Reversing metabolic syndrome: Can Metabolic Syndrome Be Reversed? Causes
Three-week Diet-Exercise Study Shows 50 Percent Reversal In Metabolic Syndrome, Type 2 Diabetes — ScienceDaily
Obese and overweight individuals suffering metabolic syndrome and Type 2 diabetes showed significant health improvements after only three weeks of diet and moderate exercise even though the participants remained overweight.
“The study shows, contrary to common belief, that Type 2 diabetes and metabolic syndrome can be reversed solely through lifestyle changes,” according to lead researcher Christian Roberts of University of California, Los Angeles.
“This regimen reversed a clinical diagnosis of Type 2 diabetes or metabolic syndrome in about half the participants who had either of those conditions. However, the regimen may not have reversed damage such as plaque development in the arteries,” Roberts said. “However, if Type 2 diabetes and metabolic syndrome continue to be controlled, further damage would likely be minimized and it’s plausible that continuing to follow the program long-term may result in reversal of atherosclerosis. ”
“The results are all the more interesting because the changes occurred in the absence of major weight loss, challenging the commonly held belief that individuals must normalize their weight before achieving health benefits,” Roberts said. Participants did lose two to three pounds per week, but they were still obese after the 3-week study.
The study, “Effect of a diet and exercise intervention on oxidative stress, inflammation, MMP-9, and monocyte chemotactic activity in men with metabolic syndrome factors,” is in the online edition of the Journal of Applied Physiology published by the American Physiological Society. Researchers were Christian K. Roberts, Dean Won, Sandeep Pruthi, Silvia Kurtovic, and R. James Barnard, all of UCLA; Ram K. Sindhu of Charles R. Drew University, Los Angeles; and Nosratola D. Vaziri of University of California, Irvine.
The study involved 31 men who ate a high-fiber, low-fat diet with no limit to the number of calories they could consume. The participants also did 45-60 minutes of aerobic exercise per day on a treadmill.
Fifteen of the men had metabolic syndrome, a condition that is characterized by excessive abdominal fat, insulin resistance, and blood fat disorders such as high levels of triglycerides (fat in the blood) or low levels of HDL (high density lipoprotein, or “good” cholesterol). Thirteen of the participants had Type 2 diabetes. There was also some overlap between the two groups and some participants who had neither metabolic syndrome nor Type 2 diabetes, but were overweight or obese.
“The diet, combined with moderate exercise, improved many factors that contribute to heart disease and that are indirect measures of plaque progression in the arteries, including insulin resistance, high cholesterol, and markers of developing atherosclerosis,” Roberts said. “The approach used in this experiment of combining exercise with a diet of unlimited calories is unusual.”
The participants in the current study, who ranged in age from 46 to 76 years old, took part in a 21-day residential program at the Pritikin Longevity Center, formerly in Santa Monica, combining the Pritikin diet and exercise program. The daily diet was low fat (12-15% of calories), moderate protein (15-20% of calories), and high in unrefined carbohydrates (65-70% of calories) and fiber (more than 40 grams).
Natural foods — whole grains (five or more servings daily), vegetables (four or more servings), and fruits (three or more servings) — were the main source of daily carbohydrates. The sources of protein were plants (such as soy, beans, and nuts), nonfat dairy (up to two servings daily), and fish and poultry (3.5-ounce portion once a week and in soups and casseroles twice a week). The remainder of the calories came from fat with a polyunsaturated-to-saturated fatty acid ratio of 2.4 to 1.
“Aside from meat and dairy, the study participants could eat as much as they wanted,” Roberts said. “Because the food was not as high calorie as a typical American diet, the participants ate less before feeling full. This is a departure from most diets, which usually leave the dieter feeling hungry,” he said.
The men also exercised daily on a treadmill, including level and graded walking, for 45-60 minutes. The exercise program was tailored to ensure each individual reached 70-85% of maximum heart rate.
Trials outside the laboratory environment are needed to test the regimen in the general population. “The findings are likely generalizable, although the magnitude of change is proportional to the degree of abnormality when the person begins the regimen,” Roberts added.
Scientists also need to determine whether long-term lifestyle change can prevent or reverse end-organ damage noted in those with metabolic syndrome or Type 2 diabetes, Roberts said. These changes may be difficult to make but the payoff for individuals and society could be enormous.
Further studies are also needed in those who are at risk for metabolic syndrome or Type 2 diabetes. Individuals should still be tested to see if Type 2 diabetes and metabolic syndrome can be prevented in the first place. Individuals may be considered healthy before developing metabolic syndrome but looking healthy does not necessarily mean being healthy, he noted.
Source and funding
“Effect of a diet and exercise intervention on oxidative stress, inflammation, MMP-9, and monocyte chemotactic activity in men with metabolic syndrome factors,” by Christian K. Roberts, Dean Won, Sandeep Pruthi, Silvia Kurtovic, and R. James Barnard, of the Department of Physiological Science at UCLA; Ram K. Sindhu of the Division of Endocrinology, Metabolism, and Molecular Medicine at Charles R. Drew University, Los Angeles; and Nosratola D. Vaziri of the Division of Nephrology and Hypertension, Department of Medicine at University of California, Irvine is in the online issue of the Journal of Applied Physiology published by the American Physiological Society.
Research was supported by a grant from the LB Research and Education Foundation, an independent foundation in California and a National Research Scholarship Award postdoctoral fellowship from the NIH.
The American Physiological Society was founded in 1887 to foster basic and applied bioscience. The Bethesda, Maryland-based society has more than 10,000 members and publishes 14 peer-reviewed journals containing almost 4,000 articles annually.
APS provides a wide range of research, educational and career support and programming to further the contributions of physiology to understanding the mechanisms of diseased and healthy states. In May 2004, APS received the Presidential Award for Excellence in Science, Mathematics and Engineering Mentoring (PAESMEM).
How Do You Treat Metabolic Syndrome?
Metabolic syndrome is a group of risk factors that include abdominal fat, high blood pressure, high blood sugar, and unhealthy cholesterol levels. Treatment is focused on tackling each of these conditions. The goal is to cut your odds of blood vessel disease and heart disease, as well as diabetes.
In most cases, the best treatment for metabolic syndrome rests with you. Changes to your behavior — such as eating healthier and getting more exercise — are the first things your doctor will suggest. By adopting some healthy habits, you may be able to eliminate your risk factors completely.
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.
Talk to Your Doctor About Medication
You may need medicine to help with metabolic syndrome, if lifestyle changes aren’t enough to reduce your risks. Some drugs you might use are:
- High blood pressure medicines, which include ACE inhibitors (like Capoten and Vasotec), angiotensin II receptor blockers (like Cozaar and Diovan), diuretics, beta-blockers, and other drugs.
- Cholesterol medicines, which include statins (like Crestor, Lescol, Lipitor, Mevacor, Pravachol, and Zocor), niacin (like Niacor, Niaspan, and Nicolar), bile acid resins (like Colestid and Questran), Zetia, and other drugs.
- Diabetes medicines, which may be necessary if you have glucose intolerance. Drugs include metformin (Glucophage), pioglitazone (Actos), and rosiglitazone (Avandia).
- Low-dose aspirin, which can reduce the risks of heart attacks and strokes. It may be especially important for people who are “prothrombotic,” or prone to blood clots.
Keep in mind that all medicines can have side effects and risks. Talk with your doctor about the pros and cons.
Reverse Metabolic Syndrome With a Paleo Diet
Metabolic syndrome is widespread, affecting 34 percent of all U.S. adults and half of those over 60. (1) Instead of a distinct disease, metabolic syndrome is a cluster of symptoms. One is diagnosed if at least three of the following five markers are present: (2)
- large waist circumference
- high blood pressure
- elevated fasting glucose
- elevated triglycerides
- low HDL (“good”) cholesterol
Metabolic syndrome is a red flag, warning you that your body isn’t healthy. In fact, each of the symptoms listed above is a separate risk factor for diabetes and/or cardiovascular disease, two leading causes of death in the United States. (3, 4, 5) Fortunately, adopting a Paleo diet can reverse the markers of diabesity and metabolic syndrome and even help those who have already developed insulin resistance, as I will discuss in this article.
Metabolic Syndrome, Insulin Resistance, and Heart Disease – What Do They All Have in Common?
Metabolic syndrome, insulin resistance, and heart disease are all considered “modern” diseases because they weren’t prevalent until the 1900s after the Industrial Revolution. Drastic changes in U.S. dietary habits have occurred only in the last century or so, including increased consumption of hydrogenated oils (trans fats), vegetable oils, processed foods, and refined sugars. Even grain consumption wasn’t common until the Agricultural Revolution around 10,000 years ago, which is actually only around 5 percent of the human species’s existence.
