Can you reverse metabolic syndrome

Contents

Make These Lifestyle Changes

  • Get some exercise. Exercise is a great way to lose weight, but don’t get down if the scale isn’t showing progress. Even if you don’t lose a single pound, exercise can lower blood pressure, improve cholesterol levels, and improve insulin resistance. If you’re out of shape, start slowly. Try walking more. Work more physical activity into your day. When you’re on foot, allow a little extra time to take the scenic route to get some extra steps. To keep track, buy a pedometer (step counter). Gradually increase your physical activity until you’re doing it on most days of the week. But don’t get too ambitious. If you try a workout regime that’s too tough, you may give up. You need to find a level of exercise that fits your personality.
  • Eat a healthy diet. Eating a healthy diet can improve your cholesterol, insulin resistance, and blood pressure — even if your weight stays the same. For advice on healthy eating, ask your doctor or registered dietitian. If you have heart disease or diabetes, you may need special meal plans. In general, a diet that’s low in saturated fats, trans fat, cholesterol, and salt — and high in fruits, vegetables, lean protein, beans, low fat dairy, and whole grains — has been shown to help people with high blood pressure and a higher risk of cardiovascular disease. Many doctors suggest a “Mediterranean” diet or the DASH diet. These meal plans emphasize “good” fats (like the monounsaturated fat in olive oil) and a balance of carbohydrates and proteins.
  • Lose some weight. Obviously, weight loss is often a by-product of exercising and eating well. But it’s a key goal in itself if you’re overweight or obese. Weight loss can improve every aspect of metabolic syndrome.
  • If you smoke, quit. It’s not a risk factor for what’s considered metabolic syndrome, yet smoking greatly increases your risk of blood vessel and heart disease.

Today, scientists have answers to Nathan Pritikin’s observations. There is a link, and it’s called the Metabolic Syndrome.

What is the Metabolic Syndrome?

The Metabolic Syndrome is not a disease, per se. It is a cluster of factors indicating a dysfunctional metabolism, and this malfunctioning metabolism often does lead to deadly diseases.

Having the Metabolic Syndrome damages our blood vessels and greatly increases our risk of diabetes, heart attacks, strokes, dementia, kidney disease, fatty liver, vision impairment, and many other woes.

You have the Metabolic Syndrome, according to the National Cholesterol Education Program (NCEP) of the National Institutes of Health, if you have at least three of the following five criteria:

  1. A resting blood pressure of 130/85 or higher (either number), or you’re currently taking blood-pressure-lowering medications.
  2. A waist circumference of greater than 35 inches in women and greater than 40 inches in men. The measurement is typically taken 1 inch above the highest part of the side of your pelvic bone. The circumference around your belly button is a good approximation. NOTE: There are high-risk groups in which the thresholds are lower – 33 inches for women and 37 for men. They include people with a personal or family history of vascular disease (such as heart disease, stroke, and diabetes) as well as specific ethnic groups, including African-Americans, Asians, Native Americans, Indian/Pakistanis, and Latinos.
  3. An HDL “good” cholesterol less than 40 mg/dL in men and less than 50 mg/dL in women, or you’re currently taking HDL-raising medications.
  4. A fasting triglyceride level of 150 mg/dL or higher, or you’re currently taking triglyceride-lowering medications. NOTE: The American Heart Association has lowered what it considers to be optimal fasting triglycerides to less than 100 mg/dL.
  5. A fasting blood glucose (blood sugar) of 100 mg/dL or higher.

Epidemic

If you have the Metabolic Syndrome, you’re far from alone. This pre-cursor of Type 2 diabetes along with another pre-cursor, pre-diabetes (defined as a fasting glucose between 100 and 125) are now so widespread that scientists estimate that the majority of Americans over age 65 has them. Nearly 50% of Americans over age 40 have the Metabolic Syndrome. And alarmingly, more and more children, especially overweight kids, are being diagnosed with the syndrome.

There’s more troubling news. The Metabolic Syndrome and pre-diabetes increase our risk of heart disease almost as much as Type 2 diabetes does.

Strangely and sadly, it could be argued that you’re lucky if you get to the Type 2 diabetes stage. Far too many people succumb to cardiovascular disease in the earlier stages of diabetes – when they have Metabolic Syndrome or pre-diabetes.

Pre-Diabetes

Almost 90 million Americans, more than 25% of our total population, have pre-diabetes, and around 90% aren’t even aware. Warns the Centers for Disease Control and Prevention: “Without lifestyle changes to improve their health, 15% to 30% of people with pre-diabetes will develop Type 2 diabetes within 5 years.

All this suffering, all this early death, is preventable . They are the direct result of the way we live – by our sedentary habits and our Western-style diets, bereft of whole, fiber-rich foods and full of fast foods and other calorie-dense junk.

How Metabolic Syndrome begins

The Metabolic Syndrome usually begins with insulin resistance. Insulin resistance happens when our cells “resist” insulin.

Here’s what’s going on in our bodies. Normally, we change the sugars and starches we eat into a form of sugar called glucose. The bloodstream carries the glucose to the body’s cells. Insulin, a hormone produced by the pancreas, “ushers” glucose into the cells, where it’s converted to energy. You are insulin resistant if your cells don’t want to “accept” the insulin. Figuratively-speaking, your cells have signs on their doors that say, “Sorry, closed for business. We already have all the glucose we need.”

So the pancreas has to pump out more insulin in an effort to “push” those doors open and keep blood sugar levels from going too high. That’s why the insulin levels of people with Metabolic Syndrome, pre-diabetes, or diabetes are often higher than the insulin levels of others.

In about half of all cases, insulin resistance leads to ever-rising blood sugar levels and Type 2 diabetes (defined as a fasting glucose of 126 or more). Ultimately, the pancreas may give out. For years, it’s been on overdrive, pumping out more and more insulin, trying to break through the cells’ doors. Eventually, it cannot produce enough extra insulin to overcome the insulin resistance. As a result, people who’ve had Type 2 diabetes for many years must often resort to insulin shots.

What causes insulin resistance?

Here’s what we know. Environment is important. The great majority of people with insulin resistance are overweight. But scientists know that genetic susceptibility plays a role as well because some normal-weight people are insulin resistant – and some very obese people are not.

In addition to being overweight and having a genetic tendency, other factors that contribute to insulin resistance are:

  • Poor diet: Even in normal-weight people, a diet high in fats and highly refined, processed foods like sugars, white breads, and dry cereals is associated with greater risk of developing insulin resistance and all other aspects of the Metabolic Syndrome.
  • Inactivity
  • Smoking
  • Aging

How do you prevent or reverse the Metabolic Syndrome?

There is no one magic pill that erases the syndrome. Pharmaceutically, it is treated in piecemeal fashion. People take one type of drug, usually statins, to control cholesterol, another to lower blood pressure, another to lower triglycerides, and still others to treat high blood sugar. To date, no drugs have been approved for insulin resistance.

The far better approach – one that treats the overall problem – is the more natural way: a healthy diet and regular exercise. It is also the most effective way, argue experts like Dr. Paul Ridker of the Center for Cardiovascular Disease Prevention at Brigham and Women’s Hospital in Boston, because it targets what are often the roots of the problem: poor diet, lack of physical activity, and excess body fat, especially in the belly.

Oh, what that spare tire can do!

Excess belly fat is problematic because it is not just a dormant roll of flab. Those fat cells, wrapped around organs like the liver and pancreas, are very active. They pump out hormones and other chemicals that raise blood pressure, worsen cholesterol levels, slow down our metabolism (so yes, we end up gaining even more weight), and foul up the delicate system by which insulin works, causing insulin resistance.

The chemicals that belly fat secrete also trigger inflammation throughout the body. That’s bad news because high levels of inflammation are increasingly linked with higher risk of heart attacks, strokes, osteoarthritis, and even Alzheimer’s disease.

A bulging belly, in short, is deadly, and it appears so even if you aren’t overweight or obese by other measures, according to research. Reporting in the Archives of Internal Medicine, , scientists analyzed data from more than 100,000 people who were followed for a decade and found that men and women with big waistlines had double, and more, the risk of dying compared to those with trimmer waistlines, and these conclusions held true for people whose overall weight, measured by BMI (body mass index), was normal.

Cleaning up a metabolic mess

Now for the good news. With lifestyle-change programs like Pritikin, the problems that make up the Metabolic Syndrome start to fade quickly and simultaneously. Over the past 40 years, studies published in peer-reviewed journals like Diabetes Care and the New England Journal of Medicine have shown that the Pritikin Program lowers blood pressure, dramatically improves cholesterol and triglyceride profiles, sheds body fat, and normalizes blood sugar levels.

