The Metabolic Syndrome

Obesity, high blood pressure, elevated blood sugar and increased triglycerides with simultaneously decreased HDL are the precursors of a heart attack. In the US, one third of the adult population suffer from metabolic syndrome, and in women at the age of 70 and over, the prevalence rises to about 60%¹⁾J.S.Moore et. al. Metabolic Syndrome Prevalence by Race/Ethnicity and Sex in the United States, National Health and Nutrition Examination Survey, 1988–2012. Prev Chronic Dis 2017;14:160287. DOI: http://dx.doi.org/10.5888/pcd14.160287. Even in the so-called developing countries, obesity continues to play a greater role. For this reason, the World Health Organization is particularly concerned with the problem of metabolic syndrome.

Definition of Terms

The metabolic syndrome is a complex metabolic disorder, the main symptom of which is insulin resistance. This is an insufficient response of the muscle, fat and liver cells to the action of insulin. That means the pancreas produces enough insulin, but the cells don’t respond well enough. In 1999 the WHO suggested the following parameters to be diagnosed for metabolic syndrome: Being diabetic or having glucose intolerance/insulin resistance, together with 2 of the following factors:²⁾R M Parikh, V Mohan. Changing definitions of metabolic syndrome. Indian J Endocrinol Metab. 2012 Jan-Feb; 16(1): 7–12. doi: 10.4103/2230-8210.91175

• Abdominal obesity with a waist/hip ration of above 0,9 in men and over 0,85 in women or Body Mass Index over 30 kg/m²
• Elevated triglyceride levels above 150 mg/dl; decreased HDL, men below 35 mg/dl and women below 39 mg/dl
• Elevated blood pressure above 140/90 mmHg
• urinary albumin excretion rate above 20 μg/minute

Causes of Metabolic Syndrome

In recent years there has been increased research into genetic factors. The body composition, the type of muscle fibers and their blood flow, and the hormone and enzyme levels play an important role in the development of the metabolic syndrome. But the problem is only triggered by a faulty lifestyle on the part of the person himself. Alcohol, smoking and stress are important triggers, but also improper nutrition and, above all, a lack of exercise. For these reasons, we also speak of the prosperity syndrome.

As the name suggests, the syndrome involves mainly metabolic diseases such as obesity (severe overweight), diabetes, high blood pressure, blood clotting disorders and disorders of lipid metabolism. This results in organ damage such as arterial occlusive diseases, coronary heart diseases, strokes, or colloquially called hardened arteries.

Obesity

According to the WHO, obesity is already a pandemic. It is the leading cause of high blood pressure and diabetes. The absolute weight plays less of a role, but more the fat distribution. The belly fat causes much more problems than the fat on the thighs and hips. Excess fat does not just stay quiet until a fat reserve is needed. Instead, fat tissue is considered a hormonal organ. Many different substances, similar to hormones, are released from the fat cells. These in turn influence blood clotting, insulin resistance, high blood pressure and control energy expenditure, to name but a few.

Sedentary Lifestyle

Physical inactivity is a risk factor by itself. Modern technology relieves us of a lot of activities that used to be mandatory. This ranges from remote controls to electronic typewriters to cars and escalators. Many professions today are sedentary and many leisure activities are carried out while sitting. Exercise falls by the wayside, just we would urgently need it to reduce our belly fat. Fortunately, the times of famine, for which a certain fat reserve would be beneficial, are not coming at the moment. Every now and then, a fasting day or skipping dinner days should be inserted – a programmed time of famine – in order to reduce excess body fat.

Increased Lipid Levels

Elevated triglycerides are often hereditary. But diet also plays an important role. If we eat high-fat, there will be lots of triglycerides circulating in the blood. Excess carbohydrates are also converted into fat in order to be stored, and insulin is needed for this process. A high-calorie diet paves the way for Diabetes.

Fortunately, there are some foods that can lower triglycerides. These include: soybeans, legumes, avocado, onion, wheat germ, and whole grains. We should incorporate several of these foods into our daily diet. Most of them help lower blood pressure at the same time. In addition, they do not contain cholesterol and even help to lower it, since we should keep cholesterol levels low.

Cholesterol is essential for life. That is why the body produces it itself. Without cholesterol, life would be bland, because it is the starting substance for sex hormones, as well as bile acid, aldosterone and cortisol. But the amount needed is very little, and any cholesterol in the diet will lead to excess. Here, too, there are foods that help to lower the cholesterol level: They are mainly nuts, avocados, flaxseed and chia, but also all fruits and vegetables.

LDL transports cholesterol to the body cells. We are used to call LDL the bad cholesterol. It’s just the taxi for the cholesterol. It only becomes dangerous when it oxidizes, i.e. reacts with oxygen and deposits as plaques in the vessel walls. This can be avoided by reducing oxidized cholesterol in the diet, not smoking, building up as little stress as possible and eating a lot of fruits and vegetables high in antioxidants, which are protecting the LDL from oxidation.

Decreased HDL

Most Metabolic Syndrome patients have low HDL levels. However, high values protect the blood vessels. HDL is the taxi for cholesterol back to the liver when it is not needed in the cells. We can increase the HDL levels by plenty of exercise. People who do regular exercise have higher levels.

High Blood Pressure

About 40% of overweight people also have high blood pressure. No wonder, because for every additional pound of fat, an extra mile of new blood vessels have to be created (3,5 km for every kg of fat). The heart therefore has to work harder. Smoking and drinking coffee, black and green tea also narrow the vessels and should be avoided. Apples, pears, grapefruits, pumpkin and celery all help lower blood pressure. They have hardly any sodium, but a lot of potassium. These two minerals are primarily that regulate blood pressure. Sausage, cheese, ham and cured meat are high in sodium, which increases blood pressure. Therefore we should avoid these foods.

Elevated Blood Sugar

This cause of Metabolic Syndrome can also be hereditary. But the trigger is again lifestyle. Lack of exercise, obesity and a high fat diet promote the development of diabetes. The resulting damage of diabetes can be very serious: blindness, kidney failure, amputation of legs and cardiovascular disease.

What can you do? Here weight reduction is again called for, through exercise and a sensible diet. Olive or canola oil are positive fat sources, as well as nuts and seeds. Fruits, vegetables and whole grains provide a lot of fiber, fill you up and help that the sugar from food flows more slowly into the bloodstream.

Drug Treatment of the Metabolic Syndrome

Unfortunately, the Metabolic Syndrome delivers a whole package of metabolic disorders. The drug treatment is accordingly, and one or more drugs for each of the problems are applied. And quickly you have gathered half a pharmacy. The doctor will prescribe all essential drugs for treating the disorders. Unfortunately, a doctor rarely has time for lifestyle advice or has little experience with proper nutrition.

The far more sensible way would be a change in lifestyle and diet, as has been listed under the individual points above.

Hope on the Horizon

A group of doctors who study the Metabolic Syndrome in great detail give hope: “The Metabolic Syndrome can be treated quite effectively. If obese people having Metabolic Syndrome lose significant weight, the metabolic disorder has disappeared in most of them. Almost everyone can reduce their medication or stop it altogether.”

I would also like to encourage in this direction. Metabolic Syndrome patients need to find a way to get more exercise. Support Groups can help. If there isn’t one around, why not start one yourself? Diet and lifestyle courses bring help. Lifestyle changes are therefore undertakings in the right direction – and success is certain!