What happens in a Syndrome-Laden society? Do we tend to “tune it out” when another one is named? Metabolic syndrome (MetS) deserves serious attention, for about 37% of the American population has MetS.1 Over a billion people worldwide have the metabolic syndrome.2
This dangerous pandemic pushes millions down the slippery slope to heart attacks, stroke, diabetes, and early death. If you don’t, you probably know someone who does have it.
Profile of Metabolic Syndrome
What’s involved in the complex mix of unhealthful conditions that make up metabolic syndrome (or MetS)?
- Insulin resistance/impaired glucose
- High cholesterol or triglycerides (blood fats) or low HDL (beneficial cholesterol)
- Hypertension (high blood pressure)
If an individual has any three of the above four unhealthful conditions, a doctor can confirm the diagnosis. Significance? Three of these conditions can double one’s risk of heart attack or stroke! And compared to those who have none of these conditions, the risk is tripled! Other physiologists would include a pro-inflammatory condition, a pro-coagulant state that encourages undesirable clotting, and a sympathetic nervous system overdrive. Obviously, MetS warrants concern.
Because understanding a disease is vital to preventing, curing, or managing it. Let’s begin by learning more about the nature and causes of MetS. Routine blood work would not necessarily indicate all of these. All persons with MetS should be evaluated on these parameters.
Complications? You Named It!
If left untreated, MetS will indeed prove deadly, for it affects virtually every system of the body. Not only does it increase the risk of developing and dying from cardiovascular disease, but it also is an independent risk factor in the development of deep vein thrombosis (undesirable clots). Heart, lung, kidney, and liver function decline.
For example, with MetS, the liver can become sick, as in non-alcoholic fatty liver disease. And unless lifestyle interventions are adopted to reverse the disease process, it can progress into nonalcoholic cirrhosis. MetS also significantly increases the risk for liver cancer. If obesity and elevated blood sugar are both present, the risk for colorectal cancer is increased. With MetS, the risk for prostate and recurrence of breast cancer also rises. Metabolic syndrome may increase one’s risk of dying from prostate cancer.
MetS contributes to ovarian or erectile dysfunction. In older individuals it predicts cognitive decline and increases the risk of falling.
Insulin resistance is the most common of the four major risk factors. This condition results when more insulin than normal is required to do the job of glucose control in the body. Although more factors may be involved, this impairment of the body’s ability to properly manage blood glucose is the primary feature of insulin resistance.
A Closer Look at Insulin Resistance
When we eat carbohydrate foods, they are broken down either into glucose or another simple sugar that is converted into glucose, which then enters the blood. Glucose provides the fuel from which the cells, especially the brain cells, make energy. In order for this process to take place, the pancreas produces insulin, a hormone which facilitates the entry of glucose into the cells. Insulin must bind to receptor sites on the cells. To simplify, one could imagine insulin as a key which unlocks the cells’ doors (insulin receptors) so that the glucose can then enter the cell. Normal insulin sensitivity results when the insulin receptors are working optimally and glucose is delivered and utilized effectively.
Obesity and saturated fats from animal products damage insulin receptors by impairing their ability to respond to normal amounts of insulin. As a result, blood sugar levels remain high. If this continues, the pancreas is “tricked” into making more insulin in an effort to bring blood glucose within normal range. As long as the pancreas is able to produce enough extra insulin to overcome this problem, blood glucose levels can remain normal. This condition is known as “insulin resistance.”
Obesity can be defined as an abnormal or excessive accumulation of fat in the adipose tissue and the body weight more than 20% of the recommended weight.3 If you are a lady, and your waist is over 35 inches, or if you are a man, and your waist is over 40 inches—watch out! Excess visceral fat which is stored over the abdominal organs, better known as “potbelly fat” or “apple-shaped fat,” is the most dangerous type. Adipocytes (fat cells) release extra free fatty acids and inflammatory substances that interfere with cellular ability to metabolize glucose and damage the insulin-producing cells in the pancreas.