The good news, too, is that just a small amount of weight loss – about 5% of body weight – can help restore insulin sensitivity. In fact, just getting started on the Pritikin Diet and Exercise Program can reverse the Metabolic Syndrome.

Metabolic Syndrome diet and lifestyle | Benefits

Within three weeks, researchers at UCLA documented in the Journal of Applied Physiology, the majority of people who arrived at the Pritikin Longevity Center with the syndrome were able to improve their cholesterol levels, blood pressure, triglycerides, and blood sugars so much that they no longer met the three-risk-factor criteria for the syndrome.

Additionally, after two weeks on the Pritikin Program, research by scientists at Washington University found that 67 adults with Type 2 diabetes and/or the Metabolic Syndrome achieved major improvements in multiple cardiovascular risk factors. Blood glucose, LDL cholesterol, and systolic and diastolic blood pressure were lowered on average 10% to 15%; triglycerides decreased 36%; body mass index fell 3%; and 37% of subjects no longer met National Cholesterol Education Program criteria for the Metabolic Syndrome.

“The results of these studies show that dramatic changes in diet and activity levels can quickly and favorably alter most of the metabolic abnormalities seen in people with the Metabolic Syndrome,” notes Kimberly Gomer, MS, RD, LDN, Director of Nutrition at the Pritikin Longevity Center.

Children benefit, too. In an investigation on overweight kids (ages 8 to 17) attending the Pritikin Program with their parents, scientists found that the children with Metabolic Syndrome left Pritikin’s two-week healthy-living program free of the syndrome.

Research has also found that the Pritikin Program is effective in curbing inflammatory factors related to the Metabolic Syndrome and excess weight. Studying overweight/obese children in the two-week Family Health Camp at Pritikin, UCLA scientists reported significantly improved markers of not only metabolic health but also chronic inflammation.

A key factor in curbing inflammation, the authors concluded, was the Pritikin Eating Plan’s dramatic decrease in saturated fat intake.

Science is also learning that reducing the factors that make up the Metabolic Syndrome may also reduce the risk of prostate cancer.

Bottom Line

The optimal approach for preventing the Metabolic Syndrome is to lose excess weight with regular exercise and a diet, like the Pritikin Eating Plan, that focuses on foods that are low in calorie density and naturally high in fiber and nutrients, including whole-grain foods like hot cereals, corn, whole-wheat pasta, and brown rice; generous amounts of fruits, vegetables, and starchy foods like potatoes, yams, beans, lentils, and peas; and modest amounts of nonfat dairy products, seafood, and lean poultry and meat.

As more than 100 studies in leading peer-reviewed medical journals have proven, and as Nathan Pritikin observed four decades ago, this simple but powerful diet-and-exercise approach acts like a one-two punch on the Metabolic Syndrome, and, in doing so, helps prevent and control the leading causes of death and disability in the United States, including cardiovascular disease, Type 2 diabetes, hypertension, and stroke.

“If ever there were a magic bullet for reversing the Metabolic Syndrome and building long-term health, the Pritikin Program is it,” sums up Gomer.

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Originally published in in 2013. Edited in 2019 by Kell Wynn

Metabolic Syndrome

How is metabolic syndrome treated?

Your healthcare provider will figure out the best treatment for you based on:

  • How old you are
  • Your overall health and past health
  • How sick you are
  • How well you can handle specific medicines, procedures, and therapies
  • How long the condition is expected to last
  • Your opinion or preference

Because metabolic syndrome increases the risk of developing more serious long-term (chronic) conditions, getting treatment is important. Without treatment, you may develop cardiovascular disease and type 2 diabetes. Other conditions that may develop as a result of metabolic syndrome include:

  • Polycystic ovarian syndrome (PCOS)
  • Fatty liver
  • Cholesterol gallstones
  • Asthma
  • Sleep problems
  • Some forms of cancer

Here are the types of treatment that may be recommended for metabolic syndrome.

Lifestyle management

Treatment usually involves lifestyle changes. This means losing weight, working with a dietitian to change your diet, and getting more exercise. Losing weight increases HDL (“good”) cholesterol and lowers LDL (“bad”) cholesterol and triglycerides. Losing weight can also reduce the risk for type 2 diabetes.

Losing even a modest amount of weight can lower blood pressure and increase sensitivity to insulin. It can also reduce the amount of fat around your middle. Diet, behavioral counseling, and exercise lower risk factors more than diet by itself.

Other lifestyle changes include quitting smoking and cutting back on the amount of alcohol you drink.

Diet

Changes in diet are important in treating metabolic syndrome. According to the AHA, treating insulin resistance is the key to changing other risk factors. In general, the best way to treat insulin resistance is by losing weight and getting more physical activity. You can do this by doing the following:

  • Include a variety of foods in your diet.
  • Use healthy fats. Polyunsaturated and monounsaturated fats may help keep your heart healthy. These healthy fats are found in nuts, seeds, and some types of oils, such as olive, safflower, and canola.
  • Choose whole grains such as brown rice and whole-wheat bread instead of white rice and white bread. Whole-grain foods are rich in nutrients compared with more processed foods. Whole grains are higher in fiber, so the body absorbs them more slowly. They do not cause a rapid spike in insulin, which can trigger hunger and cravings. The 2015-2020 Dietary Guidelines from the USDA recommend that at least half of your grains be whole-grains.
  • Eat more fruits and vegetables. According to the 2015-2020 Dietary Guidelines, a person on a 2,000-calorie-per-day diet should eat 2.5 cups of vegetables and 2 cups of fruit a day. This amount will vary depending on how many calories you need. Be sure to choose a variety of fruits and vegetables. Different fruits and vegetables have different amounts and types of nutrients.
  • When eating out, take part of your restaurant meal home. When dining out or ordering take-out food, ask for a take-home box or avoid super-size selections when you order. Many restaurant portions are too large for one person, so consider sharing an entrée. Or order an appetizer instead of a main dish from the entrée menu.
  • Read food labels carefully. Pay close attention to the number of servings in the product and the serving size. If the label says a serving is 150 calories but the number of servings per container is 3 and you eat the entire container, you are getting 450 calories. Choose foods that are low in added sugar.

Exercise

Exercise helps people who are overweight or obese by helping to keep and add lean body mass, or muscle tissue, while losing fat. It also helps you lose weight faster than just following a healthy diet because muscle tissue burns calories faster.

  • Walking is a great exercise for just about anyone. Start slowly by walking 30 minutes daily for a few days a week. Gradually add more time so that you are walking for longer periods most days of the week.
  • Exercise lowers blood pressure and can help prevent type 2 diabetes. Exercise also helps you feel better emotionally, reduces appetite, improves sleep, improves flexibility, and lowers LDL cholesterol.
  • Talk with your healthcare provider before starting any exercise program.

Medicine

People who have metabolic syndrome or are at risk for it may need to take medicine as treatment. This is especially true if diet and other lifestyle changes have not made a difference. Your doctor may prescribe medicine to help lower blood pressure, improve insulin metabolism, lower LDL cholesterol and raise HDL cholesterol, increase weight loss, or some combination of these.

Weight-loss surgery

Weight-loss surgery (bariatric surgery) is an effective treatment for morbid obesity in people who have not been able to lose weight through diet, exercise, or medicine. It may also help people who are less obese but who have significant complications from their obesity.

  • Studies have shown that gastric bypass surgery helped lower blood pressure, cholesterol, and body weight at one year after the procedure.
  • Weight-loss surgery can be done in several ways, but all are either malabsorptive, restrictive, or a combination of the two. Malabsorptive procedures change the way the digestive system works. Restrictive procedures are those that greatly reduce the size of the stomach. The stomach then holds less food, but the digestive functions remain intact.

10 Things Your Doctor Won’t Tell You About Metabolic Syndrome

Although it sounds mysterious, Syndrome X is very common. It’s better known as metabolic syndrome, which is a term for a group of risk factors that can raise your chance of developing heart disease and other health problems like diabetes.

In general, excess weight and lack of activity can lead to metabolic syndrome, but there are five specific factors that can put you at risk for it. You need to have at least three factors present in order to be officially diagnosed with metabolic syndrome. The five factors are:

  • Having a large waistline (a more than 35-inch circumference for women and more than 40 for men)
  • Low levels of HDL (“good”) cholesterol
  • High triglyceride levels
  • High levels of blood sugar
  • High blood pressure

The good news is that with changes to diet and exercise, you can prevent, control, or even reverse metabolic syndrome. If you don’t, you could develop significant health risks related to the diabetes, heart disease, and stroke as part of the condition. Your risk for metabolic syndrome increases with age, so it’s important to start adjusting your health habits early on.

Here are 10 things you should know about metabolic syndrome.

