METABOLIC SYNDROME Are You At Risk?
- How much do you know about your health?
- What are the 5 indicators of heart disease, stroke, and diabetes risk?
- Exactly what is Metabolic Syndrome and do you have it?
Look inside and learn how you can lower your risk – beginning right now….
What is the possibility that you’re at risk of developing type 2 diabetes, cardiovascular disease, heart attack, or stroke?
In this issue of Nutrition News, we discuss the five metabolic indicators for this risk, and give you suggestions for preventing and healing them.
The five indicators are excess body weight, high blood pressure, high cholesterol, high blood sugar, and high triglycerides.1
The combination of indicators is identified as Metabolic Syndrome.
Topic: METABOLIC SYNDROME
In the UK, researchers compared exercise habits of 1500 middle-aged dog owners and gym goers. They found the average dog owner walked approximately 676 miles a year while gym goers clock up 216 miles less on exercise machines. In addition, 92% of dog owners stayed with their exercise routine through the years while only 52% of gym members continued to workout regularly after two or three months.
Are You At Risk?
• How much do you know about your health?
• What are the 5 indicators of heart disease, stroke, and diabetes risk?
• Exactly what is Metabolic Syndrome and do you have it?
Look inside and learn how you can lower your risk – beginning right now….
Are You at Risk?
What is the possibility that you’re at risk of developing type 2 diabetes, cardiovascular disease, heart attack, or stroke? In this issue of Nutrition News, we discuss the five metabolic indicators for this risk, and give you suggestions for preventing and healing them.
The five indicators are excess body weight, high blood pressure, high cholesterol, high blood sugar, and high triglycerides.1 The combination of indicators is identified as Metabolic Syndrome.
In their online Patient Page, the editors of the Journal of the American Medical Association describe the five indicators:
• Waist circumference greater than 40 inches for men or 35 inches for women
• High serum triglycerides (blood fat)
• High blood pressure
• Low levels of high-density lipoprotein, known as HDL or “good cholesterol”
• Fasting blood sugar more than 110 mg/dL (hyperglycemia)2
Metabolic Syndrome was originally called Syndrome X, a name coined by Gerald Reaven, MD, Professor Emeritus of the Standford University School of Medicine. A world-renowned endocrinologist, Reaven uncovered the syndrome through his research. It results from metabolic changes that tend to occur in individuals who are insulin resistant. (See sidebar.) Noting that people with a family member who has had a heart attack are more likely to experience CVD, Reaven and others suggest there may also be a genetic component to Metabolic Syndrome (Syndrome X). Reaven discusses the syndrome in detail in Syndrome X: Overcoming the Silent Killer that Can Give You a Heart Attack. (See “Resources” on the back page.)
Another book titled Syndrome X: The Complete Nutritional Program to Prevent and Reverse Insulin Resistance was written by Jack Challem, well known nutrition author, with Burton Berkson, MD, and Melissa Diane Smith. These authors take the view that, “Syndrome X is a nutritional disease — caused primarily by the over- consumption of refined sugars and other carbohydrates.” They point out the negative influences of both the modern “fast food” diet and the sedentary lifestyle, and provide a set of recommendations for healthier living.
The inspiration for this newsletter came from Marcia Zimmerman, CN, another nutrition expert, and her book, 7-Syndrome Healing (Nutrition Solution Publications). Co-authored by Jayson Kroner, CSN, this book re-emphasized the importance of recognizing and healing this dangerous syndrome within a context of total health. Zimmerman and Kroner discuss the importance of using a nutritional supplement program.
Each of the indicators of Metabolic Syndrome is unhealthy in and of itself, and requires healing. It is important to acknowledge that having any one of these indicators can be quite serious. Plus, there may be interactions between some supplements and prescription medications. Therefore, we advise that people with these indicators (particularly those experiencing all of them) work with a qualified health care professional.
1 Triglycerides are the chemical form in which most fat exists in food as well as in the body. Most triglycerides are stored as fat tissue (adipose). Some triglycerides circulate in the blood to provide fuel for muscles to work. However, when circulating levels chronically exceed what can be used as fuel, they become a health concern.
2 These criteria were originally set by the National Cholesterol Education’s Adult Treatment Program (ATPIII). The exact measures are available at http://circ.ahajournals.org/cgi/reprint/CIRCULATIONAHA.105.169404v.