Many tribal cultures today that maintain traditional hunter–gatherer diets are virtually free from metabolic syndrome, heart disease, and type 2 diabetes. For example, the Kitavan, Masai, Machiguenga, and !Kung consume very little, if any, refined grains or processed sugars, though the specific contents of their diets vary widely. (6, 7, 8, 9)
Insulin resistance and inflammation together are believed to be the underlying causes of metabolic syndrome. (10, 11) Our modern diets contain huge contributors to both: (12, 13)
- Industrial seed oils have been shown to have a pro-inflammatory effect in some studies. (14)
- Processed grains and refined carbs cause both inflammation and metabolic dysfunction in mice, perhaps by disrupting the gut microbiota. (15)
- Excessive refined sugar intake, particularly high-fructose corn syrup, is correlated with insulin resistance and inflammation. (16, 17, 18)
Our modern diets are so detrimental to our health that when tribal cultures “Westernize” their diets, they quickly develop modern metabolic diseases. (19, 20, 21) They might be even more susceptible to modern diseases than those of European descent, who have thousands of years more evolutionary adaptation under their belts to accommodate grain consumption. Now, on the flip side, let’s see what happens when Western dieters revert to a Paleo, traditional diet.
Paleo Diets Outperform Other “Healthy” Diets
Paleo diets are finally appearing in randomized, controlled trials, to be compared to what are considered “healthy” or “heart-healthy” modern diets. Instead of focusing on macronutrients as most contemporary diet studies do, (22, 23, 24) these studies focused on avoiding or consuming different groups of foods all together, and the results are extremely promising. In the studies reviewed below, a Paleo diet was devoid of refined sugar, processed foods, vegetable oils, and grains, while also usually avoiding dairy and legumes. Favored foods included lean meats, vegetables, fish, eggs, fruit, and nuts.
Emerging research shows the Paleo diet outperforms “heart-healthy” diets.
Paleo diet is beneficial for people with type 2 diabetes
In a short, 14-day diet study, the Paleo diet was compared to the diet recommended by the American Diabetes Association in people with type 2 diabetes. (25) While both groups showed equivalent positive changes in weight and insulin sensitivity, only the Paleo group had beneficial changes in fasting glucose, total cholesterol, and LDL (“bad”) cholesterol.
In a longer, six-month crossover trial, the Paleo diet also outperformed the recommended diabetic diet. (26) In this sort of trial, half the participants started with the Paleo diet, and then switched to the Diabetic diet halfway through the study. The remaining participants did the the opposite. The Paleo diet showed greater improvements in triglycerides, HDL (“good”) cholesterol, diastolic blood pressure, body weight, and waist circumference.
In people with both insulin resistance and heart disease, a 12-week study showed that the Paleo diet resulted in more advantageous effects on both waist circumference and two-hour glucose measures than the popular Mediterranean diet. (27)
Paleo diet is beneficial for people with metabolic syndrome
In people who already had metabolic syndrome, the Paleo diet after only 14 days lowered blood pressure, cholesterol, and triglycerides, and raised HDL cholesterol better than the diet recommended by the Dutch Health Council. (28) In fact, the number of metabolic syndrome symptoms experienced by the Paleo group actually decreased over this short pilot study.
Over four months, people with hypercholesterolemia first followed the diet recommended by the American Heart Association and then followed with a Paleo diet. (29) The Paleo diet resulted in greater benefits for total cholesterol, LDL and HDL cholesterol, and triglycerides.
Two longer studies lasting two years compared the Paleo diet to modern “healthy” diets. In both cases, the Paleo diet outperformed the control diet at six months, but at the two-year mark, the diets showed mostly similar benefits. (30, 31)
Paleo diet is beneficial for healthy people
In otherwise healthy individuals, a Paleo diet improved body weight, waist circumference, and systolic blood pressure in three weeks. (32) Likewise, in non-obese yet sedentary people, a Paleo diet showed benefits for blood pressure, plasma insulin, total cholesterol, LDL cholesterol, and triglycerides. (33)
This growing collection of literature shows that reverting to a Paleo diet, even for as few as 14 days, can start to improve lipid markers and measures of metabolic syndrome. Research is finally catching up with what many people, myself included, have been advocating for a while: eat real, nutrient-dense foods, and you get healthier!
Why Does the Paleo Diet Get Such a Bad Rep?
U.S. News and World Report again ranked the Paleo diet near last, at 36 out of 38 diets in their “Best Diets Overall” rankings. Why might this be, especially since recent evidence highlights its health benefits?
Paleo dieters in controlled studies often consumed fewer calories ad libitum than dieters in the control groups, sometimes up to 35 percent fewer. (32) When Paleo groups show better health outcomes, critics ask, “Is it the Paleo diet itself or the fewer calories that is advantageous?” First, I fail to see how this can be considered a “negative” attribute of the Paleo diet. Spontaneous calorie restriction while feeling fuller calorie for calorie (34) sounds like the long-awaited solution to the current overeating epidemic. Second, many studies accounted for this extra weight loss. Boers et al., 2014, offered approved snacks to Paleo dieters. (28) At the end of the study, they still managed to lose more weight than the control group, but the researchers accounted for this in their statistical model and found the advantageous results remained, despite weight differences. Two other studies confirmed that the Paleo diet benefits remained after adjusting for weight loss or decreased waist circumference in the Paleo group. (27, 29)
Dieticians and nutritionists are also concerned with reduced calcium intake present in most Paleo diets. (26, 28, 32, 35) However, two studies reviewed above showed that while calcium intake was lower, calcium excretion was also lower, indicating that calcium absorption may be increased in Paleo dieters and/or that calcium/magnesium balance is probably not disrupted. (25, 28)
Last, the Paleo diet is ranked so low because it is considered hard to follow, with too many food restrictions. Yes, a Paleo diet is a commitment, but it is more than just a diet. Going Paleo is a lifestyle that should focus on many other aspects of health, including stress management, exercise, sleep, and reducing toxin exposure.
Adopt a Paleo Lifestyle, Transform Your Health
The Paleo diet has a lot to offer, whether you already have metabolic syndrome or if you are a healthy weight and have normal blood work. The research is finally in support of going Paleo, and hopefully more studies will follow with larger group sizes and longer follow-ups. If you are ready to transform your health, consider trying my 14Four program, which emphasizes four pillars of the Paleo lifestyle: movement, diet, stress, and sleep.
The 14Four program is perfect for beginners and for those who are already Paleo and just want a reset. With you every step of the way, this program eases you into the Paleo lifestyle with tailored meal plans and exercise routines, while tracking your results and offering community support.
What’s the Best Diet for Metabolic Syndrome? We Review the Options
[Last updated 24th July, 2019]
Metabolic syndrome is a medical condition that’s fast becoming a worldwide epidemic.
It currently affects an estimated 25% of the world population.
In the United States alone, the prevalence of metabolic syndrome has increased by more than 35% in the past 30 years (1, 2).
If left untreated, metabolic syndrome can cause serious to life-threatening medical problems.
Fortunately, changes in diet can help prevent and treat it in many cases.
This article takes a look at the best diet for metabolic syndrome.
What is Metabolic Syndrome?
Most commonly, metabolic syndrome is characterized by having at least three of the following conditions (3):
It’s important to treat these conditions so they don’t cause significant health problems down the road.
In addition to upping your risk of diabetes and non-alcoholic fatty liver disease, metabolic syndrome doubles your risk of cardiovascular disease and increases your risk of death from any cause by 1. 5 times (4).
Summary: Metabolic syndrome is a group of symptoms that increase risk for cardiovascular disease, diabetes and death. Symptoms include abdominal obesity, high blood pressure, high blood cholesterol, high triglycerides and high blood sugar.
What Causes Metabolic Syndrome?
Metabolic syndrome can be caused by any combination of genetic, lifestyle or medical factors.
Fortunately, many factors that may increase your risk—including insulin resistance, obesity and inflammation—can be modified through diet and exercise.
Insulin resistance occurs when the body’s cells become less sensitive to a hormone called insulin.
After meals, your pancreas makes insulin in response to rising blood sugar levels. Normally, insulin signals your body’s cells to pull sugar from the bloodstream. Your cells either use that sugar for energy or store it for later use.
With insulin resistance (also called impaired glucose tolerance), the body’s cells become less sensitive to the effects of insulin. Blood sugar levels increase, and so does your risk for diabetes and other complications.
