This mysterious-sounding term refers to a cluster of conditions many Americans are familiar with i.e. abdominal obesity (a “spare tire” around the middle); high blood pressure, high blood triglycerides and high blood cholesterol levels. These heart disease risk factors tend to occur together, thus the term “syndrome.” However, if you have even just one of the conditions combined with insulin resistance, a prediabetic condition that can cause any of the others, you have Syndrome X.
Syndrome X develops over time, primarily from a diet high in refined carbohydrates such as sweets, breads and flour/sugar based snack foods. These foods trigger a rapid increase in blood sugar levels, and the body responds by raising levels of insulin, the hormone that moves blood sugar into cells. The more carbohydrates consumed, the more the body pumps out insulin to deal with all the extra blood sugar. Eventually, insulin resistance develops and the body becomes overwhelmed by the volume of insulin and becomes sluggish in response to it. High insulin promotes fat storage, raises blood pressure and worsens blood fat profiles.
Signs, symptoms & indicators of Metabolic Syndrome (Syndrome X)
High systolic blood pressure
High diastolic blood pressure
Conditions that suggest Metabolic Syndrome (Syndrome X)
Elevated Insulin Levels
Syndrome X is the variable combination of obesity (usually central in distribution), insulin resistance with elevated insulin levels, high blood cholesterol and hypertension.
Menopausal Status / Issues
A recent Australian study tracked the metabolic health of 265 women aged 46-57 for five years as many of them progressed through menopause. The study found that a surprisingly high percentage of these women – nearly 1 out of 6 – developed impaired fasting glucose levels during this time.
During the menopause transition, more fat often starts to accumulate around the stomach and insulin levels begin to inch upwards. This subtle change can trigger a drop in levels of sex-hormone-binding-globulin (SHBG), the substance that attaches to sex hormones in the bloodstream and makes them inert. With reduced SHBG levels, greater amounts of bioactive “male” sex hormones – androgens such as testosterone and DHEA – begin to circulate inside a woman’s body.
Over time, this oversupply of active androgens can make women more male-like in appearance, fuel more obesity in the stomach region, and disrupt glycemic control. Left unchecked, these imbalances often become self-perpetuating, thus stimulating further weight gain and metabolic dysfunction that eventually increases the risk of syndrome X, diabetes, cardiovascular disease, and certain cancers. [Obes Relat Metab Disord. 2001;25(5): pp.646-51]
Risk factors for Metabolic Syndrome (Syndrome X)
High uric acid level
Anticoagulant Use
The link between osteocalcin, type 2 diabetes, and the full metabolic syndrome has just been confirmed in the medical literature. It will only be a matter of time before research shows that disrupting osteocalcin activity with warfarin either causes type 2 diabetes and metabolic syndrome or makes it worse.
Having abdominal fat or apple-shaped body when overweight
Please see the link between Metabolic Syndrome and Increased Fruits and Vegetables regarding the use of grapefruit and lowering insulin levels.
Counter Indicators
Pear-shaped body when overweight
Metabolic Syndrome (Syndrome X) suggests the following may be present
Menopausal Status / Issues
A recent Australian study tracked the metabolic health of 265 women aged 46-57 for five years as many of them progressed through menopause. The study found that a surprisingly high percentage of these women – nearly 1 out of 6 – developed impaired fasting glucose levels during this time.
During the menopause transition, more fat often starts to accumulate around the stomach and insulin levels begin to inch upwards. This subtle change can trigger a drop in levels of sex-hormone-binding-globulin (SHBG), the substance that attaches to sex hormones in the bloodstream and makes them inert. With reduced SHBG levels, greater amounts of bioactive “male” sex hormones – androgens such as testosterone and DHEA – begin to circulate inside a woman’s body.
Over time, this oversupply of active androgens can make women more male-like in appearance, fuel more obesity in the stomach region, and disrupt glycemic control. Left unchecked, these imbalances often become self-perpetuating, thus stimulating further weight gain and metabolic dysfunction that eventually increases the risk of syndrome X, diabetes, cardiovascular disease, and certain cancers. [Obes Relat Metab Disord. 2001;25(5): pp.646-51]
Recommendations for Metabolic Syndrome (Syndrome X)
Irvingia Gabonensis (African Mango)
Irvingia gabonensis extract administered 150 mg twice daily before meals to overweight and/or obese human volunteers favorably impacts body weight and a variety of parameters characteristic of the metabolic syndrome. [Lipids in Health and Disease 2009, 8:7doi:10.1186/1476-511X-8-]
Sugars Avoidance / Reduction
Fructose consumption clearly causes insulin resistance, while glucose alone does not. Insulin resistance and metabolic syndrome can eventually lead to full blown diabetes.