1. Metabolic Syndrome Is Closely Linked to Your Family History

Ask your family members about their medical histories. Your family’s medical history is yours, too. If one of your close relatives has diabetes or heart disease, you could be a candidate for metabolic syndrome.

According to the National Institutes of Health, a complete family health record includes information from three generations of relatives, including children, brothers and sisters, parents, aunts and uncles, nieces and nephews, grandparents, and cousins.

It may sound like a daunting task to collect this info, but questioning your family can evoke some heartfelt conversation. It could also protect your children and their children for generations to come.

2. It Matters Where You Wear Your Fat When It Comes to Metabolic Syndrome Risk

If you look more like an apple than a pear, your risk of developing metabolic syndrome is greater. In discussing your health plan, your doctor may not mention how fat that settles in your belly boosts health risks more than weight that sits in your butt.

“Reducing your waist circumference could have more of an impact on preventing and managing disease than medication,” says Erin Palinski-Wade, RD, CDE, author of Belly Fat Diet for Dummies. Carrying weight around your middle, Palinski-Wade adds, “is an indication of excess visceral fat, a key risk factor for the development of metabolic syndrome, type 2 diabetes, heart disease, and even certain cancers.” Focus on reducing waist size even more than the numbers on the scale, she advises.

3. A Plant-Based Diet Can Help Curb Metabolic Syndrome

The most current set of dietary guidelines for Americans encourages a diet that is plant-focused. Julie Upton, RD, of San Francisco, the cofounder of Appetite for Health, encourages a Mediterranean style of eating. The Mediterranean diet showcases fruits, veggies, whole grains, legumes, and seafood but has less meat, cheese, sugars, and sweets. Says Upton: “Not only is this plan helpful for your heart, but it also lowers risks for metabolic syndrome.”

4. Dietary Fiber Will Help Lower Your Risk of Metabolic Syndrome by Lowering Your Cholesterol

Your doctor may have handed you an info sheet on the foods you should be avoiding, but you might make more progress by adding certain foods to your diet. Focus on incorporating foods rich in soluble fiber, like oats and beans, into your meals. Insoluble fibers like whole grains can provide a “moving experience” by transporting foods through your gastrointestinal tract while keeping you feeling satisfied. Fill at least half your plate with veggies and fruits, and choose whole-grain carbs to make less room on your plate (and in your stomach) for less-beneficial choices.

5. What You Drink Can Affect Your Risk for Metabolic Syndrome

Your doctor may ask you about your diet, provide you with some guidance, and refer you to a registered dietitian or nutritionist who can tailor a plan to your particular needs. But your doc may not ask you what you’re drinking.

Fruit juices and sugary beverages can make your blood sugar and triglyceride levels soar. Alcoholic beverages may cause hypoglycemia and an initial drop in blood sugar, but those numbers will then climb — especially if you’re consuming mixed cocktails. Water is the best beverage for healthy hydration. And it’s good to know that tea, coffee, skim or low-fat milk, and fruits and vegetables provide water without extra calories, too.

6. Even a Little Weight Loss Could Have a Big Impact on Metabolic Syndrome

“Too often, doctors don’t set reasonable expectations,” says Lauren Harris-Pincus, RDN, of New York City. A blanket statement like “‘Lose weight and go exercise’ is not as motivating as ‘If you lose a modest 5 percent of your body weight, you can make a significant impact on the important numbers like blood pressure, blood sugar, and cholesterol/triglycerides,’” Harris-Pincus says.

For example: If you weigh 160 pounds but your ideal weight is 120, even a drop of 8 to 10 pounds could improve your laboratory test results. It could even decrease or eliminate your need for medication. And smaller and more specific goals will seem more attainable and encouraging.

7. Exercise Is Just as Important as a Balanced Diet in Combating Metabolic Syndrome

“Your doctor is probably not trained about the types of exercises and their related recommended intensities for improving specific parameters of this syndrome,” says Joey Gochnour, RDN, an exercise physiologist in Austin, Texas. Gochnour points out that even moderate aerobic exercise can improve cholesterol levels. He recommends exercising regularly, preferably at least 30 minutes a day, five days a week to help ward off metabolic syndrome.

According to Gochnour, “Strength training and intense aerobic exercise may improve your blood glucose sensitivity and reduce elevated insulin levels.” Exercise is a key component in boosting metabolism and burning calories, both of which help you keep your weight down.

8. Sitting Too Much Puts You at Risk for Metabolic Syndrome

“It may sound odd,” says Jo-Ann Heslin, RD, the author of Diabetes Counter, “but sitting or sedentary activities such as watching TV, using the computer, sitting at work or sitting while commuting have been identified as risks for metabolic syndrome even when you incorporate modest amounts of regular activity into your day.” A study published in June 2015 in Diabetologia connected sitting time with a positive risk for diabetes, reporting that for every hour of daily TV viewing, a person’s risk for diabetes increased by 3.4 percent.

9. You Should Get Your Fasting Insulin Level Tested to Assess Your Risk for Metabolic Syndrome

When it comes to laboratory values, numbers like blood glucose and A1C levels are commonly checked. Less often, doctors order a test for your fasting insulin level; yet this test can help predict your risk of developing prediabetes and metabolic syndrome. Insulin plays a key role in metabolism, and high insulin levels can promote obesity, stimulate hunger, and increase the storage of fat.

“When you eat sugary foods, your blood sugar levels rise and your pancreas releases insulin to move the sugar from your blood into your cells to be used or stored,” explains Chere Bork, RDN, a nutritionist and life coach in the Minneapolis–St. Paul area. But if your body is continuously exposed to high levels of insulin, Bork says, “the receptor cells become inefficient and resistant to the effects of insulin,” and this leaves blood glucose levels elevated. It is insulin resistance that promotes the high cholesterol, high glucose, and high blood pressure of metabolic syndrome — also known as insulin resistance syndrome.

10. To Help Assess Your Risk for Metabolic Syndrome Over Time, Keep an Up-to-Date Copy of Your Laboratory Values

Your current healthcare provider may not end up being your future provider, but your current body is yours forever. If you undergo any blood tests or exams, ask for copies of the results so that you can keep them filed away at home. It’s essential that you know your baseline numbers and keep track of the evolution of your health throughout the course of your life.

Metabolic Syndrome

What is metabolic syndrome?

Metabolic syndrome is a collection of heart disease risk factors that increase your chance of developing heart disease, stroke, and diabetes. The condition is also known by other names including Syndrome X, insulin resistance syndrome, and dysmetabolic syndrome. According to a national health survey, more than 1 in 5 Americans has metabolic syndrome. The number of people with metabolic syndrome increases with age, affecting more than 40% of people in their 60s and 70s.

Who typically has metabolic syndrome?

  • People with central obesity (increased fat in the abdomen/waist).
  • People with diabetes mellitus or a strong family history of diabetes mellitus.
  • People with other clinical features of “insulin resistance” including skin changes of acanthosis nigricans (“darkened skin” on the back of the neck or underarms) or skin tags (usually on the neck).
  • Certain ethnic backgrounds are at a higher risk of developing metabolic syndrome.

As you grow older, your risk of developing metabolic syndrome increases.

What causes metabolic syndrome?

The exact cause of metabolic syndrome is not known. Many features of the metabolic syndrome are associated with “insulin resistance.” Insulin resistance means that the body does not use insulin efficiently to lower glucose and triglyceride levels. A combination of genetic and lifestyle factors may result in insulin resistance. Lifestyle factors include dietary habits, activity and perhaps interrupted sleep patterns (such as sleep apnea).

What are the symptoms of metabolic syndrome?

Usually, there are no immediate physical symptoms. Medical problems associated with the metabolic syndrome develop over time. If you are unsure if you have metabolic syndrome, see your healthcare provider. He or she will be able to make the diagnosis by obtaining the necessary tests, including blood pressure, lipid profile (triglycerides and HDL) and blood glucose.

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George Sanders: Freeing Myself of Metabolic Syndrome

I no longer have metabolic syndrome, or pre-diabetes or obesity or hypertension or inflammation.

Freeing Myself of Metabolic Syndrome

I was raised in the typical American family, eating the typical American diet. The four food groups were meat, potatoes, bread, and dessert, all washed down with some sugary sweet drink for every meal. Despite this rich diet, I had no problems staying relatively thin and fit. I was always tall for my age and athletically inclined throughout junior and senior high school, reaching 6′ at the age of 13, after which I stopped growing.

After a brief stint at a local junior college, I entered the US Air Force as my father and brother had. It was at that time that I became interested in fitness, and started weight training. I loved to exercise and continued doing so throughout my four-year enlistment, easily maintaining my weight despite my diet.