Some experts argue that insulin resistance is the number one cause of metabolic syndrome, and that improving insulin sensitivity should be a top treatment priority.
Indeed, studies have linked insulin resistance to each of the components of the condition. Despite this, most organizations have excluded insulin resistance as a diagnostic criterion for metabolic syndrome. This may be partly due to the lack of a simple test for insulin resistance (5, 6, 7).
Obesity is a significant risk factor for metabolic syndrome.
However, that’s not to say that normal-weight adults aren’t at risk.
In one large study of more than 64,000 adults, metabolic syndrome was seen in up to 8% of normal-weight adults (BMI under 25), up to 32% in overweight adults (BMI 25-30), and up to 71% in obese adults (BMI greater than 30) (8).
Another large study of more than 13,000 adults found that as much as 17% of normal-weight adults had metabolic syndrome. Risk was especially high for men and women with BMI greater than 23.7 and 22.4, respectively. Researchers recommended further screening for those at the higher end of a healthy BMI range (9).
Obesity can increase health risks in and of itself. However, excessive fat tissue also increases production of certain chemicals that can be harmful in large amounts. One of these is clusterin–a protein that plays a key role in cell death. A study just last month linked high levels of clusterin to metabolic syndrome, but much more research is needed to understand this relationship (10).
While BMI is only loosely linked to metabolic syndrome, maintaining a healthy body weight is still key to the prevention and treatment of metabolic syndrome. Click here to calculate your BMI (3).
Studies have also linked chronic, low-grade inflammation with metabolic syndrome (11, 12).
People who are obese tend to have greater production of inflammatory chemicals called cytokines in the fat cells. Those with more body fat also have higher levels of C-reactive protein (CRP), which has been linked with increased cardiovascular risk.
Other risk factors for chronic inflammation include emotional stress and a Western diet (13).
Other Medical Conditions
Several chronic medical conditions can increase your risk for metabolic syndrome, including:
- Hypothyroidism: This occurs when the body doesn’t produce enough thyroid hormone.
In one large study of more than 3,900 women, 33% with hypothyroidism also had metabolic syndrome. This was significantly greater than the women with normal thyroid function (14).
Abdominal obesity and insulin resistance are key features of PCOS. In fact, up to 70% of women with PCOS are insulin resistant (15, 16).
Clusterin is a protein that’s thought to play a key role in cell death.
As is the case with cytokines and CRP, greater amounts of clusterin are seen in those who are overweight and obese. A small, recent study suggests that excessive clusterin might increase risk of metabolic syndrome (10).
This is preliminary research that requires much more follow-up. It’ll be interesting to see if any further connections are observed.
Summary: Several factors play a role in the development of metabolic syndrome, although some have been more strongly linked than others. Insulin resistance and obesity are both major risk factors that can be modified by lifestyle. Studies have also linked the condition to chronic inflammation, hypothyroidism, polycystic ovary syndrome and elevated clusterin levels.
Medical Management of Insulin Resistance
There’s no uniform treatment strategy for metabolic syndrome.
It’s more common to manage each of its five diagnostic criteria independently. This sometimes involves medications (5).
As the name suggests, insulin sensitizers make the body more sensitive to the effects of insulin.
Metformin and Pioglitazone are among the most common. Though often used in those with type 2 diabetes, they’re also sometimes prescribed to lower risk for metabolic syndrome.
Both Metformin and Pioglitazone have shown success at lowering blood sugar and triglycerides while increasing HDL (the good type of cholesterol). Metformin has also been shown to significantly lower BMI (5).
Interestingly, though, at least one large study found that Metformin was less effective in reducing metabolic syndrome risk than lifestyle intervention. In the same study, Metformin was no more effective than placebo among women with the condition (17).
To some degree, this may be influenced by medication dose and other factors. Your doctor can help you decide if insulin sensitizers are right for you.
Blood Pressure and Cholesterol Medications
High blood pressure is one of the most common issues among those with metabolic syndrome.
One large study estimated that nearly 28% of those with metabolic syndrome have hypertension. Doctors use several types of medication to control high blood pressure, including (18):
- Calcium channel blockers
- ACE inhibitors
Your doctor may prescribe one of these medications if diet and lifestyle changes fail to improve your blood pressure. Similarly, they may suggest statins or cholesterol absorption inhibitors to lower your cholesterol and possibly your triglycerides.
Weight Loss Drugs
Weight loss drugs aren’t a first line of treatment for metabolic syndrome.
However, since weight loss can help reverse metabolic syndrome, they’re sometimes used among patients with a BMI of 30 or greater, or a BMI as low as 27 when multiple metabolic risk factors are also present (19).
Studies have shown that certain types of weight loss drugs promote modest weight loss of about 3-5 kilograms (7-11 pounds) compared to placebo. However, they don’t guarantee success and are meant to be taken under close medical supervision.
Over-the-counter weight loss supplements should never be taken without speaking with a doctor (19).
While doctors sometimes prescribe weight loss pills and other drugs to manage metabolic syndrome, lifestyle changes can be as effective if not more so. The rest of this article will look at some of those diet changes.
Summary: Lifestyle changes can go a long way in the treatment of metabolic syndrome. However, doctors may sometimes prescribe medications, including insulin sensitizers, blood pressure medications, cholesterol medications or weight loss drugs.
The Best Diet for Metabolic Syndrome
Those with metabolic syndrome can lower their risk with any diet that promotes weight loss, though certain diets have shown to be especially helpful.
The Mediterranean Diet
The Mediterranean Diet emphasizes fruits, vegetables, whole grains, lean proteins and healthy fats.
It’s widely considered to be one of the healthiest diets. Even U.S. News and World Report named it the 2019 Best Diet Overall. It’s also been shown to help prevent and reverse metabolic syndrome.
In one large review of 50 studies and nearly 535,000 participants, those who followed a Mediterranean Diet were 50% less likely to have metabolic syndrome (3, 20).
Adopting a Mediterranean Diet can also help with treatment.
In one study, one group of 90 volunteers with metabolic syndrome received diet and exercise advice at bi-monthly visits with a nutritionist for 2 years. A second group of 90 volunteers were instructed to follow a Mediterranean Diet for 2 years that aimed to include a certain amount of fruits, vegetables, walnuts, whole grains and olive oil consumption per day.
Both groups ate 50-60% of calories from carbohydrates, 15-20% of calories from protein, and less than 30% of calories from fat.
After 2 years, the Mediterranean Diet group saw significant increases in HDL cholesterol, as well as significant improvements in BMI, waist circumference, body weight, insulin resistance, blood pressure, blood glucose, total cholesterol, triglycerides and blood markers of inflammation.
Even more impressive, nearly 49% of those in the second group were no longer considered to have metabolic syndrome at the end of the 2-year study. By contrast, 89% of volunteers in the first group still had metabolic syndrome (21).
The Mediterranean Diet may be helpful because it promotes weight loss. But, due to it being rich in antioxidants, fiber and healthy fats, it can also lower inflammation and improve endothelial function (22).
Low-carb diets are generally considered to contain fewer than 30% of calories from carbohydrates.
They’re very popular for weight loss, which may help reverse risks associated with metabolic syndrome. It’s also been suggested that low-carb diets may reverse metabolic syndrome by improving insulin sensitivity. However, the evidence is somewhat underwhelming.
Two small human studies have found only modest improvements after six months on a low-carb diet. A third, slightly larger study also found that a low-carb diet was not much more effective than a low-fat diet at improving insulin sensitivity (23, 24).
Notably, it’s possible to reap some of the metabolic benefits of low-carb diets without drastically cutting carbs. In one study of 164 adults with hypertension, each volunteer followed three separate diets for 6 weeks:
- 58% of calories from carbohydrate, 15% from protein, and 27% from fat
- 48% of calories from carbohydrate, 25% from protein, and 27% from fat
- 48% of calories from carbohydrate, 15% from protein, and 37% from fat.
(The increased fats were mostly monounsaturated, from foods like nuts, seeds, olive oil, canola oil and safflower oil.)
The higher fat diet caused significant improvements in insulin sensitivity compared to the higher carb diet. Thus, reducing daily carb intake may help reduce metabolic syndrome risk in those with cardiovascular risk factors. However, some of these benefits may be offset if the carbs are replaced with saturated fats (25).
Large studies have linked vegetarian diets to lower risk for metabolic syndrome (3).
One recent study found better insulin sensitivity in vegetarians, and especially vegans. However, no studies to our knowledge have looked at whether plant-based diets can reverse metabolic syndrome in those who already have it (26).
