabolic syndrome. Though not everyone agrees, inflammation is receiving a lot of attention, and deserves mention here.

Inflammation can be caused by many different molecules. Some of these molecules are involved in inflammatory reactions and others work to quell the inflammation. One important molecule to mention is the cytokine. Cytokines are involved in cellular communication. There are many different types of cytokines which may be present in those with metabolic syndrome.Two of the most common indicators of inflammation you may see on bloodwork are C-reactive protein (CRP) and homocysteine levels.

bp_cuff_hamb_ff-556x371CRP is made in the liver and found in the blood when there has been an inflammatory response. It is a general index of inflammation in the body. It is often tested for in those with high risk for cardiovascular disease.Homocysteine is an amino acid that is normally found in the bloodstream, but when elevated it can damage the arterial wall and other cells of the body furthering inflammation. Your integrative doctor may also test for other markers.

The anti-inflammatory cytokine adiponectin also has been found to be low in people with metabolic syndrome. In addition to decreasing inflammation, it also increases insulin sensitivity, which is important for lowering blood glucose levels.

What Causes It?

Here is a look at each of the components of metabolic syndrome to get a better understanding of what is happening in the body. (read more)

Abdominal Fat (Central Obesity)

Central obesity is the accumulation of fat in the abdominal area. People who experience weight gain in the abdominal area (as opposed to around the hips and thighs) are at higher risk for developing cardiovascular disease and type 2 diabetes. Central obesity is usually the result of overeating and reduced or sedentary activity. The fact that some people accumulate fat in the abdomen and others do not is probably a result of genetics.

It is argued that the real source of trouble is not just abdominal fat, but may also be fat in the liver. Fatty liver, or non-alcoholic fatty liver disease (NAFLD), is quickly being recognized as leading to the development of chronic disease. When there is an abundance of fat in the liver, inflammation and cholesterol production increase; both are contributors to cardiovascular disease. Insulin sensitivity is also reduced as a result of an imbalance in liver metabolism. Abdominal fat can contribute to fatty liver because fat cells in the abdomen release directly to the liver,  however, fatty liver may be present even in the absence of abdominal fat.

High Triglycerides (Hyperlipidemia)

Triglycerides are the form that fat takes when it is not used for energy after eating. It circulates in the blood, and is also stored in the body. No matter what type of food is consumed (fat, protein or carbohydrate), if it is not used for energy, it is stored as triglycerides. This is why people who overeat are more likely to have high triglycerides. In the liver, triglycerides are used to produce very low-density lipoproteins (VLDL). VLDLs are thought to contribute to the development of cardiovascular disease by increasing the hardening of the arteries or thickening of the artery walls. This is, in part, due to their compact size.

Triglyceride levels are classified as follows:man_pizza_beer-556x371

• Normal:  <150 mg/dL

• Borderline high:  150 – 199

• High:  200 – 499

• Very high:  ≥500

High triglycerides may be caused by:

• Obesity and overeating (especially refined carbohydrates and sugars in any form)

• Poorly controlled diabetes

• Underactive thyroid

• Kidney disease

• Over-consumption of alcohol

• Certain medications

Low “Good” (HDL) Cholesterol

Cholesterol is a waxy substance, similar to fat, that is produced in the liver. The body needs a small amount of cholesterol to make hormones and bile acids, but it does not take much to obtain the necessary levels of cholesterol. Cholesterol travels in the body attached to a protein called a lipoprotein. There are three types of cholesterol-lipoprotein complexes:

• Low-density lipoproteins (LDL), aka “bad” cholesterol, so named because it causes a buildup of plaque on artery walls.

• Very low-density lipoproteins (VLDL) are also harmful. VLDLs circulate through the blood giving up their triglycerides for storage in fat and muscle tissue, and then convert to LDL.

• High-density lipoproteins (HDL), aka “good” form of cholesterol, because it helps remove cholesterol from the artery walls, and transports it back to the liver for elimination.

In metabolic syndrome, low HDL (good) cholesterol levels are found. Sometimes this is associated with high LDL (bad) levels, but not necessarily. If HDL levels are low, the LDL cholesterol is not moved out of the body efficiently enough. This can contribute to higher LDL levels. The real problem with cholesterol is the LDL. When LDL becomes oxidized (oxLDL), it penetrates arterial walls and causes immune cells to enter the wall to trap the oxLDL. This creates an intense inflammatory reaction with resultant calcification of the arterial wall, which leads to calcified plaques. These calcified plaques can either rupture and cause a sudden heart attack, or gradually narrow the artery to the extent that either surgery or stent placement is needed to maintain blood flow.