3 Zimmerman’s dietary recommendations can be found in her book, 7-Color Cuisine.
Diet & Exercise!!!
Yes, here it is again. We can’t avoid it. The combination of healthy diet and regular exercise is the foundation of good health and the prevention of disease. Specifically, we use this recommendation to reduce the risk of Metabolic Syndrome.
A Therapeutic Diet
What kind of diet is recommended? Gerald Reaven, MD, who uncovered the syndrome, is our authority when it comes to dietary recommendations. In his book, Reaven recommends carefully balanced proportions of carbohydrates, protein, and fat. He cautions that some popular diets keep insulin under control, but may raise the person’s LDL levels (low-density lipoprotein or “bad” cholesterol). He adds that other diets can lower LDL levels while sending the dieter’s insulin soaring. (Similar cautions hold true for managing blood sugar levels.)
Reaven acknowledges that his dietary recommendations are controversial: consuming 45 percent of daily calories as carbohydrate, 40 percent as fat, and 15 percent, protein. Beyond this balanced intake, Reaven stresses reducing total calories and increasing exercise as the key to weight loss. In his book, there are 30-day specific meal suggestions for a daily calorie count of both 1200 and 1800 calories. There are also 100, 200, and 300 calorie snacks for modifying daily calorie intake. Each suggested menu item includes calories, fats, carbs, and cholesterol.
Zimmerman writes that there is little doubt that the obesity epidemic is behind the increase in the occurrence of Metabolic Syndrome. In 7-Syndrome Healing, Zimmerman does not detail a particular diet for those needing to lose weight and combat the syndrome. She focuses instead on the need for quality foods and supplements, recommending specific nutrients for addressing each facet of the syndrome.3
See the sidebar on the back page for the nine excellent principles created by Challem and co-writers for helping you develop a diet to combat Metabolic Syndrome.
Speaking of diet, let’s discuss triglycerides. These are naturally occurring esters of fatty acids and glycerol. The molecules compose the common fat found in food and in our bodies. There, they are involved in the transport and storage of fat. Fat is necessary to health and acts as the body’s most efficient fuel. Too much fat is the problem.
Together with high cholesterol, high triglycerides are one of the warning signs of CVD, cardiovascular disease. Unfortunately, high triglycerides can be the result of the impact that insulin resistance has on the liver. Insulin resistance leaves the liver unable to function properly; thus, there is more fat in the blood. In addition to the other recommendations for diet, exercise, and supplements, here are two healthy habits for controlling triglyceride levels: Stop smoking and limit alcohol consumption.
Get A Move On
Challem et al. state, “Moderate physical activity is vital for both preventing and reversing insulin resistance, Syndrome X, obesity, and type 2 diabetes.” At Nutrition News, we recommend walking as a perfect way to start moving. A sturdy pair of shoes is all you need. And, walking does far more than help you burn more calories.
Walking increases …
• your energy, stamina, and metabolism
• your sound restful sleep
• your muscle tone and bone density
• your HDL — the “good” cholesterol
• your blood plasma (This, in tern, brings thinner blood, reducing the risk of clotting.)
• immune response
• your wellness, fitness, and happiness!
Walking decreases …
• your risk of heart disease, some cancers, osteoporosis, and other diseases.
• your risk of diabetes by lowering blood sugars and body fat levels
• your number of sick days from work and school
• your symptoms of PMS, back pain, arthritis
• your number of colds
• your blood pressure and LDL — the “bad” cholesterol
• your negative moods
• your stress!!!
In the end, it’s not so important what type of activity you choose. The key is becoming more active and staying with it on a regular basis.
Supplements to the Rescue
By combining diet and exercise with the selective use of nutritional supplements, there is the possibility of reversing insulin resistance. The list of supplements that can be supportive to those at risk is a long one. We have chosen the nutrients we believe to be the most effective.
A multivitamin-mineral preparation is a good place to start. Vitamins A, B-6, B-12, C, D, E, and folic acid, plus the minerals zinc, magnesium, manganese, selenium, and vanadium all have helpful roles in reversing and preventing Metabolic Syndrome. Except for vanadium (as vanadyl sulphate), all these nutrients are commonly found in any vitamin-mineral formula. At Nutrition News, we recommend additional vitamins C, E, and D; additional calcium and magnesium, and an omega-3 fatty acid supplement.