Still, it’s never a bad idea to incorporate more fresh fruits and vegetables in your diet—whether you’re vegetarian or not.
Intermittent fasting has become a popular diet approach in recent years.
There are a few ways to do it. Some protocols involve restricting food for several hours per day (most often, consuming all meals within eight hours). Others sharply restrict calories for several days per week.
Studies have demonstrated that it can be a powerful weight loss strategy. So, in theory, it should help with metabolic syndrome, but evidence is mixed as to whether it’s beneficial or harmful (27).
Human and animal studies have found that intermittent fasting can lower insulin resistance and diabetes risk. Rodent studies also suggest that it can improve cardiovascular risk factors, including blood pressure variability (28, 29, 30).
However, one small human study found alternate day fasting to be no more effective than a traditional low-calorie diet in terms of weight loss or insulin sensitivity (31).
Other human studies have linked three or more meals per day with better insulin sensitivity and a lower risk for metabolic syndrome. Some even suggest that intermittent fasting may worsen insulin resistance in normal weight adults (32, 33, 34, 35).
While intermittent fasting can help you lose weight, we don’t know enough about its effects on other metabolic markers to recommend it at this time.
Summary: Of the diets reported to help with metabolic syndrome, the Mediterranean Diet has shown the most promise. Lower carb diets may lower risk for those with metabolic risk factors, but only if unsaturated fats are eaten in the place of carbs. Vegetarian diets may also protect against metabolic syndrome, but we don’t know if they can treat it. Evidence is mixed as to the effects of intermittent fasting on metabolic syndrome.
Top Diet Tips for Metabolic Syndrome
There’s no one-size-fits-all diet approach for metabolic syndrome.
Of the diets that have shown success, there’s some benefit to choosing the one that is easiest for you to stick with long-term. You can also take cues from the most effective diets without strict adherence to any single plan.
Here are some of the best tips taken from the diets mentioned above:
- Limit alcohol. Alcohol is an optional part of the Mediterranean Diet. Studies suggest that small amounts of alcohol, especially red wine, may protect against metabolic syndrome. However, too much of it will actually increase your risk.There’s no need to start drinking alcohol if you don’t already. Women who currently drink should limit themselves to 20 grams, or one drink, per day. Men should stick to no more than 40 grams, or two drinks, per day (3).
- Eat a variety of fresh fruits and vegetables. Mediterranean and vegetarian diets are both abundant in colorful produce. Fresh fruits and vegetables are rich in phytochemicals and antioxidants, which help reverse cell damage and inflammation. Fill half of your plate at each meal with fruits and veggies, aiming for 5-9 servings per day.
- Limit simple sugars. Simple sugars raise your risk for obesity and diabetes and, over time, increase your odds for insulin resistance. This may account for some of the success in Mediterranean and low-carb diets. Keep sweets, white starches, sugar-sweetened drinks and other processed sugars to a minimum.
- Choose healthy fats. There’s some controversy lately over the health impacts of saturated fats. However, monounsaturated and polyunsaturated fats have been shown to protect the heart. These fats are prominent in Mediterranean and vegetarian diets. As much as possible, your dietary fats should come from nuts, seeds, olive oil, salmon, mackerel and other sources of unsaturated fats. There’s also some evidence that avocado may be beneficial for those with metabolic syndrome, but more studies are needed to confirm this (36).
- Limit sodium. Studies have consistently linked excessive dietary sodium with heart risk. Still, more than 99% of Americans consume too much of it. One recent analysis including more than 66,000 adults found a direct link between high-sodium diets and metabolic syndrome (37, 38).
It’s best to limit restaurant meals and processed foods, and avoid salting foods at the table.
- Eat high-potassium foods. Only 2% of Americans get enough potassium in their diet. Studies have linked low potassium intake to increased risk for metabolic syndrome, at least in postmenopausal women (39 , 40).
The recommendation for potassium is 4,700 milligrams per day for adults. Many fruits and vegetables are rich in potassium, which may account for some of the success of Mediterranean and vegetarian diets. High-potassium foods include baked (not fried!) potatoes, tomato sauces, beet greens and bananas.
Summary: It’s possible to improve metabolic health by picking and choosing strategies from successful diets, like the Mediterranean Diet. Be sure to eat adequate fruits and vegetables, healthy fats and potassium. Limit simple sugars, alcohol, sodium and saturated fats.
The Take-Home Message
Metabolic syndrome is a common condition that increases your risk for cardiovascular disease, diabetes and other health problems.
If left untreated, it can also increase your risk of death.
The good news is, you can do a lot to improve your health with diet alone. Mediterranean and lower carb diets may be able to reverse certain symptoms of metabolic syndrome, while a well-planned vegetarian diet may help prevent it.
In fact, you don’t even need to follow a strict diet plan as long as you’re able to follow certain strategies that can help lower your risk. Your best bet is to eat more fruits and vegetables, healthy fats and potassium and avoid sodium, alcohol, saturated fats and simple sugars.
Making these types of diet changes, and adding in regular exercise, will go a long way in preventing and treating metabolic syndrome.
Low Carbohydrate Diet Versus Low Fat Diet in Reversing the Metabolic Syndrome Using NCEP ATP III Criteria – Full Text View
The metabolic syndrome (MetS) is a major and escalating public health and clinical challenge worldwide in the wake of urbanization, excess energy intake, increasing obesity, and sedentary life style. Metabolic syndrome a five-fold increasing the risk of type 2 diabetes mellitus (T2DM) and two fold increasing the risk of developing cardiovascular disease (CVD) over the next 5 to 10 years. Worldwide prevalence of MetS ranges from <10% to as much as 84%, depending on the region, urban or rural environment, population composition (sex, age, race, and ethnicity), and the definition of the syndrome used. The NCEP ATP III definition is one of the most widely used criteria of metabolic syndrome. It incorporates the key features of hyperglycaemia/insulin resistance, visceral obesity, dyslipidaemia and hypertension.
The treatment of metabolic syndrome intends to improve insulin sensitivity and correct the associated metabolic and cardiovascular abnormalities. During the past few years, several studies have evaluated the health effects of low carbohydrate-high protein diet (LCD), with emphasis on cardiovascular diseases versus low fat diet (LFD). Low-carbohydrate diet has become a popular strategy for weight loss and weight management in recent years. In addition, data from several randomized trials have demonstrated that LCD produced greater effects on weight loss and reducing cardiovascular and metabolic risk factors than LFD. A popular version of this LCD recommends extreme restriction of carbohydrate intake to less than 20 gram/day initially.
Although the pathogenesis of MetS is strongly linked to excessive food consumption, in particular fat intake, still there is no consensus about the effects of LCD versus LFD on reversing the MetS and on its metabolic risk factors. However, concerns have been raised with regard to the macronutrient shift with high CHO restriction and the substantial intakes of fats, which may present unfavorable effects on CVD risk factors. Meanwhile the LFD has generally been supported by studies to have beneficial effects on these risk factors.
The purpose of this study was to investigate the effects of a low carb diet compared to low fat diet on reversing and treating metabolic syndrome and their risk factors among a sample of obese adults in Erbil city/ Iraq Kurdistan.
This study is a randomized clinical trial conducted over 6 months, between (January and June 2017) with outcome assessments at baseline, at 3, and 6 months of intervention.
Eight hundred adults (≥18year old) of both gender (358 males and 442 females) are surveyed in the 12 population clusters in Erbil city to estimate the prevalence of MetS. The population frame of household of Erbil population based on all 12 offices of Family ID card in Erbil city. The randomized cluster sampling survey method of the houses is used for sample selection. Out of 289 obese adult participants who had the inclusion criteria to participate in the study, only 94 of them agreed to participate in the intervention (23 males and 71 females). Those 94 are randomly assigned into two groups, the LCD (n=54) and LFD (n=40) group. All the adult participants are completed a comprehensive medical examination and routine blood tests.
A modified questionnaire of world health organization (WHO) STEPwise approach to Surveillance of noncommunicable diseases (STEPS) was used in this study. The modified questionnaire included 25 questions on socio-demographic (9 questions), anthropometric measurements (7 questions) and biochemical measurements (9 questions).
According to the NCEP ATP III guidelines, in our study, the participants having the metabolic syndrome if they possess three or more of the following criteria is written in the following: Abdominal obesity: Increased waist circumference Men: > 102 cm, Women: > 88 cm, Elevated triglycerides > 150 mg/dL, Reduced HDL Men: < 40 mg/dL, Women: < 50 mg/dL, Elevated blood pressure > 130/85 mm Hg & Elevated fasting glucose > 100 mg/dL.