HDL cholesterol levels:

• Low HDL cholesterol (heart disease risk):  <40 mg/dL for men, <50 mg/dL for women

• High HDL cholesterol (protects against heart disease):  ≥60 mg/dL

High cholesterol levels can be caused by:

• Saturated fat, cholesterol, and too much sugar in any form in the diet

• Overweight and obesity

• Sedentary lifestyle

• Smoking

• Diabetes

• Heredity

• Age

Cholesterol can build up on artery walls along with other deposits, forming a substance called plaque. This is called atherosclerosis, which increases the risk of having a heart attack or stroke.

For further clarification, according to the International Diabetes Federation’s definition of metabolic syndrome, the only cholesterol level that is considered is HDL cholesterol. But total cholesterol (which is HDL plus LDL plus VLDL) and LDL cholesterol levels are also important. The following outlines these cholesterol levels.

Total cholesterol:

• Normal total cholesterol:  <200 mg/dL

• Borderline:  200 – 239 mg/dL

• High cholesterol:  ≥240 mg/dL

LDL cholesterol:

• Optimal:  <100 mg/dL

• Near optimal:  100 – 129 mg/dL

• Borderline:  130 – 159 mg/dL

• High:  160 – 189 mg/dL

• Very high:  ≥190 mg/dL

High Blood Pressure (Hypertension)

ss_heart_donutBlood pressure refers to how much blood flows in the arteries, and to how much resistance the arteries present to that flow. The more blood that flows and/or the narrower the arteries, the higher the blood pressure. Two measures are taken. Systolic measures the blood pressure as the heart is pumping. Diastolic measures the blood pressure between beats. That is why two numbers are given, systolic over diastolic, such as 120 over 80.

High blood pressure is broken down into categories:

• Normal blood pressure:  less than 120/80 mm Hg

• Prehypertension:  120 – 139/80 – 89 mmHg

• Hypertension:  greater than 140/90 mm Hg

• Stage 1 hypertension:  140 – 159/90 – 99 mm Hg

• Stage 2 hypertension:  160 or greater/100 or greater mm Hg

It is not always known what causes high blood pressure (or hypertension), but there are some factors that can contribute:

• Overweight and obesity

• Heavy metal exposure

• Sedentary lifestyle

• High salt intake

• Family history

• Stress

• Age

High blood pressure alone can lead to a number of health complications, but in combination with other metabolic abnormalities (high cholesterol, high triglycerides, etc.), the problem becomes magnified.

High Blood Sugar (Hyperglycemia)

High blood sugar, or hyperglycemia, occurs when there is too much sugar in the blood. High blood sugar is present in a number of conditions, the most noteworthy being diabetes.

Normal blood sugar levels (with fasting blood glucose test):

• Normal blood sugar:  100 mg/dL or less. In fact, it is now believed that anything over 85 mg/dL indicates dysglycemia (imbalance between blood sugar and insulin)

• Prediabetes:  100 – 125 mg/dL

• Possible diabetes:  ≥126 mg/dL

High blood sugar can occur for different reasons:

• Consumption of high sugar foods

• Consumption of simple carbohydrate foods

• Air pollution exposure

• Pesticide exposure

• Infection or illness

• Injury or surgery

• Acute or chronic stress

• Insulin resistance

Belly_fat_cycle-1High blood sugar leads to insulin resistance, the main feature of diabetes, which involves an inability of insulin to perform its function of moving sugar from the blood to the cells for use as energy. Insulin resistance, in turn, leads to increased blood sugar. Thus, a vicious cycle can develop in which the body cannot balance blood sugar levels, and further health consequences develop.

Non-Alcoholic Fatty Liver Disease (NAFLD)

Another risk factor that should be mentioned here is non-alcoholic fatty liver disease (NAFLD), which tends to occur in conjunction with metabolic syndrome. NAFLD has become the most common liver condition, affecting as many as 30 percent of the population. Usually, weight gain leads to its development, involving the accumulation of excess fat in the liver. This progresses to insulin resistance, which leads to diabetes.