The drive is on to encourage people to eat more omega-3 fatty acids (the type found in deep water fish and wild game) or take supplements. Experiments have shown that eating lots of saturated fats (from meats and dairy products) or omega-6 fats (predominate in most vegetable oils) has a high association with insulin resistance. Although many Americans have reduced their intake of saturated fats, they have increased omega-6 intake way beyond recommendations.
Challem, et al and others suggest a balanced fatty acid ratio of approximately 4 to 1 omega-6 to omega-3 fats. Depending on individual preferences fish, game, fish oils and flax seed oil can be good sources of omega-3. Zimmerman recommends that we also add CLA (conjugated linoleic acid). Because CLA is an omega-6 fatty acid, this recommendation may seem paradoxical. However, both wild and domestic animals grazed on pasture previously provided us with this fatty acid. Research at the University of Wisconsin (Madison) has shown that CLA is an aid to weight reduction, cardiovascular health, and immune system support.
Our next recommendation is chromium. One time deficient in 95 percent of the population, chromium is now the top selling mineral supplement after calcium. It aids in metabolism of carbohydrates, fats, and proteins, and it also facilitates insulin functioning. In fact, chromium is one of the best natural ways to help decrease insulin resistance.
Chromium comes in various forms, and is sometimes included in multivitamin-mineral preparations. Although both chromium picolinate and polynicotinate are frequently suggested, Zimmerman recommends GTF (glucose tolerance factor) chromium specifically for blood sugar management. The recommendation for prevention is 200 mcg daily. Higher doses of 400-1,000 mcg are recommended for people who already have some symptoms. Because of its influence on lowering blood sugar levels, Zimmerman suggests that anyone with diabetes consult with their physician before supplementing with chromium.
According to experts, the cornerstone of Metabolic Syndrome is insulin resistance. In 7-Syndrome Healing, author and nutritionist Marcia Zimmerman writes, “Insulin resistance and its related deviations in glucose metabolism have reached pandemic proportions.” She reports that worldwide 150 million people currently have type 2 diabetes, the ultimate result of this dysfunction.
What is “insulin resistance”? Insulin is a hormone secreted by the pancreas gland. It attaches to receptors on cell membranes and helps blood sugar (glucose) move into the cells. When a person is insulin resistant, the receptors don’t work properly. Insulin can’t “dock” on the membranes, and glucose doesn’t pass into the cells as it should. This means that it stays in the circulatory system. The result is high blood sugar and a multitude of health problems.
Things become even more complicated because the pancreas senses too high glucose levels and continues secreting insulin to normalize them. Thus, the body is running with both too much glucose and too much insulin. Among other effects, syrupy blood can result in premature aging, inflammation, and abnormalities in fat and protein metabolism and in immune system function. Insulin levels can be increased further by the hormone cortisol, the stress hormone.
Nutrition News has long encouraged the use of antioxidants, both as they occur naturally in whole foods and as various supplements. In fact, we have recently written about two of the most powerful antioxidants known: PCOs (currently in print) and astaxanthin (to be published in future). They are important in combatting Metabolic Syndrome. Virtually all of them have some positive influence on glucose and insulin. Many also have anti-inflammatory properties.4
Challem cites studies in which people with diets rich in fruits and vegetables (high in antioxidants) showed a relatively low risk of heart disease, stroke, and cancer. On the other hand, Zimmerman reports a study involving 8,808 adults in which those with Metabolic Syndrome had lower levels of antioxidants (except lycopene — found in cooked tomatoes, think pizza). They also had low levels of vitamins C and E, two vitamins known for their antioxidant capacity. Zimmerman recommends a daily natural multi-carotene formula, in addition to a multivitamin-mineral formula.
Alpha lipoic acid is the most frequently recommended antioxidant for those with or at risk for diabetes. It is produced in our bodies but supplements are necessary for therapeutic results. In Germany, lipoic acid is approved for the prevention and treatment of diabetic neuropathy. Lipoic lowers blood glucose and insulin levels, reduces insulin resistance, and improves insulin sensitivity. It has been shown to deliver glucose into the cells independent of insulin. Although 250-500 mg per day are adequate, people with diabetes may need more. Amounts over 100 mg should be taken with biotin (a B vitamin found in most vitamin-mineral formulas).