Excessive abdominal fat is an arsenal of many pro-inflammatory and pro-atherogenic agents that fuel chronic disease. Inflammation contribute to insulin resistance. Insulin resistance can also trigger inflammation into a vicious cycle.
Please note that both weight and the percentage of body fat are important. Women who are within their normal weight range, but whose fat mass is greater than 30 percent of their total body weight, have elevated markers for inflammation. Weight alone isn’t enough; the fat percentage must be considered as well.4
Although many people who develop high blood pressure are not obese, the fact remains that obesity reduces the ability of the blood vessels to dilate and makes the arteries more subject to constriction.
Obesity and Poor Nutrition Contribute to MetS.
Ninety five percent of individuals who have MetS are overweight or obese. The Framingham study showed that women who were obese and/or had the pattern of consuming empty calories were substantially at risk for developing MetS. It is interesting to note that both the dietary pattern of consuming empty calories and obesity increased the risk of developing MetS, whether or not cardiovascular risk factors were present.5
The Framingham authors concluded that, while the disease traits in MetS can exist independently of the metabolic syndrome, many of them are the result of obesity and would be nonexistent without it. Furthermore, suitable amounts of the right diet, especially a high-fiber diet emphasizing fruits, grains, nuts, and vegetables, would prevent the syndrome in most individuals. Might it not even render it essentially obsolete?6
Ideally, for optimal health your triglycerides should be below 100. The level at which total cholesterol is considered normal has been dropping for years. First, it was 240 then—oops!—it was 220, 200, and then 180. So… average is not normal! Two hundred is too high.
As useful as these numbers are, they do not tell everything. Not all LDL cholesterol is created equally. Small dense LDL’s are the most atherogenic. Oxidized cholesterol pushes inflammation inside the arteries and encourages the development of atherosclerosis. Many experts believe that your LDLs level should be less than 100 mg/dL.
Above 60 is ideal for HDL (“good cholesterol”). While HDL is considered protective against atherosclerosis, HDL itself can become oxidized from smoking, a deficient diet, or a pro-inflammatory condition such as obesity, pre-diabetes, and diabetes. When HDL becomes oxidized, it becomes dysfunctional and cannot remove cholesterol from arteries.7 In other words, a person’s diet and medical history should be carefully evaluated even when the numbers are within normal levels. One caveat here: No vitamin pill can replace the thousands of anti-oxidants and anti-inflammatory compounds found in plant foods!
High Blood Pressure
Though high blood pressure is not always a pillar of metabolic syndrome, it is still significantly dangerous. Again, what was considered “normal” 10 years ago is no longer normal. If your systolic (top) number reads 120 to 129 or if the diastolic (lower) number is less than 80 your blood pressure is elevated. The first stage of hypertension is any systolic reading between 130 – 139 and diastolic reading between 80 – 89.
Unavoidable Risk Factors:
Some risk factors for MetS are uncontrollable, including a family history of type II diabetes, hypertension, heart disease, bipolar disorders, and aging. Hispanics and Asians seem to be at greater risk than other ethnic groups. Women with fibromyalgia are 5.56 times more likely than healthy controls to have metabolic syndrome.8
A pregnant woman’s metabolic state has a powerful influence on whether her child (either male or female) will develop obesity, hyperinsulinemia (elevated insulin), and related conditions. Early studies suggest that children of parents with MetS have higher levels of inflammatory markers making the children more susceptible to developing atherosclerosis later.