Individuals with history or diagnosed with diseases and health related issues like diabetes mellitus, hypertension, chronic skin disease, heart disease, hyperlipidemia, malignant disease, and rheumatoid arthritis and those who had undergone surgery during one month before the study are excluded in the study.
More than half of the participants (n = 54) were followed the LCD. In this diet program, the primary behavioral target was to limit carbohydrate intake. Therefore, the limited carbohydrate intake and unrestricted consumption of fat and protein are allowed. During the first two weeks of the intervention, participants were instructed to limit carbohydrate intake to 20-gram per day. After the first two weeks, the participants were instructed to gradually increase 5-gram of the carbohydrate intake every week.
Forty participants were followed the LFD. The primary behavioral target was to limit the overall energy intake (1200 kcal/d). They received instructions to increase calorie intake from 1200 to 1800 kcal per day (≤ 30% of calories from fat, <7% saturated fat).
All 94 participants completed the 6 months of intervention. They were followed up regularly by direct interview every two weeks by the researcher. Each follow-up session lasted 15 to 30 minutes. All of them were prescribed the same level of instruction concerning drinking 10-12 glasses of water /day and physical activity (principally walking), beginning at week 2, with 1 session of 30-45 minutes per day then increasing the duration of physical activity to reach at least 60 minutes /day.
An electronic weight scale (model 770: Seca, Germany) was used to measure the participants’ weight to the nearest 0.1 kg. While the participants were asked to stand still without shoes, a measuring tape was utilized to measure their lightly clothed height to the nearest 0.5 cm. The formula used for calculating body mass index (BMI) was as following: BMI=weight(kg)/height(m2). The measurements were collected at baseline, at 3 months and 6 months.
Waist circumference (WC) was measured midway above umbilical between the distal border of the lowest rib and the superior border of the iliac crest at the end of a normal expiration. Measurements were done with the subject in upright position, without clothes, both feet touching the ground, and arms hanging freely. A non-elastic tape measure was placed directly on the skin on the waist line without putting pressure on the abdominal wall.
Blood pressure (BP) was measured by the researcher using an MDF Desk Mercury Sphygmomanometer (Model No: MDF 800), with cuff sizes based on measured arm circumference. Blood pressure checked after participants were asked to sit and take rest for 10 minutes. The measurements were collected at baseline, at 12 and 24 weeks.
Blood samples were obtained after participants fasted overnight (8-10 hours). Blood sample analyzed in the laboratory department of one of the two main hospitals in Erbil city, the Rzgary Teaching Hospital. The serum analyzed by the same laboratory and by the same device (BIOTECNICA BT4500 Full Automated Chemistry Analyser, 2016).
The adherence of the diet programs was done based on participants’ self-reporting. Also, delivery of the intervention and assessment of the outcomes are not blinded.
Data on baseline characteristics of adult participants were expressed as means ± SD and/ or frequencies and percentage. The data checked for normal distribution by Shapiro-Wilk test; the p-value was 0.10 which indicates that the data was normally distributed. The study used t tests and Chi square test of association to compare baseline characteristics between both diet programs. When the expected count more than 20% of the cells of the table was less than 5, Fisher exact test was used. An independent samples t-test was used to compare the means of a normally distributed metabolic risk factors for both independent diet programs at the baseline and after 6 months of intervention. A two-way repeated measures ANOVA was used to compare differences of metabolic dependent variables between the two independent variables, the LCD & LFD, at baseline, after 3 months and after 6 months. To determine how much of an effect of intervention has had on the participants, the study used the following cut-offs to interpret the results: 0.14 or more are large effects, 0.06 are medium effects and 0.01 are small effects. A p-value of ≤0.05 was considered as the level of significance for all analyses. The Statistical Package for the Social Sciences (SPSS) software, version 22 was used for data analysis.
Reversing Metabolic Syndrome Using Natural Medicine
Dr. Ariel Jones, ND
What is Metabolic Syndrome or Syndrome X?
Metabolic syndrome is a cluster of risk factors that increase one’s chances of developing serious illnesses in the future. Metabolic syndrome doubles the chance of developing cardiovascular disease1 while increasing the risk of diabetes, fatty liver, and several types of cancers2.
It is diagnosed by having three or more of the following symptoms3:
- High fasting blood glucose levels: ≥100 mg/dL (or receiving drug therapy for hyperglycemia)
- High blood pressure: ≥130/85 mm Hg (or receiving drug therapy for hypertension)
- High triglyceride levels: Triglycerides ≥150 mg/dL (or receiving drug therapy for hypertriglyceridemia)
- Low high density lioprotein (HDL) levels: < 40 mg/dL in men or < 50 mg/dL in women (or receiving drug therapy for reduced HDL-C)
- Large waist circumference: ≥102 cm (40 in) in men or ≥88 cm (35 in) in women; if Asian American, ≥90 cm (35 in) in men or ≥80 cm (32 in) in women
When a patient presents with these risk factors together, the chances for future cardiovascular problems are greater than any one factor presenting alone.
What Causes Metabolic Syndrome?
Low grade inflammation has been linked to the cause of many serious health conditions such as4:
- Coronary Heart Disease
- Spontaneous Pre-term Birth
As well as more common and pervasive conditions5:
- Leaky gut
- Cognitive impairment
- Sleep problems
There are many ways the body develops low grade inflammation. The western lifestyle, characterized by lack of exercise and a diet rich in refined foods, is the most likely culprit6. These habits lead to obesity, high blood pressure, increased triglycerides, insulin resistance and high blood sugar; the collection of symptoms that make up Metabolic Syndrome. Obesity promotes inflammation via chronic activation of the immune system7.
Exercise increases skeletal muscle which acts as an endocrine organ by increasing the metabolism in those tissues and modifying the immune system. Sedentary patients who engaged in a 20 week aerobic exercise regime saw a reduction in their C-reactive protein, a common marker of inflammation8.
Eating processed and refined foods leads to inflammation. Here is a list of refined foods common to the Western Diet:
- Sugar- granulated sugar, white, brown, high fructose corn syrup
- Saturated Fats- cheese, red meat, full fat dairy
- Trans-Fats- fast food, fried products, processed snack foods: cookies, donuts, margarine
- Omega 6 Fatty Acids- corn oil safflower oil, canola oil, grapeseed oil, soy, peanut, vegetable oils, mayonnaise, store bought salad dressing
- Refined Carbohydrates- white flour products, white rice, white potatoes, breakfast cereals
- Gluten- this is the protein found in many grains such as: wheat, barley and spelt.
- Casein- the protein found in whey.
- GMO- genetically modified foods have had their organic structure modified for a production or profit purpose. They contain genetic structures our bodies haven’t seen before and aren’t equipped to metabolize properly. Non-metabolized food sits in our gut and gets fermented by bacteria leading to bacterial dysbiosis.
Eating these processed and toxic foods leads to chronic inflammation in the gut affecting the tight junctions between the cells causing them to separate. When this happens small food particles leak out into the tissues activating the immune system. Food particles in our tissues look like a foreign invader to our immune system that reacts to protect us. Unfortunately the immune system doesn’t forget, and unless we treat our “leaky gut”, our body develops an allergy to these common foods.
How to Cure Metabolic Syndrome
Detoxification and lifestyle changes reverse metabolic syndrome. Treatment involves decreasing your weight, eating heart-healthy foods, managing blood glucose, cholesterol, and blood pressure using diet, exercise, and supplements.
Treatment principles are:
- Stop low-grade inflammation
- Decrease weight
- Lower triglycerides
- Increase HDL
- Lower blood sugar/improve insulin sensitivity
Stop Low-grade inflammation
Removing all of the processed and refined foods listed above is the best first step you can take to reducing low-grade inflammation. Eating a diet of fresh, organic fruits, vegetables, nuts, seeds, herbs and healthy fats is the basis of an anti-inflammatory diet.
Bright colored foods contain flavonoids which are highly effective antioxidants. They scavenge the free radicals, that cause damage to tissues and blood vessels, reducing inflammation. Antioxidants are in brightly colored foods such as berries, red grapes, apples, citrus fruits, kale, broccoli, pumpkin, parsley, thyme, oregano, celery, green tea, and peppers9.