The presence of glucose accelerates fructose absorption. So when you mix glucose and fructose together, you absorb more fructose than if you consumed fructose alone. Sucrose, or table sugar, is a 50/50 blend of fructose and glucose.
Fructose Avoidance/reduction
Metabolic syndrome, characterized by truncal obesity, hypertriglyceridemia, elevated BP, and insulin resistance, is recognized increasingly as a major risk factor for kidney disease and also is a common feature of patients who are on dialysis. One feature that is common to patients with metabolic syndrome is an elevated uric acid.
Although often considered to be secondary to hyperinsulinemia, recent evidence supports a primary role for uric acid in mediating this syndrome. Specifically, fructose, which rapidly can cause metabolic syndrome in rats, also raises uric acid, and lowering uric acid in fructose-fed rats prevents features of the metabolic syndrome. Uric acid also can accelerate renal disease in experimental animals and epidemiologically is associated with progressive renal disease in humans. It is proposed that fructose- and purine-rich foods that have in common the raising of uric acid may have a role in the epidemic of metabolic syndrome and renal disease that is occurring throughout the world. [J Am Soc Nephrol 17: 165-168, 2006]
Hydrogenated Fats / Trans Fatty Acids Avoidance
The major findings of this study, conducted in monkeys, showed that, in the absence of caloric excess, Trans-fatty acid (TFA) induces greater weight gain over time, with enhanced intra-abdominal deposition of fat between the two groups as measured at study termination.
There was evidence of impaired insulin sensitivity in the TFA group associated with abdominal obesity and reductions in insulin signal transduction efficiency at the post-receptor binding level compared with monkeys fed the unmodified fat diet at study end. The TFA diet models the trends seen in fats available in grocery stores, which have become more oleate rich and less TFA rich as canola oil has been increasingly substituted for partially hydrogenated soybean oil. Therefore, a comparison of cis- and trans-monounsaturates better represents the shift in the food fat composition that is already occurring in the U.S.
The trans fat used in this study was partially hydrogenated soybean oil, which constitutes the major source (80% to 90% ) of TFAs in the American diet [Obesity (2007) 15, pp. 1675–1684]
High/Increased Protein Diet
Researchers compared the effect of whey versus lean ham and lactose on 14 diabetics after they ate high-glycemic-index breakfasts (white bread) and lunches (mashed potatoes and meatballs) on separate days.The goal was to evaluate whether supplementation of meals with a high glycemic index with whey protein increased insulin secretion and improved postprandial blood glucose in type 2 diabetic patients.
Results showed:
– Insulin responses were higher after eating breakfast (31 percent) and lunch (57 percent) supplemented with whey than when whey was not included.
– No significant differences in blood glucose were found after eating breakfast; however, after lunch the blood glucose response of patients who ate whey dropped by more than 20%.
Based on these findings, it can be concluded that adding whey to meals with rapidly digested and absorbed carbohydrates spurs insulin release and reduces blood glucose digression in type 2 diabetics. Such results may turn whey into the 21st century’s protein of choice. [American Journal of Clinical Nutrition July 2005;82(1):69-75]
Increased Fruit/Vegetable Consumption
Researchers at Scripps Clinic of San Diego divided a group of 100 obese subjects into three equal groups: one group ate
half a grapefruit before each meal, one group drank a glass of grapefruit juice before each meal, and one group was
instructed not to eat any grapefruit or drink any grapefruit juice. Subjects followed their regimens for three months,
while continuing to eat as they normally would.
The results were striking. Those in the group that ate grapefruit with each meal lost an average of 3.6 pounds. Subjects in the grapefruit juice group lost an average of 3.3 pounds. A few of the subjects in both of these groups lost nearly 10 pounds. Meanwhile, the average weight loss in the group that consumed no grapefruit was less than one pound.
Researchers believe that grapefruit contains chemical properties that assist in the management of insulin levels – a potential boon to dieters and diabetics alike. At the beginning and the completion of the Scripps study, researchers measured the insulin and glucose levels of all subjects. When the test was over, those in the two grapefruit groups had lower levels of insulin and glucose than they did at the beginning, while levels in the non-grapefruit group were unchanged.
High/Increased Fiber Diet
Any fiber choice is useful for Syndrome X sufferers, but psyllium, pectin or guar gum would offer the additional benefit of lowering cholesterol. The amount of pectin in approximately two servings of pectin rich fruit such as pears, apples, grapefruit, and oranges is 15 grams. Psyllium or guar gum are obtained by supplement. The RDA of total fiber is 20-30 grams.