Modifiable Risk Factors:
Lifestyle factors that contribute to MetS include obesity, overeating, snacking, consumption of refined and sugary carbohydrates, and sedentary lifestyle. “The metabolic syndrome is present in about 5 percent of people with normal body weight, 22 percent of those who are overweight, and 60 percent of those considered obese. Adults who continue to gain five or more pounds per year raise their risk of developing metabolic syndrome up to 45 percent.”9
How to Reduce Your Risk:
1. Eat a Largely Vegetarian Diet.
In a study of 700 participants, researchers at Loma Linda University found that vegetarians experience a 36 percent lower prevalence of metabolic syndrome than non-vegetarians, even after researchers adjusted for factors such as age, gender, race, physical activity, calories consumed, smoking, and alcohol intake.10 Plants foods are rich in fiber and anti-oxidant, anti-inflammatory phytochemicals.
Caveats: Consuming a well-balanced, largely whole plant food diet helps to reduce elevated cholesterol. However, replacing the meat with refined carbohydrates will not reduce elevated cholesterol levels. A plant-based diet high in refined carbohydrate, sugar, salty vegetables, low in fiber-rich plant foods increases one’s risk for the metabolic syndrome.11
2. Include Weight Lifting in Your Exercise Routine.
Persistent, regular exercise increases the number of mitochondria in the muscle cells. Additionally, exercise also increases the metabolically beneficial hormone irisin that helps to reverse muscle insulin resistance and reduces fat production in the liver. 12
Greater muscle strength and muscle mass have been linked to a lower risk for metabolic syndrome. A large study found that weight lifters have approximately 13% lower risk for developing MetS than non-weight lifters.13 If you are not used to weight lifting, start out with stretches first, then lift soup cans and gradually increase weight. Learn how to do weight lifting properly.
3. Check Vitamin D Level.
Why? Mounting evidence suggests vitamin D inadequacy may be a risk factor for the metabolic syndrome, especially in the elderly.14 Vitamin D deficiency increases one’s risk for diabetes, inflammatory problems, and possibly atherosclerosis. Nutrition epidemiologists estimate that 50 percent of the populations in North America and Europe are vitamin D deficient! Adequate amounts of vitamin D may reduce complications of MetS, such as reducing the risks for colon cancer and inflammatory processes.
It should be noted that exposure to sunlight increases vitamin D-2 synthesis, and both obesity and kidney disease compromise the ability of the body to convert vitamin D-2 into its active hormone form. Therefore, a select group of individuals with vitamin D deficiency and chronic kidney disease require vitamin D-3 supplementation.
4. Limit Television and Sitting Time.
Research shows a strong inverse association between physical activity and MetS. Low cardiovascular status is an important risk factor for metabolic syndrome. In Australia, researchers studied 6,241 adults aged 35 years or older who were free from diagnosed diabetes mellitus, and self-reported ischemic heart disease. These participants were not taking any lipid-lowering or anti-hypertensive drugs. In women who watched more than 14 hours of TV a week, MetS was twice as prevalent compared to women who watched 7 hours of TV or less. The incidence of MetS increased 48 percent for men who watched TV more than 14 hours per week compared with those who watched it less than 7 hours per week. Women, who were active 2.5 hours or more per week, had 28 percent less risk of developing MetS. Men who were as active dropped their risk for MetS by 45 percent.15
Physical inactivity causes the muscle cells to become less sensitive to insulin, and damages the glucose transport in the cells. The number of power plants (mitochondria) in muscle cells also declines; as a result, glucose and fats are not burned as efficiently. An encouraging bit of news is that those who are physically fit, even if overweight, have less risk of developing metabolic syndrome than those who are not fit.
Only one hour of sitting causes blood pools in the leg, decreases blood flow in the thigh, and increases blood viscosity. All these provide a dangerous milieu that encourages atherosclerosis and undesirable clots. If you are going to watch T.V, exercise while doing so!
5. If Obese, Work on Losing 10% of Your Body Weight.
That in itself may substantially reduce one’s risk of diabetes and help decrease elevated blood sugar. Limit your food intake to three meals, with your last meal being your smallest. Do not drink your calories (unless you make a fresh vegetable juice). One of the most important steps is eliminating the consumption of high fructose corn syrup(HFCS) so common in soft drinks, many packaged cereals, and baked goodies. HFCS elevates triglycerides and over a period of time can increase one’s risk for liver and kidney damage. If you fill up with wholesome foods such as whole fruits, salads, vegetables, and legumes, you will be able to control your appetite more easily.