After the military I went back to college determined to complete an education before entering the “real” world of work. However, by this time life’s priorities had changed and my exercise pursuits took a backseat to everything. I gained a few pounds during college, eventually reaching 190 pounds.

I ended up dropping out of college in my final year and decided to re-enter the USAF, but I needed to lose a few pounds to qualify. So I went on a calorie-restricted, portion-controlled diet, and I lost about 30 pounds in two months. It wasn’t easy but I was determined.

Once I was back in the Air Force I struggled with my weight as it slowly increased: a pound here, a pound there. Every year, three to five new pounds found their way to my body. And along with it came the usual aches and pains; you know, all the things we “know” are just the facts of aging: expanding waist line, lower back pain, sore knees and ankles, indigestion, heartburn, headaches, frequent colds, tiredness, etc. It was all to be expected—right?

While in the military I found myself constantly bumping up against its weight limits. This started a never-ending cycle of yo-yo dieting to stay a few pounds under my limit. I was able to maintain this until I left the USAF, for the second and final time, in 1991.

My Post-Military Slide

Suddenly, without the need to keep my weight in check, there was no stopping my weight gain. Every year I was gaining more and more, and by 1996 I had reached about 240 pounds.

It was then that I decided to donate a kidney to my sister who was suffering from the ravages of Type 1 diabetes. I was nearly denied the opportunity because of my weight, but I was finally approved and all went well with the transplant; and my sister recovered in a matter of days.

My recovery, however, was slow and painful. The doctor had made a 17-inch incision starting just above my navel and curving around to my back to my kidney. I was still in pain three months after the surgery. Eventually, I healed but not without a nasty scar and some permanent numbness.

I still had not learned to control my weight and just kept gaining a few pounds every year. By 2005 I hit 260 pounds with no end in sight. My “age-related” health issues kept escalating, but I did not consider any of them serious, at least not serious enough to make a wholesale lifestyle change.

Not happy with how I felt or looked I decided to lose weight once again. I had previously read some of Dr. McDougall’s older works: A Challenging Second Opinion and his 12-Day Plan books. So I was familiar with the science and the basic program. But along with many other people, could not see myself becoming a vegan or giving up all of my most treasured foods.

So, I decided to try more conventional dietary advice: I cut out some meats, ate lower-fat food, and increased my intake of fruits and veggies. I also tried calorie restriction and portion control. And it worked! Over a year’s time I had lost over 70 pounds and was looking and feeling a bit healthier, though it was a very difficult year.

I was hungry a lot and fought my old cravings; it was a severe battle of will power. It wasn’t long before life’s little interruptions started disrupting my dietary goals, and within another year I had regained all the weight I had lost and was back to my usual pattern of SAD (Standard American Diet) eating. Typical of so many diet programs, it was ineffective and temporary. It just wasn’t sustainable, and by 2009, at 52 years old, I found myself at 291 pounds.

I was still gaining three to five pounds a year, every year. And all my aches and pains and little “issues of aging” intensified along with the weight gain. It was in 2009 that I decide to have a routine heart and vascular health checkup. I didn’t think I was really sick, but I knew I also wasn’t feeling as good as I could.

The results of my checkup surprised me: they were validation that I was in no way healthy and that I was heading down the road to serious health issues. My diagnosis: obesity, mild vascular disease, pre-diabetic, high inflammation levels and hypertensive. This conglomeration of issues, I learned, was called “Metabolic Syndrome.”

Needless to say I was concerned, but my Doctor assured me this was not at all unusual for my age and all I needed to do was just lose a little weight and take a handful of medications and everything would be under control; not cured, mind you, just under control, whatever that means.

The diet my doctor prescribed was nothing more than what I had already tried in the past—low-calorie, low-fat, portion-controlled, and lots of will power—and I knew it wasn’t maintainable for me. Along with this advice, I was also given a whole bunch of medications for every symptom I had. I hate taking pills, so I simply refused them.

Of course this did not please my doctor, but he was willing to give me a few months to see how I did with diet alone. I thanked my doctor and went home feeling dejected. I carried on with life as usual. After all, I didn’t feel that sick or really look sick. Sure, I was a bit overweight but I thought I carried it well, as they say. It’s amazing how easily we can delude ourselves.

For Christmas 2010 I had a picture taken of me and my daughter with Santa. I should have been the one wearing the Santa suit; it would have fit me better! It was then that I realized how badly I really looked. At age 53, I was at my maximum weight of 297 pounds with a BMI of 40.5 and a class 3 obesity level. I had reached the pinnacle of obesity classification and I looked and felt every part of it.

I immediately made a New Year’s resolution for 2011 to lose the weight and, if possible, improve my health. So I tried really hard once again, eating the typical low-calorie, portion-controlled SAD diet. This time I consumed 1,000 calories a day; it didn’t matter what I ate as long as it was less than 1,000 calories. And it worked. At least for as long as I could tolerate the constant hunger and tiredness that are so typical of “diets.”

That started a cycle of yo-yo dieting that usually amounted to about two to three months of starvation, followed by losing a fair amount of weight until I couldn’t tolerate the hunger anymore, before going back to my usual eating and gaining. Then after a few months I would try again with the same results, repeating the cycle several times in the year.

By the end of 2011, I had lost 36 pounds, basically through hunger and deprivation. It took all the willpower I had, and the results were barely noticeable. I feared there was simply no way I could continue with this dieting game—and believe me, it was all just a game. I would simply diet until I lost the weight and then go back to my usual eating patterns, trying my best to control everything with willpower. But now I simply had no willpower left. I couldn’t do it anymore.

In Feb 2012, I decided to have another set of heart health tests done, just to see if there were any positive changes since losing the little bit of weight. Well, the results were eye-opening, and not for the better. My weight was back to where it was in 2005, 261 pounds, but my blood pressure was worse, my sugars were now in the diabetic range, my cholesterol and triglycerides were still very high, and inflammation levels were in the high-risk range. In spite of losing weight, I was getting sicker, not better. The dieting wasn’t helping and I was beginning to panic. There had to be a better way.

Finding a Better Way

I had collected a small library of diet books over the years, so I started looking through them. I found a copy of Dr. McDougall’s Program for Maximum Weight Loss that I had picked up a few years earlier but had never read. So I sat down and read it from cover to cover in one day. This time something in me was touched; it somehow just made sense. There was no pseudo-science about “miracle” foods, no exhortations to buy every supplement known to man, no magic formulas, no calorie, carb, fat or protein counting or ratio balancing, and no exhaustive exercising.

The message was simple: eat real whole food, as much as would satisfy, whenever you were hungry, cut out or limit the fatty foods, and eliminate the meat and dairy. Essentially, do what your mama always told you: eat your fruits and veggies! There was one twist though: focus the majority of your food on satiating starches such as potatoes, grains, and beans.

That just made so much sense to me. After all it’s the food that Mother Nature provides; how could we have survived as a species without it? It appealed to my understanding of science. I decided right then and there that I had nothing to lose and everything to gain, so the next day I started the program. I ate everything recommended: plain, simple foods in their natural state, and it was good! It didn’t just taste good but the food was so quick and easy to make as well. I was in no way a cook, but I could easily throw a potato in the microwave and top it off with some nice spicy salsa, heat up a side of asparagus or Brussels sprouts, and make a big green salad with all sorts of raw veggies. And Dr McDougall said to eat till you were satisfied, so I did.

If after one plateful of food I was still hungry I would go back for seconds, and even thirds. I never left the table hungry. Being a volume eater, this way of eating fit me perfectly. I could easily find foods that satisfied my taste buds and hunger drive. I never worried about staying full. If I got hungry I would just eat; simple as that. I didn’t worry about how many meals or snacks I had as long as the food was compliant with the program.

I also used Dr McDougall’s online forums to start a journal of my experiences. I wanted to record everything I ate and did, giving myself a year to see real results. The journal would serve as my motivation for staying on course and staying honest. I didn’t know if I would succeed at losing the weight, let alone fixing my health issues. But Dr McDougall is a very convincing man. His science was there and everything made logical sense, yet I still had my doubts. Years of yo-yo dieting had taught me what to expect. After all, losing the weight was one thing; getting healthy was another. And then maintaining my weight was the biggest hurdle of all. It was going to be a long year, or at least I thought.

Real Changes

The weight started coming off right from the first week, and not just slowly. I was losing huge amounts of weight: five to six pounds a week the first few weeks. It felt like the fat was literally melting off me, all while eating all the food I wanted. My energy levels soon improved and I found myself easily being able to take walks, the recommended exercise. At first I would walk just 10 to 15 minutes around the neighborhood, but within weeks I could easily walk for an hour at a time and, more importantly, I was enjoying it, and without pain.