Healing a leaky gut is an important step to decreasing low-grade inflammation. Determining food allergies can be diagnosed using a food elimination/reintroduction protocol or a blood test. The food elimination/reintroduction protocol works by removing allergenic foods for 3-6 months while adding in probiotics, L-glutamine and fish oil to heal the gut. Once the symptoms of food allergies have decreased, foods are added in one by one to observe the reaction and determine the allergenic foods. Alternatively there are labs that do an IgG/IgE food allergy panel which measures your immune response to dozens of different foods.
Resveratrol, found in the skin of grapes has been shown to lower low-grade inflammation as well as decrease the associated bone loss10,11. Omega 3’s found in fish and flax oil have numerous studies showing their ability to reduce inflammation, cardiac events, improve ulcerative colitis, autoimmune arthritis and reduce tumors12, 13.
Exercise, as mentioned above, helps to reduce the inflammation in the body by increasing the metabolism in the tissues. Not to mention it lifts the mood!
Lowering blood pressure
Diet can often be enough to lower blood pressure. Eliminating salt intake is the first step to decreasing your blood pressure naturally. Be mindful to eliminate processed foods which have high sodium content.
Nutritional supplements can help to lower blood pressure. Arginine is an amino acid that lowers blood pressure by increasing the production of nitric oxide.
Exercise lowers blood pressure by making your heart stronger and more efficient. Mild exercise of walking 30 minutes per day lowers systolic blood pressure by 4-9 points14. Exercise must be done on a regular basis for 1-3 months to see an effect. Exercise can lower stress, a predictor of high blood pressure, because it releases pent up energy from high intensity situations or emotional circumstances15.
Stress management begins by assessing your life and determining your stressors. Applying positive coping mechanisms for the individual stressors is key. Whether it is eliminating a thought process, circumstance or relationship from your life, stress management is an important factor in lowering blood pressure. Restructuring how you interpret situations and other people’s actions is a great way to take control of your thoughts which are, for the most part, our source of stress and suffering in the western world.
Losing weight starts with eliminating non-nutritious foods and incorporating healthy food choices listed above. When losing weight is combined with exercise, they are more effective at reducing blood pressure than exercise alone14. Other effective ways to lose weight include juice and water fasting combined with nutritional education so weight is not put on after the treatment. Many of the environmental toxins we store are fat soluble. When we break down this tissue, the toxins are mobilized and need to be excreted. Eating a diet high in fiber can help to bind toxins for elimination. Infrared saunas and skin brushing help to detox the body during toxin mobilization. Remember to wipe your skin off after a sauna to remove toxins from the surface of the skin.
Increasing HDL + Lowering Triglycerides
All fats are not created equal. The western diet is full of omega 6 oils found in processed and fried foods. Ideally our diet should be 1:1 ratio of omega 6 to omega 3 fatty acids. Studies have shown anywhere from a 10:1 ratio existing in society to a 25:1 ratio16. Omega 3 fatty acids are an important nutrient for the body. They lower cholesterol, reduce inflammation, prevent heart disease, improve autoimmune conditions and irritable bowel disease, and enhance cognition. Omega 3’s are in the highest concentration in fish oils. It is best to have a ratio of EPA to DHA 3:1. Studies have shown that 4 g of fish oil is required to lower cholesterols (triglycerides and LDL)17. Good dietary fats can be found in organic avocados, coconut meat, flax oil and nuts.
B vitamins lower cholesterol especially B3 also known as niacin. Niacin has a flushing quality which is useful for lowering cholesterol. It has to be taken in a high dose beginning at 500 mg. It is titrated up to a maximum of 3 g. Niacin can lower triglycerides and increase HDL. Pantethine, vitamin B5, lowers total cholesterol and LDL levels when taken consistently for 16 weeks19.
Vitamin E is made up of 2 different groups: tocopherols, and tocotrienols. Tocotrienols have been shown to reduce blood pressure, plasma glucose levels, obesity and improve lipid profiles and therefore protect the heart and liver20. Because they increase insulin sensitivity as well as glucose uptake, they are useful to lower the blood glucose found in Metabolic syndrome21.
Carnitine is an amino acid derivative that has been shown to reduce oxidized LDL cholesterol, and increase HDL22, 23.
Decreasing Blood sugar, improving insulin resistance
Blood sugar can be well regulated by a raw food diet, which is high in fiber and low in simple or refined carbohydrates and refined sugar. Without the spikes in blood sugar from processed foods and refined sugars, with the added benefit of fiber from raw fruits, vegetables, nuts and seeds, the body metabolizes and absorbs carbohydrates properly. An inconsistent rising and falling of blood sugar from processed foods burn out the cells of the pancreas responsible for secreting insulin. As the blood sugar becomes more regulated, the insulin sensitivity returns to the cells and the pancreas heals. Carrot Juice fasting is a tool we use to help regulate and heal blood sugar dysregulation issues such as Type ll Diabetes.
Maca is the root of a Peruvian plant that significantly decreases the levels of LDL cholesterol, total cholesterol, and triacylglycerols in both the blood and liver and increase glucose tolerance factor24. It also acts as a free radical scavenger which protect against the oxidative stress caused by the pro-oxidation process of diabetes.
Chia seed is a powerhouse of nutrients, protein, omega 3 fatty acids and fiber. The fiber + protein in chia helps to slow the absorption of carbohydrates and regulate blood sugar25. It has been shown to lower blood pressure in diabetics, decrease inflammation, blood sugar and improved blood viscosity leading to improved cardiovascular health 27. Chia seeds prevent glucose spiking after meals.
Minerals such as chromium, zinc and vanadium are essential in the treatment of blood sugar issues. Chromium is a mineral that improves blood sugar regulation and insulin sensitivity by supporting Glucose Tolerance Factor in cells26. Vanadium is an insulin mimic, helping to remove glucose from the blood and into the tissues where it is used to power the reactions in the cells. Zinc is used in all insulin reactions.
Herbal medicine is used to control blood sugar and improve insulin sensitivity. Cinnamon Cassia and Zeylenicum work to lower blood sugar, triglyceride and LDL cholesterol. They are a good addition to any dessert or morning smoothie. Fenugreek acts on the adrenal glands to lower blood glucose. Gymnema can help stimulate insulin secretion and improve blood glucose control.
Metabolic disease can be reversed using naturopathic medical principles and treatment.
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Dr. Ariel Jones is a native of Vancouver BC and a graduate of BINM (2013). Her practice emphasizes removing the physical, mental and spiritual obstacles to cure while implementing a toxin-free lifestyle for raw, radiant health. Ariel has enjoyed living in Victoria, BC during her BSc. in biology and psychology, Calgary AB and Hilo Hawaii for a post-graduate residency focused on raw food diet, detoxification, addictions and cancer therapies.
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A Mediterranean-Style Diet May Be The Best Metabolic Syndrome Diet
Roughly one-third of Americans have metabolic syndrome and need to be following a metabolic syndrome diet. But what’s the best one?
We are facing a pandemic of metabolic syndrome in the West, where more than a third of adults now has the condition and is in dire need of the undisputed first-line treatment: adherence to a metabolic syndrome diet and lifestyle changes. Without diet and lifestyle changes, reversal of metabolic syndrome is virtually impossible, and those with the condition remain at extremely heightened risk for heart disease, cardiovascular events like strokes and heart attacks, type 2 diabetes, and more.
What Is Metabolic Syndrome?
Metabolic syndrome is a combination of risk factors that greatly multiply your chance for heart disease, diabetes and stroke. It is diagnosed when you have three or more of the following conditions:
- Abdominal obesity (waist circumference 40-inches or greater (men) or 35 inches or greater (women)
- Triglyceride level of 150 mg/dL or greater
- HDL cholesterol of less than 40 mg/dL in men or less than 50 mg/dL in women
- Systolic blood pressure (top number) of 130 mmHg or greater, or diastolic blood pressure (bottom number) of 85 mmHg or greater
- Fasting glucose of 100 mg/dL or greater
- Insulin resistance or glucose intolerance (the body can’t properly use insulin or blood sugar)
[Illustration: © Elenabsl | Dreamstime.com]
Dangerous Consequences of Metabolic Syndrome
When you have these risk factors together, your chances for cardiovascular problems are greater than if you have any one factor presenting alone. For example, having high blood pressure alone is serious, but high blood pressure along with high blood sugar levels and abdominal obesity, a combination characteristic of metabolic syndrome, means there is a much greater chance of cardiovascular problems and diabetes because of the combination of risk factors.
The underlying causes of metabolic syndrome are poor diet, being overweight or obese, physical inactivity, and genetic factors. Switching to a healthier diet, losing weight, and getting more exercise are the cornerstone treatments. While virtually any healthy diet that helps a person lose weight can improve some features of the metabolic syndrome, researchers are working frantically to sort out which diet works best.