6. Skip the Fish.
Omega-3 fats are vital to the health, but fish is not a safe source. Why? Perfluorinated compounds (PFCs) are a class of synthetic compounds containing thousands of chemicals formed from carbon chains with fluorine attached to these chains. According to the Environmental Protection Agency, PFCs have been associated with immunotoxicity, thyroid disease, endocrine disruption, and cancer in animals. They also can damage the liver and the kidneys. The EPA estimates that PFC contamination in food may account for more than 90% of human exposure to PFOS (one type of PFC). Studies indicate that fish from contaminated waters may be the primary source of exposure to PFOS.16 Flaxseed, chia, walnuts, spinach, and organic soybeans are the best sources of omega-3 fats for most people.
We should mention that PFC’s are also found in fast food wrappers, popcorn bags, non-stick cookware such as Teflon, stain-resistant carpet and scotch-guard products. Overweight children who were exposed to higher levels of perfluorinated chemicals tended to show early signs of developing the metabolic syndrome such as higher concentrations of insulin and triglycerides in their blood.17
7. Don’t Skip, Nor Go Skimpy on Breakfast.
Adolescents who either neglected to eat breakfast or who ate a poor breakfast had a 68% higher incidence of metabolic syndrome than adults who ate a substantial breakfast.18
8. Take Frequent, Short Exercise Breaks!
Yes, you do need to schedule a 20 to 30 minutes slot for exercise each day, but that is not enough if you are sedentary. MetS increases your risks of forming undesirable clots. In fact, sitting for 3 hours straight impairs the blood flow in a main artery (femoral artery) of a leg by 50%. Unfortunately, the ability of this artery to dilate starts to become impaired after just one hour of sitting. When people sit, slack muscles do not contract to pump blood to the heart effectively. Blood can pool in the legs and affect the ability of blood vessels to expand and increase the risk for clots! Even slow 5-10 minute walks around the office can reverse harm caused to leg arteries during three hours of prolonged sitting.19
9. Practice Good Oral Hygiene.
Chronic inflammation fuels atherosclerosis, obesity, diabetes, clots, and many other problems. Individuals that have MetS have increased odds of developing periodontal disease. On the other hand, periodontal disease itself increases the risk of metabolic syndrome. Bacteria that cause inflammation inside the mouth can also increase inflammatory mediators elsewhere in the body. As a result, a sustained infection with periodontal bacteria can increase body weight and encourage insulin resistance.20 These infections may kickstart damage to the heart valves, neurons, and other complications. Evidence suggests that adequate dental care and periodontal therapy can reduce the levels of inflammatory mediators in serum.21
10. Take Good Care of Your Gut!
MetS is often accompanied by an imbalance of the gut microbiota, inducing a low-grade inflammatory response in the body by destroying the gut barrier. Eventually, this change in gut microflora produces insulin resistance through metabolites that affect host metabolism and hormone release, forming a vicious circle that promotes the continuous progress of MetS. 22A typical Western diet (high in saturated fats, refined foods, animal products, but low in fiber) or a plant-based diet low in fiber but high in sugars and refined carbs. So emphasize whole plant foods and include multiple servings of raw fruits and vegetables to improve your gut health. Sleep deprivation and an irregular schedule encourages the proliferation of pro-inflammatory gut microbes.
Metabolic Syndrome is a perilous condition and often proves deadly. The good news is that lifestyle strategies can substantially reduce one’s risk for MetS. In a future article, we will discuss lifestyle solutions for reversing this serious condition. It is important to work with one’s health care team if one does have Metabolic Syndrome.
© 2022, Wildwood Sanitarium. All rights reserved.