The changes were coming so easily and quickly, it was scary. I was improving in all ways and there was no struggle whatsoever. I still had cravings for my old SAD food that the rest of my family ate, but it was easy to just spend 10 minutes and make myself a great-tasting McDougall meal. After the first month I started to lose those SAD cravings; my tastes had begun to change.

While I was enjoying my new way of eating, the rest of my family continued to eat their regular food. I was never bothered by this. Making my McDougall meals was so easy and quick (not to mention tasty) that it was no problem for me to cook my own meals while cooking their food as well. I never had any temptations to stray. While I’ve not been able to get my family to totally switch to this way of eating, they have picked up many of my new habits and now incorporate more starches, fruits, and vegetables in their diets.

As the months went by, I started noticing that a lot of the issues I had started disappearing. The constant heartburn I had was gone, from day one. The horrible sinus issues that kept me awake at night simply disappeared. The chronic knee pain that kept me popping aspirin everyday magically went away. I not only was losing weight and looking better—and getting comments on how good I looked—but I was feeling so much better. Throughout this whole time I never once had the desire to revert back to my old way of eating. It was as if my body was telling me it was receiving exactly what it needed and wanted. And I was more than happy to comply.

Every three months I would go in and get my lab work done just to make sure the results were for real and not just my imagination. The tests showed the results were indeed for real. I was getting better and not just a little better, either. My blood lipids that were once through the roof were now dropping dramatically. My high blood pressure dropped into the normal range, and my blood sugars dramatically dropped to normal. Inflammation markers dropped significantly as well. Everything was improving and in significant ways, not just 5 to 10 percent changes. I was seeing 30 to 50 percent changes in a matter of a few months. And all without any drugs whatsoever.

I was amazed that just eating real foods could bring on such a dramatic shift in my health. As the months went by, I continued to improve and my body slowly but surely healed itself. And every time I went to get labs done, the results were better and better. During this journey I never did go back to see my doctor. I had decided early on that if modern medicine had nothing to offer me other than pills, potions and food deprivation, then I would take control of my health and treat myself in the only way that made sense to me: the McDougall way. I bet my health on Dr McDougall and it paid off!

I’ve lost over 106 pounds this past year. My pants size has gone from a tight 46+ to a loose 32″ waist. I’m a new man: trim, fit, healthy, happy and enjoying life like I never had before. All the chronic diseases I suffered from for years are now gone. I no longer have metabolic syndrome, or pre-diabetes or obesity or hypertension or inflammation. All of those little aches and pains and issues of aging are also gone. I sleep great. I can now walk for hours on end and have seemingly endless energy. I no longer think of myself as being on a diet and exercise program, it’s just simply how I eat; it is my new lifestyle. And the results speak for themselves.

Dr McDougall’s program has given me back my health and my life and at no cost.

Thank you Dr McDougall!

George Sanders
Macomb, Michigan
March, 2013

Treating metabolic syndrome requires addressing several conditions together. My Life Check provides a scoring tool and checklist with seven key heart-healthy targets for improving the quality and length of your life. Life’s Simple 7™ will improve your overall cardiovascular health and greatly improve the individual conditions that make up metabolic syndrome.

Here’s what you can do starting today:

  • Eat better. Adopt a diet rich in whole grains, fruits, vegetables, lean meats, skinless poultry and non-fried fish, and low-fat or fat-free dairy products. Avoid processed foods, which are often high in saturated and trans fats, sodium and added sugar.
  • Get active. Incorporate at least 150 minutes of moderately vigorous physical activity into your weekly routine. Walking is the easiest place to start, but you may want to experiment to find something else you like to do that gets your heart rate up. If needed, break your exercise up into several short, sessions throughout the day to reach your goal.
  • Lose weight. Reduce your risk for heart disease by successfully losing weight and keeping it off. Learn your recommended calorie intake, the amount of food calories you’re consuming, and the energy calories you’re burning off with different levels of physical activity. Balance healthy eating with a healthy level of exercise to reach your goals.

When changes in lifestyle alone do not control the conditions related to metabolic syndrome, your health practitioner may prescribe medications to control blood pressure, cholesterol, and other symptoms. Carefully following your practitioner’s instructions can help prevent many of the long term effects of metabolic syndrome. Every step counts and your hard work and attention to these areas will make a difference in your health!

Download our printable Answers by Heart sheet: What is Metabolic Syndrome? (PDF)

Clinical Trials

Clinical trials are scientific studies that determine if a possible new medical advance can help people and whether it has harmful side effects. Find answers to common questions about clinical trials in our Guide to Understanding Clinical Trials.

Intermittent fasting can help ease metabolic syndrome

For those with metabolic syndrome, the necessary lifestyle and weight changes can be challenging. Now, a study has shown that eating within a certain time window can help tackle that.

Share on PinterestNew research shows how intermittent fasting can help ease metabolic syndrome.

Metabolic syndrome is an umbrella term for a number of risk factors for serious conditions, such as diabetes, heart disease, and stroke. These risk factors include obesity and high blood pressure, among others.

This is no small issue in the United States, where one-third of adults have metabolic syndrome. In fact, the condition affects around 50% of people aged 60 and over.

Obesity is also prevalent, affecting around 39.8% of adults in the U.S. Obesity is closely linked to metabolic syndrome.

Receiving a diagnosis of metabolic syndrome offers a critical window of opportunity for making committed lifestyle changes before conditions such as diabetes set in.

However, making the necessary long-term lifestyle changes to improve one’s health outlook is not always easy. Such changes include losing weight, managing stress, being as active as possible, and quitting smoking.

For the first time, a new study has looked into time-restricted eating, or intermittent fasting, as a means of losing weight and managing blood sugar and blood pressure for people with metabolic syndrome.

This new study, which appears in the journal Cell Metabolism, is set apart from previous studies that looked at the health and weight loss benefits of time-restricted eating in mice and healthy people.

” who have metabolic syndrome/prediabetes are often told to make lifestyle interventions to prevent progression of their risk factors to disease,” said co-corresponding study author Dr. Pam Taub, of the University of California San Diego School of Medicine.

“These are at a crucial tipping point, where their disease process can be reversed.”

“However, many of these lifestyle changes are difficult to make. We saw there was an unmet need in with metabolic syndrome to come up with lifestyle strategies that could be easily implemented.”

Clinical testing of time-restricted eating

Armed with the knowledge that time-restricted eating and intermittent fasting had been effective in treating and reversing metabolic syndrome in mice, the researchers set out to test these findings in a clinical setting.

“There are a lot of claims in the lay press about promising lifestyle strategies that have no data to back up the claims. We wanted to study in a rigorous, well-designed clinical trial,” said Dr. Taub.

Participants could eat what they wanted, when they wanted, within 10-hour windows.

The good news for the 19 participants with metabolic syndrome was that they could decide how much to eat and when they ate, as long as they restricted their eating to a window of 10 hours or less.

A 10-hour window had been effective with mice, and it offered people enough leeway that would be easy to comply with long-term.

“The participants in the study had control of their eating window,” said Dr. Taub. “They could determine which 10-hour period they wanted to consume calories. They also had flexibility in adjusting their eating window by a couple hours based on their schedule.”

“Overall, participants felt they could adhere to this eating window. We did not restrict how many calories they consumed during their eating window,” Dr. Taub told Medical News Today.

Most of the participants had obesity, and 84% were taking at least one medication, such as an antihypertensive drug or a statin.

Metabolic syndrome is associated with at least three of the following: high blood pressure, high fasting blood sugar, high triglyceride (body fat) levels, low high-density lipoprotein, or “good,” cholesterol, and abdominal obesity.

Weight loss and better sleep

“As they started to adhere to this eating window, they started feeling better with more energy and better sleep, and this was positive reinforcement for them to continue with this 10-hour eating window,” said Dr. Taub.

Almost all the participants ate breakfast later (around 2 hours after waking) and dinner earlier (around 3 hours before bed).

The study lasted for 3 months, during which time the participants showed a 3% weight and body mass index (BMI) reduction, on average, and a 3% loss of abdominal, or visceral, fat.

“All of these improvements reduce their risk of cardiovascular disease,” said Dr. Taub.

Also, many participants showed a reduction in blood pressure and cholesterol, as well as improvements in fasting glucose. They also reported having more energy, and 70% reported an increase in the amount of time they slept or experienced sleep satisfaction.

The participants said that the plan was easier to follow than counting calories or exercising, and more than two-thirds kept it up for around a year after the study ended.

Dr. Taub recommends that anyone interested in trying time-restricted eating speak to their healthcare provider first, especially if they have metabolic syndrome and are taking medication, as weight loss may mean that medications require adjustment.