PCOs (proanthocyanidins) as grape seed and pine bark extracts are very powerful antioxidants and have been shown to be effective in fighting free radicals and supporting vascular health in people with both heart disease and diabetes. Research has also shown both substances to be effective anti-inflammatories. (Most studies with pine bark extract have been conducted using Pycnogenol.) For general prevention, take 50 mg daily. Therapeutic dosages range from 150 to 300 mg per day.
Silymarin, the active ingredient in milk thistle extract (Silybum marianum) is an antioxidant worthy of special note. Historically, this herb has been associated with liver health. Air quality in particular makes liver support important to most of us. However, because liver function can be compromised by insulin resistance, this supplement is especially helpful to those at risk for Metabolic Syndrome. Silymarin is effective in helping the body break down fats, eliminate toxins, and absorb nutrients. It has also been shown to reduce insulin resistance and other symptoms of diabetes. Purchase milk thistle extract that has been standardized to 80 percent silymarin. Studies have used 200-800 mg of the herb.
Coenzyme Q10, also called CoQ10, is a vitamin-like compound produced naturally in the body. CoQ10 helps cells produce energy and acts as an antioxidant. It has been shown to stimulate the immune system, enhance gum health, and strengthen the heart. It also protects the heart from certain drug side effects, particularly from the effects of the cholesterol lowering -statins. For addressing Metabolic Syndrome, CoQ10’s potentially beneficial actions include eliminating free-radicals, lowering blood pressure, lowering LDL (bad) cholesterol, and normalizing the insulin response to glucose. For people with heart disease, CoQ10 is not a substitute for medical supervision. The body slows down on its production of this metabolite after age 40.
The Nine Anti-X Diet Principles
1. Avoid refined carbohydrates.
2. Eat foods as natural and fresh as possible.
3. Choose lots of non-starchy vegetables.
4. Keep your intake of natural carb-rich foods low.
5. Avoid highly processed drinks (soda, altered juices, alcohol).
6. Use olive oil instead of other common vegetable oils.
7. Enrich your diet with omega-3 fats.
8. Stay away from trans-fatty acids.
9. Eat protein at every meal and snack.
(from Syndrome X, by Challem, Berkson, & Smith)
• Challem, J., Berkson B., and Smith, M.D. (2000) Syndrome X: The complete nutritional program to prevent and reverse insulin resistance, John Wiley & Sons, NY.
• Grundy, S.M., et al. (1999-2006) Four papers in Circulation, Diabetes Care, J. Am. Coll. Cardiol., and Arch. Intern. Med.
• Khalsa, S.D. (October 2006). PCOs: Super Antioxidants, Nutrition News, Vol. XXX, No. 9.
• Khalsa, S.D. (December 2005). Defeating Diabetes and Aging with Supplements, Nutrition News, Vol. XXIX, No.12.
• Khalsa, S.D. (November 2001). Blood Sugar Blues, Nutrition News, Vol. XXV, No. 11.
• Khalsa, S.D. (June 2001). Supplement Your Heart, Nutrition News, Vol. XXV, No. 6.
• Reaven, G., Strom T.K., and Fox B. (2000) Syndrome X: Overcoming the silent killer that can give you a heart attack. Simon & Schuster, NY.
• Tan, C., et al. (2004) Diabetes Care, 27:1182-1186.
• Vinicor, F. and Bowman, B. (2004) The Metabolic Syndrome: The Emperor Needs Some Consistent Clothes, Diabetes Care, 27:1243.
• Zimmerman. M., & Kroner, J. (2006) 7-Syndrome Healing: Supplement essentials for the mind and body. Nutrition Solution Publications, Chico, CA.
• Coenzyme Q10 information from NIH. Last modified June 19, 2006. Retrieved October 26, 2006 from http://www.cancer.gov/cancertopics/pdq/cam/coenzymeQ10/HealthProfessional
• Metabolic Syndrome defined. Dated February 15, 2006. Retrieved October 10, 2006 from http://www.jama.ama-assn.org/cgi/content/full/295/7/850.
• Milk thistle information from Mayo Clinic. Last modified May 1, 2006. Retrieved October 26, 2006 from
• People with dogs fare better. Dated December 27, 2006. Retrieved January 24, 2007 from http://www.whi.org.uk/
• Statin Drugs and Coenzyme Q10 – A Potential for Drug Induced Nutrient Depletion. Dated May, 2001. Retrieved on January 25, 2007 from http://www.thyroid%2Dinfo.com/articles/coq10.htm.