Disclaimer: The information in this article is educational and general in nature. Neither Wildwood Lifestyle Center, its entities, nor author intend this article as a substitute for medical diagnosis, counsel, or treatment by a qualified health professional.
- Hirode G. Trends in the Prevalence of Metabolic Syndrome in the United States, 2011-2016.
- Saklayen MG. The Global Epidemic of the Metabolic Syndrome. Curr Hypertens Rep. 2018;20(2):12. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5866840/
- Park, Jung Eun et al. “Vitamin D and Metabolic Diseases: Growing Roles of Vitamin D.” Journal of obesity & metabolic syndrome vol. 27,4 (2018): 223-232. doi:10.7570/jomes.2018.27.4.223
- De Lorenso, A., et al., Normal-weight obese syndrome: early inflammation? Am J Clin Nutr, 85(1):40-5, 2007
- Sonnenberg, L., et al., Dietary Patterns and the Metabolic Syndrome in Obese and Non Obese Framingham Women. Obese Res, 13:153-62, 2005
- Sonnenberg, L., et al., Dietary Patterns and the Metabolic Syndrome in Obese and Non Obese Framingham Women. Obese Res, 13:153-62, 2005
- O’Riordan, Michael Oxidized, Dysfunctional HDL Evident in Atheroma, January 27, 2014 www.medscape.com/viewarticle/819773
- Loevinger, B.L., et al., Metabolic syndrome in women with chronic pain. Metabolism, 56(1):87-93, 2007
- Gill, Colleen, Medicine Net.com, Metabolic Syndrome, Denver and Health Sciences Center
- Rizzo, N, Sabate, et al., Vegetarian Dietary Patterns Are Associated With a Lower Risk of Metabolic Syndrome: The Adventist Health Study 2. Diabetes Care, 2011
- Kim H., et at., Plant-based diets and incident metabolic syndrome: Results from a South Korean prospective cohort study. Plos Medicine. Nov. 2020. https://doi.org/10.1371/journal.pmed.1003371
- Saklayen, Mohammad G. “The Global Epidemic of the Metabolic Syndrome.” Current hypertension reports vol. 20,2 12. 26 Feb. 2018, doi:10.1007/s11906-018-0812-z. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5866840/
- Wolters Kluwer Health. “Lifting weights protects against metabolic syndrome, study suggests.” ScienceDaily, 23 October 2012www.sciencedaily.com/releases/2012/10/121023124404.htm
- The Endocrine Society. “Low vitamin D linked to the metabolic syndrome in elderly people.” ScienceDaily, 6 July 2010
- Dunstan, W., et al., Lipids Online, Watching television risk factor for metabolic syndrome. Public Health,121: 83-91, 2007
- Contaminants of Emerging Concern in Fish: Perfluorinated…water.epa.gov/scitech/cec/upload/cec_pfc.pdf
- Endocrine Society. “PFC exposure may spark metabolic changes in overweight children.” ScienceDaily. ScienceDaily, 25 February 2014. www.sciencedaily.com/releases/2014/02/140225134231.htm
- Wennberg, Maria, et al., Poor breakfast habits in adolescence predict the metabolic syndrome in adulthood. Public Health Nutrition, 2014; 1
- University of Missouri-Columbia. “A walk around the office can reverse vascular dysfunction caused by hours at a computer.” ScienceDaily, 28 September 2015
- Watanabe K. et al., Porphyromonas gingivalis impairs glucose uptake in skeletal muscle associated with altering gut microbiota. The FASEB Journal, 2020; DOI: 10.1096/fj.202001158R
- Lamster IB, Pagan M. Periodontal disease and the metabolic syndrome. Int Dent J. 2017 Apr;67(2):67-77. https://pubmed.ncbi.nlm.nih.gov/27861820/
- Wang PX, Deng XR, Zhang CH, Yuan HJ. Gut microbiota and metabolic syndrome. Chin Med J (Engl). 2020;133(7):808-816. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7147654/