Metabolic Syndrome: What It Is and How to Reverse It

Hey everyone!

I hope you’re enjoying the colder weather. It is time to load up on vitamin C, zinc, selenium, and probiotics to keep your immune system in full working order.

I refuse the flu shot for myself and my kids, and we’ve done fine without it for a number of years just by boosting our diet with the necessary phytonutrients and micronutrients.

I’ve treated thousands of patients in my career and it’s a real joy when I can win over the most stubborn ones; hard cases both in temperament and in clinical presentations. I enjoy a good challenge.

As a physical therapist, I become frustrated when patients don’t get well after structural and muscular fixes with the modalities that I use. I typically get a good outcome, but there are times when my patients’ pain is more systemic in nature.

By that I mean that low back pain can be due to strain, sprain, and of course, structural issues like herniation, degeneration, and facet issues.

However, when I’ve addressed all these issues, sometimes the pain persists, and is usually diffused and debilitating. This is when I look to more “systemic” inflammation as the root of such pain.

When you have pain, while many times you can trace the pain to the cause, often, there’s not a clear cut reason for the pain.

What I do know is that when you’ve got underlying inflammation in your body, your receptors can be hypersensitive and responsive, resulting in decreased tolerance for pain.

Many variables revolve around this issue, but notably, the underlying inflammation is at the root. This inflammation can decrease pain threshold, which is your body’s way of telling you something is a bit off.

I’ll use low back pain today as an example because many times, my patients’ muscle and bone related issues are largely fueled by the systemic inflammatory process in their bodies.

Truth is that we all get old. As we age, not only do things not work as well as they used to, but they also degenerate at a speed that at times we’re not ready for. Yes it really is true, and it sucks getting old.

But you can reverse this. Which leads me to Dick.

Reversing Disease

Dick Peterson, one of my favorite patients, was very cynical and resistant to anything that I would offer when he first came into my office over a year ago with his lovely wife, Debbie.

While Debbie eagerly wanted to get started with my care, Dick felt sure that our program was not something that he wanted to pursue.

At the time, his main concern was the low back pain that kept him from exercising, which he attributed to his recent weight gain and declining health status.

At the time, he was struggling with some fatigue, water retention, difficulty maintaining his weight. Dick also suffered from diabetes, hypertension, and high cholesterol.

He was on a list of medications for his health issues, but he was concerned with the lack of control over his increasing body weight.

Dick is and has always been a man of his word, and very disciplined. He’s used to exercising and watching what he eats, and the weight would usually come off.

He came to me with not only unrelenting low back pain, but concern for his fatigue and persistent weight gain.

At first he was assessing our program. I gave him my clinical impression of how I felt systemic inflammation causes the weight gain, and the loading to his spine due to the weight around his belly perpetuates the low back pain.

I told him at that time too that he looked as if he was retaining water and noted his pitting edema, which was concerning to me.

Long and short of it was that he chose to go to another physical therapy center, and Debbie, his wife, began care with me.

After a few weeks of no relief at the other center, he decided to give me a try for his low back pain. After 4 visits, he was all better and didn’t need further treatment.

He returns approximately 3 months ago with unrelenting low back pain, severe fatigue, and labs out of normal ranges, so much so that his doctor referred him to a nephrologist.

He was concerned and was ready to discuss how I could help.

We were able to modify and meet his needs. He has a serious aversion to vegetables. He was able to go through the three month metabolic detox program, but not without problems.

As he began to see results, he was able to modify his cholesterol, diabetes, and blood pressure medications. All were tapered down significantly due to less toxins in his body now.

His body had begun to regain its balance.

Upon completion, he reported significantly improved energy, NO low back pain, and NO foggy brain. The link for Dick’s full testimonial can be found here.

What is Metabolic Syndrome?

So with that I’d like to go a bit deeper into the concept of metabolic syndrome, as it affects so many Americans in general, but is much more common for us autoimmune and Lupus patients.

Again, this validates my notion that there are no diseases, there are only manifestations of our physiological imbalances.

Due to high levels of steroids and pain, along with difficulty moving, we begin to gain weight. When this happens, we tend to gain the weight around the waist line and around the organs of our body, known as visceral adiposity.

This “fat” gain causes inflammation, insulin resistance, fatty liver, fatty muscle, atherosclerosis, fatigue, foggy brain, and pain.

Pretty soon these fat cells are in your liver (fatty liver), in your muscles, and other organs of your body, and they begin to act like their own endocrine organ.

This creates disruption in our hormone signaling and receptivity, which in turn creates more inflammation.

As the dial turns up the heat in the body, our immune system becomes stimulated, our blood vessels become constricted, leading to hypertension, and our cells slowly become destructive due to too much fat and glucose.

Eventually, our cells begin to die. The remaining cells then become toxic and the metabolic fire becomes a hot mess.

The fat now becomes toxic as it enters our blood stream as triglycerides, LDL, and HDL.

The ultimate result is that we become insulin resistant because our cells have lost the ability to shunt the sugar and fat into the cells, or if they do, they’ve caused too much shunting into the cells, so much so that the cells become burdened with fat molecules, rendering them unable to produce the energy that our body requires to function.

So the ultimate reason for your fatigue is this:

Too much food creates a surge in blood sugar and fat. The pancreas responds by creating and releasing excess insulin. Our cells slowly lose the ability to shunt the sugar and fat into the cells to produce energy.

This leads to increased sugar, insulin, and triglycerides floating around in our blood stream, all without producing energy.

Over time, you can see how this can create a hot, messy soup of dysfunction leading to disease.

So, metabolic syndrome can cause the following physiological manifestations:

  • Type II DM
  • Cardiovascular Disease
  • Dyslipidemia
  • Hypertension
  • Erectile Dysfunction
  • PCOS
  • Cognitive decline
  • Osteoporosis
  • Obesity
  • Sleep Apnea
  • Sarcopenia (shrinking muscle tissue)

This list shows how metabolic syndrome spans the whole population, especially autoimmune patients.

The point of today’s blog is to let you know that we can reverse this.

So for those of you who are struggling with this and have been told to watch your sugar, blood pressure, or cholesterol, please get serious about turning this around.

Metabolic syndrome can lead to worsening of autoimmune conditions or the creation of them.

How Can You Reverse Metabolic Syndrome?

  1. Eat a whole foods diet, mostly made by mother nature. Refer to our Alkaline Diet Guide here.
  2. Take probiotics, curcuminoids, fish oil, and vitamin D.
  3. Exercise, as it is just as effective as medications in lowering cholesterol and decreasing toxic burden.
  4. Manage your stress. Often we are hyper wired and our sympathetic nerve pathways are hypersensitive. We can improve this with meditation or guided breathing.
  5. Consider a comprehensive Metabolic Detox to lower inflammation, heal your gut, and improve mitochondrial health.

Please believe me, we can reverse our disease, prevent illness, and create health in our bodies once and for all.

If you enjoyed this blog, please share, comment, like, and follow us on our social media.

I also would greatly appreciate it if you would subscribe to and rate our podcast, Health Made Easy.

Thanks so much for reading, see you next week.

Metabolic Syndrome: Prevention

How do I prevent or reverse metabolic syndrome?

Since physical inactivity and excess weight are the main underlying contributors to the development of metabolic syndrome, exercising, eating healthy and, if you are currently overweight or obese, attempting to lose weight can help reduce or prevent the complications associated with this condition. Your doctor may also prescribe medications to manage some aspects of your problems associated with the metabolic syndrome. Some of the ways to reduce your risk:

  • Healthy eating and attempting to lose weight if currently overweight or obese: Healthy eating and moderate weight loss, in the range of 5 percent to 10 percent of body weight, can help restore your body’s ability to recognize insulin and greatly reduce the chance that the syndrome will become a more serious illness. This can be done through diet, exercise, or even with help from weight-loss medications if recommended by your doctor.
  • Exercise: Increased activity alone can improve your insulin sensitivity. Aerobic exercise such as a brisk 30-minute daily walk can promote weight loss, improved blood pressure and triglycerides levels and a reduced risk of developing diabetes. Most healthcare providers recommend 150 minutes of aerobic exercise each week. Exercise may reduce the risk for heart disease even without accompanying weight loss. Any increase in physical activity is helpful, even for those unable to perform 150 minutes of activity per week.
  • Dietary changes: Maintain a diet that keeps carbohydrates to no more than 50 percent of total calories. The source of carbohydrates should be from whole grains (complex carbohydrates), such as whole grain bread (instead of white) and brown rice (instead of white). Whole grain products along with legumes (for example, beans), fruits and vegetables allow you to have a higher dietary fiber. Eat less red meats and poultry. Instead, eat more fish (without the skin and not fried). Thirty percent of your daily calories should come from fat. Consume healthy fats such as those in canola oil, olive oil, flaxseed oil and tree nuts.