The role that the gut plays in the development of metabolic syndrome is becoming increasingly clear. Not only does diet play an important role in this condition, but so does intestinal bacterial balance, leaky gut and toxin exposure.

Studies are now showing that an imbalance in the gut bacteria, along with a high-fat diet, increase the amount of bacterial toxins that get into the bloodstream through a leaky gut or increased intestinal permeability.  The bacterial toxins, or lipopolysaccharides (LPS), trigger a silent inflammatory immune response that leads to weight gain and insulin resistance, both major components of the metabolic syndrome. Gut bacterial imbalance has also been shown to create changes in appetite and metabolism that lead to the development of metabolic syndrome.

What Are the Signs and Symptoms?

The symptoms of metabolic syndrome are largely absent. A person may, in fact, experience each of the components of the syndrome, yet not feel any different than a healthy individual. Indeed, this is why many people fail to learn of their poor health until further disease develops. (read more)

Those with high blood pressure may experience headaches, dizzy spells or nosebleeds. Individuals with high blood sugar may experience:

• Thirst

• Frequent urination

• Blurry vision

• Increased appetite

 


Brenda's Better Way

brendasbottomlineSo what is metabolic syndrome? As we mentioned previously there are a multitude of definitions available on the internet. One of my favorite’s comes from the Public Health Agency of Canada:  “Metabolic syndrome is a combination of medical problems that increase risk of heart disease and diabetes. People with metabolic syndrome have some or all of the following: high fasting blood glucose, high blood pressure, abdominal obesity, low HDL elevated cholesterol and high triglycerides.” I would like to add to this the following:  “Metabolic syndrome increases the risk of MOST ALL DISEASES, and is connected to gut issues, diet, lack of exercise, stress (both psychological and physical), and finally, toxic exposure.”  So let’s think about it, metabolic syndrome is the starting point for most every affliction humans face in their lifetime. This being the case, we need doctors who see the big picture, and who are interested in prevention and very early intervention.

People with metabolic syndrome are at a critical point; they need to make some changes to avoid a life of illness, medications and never-ending chronic health conditions. Metabolic syndrome strikes home for me because my father had it. At 70, he was overweight and on 10 to 12 different medications following triple bypass surgery. I took him to an alternative doctor to learn about chelation therapy. He was impressed, and went home to find a doctor who could perform this therapy. He also started taking natural supplements, and doing cleansing programs and colonics to enhance his health. With all this he was able to lose 30 pounds. Within six months, his blood sugar, cholesterol and blood pressure were normal, and he was off his medications. If a 70-year-old man can do this to improve his health, anyone can!

If we are going to bring down the cost of healthcare in this country, taking control of metabolic syndrome through nutritional and lifestyle changes is necessary since this condition leads to so many other chronic illnesses. With this information and so much that is available all around you these days, you have the information you need at your fingertips to help make the changes that can turn around your health. Now it’s up to you. Please take this information and use it. The pharmaceutical industry’s agenda is to sell sickness. Don’t buy it. If your metabolic syndrome is under control, you are in control. Follow the recommendations below to gain control of your health.   

Recommended Testing

• HDL Bloodwork

• Heavy metal hair analysis

• Comprehensive stool analysis

Diet

• A diet high in fruits and vegetables, and low in saturated and trans fats is protective against metabolic syndrome. Follow the Get Lean Phase of the Skinny Gut Diet Eating Plan.

• Replace saturated fats with monounsaturated and polyunsaturated fats.

• Limit sugar and simple carbohydrate (white flour, white rice, white pasta, etc.) intake, which increases many risk factors for cardiovascular disease.

• Eat small, frequent meals to avoid blood sugar spikes and falls.

• Limit salt intake because high-salt intake increases blood pressure.

• Use natural sweeteners substitutes like stevia or lo han.

Lifestyle

• If overweight or obese, lose weight to improve insulin sensitivity.

• Smoking and second-hand smoke exposure are associated with insulin resistance. If you do smoke, quit. If you are exposed to second-hand smoke, reduce that exposure.

• Aerobic and strength-training exercise increase insulin sensitivity.

Complementary Mind/Body Therapies

• Stress can be a major component of this disease, so find ways to reduce it with therapies such as meditation, yoga, deep breathing, massage, biofeedback, or music therapy.

• Acupuncture is helpful for people with metabolic syndrome.

• Colon hydrotherapy is beneficial, especially when bowel elimination is not optimal.