A Mediterranean-Style Diet: The Best Metabolic Syndrome Diet
For a number of years, investigators have known that adherence to an overall Mediterranean-style food pattern significantly reduces the prevalence of metabolic syndrome.
They also have known that a low-glycemic load diet, which minimizes sharp increases in blood sugar, works extremely well for treating blood sugar and insulin problems.
Combining the two—Mediterranean-style and low glycemic load—therefore makes perfect sense for the treatment of metabolic syndrome.
What Constitutes a Mediterranean-Style Diet?
The Mediterranean-style part of the metabolic syndrome diet is based on the dietary habits of people living in different regions of the Mediterranean basin. It consists of minimally processed foods, including vegetables, fruits, unrefined grains, fish, vegetable proteins from legumes, vegetable fats mainly from olive oil, moderate consumption of red wine (with meals), and more rarely poultry. Conversely, fast food, red meat, processed meat products, and full-fat dairy products are rarely consumed as part of traditional Mediterranean diets.
Eliminating added sugars and refined grains while at the same time limiting alcohol, dried fruits and fruit juices, whole grains, and starchy vegetables (like potatoes) lowers the glycemic load of Mediterranean-style diets.
The glycemic load is a well-known, effective tool in controlling blood sugar and insulin levels. A high-glycemic-load diet causes rapid rises in blood glucose and insulin levels. Over time, this leads to increased insulin resistance, a hallmark of metabolic syndrome. On the other hand, a low-glycemic-load diet keeps blood sugar and insulin levels lower and more stable and helps to reverse insulin resistance.
Can a Combo Diet Reduce Other Metabolic Syndrome Components?
So far, studies that have examined the low-glycemic-load/Mediterranean-style diet show that it positively affects many aspects of the metabolic syndrome. Besides reducing the prevalence of metabolic syndrome and lowering the risk for type 2 diabetes by about 20 percent, the Mediterranean-style low glycemic load diet has been shown in studies to lead to decreases in:
- Weight, body mass index (BMI), body fat percentage, and waist circumference
- Blood pressure
- Total cholesterol, LDL cholesterol, cholesterol/HDL ratio, and oxidized LDL
- Fasting blood sugar and average blood sugar (hemoglobin A1C)
- Fasting insulin
- Food cravings
Researchers believe these benefits are not just through weight control but also through other characteristics of the diet, such as its high phytonutrient content, which has anti-inflammatory and other desirable effects; the use of extra virgin olive oil, which leads to a high ratio of monounsaturated to saturated fatty acids; and its ability to improve the body’s sensitivity to insulin.
How to Get Started
Adopting a Mediterranean-style/low-glycemic-load diet isn’t difficult once you learn more about these two concepts. While the initial learning process certainly takes some research, patience, and planning, once you get the hang of it, the diet is relatively simple and easy to follow. You can use our “Mediterranean Diet Meal Plan” and “Glycemic Index Food List” to get started.
If you keep your metabolic syndrome diet focused on fruits and vegetables, beans, olive oil, fish, and limited whole grains and poultry, you’ll quickly start experiencing the benefits of this amazing way to eat.
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This article originally appeared in 2013 and is regularly updated.
METABOLIC SYNDROME – Medical Center “Alone”
Metabolic syndrome – what is it?
The term metabolic syndrome (MS) is used to refer to frequently occurring risk factors (RF). This pathological process affects the development and progression of the atherosclerotic process, affects cardiovascular morbidity and life expectancy.
Metabolism – a set of chemical reactions that occur in a living organism; they are necessary to keep him alive.
Syndrome is a set of pathological signs.
1) obesity (abdominal form) – abdominal enlargement
2) increased cholesterol levels
3) insulin resistance or insulinemia – high insulin numbers
4) increased blood pressure
Predisposing factors for the development of MS and cardiovascular diseases include obesity, decreased physical activity, a diet dominated by refractory animal fats, smoking, arterial hypertension, increased cholesterol levels, familial predisposition and age.
Abdominal obesity (AO) – this term refers to the deposition of fat in the organs of the abdominal cavity and the anterior abdominal wall. Excess fat is deposited in the abdominal area, and the figure resembles an apple. This type of obesity is often found in men and is considered a male type of weight gain. However, some women can also see this figure.
The diagnostic criterion for abdominal obesity for men is the waist circumference> 120 cm, for women> 88 cm.
Sometimes, instead of determining the waist circumference, you can determine the body mass index (BMI), which characterizes the degree of obesity.
Each person can define it by a very simple formula:
BMI = weight in kg = kg / m2
height in m2
BMI norm = from 18.5 to 25 kg / m2
Dyslipidemia (DL) is a violation of lipid (fat) metabolism: an increased level of triglycerides and a low level of high-density lipoproteins.
Lipid metabolism disorder leads to the development of atherosclerosis and is detected by a biochemical blood test. Diagnostic criteria for a risk factor are cholesterol> 5 mmol / L, triglycerides> 150 mg / dL (1.69 mmol / L) and high-density lipoprotein cholesterol in men < 40 ml / dL (1.04 μmol / L) and women <50 mg / dL (1.29 mmol / L).
Excess cholesterol is deposited in the vessel wall in the form of plaques (dense shiny spots), and vasoconstriction occurs.
III insulin resistance (IR or hyperinsulinemia) (increased amount of insulin).
Insulin is a pancreatic hormone that helps cells absorb sugar. Resistance – stability, immunity.
With IR, the cell receptors become immune to insulin, as a result, the absorption of sugar by the cell does not occur, and it begins to starve. And glucose is the main nutrient for the body.As a result of insulin resistance, an excess of insulin is formed, which lowers glucose levels, the blood is depleted in sugar and after eating a person feels hungry. The body sends a signal to the brain that it urgently needs nutrients. This creates a vicious circle: the more carbohydrates we eat, the stronger the hunger.
Among the reasons for the rapid weight gain, which most often occurs in people over 30 years old, is a decrease in carbohydrate metabolism and a decrease in insulin sensitivity, i.e.e. insulin resistance.
When we overeat for a long time, when we saturate our food with refined carbohydrates, insulin and glucose begin to “bomb” the cell, as a result of which some of the receptors that receive insulin die, and the cell does not absorb glucose, which results in an increase in insulin (hyperinsulinemia). Over time, the insulin-secreting cells in the pancreas become depleted and elevated blood glucose levels (glycemia) occur.A risk factor for metabolic obesity is an increase in fasting glucose.
Arterial hypertension (AH).
Increased blood pressure (BP) is often associated with obesity and is often observed in people with insulin resistance (hyperinsulinemia). So arterial hypertension occurs more often in patients with type II diabetes mellitus 2 times more often than in patients without this disease.
Normally, insulin causes vasodilation, and under stressful situations, when a large amount of stress hormones are released into the blood, blood pressure does not change.With the development of insulin resistance, the vasodilating effect of insulin is blocked and the tonic tension of the vessel wall increases.
In conditions of an increase in blood sugar levels, the reabsorption of glucose in the kidneys increases along with sodium, which leads to an increase in blood pressure.
If blood pressure is higher than 135/85 mm Hg, then this is a risk factor for the development of arterial hypertension.
Added to this are other factors:
? inflammation of the vascular wall
? violation of the blood coagulation system
? genetic factors
? age (more often MS develops in elderly people from 50 years of age and older)
? hormonal disorders.
The most important role in the formation of the metabolic syndrome is played by an increase in body weight and a sedentary lifestyle. In this regard, an important therapeutic measure in such patients is a decrease in body weight and an increase in physical activity.
With a decrease in body weight, the optimal positive effect can be considered a weight loss of 7-10% over a period of 6 to 12 months. Weight loss should always be combined with aerobic exercise.
The diet should contain a minimum of saturated fatty acids, cholesterol, and simple sugars. It is necessary to increase the content of fruits, vegetables, products made from cereals in food.
The tasks of drug therapy for MS include the normalization of blood pressure, elimination of dyslipidemia and insulin resistance. The choice of antihypertensive, antihypertensive therapy should be selected by a physician.
A person will be happy if he is healthy.Health is needed for work, for recreation, for the family. Health is not only a personal benefit, but also a social value.
A person can live up to a hundred years. We will fight together with incontinence, with the ugly treatment of our own body.
Proper nutrition, an active lifestyle and preventive examinations will help you avoid disability, severe cardiovascular diseases and diabetes mellitus.