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Metabolic Syndrome

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About one in five American adults suffers from metabolic syndrome*, a preventable and reversible disorder that puts you at significant risk for heart disease, stroke, diabetes, and other medical problems. Sometimes referred to as insulin resistance syndrome and syndrome X, this condition can damage your body for years without giving you a clue that you have a problem.

Capable of affecting anyone at any age, metabolic syndrome is a group of cardiovascular risk factors that are linked to your body’s metabolism (the name given to all the chemical processes that take place in your body). Usually linked to obesity, physical inactivity, and genetic factors, metabolic syndrome is characterized by a clustering of risk factors for heart disease that include:

  • Central obesity (excessive fat tissue in and around the abdomen)
  • Dyslipidemia (blood fat disorders – mainly high triglycerides and low HDL “good” cholesterol – that promote plaque buildups in artery walls)
  • Insulin resistance or glucose intolerance (problems with how your body uses insulin, resulting in too much glucose (sugar) in your blood
  • High blood pressure

If you have one component of metabolic syndrome, you are at increased risk for having one or more of the others. And the more components you have, the greater your risk of developing major medical problems. Studies have shown that people who have metabolic syndrome are twice as likely to develop cardiovascular problems and four times as likely to develop type 2 diabetes as people who don’t have metabolic syndrome.

Quick Facts

  • About 47 million U.S. adults have metabolic syndrome, a set of health risks that increase your chance of developing heart disease, stroke, and diabetes. The number of people with metabolic syndrome increases with age, affecting more than 40 percent of people in their 60s and 70s.
  • The underlying causes of metabolic syndrome are overweight/obesity, physical inactivity and genetic factors.
  • You are diagnosed with metabolic syndrome if you have three or more of the following risk factors:
    • A waistline of 40 inches or more for men and 35 inches or more for women (measured across the belly)
    • A blood pressure of 130/85 mm Hg or higher
    • A triglyceride level above 150 mg/dl
    • A fasting blood glucose (sugar) level greater than 100 mg/dl
    • A high density lipoprotein level (HDL) less than 40 mg/dl (men) or under 50 mg/dl (women)
  • If you have all the components of metabolic syndrome, you are six times as likely to develop heart disease as someone who has none of the risk factors.
  • Metabolic syndrome is closely associated with insulin resistance, a metabolic disorder which interferes with the body’s ability to use insulin efficiently. This is why the metabolic syndrome is also called the insulin resistance syndrome.
  • According to the American Heart Association, three groups of people often have metabolic syndrome:
    • People with diabetes who cannot maintain a proper level of glucose (glucose intolerance)
    • People without diabetes who have high blood pressure and who also secrete large amounts of insulin (hyperinsulinemia) to maintain blood glucose levels
    • Heart attack survivors who have hyperinsulinemia without glucose intolerance
  • Physical inactivity and excess weight are the main underlying contributors to the development metabolic syndrome. So getting more exercise and losing weight can help reduce or prevent the complications associated with the condition. Doctors may also prescribe medications to manage components of the disorder..
  • It’s not inevitable that people who have metabolic syndrome will develop diabetes. Studies in the United States and abroad show that lifestyle changes, including weight loss, dietary modifications, and increased physical activity, can prevent or delay the onset of type 2 diabetes among high-risk adults.
  • Improved control of cholesterol and lipids can reduce cardiovascular complications by 20% to 50%.
  • Blood pressure control can reduce the risk of heart disease and stroke by approximately 33% to 50%.

*Quick Facts have been reviewed by Medical Advisors and are current as of October 2005.

Ask Your Doctor

This list questions will provide a good starting point for a discussion with your doctor. However, it is not a complete list.

General

  • What exactly is metabolic syndrome?
  • What are the health risks associated with metabolic syndrome?
  • Am I at risk for metabolic syndrome?
  • How do I know if I have it? What are the symptoms?
  • Are there tests for metabolic syndrome?
  • What can I do to reduce my risk of metabolic syndrome?
  • If I have metabolic syndrome, what can I do about it?
  • What are my treatment options?
  • How will we determine if the treatment is working?
  • If I have metabolic syndrome, are others in my family at risk?

Heart Disease, Stroke, Diabetes

  • What are my risk factors for heart disease?
  • Am I at risk for stroke?
  • What are the warning signs of heart disease and stroke?
  • What kind of physical activity is right for me?
  • What is my blood pressure, and is it at a healthy level?
  • What is my blood cholesterol, and is it at a healthy level?
  • What can I do to lower my risk of heart disease and stroke?
  • What is insulin resistance and how does that affect my risk for heart disease?
  • Am I at risk for developing diabetes?
  • What can I do to prevent diabetes?

Weight Control, Diet, and Physical Activity

  • Do I need to lose weight?
  • What is the best way for me to lose weight?
  • How much weight should I lose, and how fast? What’s a realistic goal for me?
  • What diet guidelines should I follow?
  • What should my daily calorie, fat and cholesterol intake be?
  • Do I need to see a nutritionist or dietitian? If so, can you recommend one?
  • Do I need to exercise to lose weight?
  • What are the best types of activities for me?
  • How much activity do I need to do?
  • Once I lose the weight, how do I keep it off?

Cholesterol

  • What do my cholesterol numbers mean?
  • How often should I have my levels checked?
  • How does physical activity affect my levels?
  • What type of diet should I eat?
  • Will I need cholesterol-lowering medicine?
  • How long will it take to reach my cholesterol goals?

High Blood Pressure

  • What should my blood pressure be?
  • How often should my blood pressure be checked?
  • What about home blood pressure monitors?
  • Should I use blood pressure machines at stores?
  • How does physical activity affect my blood pressure?
  • What’s my daily sodium (or salt) limit?

Medications

  • Will you prescribe one or more medications as part of my treatment?
  • What is the medicine supposed to do?
  • How and when do I take it, and for how long?
  • What foods, drinks, other medicines or activities should I avoid while taking this medicine?
  • What are the possible side effects and what should I do if they occur?
  • Is there any written information available about the medicine?
  • How will I know that my medication is working?
  • What are the risks of taking this medication?
  • What are the risks of not taking this medication?

Smoking

  • What effects does smoking have on metabolic syndrome?
  • What can I do to stop the cravings? When will they stop?
  • Will a nicotine patch or gum help?
  • Can I take a smoking cessation medication?
  • What if I slip and go back to tobacco?
  • How long will it take to reduce my risk?

Key Point 1

Most people who have metabolic syndrome are completely unaware. It is a cluster of disorders with your body’s metabolism, each of these disorders is by itself a risk factor for other diseases. In combination, they dramatically boost your chance for developing life-threatening illnesses.

Information about metabolic syndrome is just starting to show up in the popular press, even though doctors have debated its existence for years. Today, most medical professionals accept the syndrome, not as a disease but rather as a cluster of risk factors. Still, metabolic syndrome is under recognized and most of the over 40 million Americans with it remain undiagnosed.

Each one of the conditions involved in metabolic syndrome is a risk factor for other diseases. When they come together, they can dramatically multiply your risk of developing heart disease, stroke, and type 2 diabetes. If you have all the components of metabolic syndrome, you are six times as likely to get heart disease than someone who has none of the risk factors.

Here’s a look at the key medical disorders that come together in metabolic syndrome:

  • Central obesity. The location of body fat is important. If fat accumulates mostly around your stomach (central obesity is sometimes called apple-shaped obesity), you are at greater risk for type 2 diabetes, high blood pressure, high cholesterol, and cardiovascular disease than people who are lean or people with fat around the hips (called peripheral or pear-shaped obesity). Obesity is linked to 280,000 deaths in the United States each year, making it second only to cigarette smoking as a cause of death.
  • Hypertriglyceridemia. If you have very high levels of triglycerides in your blood, you have hypertriglyceridemia and are at increased risk of developing heart disease. Triglycerides are a group of fatty compounds that circulate in the bloodstream and are stored in your fat tissue. Very high triglycerides can cause health problems including pancreatitis and enlarged liver and spleen. High-fat foods, weight gain, and aging are some of the things that cause high triglyceride concentrations in the blood.
  • Low HDL cholesterol. Cholesterol is a type of fat that is needed for many bodily functions, such as the production of hormones. It comes from food sources and is also manufactured in your body by the liver. There are two forms of blood cholesterol. Low density lipoprotein (LDL) cholesterol is known as the ‘bad’ cholesterol because it contributes to heart disease by sticking to and narrowing blood vessels. High density lipoprotein (HDL) cholesterol is known as the ‘good’ cholesterol because it keeps LDL levels in check and helps protect against heart disease. The opposite is also true: low levels of HDL cholesterol increase the risk of heart attack.
  • Hypertension, or elevated blood pressure, indicates that the heart is working harder than normal, putting both the heart and the arteries under a greater strain. This may contribute to heart attacks, strokes, kidney failure and atherosclerosis. If high blood pressure isn’t treated, the heart may have to work progressively harder to pump enough blood and oxygen to the body’s organs and tissues to meet their needs.
  • Fasting hyperglycemia is when blood glucose stays above a desirable level after you have not eaten for at least eight hours. It occurs when the body does not have enough insulin or cannot use the insulin it has to turn glucose into energy. This condition can signal the start of type 2 diabetes, a disease that can increase your risk for a heart attack or stroke, as well as damage your eyes, nerves or kidneys.

