Metabolic Syndrome

Metabolic Syndrome is a cluster of conditions that occur together and increase the risk of heart disease, stroke, and diabetes. As the name suggests, metabolic syndrome is tied to your body’s metabolism, and more specifically to the ability of the hormone insulin to function correctly. Insulin is one of the most important hormones in the body. It either directly or indirectly regulates the absorption of all nutrients into the cells and acts as one of the main anabolic (building) hormones, turning on rebuilding pathways of proteins, fats, and sugars. However, when the signs and symptoms of Metabolic Syndrome start to show themselves, we can bet that insulin is no longer able to work properly, which means heart disease, stroke, and/or diabetes is not too far away. Signs and symptoms of Metabolic Syndrome include:

• Obesity, particularly around the waist
• High blood pressure
• High levels of blood fat called triglycerides and low levels of HDL (or “good”) cholesterol
• Resistance to insulin

Having one component of Metabolic Syndrome means you are more likely to have others, and having three of these factors has been shown to double the risk of heart attack and triple the risk of heart disease. However, there is good news. The good news is that even if you find yourself in this position, there is something you can do to begin reversing the risk right away. Aggressive diet and lifestyle changes, including eliminating all sugar and refined carbohydrates, getting more physical activity, and quitting smoking will help. To understand why these changes will make a difference let’s look at a healthy response to insulin and follow the pathophysiology that leads to Insulin Resistance and Metabolic Syndrome.

In a healthy body insulin takes the glucose (carbohydrates/sugars), fatty acids (fats), and amino acids (proteins) that were broken down by your digestive system and carries them into your body’s cells to be used as fuel. If this fuel is not used up, it just gets stored in the cell. If over a period of time that stored energy still has not been used, but insulin continues to add more and more of it into the cell each time you eat, the cell eventually becomes full and can no longer take in any more nutrients. At this point the cell will literally close its receptor doors to the insulin, not allowing anymore nutrients to enter. When insulin is no longer able to do its job in carrying these nutrients into the cells, this is called Insulin Resistance. Insulin Resistance is common in people who over-eat and do not exercise, as well as in people who have been yo-yo dieting for many years. People on yo-yo diets often ignore the body’s cravings for food and therefore force the body (through what they consider willpower!) to use up its own reserves from the muscles and bones to keep vital functions going. This leads to less lean body mass and less cells for the insulin to fill up with energy in the first place.

Another way we get Insulin Resistance is through the function of Counter-Regulatory Hormones (CRH’s), which actually block the action of insulin. CRH’s are activated when we are under stress (Cortisol and Adrenaline are both CRH’s). Stress in the body occurs not only when we are under emotional stress, but by skipping meals (nutritional stress), lack of sleep or over exercising (physiological stress), drinking too much alcohol, taking drugs (prescription and otherwise), drinking caffeine, and eating too much sugar or non-organic food (chemical stress). It is important to look closely at all of these factors when trying to reduce stress. After a while, if we continued to be stressed, the CRH response wins out over the insulin and the body begins to break down, causing the warning signs and symptoms of Metabolic Syndrome.

Other factors that may lead to Metabolic Syndrome include genetics, which in some cases do not allow insulin secretion to keep up with demand; free radicals that cause oxidative damage to the beta cells of the pancreas that produce the insulin; and free fatty acids that have leaked out of fat cells and are toxic to the pancreas, blocking the secretion of insulin. The irony here is that Insulin Resistance is what causes the fat cells to leak in the first place, causing an anti-inflammatory response (see my post on Silent Inflammation) which includes the release of the CRH Cortisol, and so we begin to see the this vicious cycle literally feeding itself.

Other risk factors that increase the chances of having Metabolic Syndrome:

• Age. 40% of people in their 60s are affected, however we are beginning to see more and more school-aged children having three or more signs and symptoms listed above.
• Race. Hispanics and Asians seem to be at higher risk for Metabolic Syndrome than other races.
• Obesity. Body Mass Index (or BMI, which is calculated as height/ (weight x weight) x 703) of greater than 25 increases your risk of Metabolic Syndrome.
• History of Diabetes. If Diabetes runs in your family you’re more likely to have Metabolic Syndrome.

Type II Diabetes is an advanced stage of Insulin Resistance. The only difference between someone with Metabolic Syndrome and Type II Diabetes is that the pancreas of the Type II Diabetic is no longer able to keep up with the demand for Insulin, becomes over-worked and stops producing it. Diabetes leads to complications such as nerve, eye, kidney, and blood vessel damage. Either way, being in the last stages of this disease can be devastating.

Unfortunately, the signs and symptoms of the Metabolic Syndrome don’t show up until pretty late in the game. Stage I and II of Insulin Resistance actually look almost exactly like normal metabolic function. If we were to get our blood levels checked, they would still be in the normal range, except in Stage II where we would begin to see Insulin Resistance at the muscle level. Although it is difficult to diagnose someone at these early stages, looking at diet, exercise, and stress levels can show us if we may already be headed down this pathway.

As with anything else, prevention is the key. Understanding what foods cause an increase of insulin and balancing insulin response is the first step. Eating small frequent meals (always including breakfast) that are balanced with protein, good quality fats, and complex carbohydrates will slow down an insulin response. Avoiding sugar, refined carbohydrates, and long-chain saturated fats (as in animal protein) is going to be very important as we heal the digestive system and start to unload the over-filled cells. Getting an abundance of antioxidants will also be important as oxidative damage is highly likely to be occurring. Getting enough sleep, practicing de-stressing techniques such as meditation, yoga, or deep breathing, not missing meals, and avoiding chemicals (including coffee, alcohol and caffeine), will slow or avoid a response from the CRH’s. Exercising is also a key factor in reversing the Metabolic Syndrome, however starting an exercise regimen without changing to a properly balanced diet first, or exercising too much, would be seen as a stress in the body which we know releases CRH’s and is a cause of Insulin Resistance.

If you think you have any one of the signs or symptoms of the Metabolic Syndrome, please talk to your doctor immediately and have your blood levels checked. Remember though, the first stages of this disease process are hardly recognizable with tests. The only way to be sure from the start is to look at your overall diet and stress levels. If you suspect or are even unsure about if your current lifestyle and food choices are causing an overproduction of insulin or of the CRH's, you should sit down with your Health Coach to review these things right away. We can talk about ways to implement a more balanced lifestyle, avoid or reverse Insulin Resistance, and make sure you are on the path of health and wellness.