The specialist in this area is Lilia Evgenievna Malgina
90,000 Treatment outcomes and metabolic syndrome
One of the most important factors that halves the effectiveness of antiviral therapy for hepatitis B and hepatitis C is metabolic syndrome.In addition, the presence of metabolic syndrome in a patient with hepatitis increases the incidence of liver cirrhosis by 3 times compared with patients without metabolic syndrome.
WHO experts characterized metabolic syndrome as “pandemic 21
century “. Not being an independent disease, in recent years he
is considered one of the most significant health threats due to
the syndrome is characterized by an increase in the mass of visceral fat (in the area
abdomen, waist and abdominal organs) and decreased sensitivity
tissues to insulin (insulin resistance).
Abdominal obesity is one of the most significant
clinical criteria for metabolic syndrome. For abdominal
obesity is characterized by an increase in waist circumference in women over 80 cm and in
men over 94 cm and the formation of an “apple figure”, i.e. accumulation
adipose tissue mainly in the waist and abdomen.
Arterial hypertension (increased blood pressure above 130 \ 85 mm Hg)
Increased fasting glucose (blood sugar) level (more than 6.1 mmol \ L)
Impaired glucose tolerance or diabetes mellitus (plasma glucose 2 hours after glucose load more than 7.8 mmol \ L)
· Lipid metabolism disorders.
In metabolic syndrome, fatty acids accumulate in cells
liver, leading to a violation of its function and, as a result, the classic
a manifestation of the metabolic syndrome is fatty hepatosis.
This condition is associated with a high risk of developing severe
fibrotic changes in the liver and liver failure.In patients with
obesity, high cholesterol and diabetes risk
The mainstay of treatment for metabolic syndrome is dietary change and
lifestyle in general. However, the success of the treatment and, most importantly, the preservation
the result obtained requires qualified assistance
endocrinologist and patient effort. Exists
drugs that improve hepatic insulin sensitivity and
thus allowing to reduce the manifestations of fatty hepatosis.
Management of patients with viral hepatitis in combination with
metabolic syndrome is determined jointly by a hepatologist and
Weight reduction by only 4-5% allows to achieve significant improvement in liver condition and prognosis of viral hepatitis treatment.
90,000 A teleconference from the Straton Medical Center in New York (USA) was held at the MEDSI Academy
Teleconference “Metabolic syndrome in the 21st century: modern approaches in diagnosis, treatment and prevention” was held at the MEDSI Medical Academy.The teleconference, which connected Moscow and the Straton Medical Center in the state of New York, gathered a representative audience – more than 55 general practitioners, endocrinologists, cardiologists, neurologists and rheumatologists.
Aidar Gosmanov , a graduate of the Kazan Medical Institute, and now a Doctor of Medical Sciences, Associate Professor of the Department of Endocrinology at Albany Medical School (New York State, USA), author of numerous works and studies on endocrinology, diabetes and pharmacology, spoke to the audience.
He once again drew the attention of the audience that changes in the lifestyle of modern people are increasingly leading them to the risk of metabolic syndrome – a complex of metabolic, hormonal and clinical disorders that are risk factors for diabetes and cardiovascular diseases. Metabolic syndrome is characterized by an increase in fasting blood glucose, abdominal obesity, increased blood pressure, and impaired lipid metabolism.
All this leads to serious consequences – mortality increases 2-3 times, the risk of cardiovascular diseases – 3 times, and diabetes mellitus – 5 times.According to international statistics, 20-25% of the adult population has metabolic syndrome. During the teleconference, experts discussed the importance of early diagnosis, correct diagnosis and timely treatment.
Ideal health is smoking cessation, healthy weight, physical activity, proper nutrition, and ideal metabolic factors are lipid metabolism, blood pressure, glucose metabolism. The main thing in the treatment of metabolic syndrome is changing the lifestyle and maintaining it – losing weight by at least 5-10%, preventing type 2 diabetes mellitus, monitoring lipid metabolism, and controlling blood pressure.
The pharmacotherapy of weight loss, which is prescribed only in addition to diet and physical activity, has been of particular interest to doctors. The drugs help reduce appetite, stabilize weight loss, and improve other health components. There are now 4 drugs in the arsenal of American doctors.
It is the mutual exchange of experience and opinions, discussion of complex clinical cases and treatment approaches that is the advantage of the MEDSI Medical Academy. When an expert communicates with an expert, it enriches both parties.
Modern views on dysfunction of the autonomic nervous system as a pathogenetic factor in the development of metabolic syndrome in children
SOVREMENNAYA PEDIATRIYA. 2014.7 (63): 41–45; doi 10.15574 / SP.2014.63.41
Modern views on dysfunction of the autonomic nervous system as a pathogenetic factor in the development of metabolic syndrome in children
UDC 616P056.5P008.6P02: 616.839
The activity of the autonomic nervous system in children with metabolic syndrome was analyzed. It was found that metabolic syndrome in children is characterized by an imbalance of the autonomic nervous system with a decrease in heart rate variability and parasympathetic activity with a relative increase in the activity of the sympathetic nervous system and central neurohumoral influences, which is rational to use as an additional diagnostic criterion.Assessment of the functional state of the autonomic nervous system according to the data on heart rate variability in metabolic syndrome in children allows diagnosing autonomic support disorders at an early preclinical stage, assessing the reserve and prognosis, and optimizing treatment taking into account changes in the autonomic regulation of the heart rate.
Keywords: autonomic nervous system, heart rate variability, metabolic syndrome, children.
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90,000 5 steps to protect your child from metabolic syndrome
The causes of metabolic syndrome in adults seem to be already known: overweight, high blood pressure, high blood sugar, abnormal cholesterol and high triglyceride levels. But children are not small adults, so the causes of metabolic syndrome in children are completely different.
How to protect a child from the development of metabolic syndrome?
✔️Quality food.Among the many nutritional factors associated with obesity, lack of whole grains and fiber intake are most significantly correlated with the development of insulin resistance. It is known that a large intake of fruits and vegetables, which contain dietary fiber, trace elements, reduces the risk of developing atherosclerotic cardiovascular diseases in adulthood. A diet high in calories and low in nutrients, as well as consuming large amounts of fast food and sweetened drinks, can put children at risk of metabolic syndrome.
✔️ Regular physical activity. Physical activity is beneficial for weight management. By replacing even one hour of screen time with exercise that increases the movement of blood in the body, children can dramatically improve their blood pressure, cholesterol levels, and insulin sensitivity.
✔️ Control of the time spent in front of the screen. The number of hours a child spends daily in front of the screen directly depends on the body mass index (BMI) and the calories consumed per day.Pediatricians do not recommend handing gadgets or planting children under 2 years old in front of a monitor / TV screen.
✔️ Adequate sleep. Some studies in adults and children have found that too much or too little sleep causes health problems and often contributes to weight gain.
✔️Avoid exposure to tobacco smoke. It is clear that this is the worst thing that people can do to their heart and lungs. Both alone and in combination with risk factors for metabolic syndrome, smoking significantly increases a child’s risk of developing heart disease.
90,000 Obesity. Part 2
Dietary fiber is the sum of various polysaccharides and lignin, which are essential not only for the digestive tube, but for the whole organism.
Insoluble coarse fibers better retain water, contributing to the formation of a soft elastic mass in the intestine and improve its excretion.
Soluble (soft) fibers better adsorb and remove heavy metals, toxic substances, radioisotopes, cholesterol, support the intestinal microbiotic composition.
Physiological effects of dietary fiber at the stomach level
Indications for use in the treatment of dietary fiber:
The consumption of vegetables, coarse fiber helps to lengthen the residence time of the food lump in the stomach, which contributes to the rapid onset of a feeling of satiety and suppresses appetite. They are used for the following diseases:
– Metabolic syndrome (VO, CVD, AH, NAFLD, etc.)
– Soft dietary fibers have a cytoprotective effect on the gastric and duodenal membrane
– PU and DU (soft fibers)
Physiological effects at the level of the small intestine
Slowdown in the absorption of fatty acids and glucose:
• decrease in the degree of fat absorption;
• a decrease in the total GI of food, which slows down the absorption of glucose and does not give high peaks in blood glucose after a meal.
– Metabolic syndrome
– NTG and diabetes mellitus
Adsorption and decreased reabsorption of cholesterol and bile acids:
• Decreased cholesterol in the blood
• Decreased lithogenicity of bile
– Liver diseases
– Cholestasis and gallstone syndrome
– Autoimmune processes and allergies
– Liver cirrhosis
Physiological effects of dietary fiber at the level of the colon
- Dietary fiber binds carcinogens, co-carcinogens, heavy metals and radionuclides.