Key Point 2

Just because you haven’t heard of metabolic syndrome doesn’t mean it is not important. It is the “perfect storm” of risk factors.

When you have metabolic syndrome, your body goes through a series of biochemical changes which, over time, can lead to the development of one or more interrelated medical conditions. Think of it as a metabolic chain-reaction that begins when insulin, a hormone excreted from your pancreas, loses its ability to make your cells absorb glucose (sugar) from the blood. When this happens, your glucose levels remain elevated for an abnormally long time after you eat. Your pancreas, sensing a high glucose level in your blood, continues to produce insulin.

Consistently high levels of insulin and glucose in your blood can bring about a number of harmful changes in your body, including:

  • Damage to the lining of coronary and other arteries, a key step toward the development of heart disease and stroke.
  • Changes in your kidneys’ ability to remove salt, which can lead to high blood pressure, heart disease, and stroke.
  • An increase in triglyceride levels, which increases your risk of developing cardiovascular disease.
  • An increased risk of blood clot formation, which can block your arteries and cause heart attacks and strokes.
  • A slowing of insulin production, which can signal the start of type 2 diabetes, a disease that can increase your risk for heart attack, stroke and other serious conditions associated with diabetes.

Doctors generally diagnose metabolic syndrome with a physical exam, medical history, and blood tests (using criteria outlined by the Adult Treatment Panel III (ATP III) of the National Cholesterol Education Program) to identify specific risk factors. Patients with three or more risk factors are usually diagnosed with metabolic syndrome.

Criteria for diagnosing metabolic syndrome

Risk factor Defining level
Central abdominal obesity (waist circumference) Men: Greater than 40 in. (101.6 cm)
Women: Greater than 35 in. (88.9 cm)
Hypertriglyceridemia (high triglycerides) Greater than 149 mg/dL
Low HDL (“good”) cholesterol Men: Less than 40 mg/dL
Woman: Less than 50 mg/dL
Hypertension (high blood pressure) Greater than 129/84 mm Hg
Fasting hyperglycemia (elevated fasting glucose/blood sugar) Greater than 109 mg/dL

Based on guidelines set forth by the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III).

There are many other variables that may influence a diagnosis, including:

  • Age. The incidence of metabolic syndrome increases with age.
  • Personal or family history of heart disease, high blood pressure, or diabetes. (There is a greater risk for metabolic syndrome for those who have experienced diabetes during pregnancy (gestational diabetes) or who have a family member with type 2 diabetes
  • High-fat diet
  • Sedentary lifestyle
  • Smoking
  • History of heavy drinking
  • Ethnicity – African Americans and Mexican Americans are more prone to metabolic syndrome. African-American women are about 60 percent more likely than African-American men to have the syndrome.

Key Point 3

If you’ve been diagnosed as having metabolic syndrome, it is not too late. If you can exercise and lose the weight, you can beat the rap. And drug therapy will be a part of your treatment. Metabolic syndrome can be treated and reversed, even prevented…and you can live longer.

Metabolic syndrome is preventable and many of its risk factors are reversible. In some cases, medicines are given to treat metabolic syndrome, but it’s likely that your doctor will first want you to try to make lifestyle changes – including weight loss, increased physical activity, and dietary modifications – to reduce your risk factors.

Central body fat
Studies of overweight, sedentary adults have found that those who start to exercise can lose, or at least not add to, their stores of abdominal fat. Even moderate exercise, such as brisk walking, can help. In fact, amount of exercise matters more than intensity of exercise. So, if you walk briskly 5 hours a week, you’ll do better than someone who participates in more vigorous exercise for a couple of hours a week.

Exercise is half the equation — making wise food choices is the other:

  • By making wise food choices, you can help control your body weight, blood pressure and cholesterol.
  • Consider the serving sizes you eat. Reduce serving sizes of foods high in fat and increase the amount of fruits and vegetables you consume.
  • Limit your fat intake to about 25 percent of your total calories. Your doctor or a dietitian can help you figure how much fat you need to eat.
  • Keep a food and exercise log. By writing this down, you are more likely to stay on track.
  • When you meet your goal, reward yourself with a nonfood item or activity.

Diabetes
There’s a lot you can do to lower your chances of getting diabetes. Exercising regularly, reducing fat and calorie intake, and losing weight can all help. Lowering blood pressure and cholesterol levels can also promote better health. Your doctor, a dietitian, or a nutrition or fitness counselor can help you make a plan. Here are some of the areas to consider in reducing your risk of diabetes.

Reach and maintain a reasonable body weight
Your weight affects your health in many ways. Being overweight can keep your body from making and using insulin properly. Losing even a few pounds can help reduce your risk of developing Type 2 diabetes. One way to determine if you are overweight is by checking your BMI (Body Mass Index), a weight to height ratio. See the following link to determine your BMI:

Be physically active every day
Exercise for at least 30 minutes a day, 5 days a week. If you’re not a very active person now, start slowly. And talk with your doctor about the kinds of exercise that are safe for you.

Control diabetes with drugs
In some people, blood glucose levels can be successfully controlled with diet and exercise, but many people require insulin or drugs designed to overcome the body’s
resistance to insulin.

Dyslipidemia
Dyslipidemia is a blood fat disorder that increases the risk for heart disease. It occurs when the amounts of lipids in the blood (e.g. LDL cholesterol, HDL cholesterol, and triglycerides) are higher or lower than normal.

It’s estimated that a 1% reduction in LDL cholesterol is equivalent to a 1% reduction in risk for cardiovascular disease. So a treatment option that safely reduces LDL levels is an important component in battling elevated total and LDL cholesterol levels.

There are two basic ways to manage dyslipidemia. The first is to modify your lifestyle by changing your diet, managing your weight, increasing exercise, and quitting smoking. The other is to use one or more cholesterol-lowering medications while modifying your lifestyle. Both treatment methods are aimed at lowering LDL cholesterol, raising HDL cholesterol, lowering triglycerides, and reducing other risk factors for heart disease. Your doctor can help you determine the best course of action.

Statins, or cholesterol-lowering drugs, have been shown to be very effective in reducing LDL levels along with decreasing total cholesterol. They can also help to raise HDL cholesterol. The effectiveness of statins, along with their low incidence of serious side events and good tolerability, has made them the drug treatment of choice for managing dyslipidemia.

Tips for Dealing with Dyslipidemia

  • Watch what you eat. Limit your total fat intake to 25% to 35% of your total calories each day. Most of your calories (50% to 60%) should come from carbohydrates, such as bread, cereals, rice, and grains. The other 15% of your total daily calories should come from proteins, such as meat, fish, eggs, or beans.
  • Limit your intake of saturated fats to less than 7% of your total fat intake. Saturated fats, such as shortening, lard, or butter are solid at room temperature. Better sources of fat include vegetable, olive, and fish oils.
  • Cut back on margarine and butter. If you use them, the whipped types are lower in fat than the type that comes in sticks. Be sure to use any type only in small amounts.
  • Get moving. Do exercises that raise your heart rate such as walking, running, swimming, biking, or dancing. Work out for 30 to 45 minutes, 5 days a week. Be sure to talk with your doctor before starting a fitness program.
  • Don’t smoke. If you smoke, stop. If you need help breaking the habit, ask your health care provider about techniques or treatments that can help you quit.
  • Limit your alcohol intake. If you are a woman or small man and drink alcohol, don’t have more than one drink a day. If you’re a medium- to large-sized man, don’t have more than two drinks a day.
  • Eat 20 to 30 grams of soluble fiber every day. Foods such as bran, beans, and peas help lower your bad cholesterol (LDL).
  • Take your medicine. For many people, diet and exercise aren’t enough; some people need drugs to help lower their cholesterol. You and your health care provider will decide which drug is right for you. You may need to take more than one type of medicine to get your cholesterol under control.

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