Metabolic Syndrome: It's In The Numbers

Symptoms act as the dashboard of your body, the alerts to let you know that something might be amiss.  Using wisdom, a person would then look at the symptom and question what it is alerting them to, and the resolution process can begin. 

But physically felt symptoms are not the only dashboard indicators;  metrics are an important indicator as well.  When you’re driving down the road in your vehicle, it can be a shock when the “fuel low” light abruptly pops on.  There were no SIGNS that your vehicle’s tank was getting low.  The fuel light is simply an alert that is set from a metric that is measured so that you can be alerted before you run out of fuel. 

Your physical body is much the same way.  Not always will there be a physical symptom that alerts you to the presence of a need.  Sometimes, it’s the measurements that are the indicator.  This perfectly describes the presence of metabolic syndrome. 

Metabolic syndrome comes with measurements that define the syndrome.  Three of the following five must be present for metabolic syndrome to be diagnosed:1

• Elevated fasting glucose

• Elevated triglycerides

• Reduced HDL (the “good”) cholesterol

• High blood pressure

• Central obesity

Research conducted in 2015 estimated that 35% of US adults overall make up the metabolic syndrome population, making it a syndrome of epidemic proportions.1   A key factor in metabolic syndrome is the factor of central obesity.  Adipose fat (around the organs in the belly) can influence the individual towards the development of diabetes, liver, and cardiovascular diseases.2

What causes it?

The process of metabolism involves a cascade of interworking gears.  Insulin is one of those major contributing gears. Insulin is responsible for maintaining regulated blood sugar levels. Insulin also affects how the body utilizes and stores your fats.3  Insulin resistance is a decreased response to levels of insulin in the blood and is considered the major contributing factor of metabolic syndrome.  As a result, glucose cannot enter tissue and cells from the blood stream. Glucose is then produced by the pancreas to balance out these higher levels of insulin.  Impairment of the insulin production is a critical factor in metabolic syndrome which leads to defective insulin response to glucose.1  The increased prevalence of the disease is thought to be heavily attributed to the steep rise in obesity today.1

Can nutrition help?

The Mediterranean diet has garnered much attention for its benefit in weight loss, cardiovascular disease and metabolic conditions including metabolic syndrome.   Evidence exists showing that  nutritional interventions such as the Mediterranean diet can influence markers that cause inflammation,4 an important factor when considering that chronic low grade inflammation plays a central role in the pathogenesis of insulin resistance and thus metabolic syndrome. 1

One particular study of 90 participants that followed the Mediterranean diet for 2 years revealed that only 40 of the 90 still showed features associated with metabolic syndrome.1

What Do You Eat on a Mediterranean Diet?

The diet is focused on plant based components, rich in colorful fruits and vegetables across the rainbow, plus mushrooms, nuts, seeds, and whole grains, fatty fish like salmon, and olive oil.  The goal is to each as much fresh food as possible, limiting the amount of highly-processed foods.5

One of the therapeutic food groupings common to the success of this diet is sources that are rich in fiber like wheat bran, whole wheat, brown rice, oat bran, beans, lentils and pears.  Fiber helps protect against heart disease, hypertension, constipation, and obesity. 

Nuts are also an excellent option as part of a balanced Mediterranean diet as they are known to lower LDL cholesterol and reduce risk of heart disease.5  They are also a good source of vitamin E, which has been demonstrated to have liver protective effects, essential concerns for those with metabolic syndrome.1

Are Supplements an Option?

Chromium is a trace mineral excellent and important for prevention of insulin resistance and dyslipidemia associated with obesity.  It has been found to increase insulin sensitivity and increase glucose disposal.1  Research has shown that the recommended effective dose is 200-1000mg/day.1  Those taking thyroid medications should take chromium a half hour before or 3-4 hours after their medications as chromium can reduce absorption.1

Zinc is a mineral that has been known to be associated with a reduction in insulin resistance.  In fact, randomized controlled trials have shown a reduction in fasting glucose and insulin levels following zinc supplementation.  Research has shown dosing to be 20mg/day.1  There are no known side effects at the recommended dose.

Other suggestions include lifestyle modifications that may include mindful eating, exercise, sleep and stress management. 6

The key take away here is that symptoms are not the only indicators of dis-ease in the body.  Following  measurements and biometric markers are an important part of assessing the body for health or underlying disease, as is the case with metabolic syndrome.

References

1. Nicolai J, Lupiani J, Wolf A. Integrative Medicine. In: Integrative Medicine. 4th ed. Elsevier; 2018:320-333.

2. Wharton S, Lau DCW, Vallis M, et al. Obesity in adults: A clinical practice guideline. Cmaj. 2020;192(31):E875-E891. doi:10.1503/cmaj.191707

3. Ross K. Insulin resistance and type 2 diabetes. In: Presented: Insulin Resistance, Metabolic Syndrome, Type 2 Diabetes as Part of Masters Program in Clinical Nutrition, SCNM, Tempe, AZ. Vol 61. ; 2012:778-779. doi:10.2337/db12-0073

4. Venter C, Eyerich S, Sarin T, Klatt KC. Nutrition and the Immune System: A Complicated Tango. Nutr 2020, Vol 12, Page 818. 2020;12(3):818. doi:10.3390/NU12030818

5. Stump SE. Nutrient Recommendations for Adults - The Mediterranean Diet. In: Nutrition and Diagnosis Related Care. 8th ed. Wolters Kluwer Health; 2015:49.

6. Ross K. Nutritional Interventions for Chronic Disease. In: Nutritional Interventions for Chronic Disease Live Session 1, Delivered as a Part of the Masters in Clinical Nutrition Program, SCNM, Tempe, AZ. ; 2021.

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