Conventional Drugs / Information
ACTOS is a once-a-day prescription medication for type 2 diabetes that, along with healthy eating and physical activity, helps your body control blood sugar (glucose) levels. ACTOS makes the cells in your body more sensitive to insulin, a hormone produced by the pancreas that allows the cells in your body to use blood sugar for energy.
ACTOS can be used by itself or in combination with certain other diabetes medications (sulfonylureas, metformin, or insulin) when your necessary efforts at healthy eating and physical activity do not control your blood sugar levels.
ACTOS is a member of the type of oral diabetes medications called thiazolidinediones.
Aerobic Exercise
Researchers at Yale University School of Medicine have determined, via new imaging technologies, that insulin resistance in skeletal muscle leads to changes in energy storage, leading to metabolic syndrome.
Insulin resistance, which occurs when the body becomes resistant to the hormone insulin, occurs in skeletal muscle when the muscles are no longer able to make glycogen, a form of stored carbohydrate, from food energy. In turn, insulin resistance in skeletal muscle promotes an increase in fats in the bloodstream, which leads to metabolic syndrome.
Using magnetic resonance imaging techniques, the researchers were able to determine that insulin-sensitive individuals in their study converted carbohydrate energy (from eating a high-carb meal) into glycogen that was stored in the liver and muscle.
Among insulin-resistant individuals, however, the carbohydrate energy was rerouted to liver fat production. The process elevated the participants’ triglycerides in the blood by as much as 60 percent while lowering HDL (good) cholesterol by 20 percent. This occurred even though the participants were young and lean, with no excess of abdominal fat.
More than 50 million Americans suffer from metabolic syndrome, and half of the population is predisposed to it.
The researchers pointed out that there is good news to their findings: insulin resistance in skeletal muscle can be treated with a simple method, exercise. [Proceedings of the National Academy of Sciences July 18, 2007]
Magnesium
A diet rich in magnesium may help reduce the incidence of metabolic syndrome, the cluster of conditions that can lead to diabetes and coronary heart disease, new research finds.
The study of more than 4,600 Americans, begun in 1985, found the risk of developing metabolic syndrome over the next 15 years was 31 percent lower for those with the highest intake of magnesium, according to a report in the March 28 issue of Circulation.
The components of metabolic syndrome include high blood pressure, high blood sugar levels, elevated blood fats and low levels of HDL cholesterol: the “good” kind that helps keep arteries clear. Having at least three of these factors increases the risk of cardiovascular disease and diabetes.
This is not the first study to link magnesium and metabolic syndrome. An analysis of data on 11,686 participants in the Women’s Health Study, published last year by Dr. Paul M. Ridker and others at Brigham and Women’s Hospital in Boston, yielded similar results, with a 27 percent lower incidence of the symdrome for women with the highest magnesium intake compared to those with the lowest.
This study does add something new, says study author Dr. Ka He, an assistant professor of medicine at Northwestern University. It showed that “a higher magnesium intake was associated with a reduced risk of each individual component of the metabolic syndrome,” he says. [Circulation March 28 2006]
Alpha Lipoic Acid
Numerous additional studies have indicated that alpha lipoic acid (ALA) is useful for the treatment of diabetes mellitus which follows syndrome X. ALA stimulates increased glucose utilization in muscle cells and significantly reduces human insulin resistance. This process may occur via an insulin signaling pathway.
Vitamin K1/K2
In a published study of 38,094 Dutch men and women ages 20 – 70 it was found that vitamin K2 intake had a statistically significant inverse relationship to the risk of developing type 2 diabetes. Vitamin K1 intake also trended in the preventive direction, though the benefit was not enough to be statistically significant. This finding corresponds to the science showing that vitamin K2 is a more potent activator of osteocalcin than vitamin K1 (although both help).
Key
| Weak or unproven link |
| Strong or generally accepted link |
| Proven definite or direct link |
| Strongly counter-indicative |
| May do some good |
| Likely to help |
| Highly recommended |
Glossary
Triglyceride
The main form of fat found in foods and the human body. Containing three fatty acids and one unit of glycerol, triglycerides are stored in adipose cells in the body, which, when broken down, release fatty acids into the blood. Triglycerides are fat storage molecules and are the major lipid component of the diet.
Cholesterol
A waxy, fat-like substance manufactured in the liver and found in all tissues, it facilitates the transport and absorption of fatty acids. In foods, only animal products contain cholesterol. An excess of cholesterol in the bloodstream can contribute to the development of atherosclerosis.
Insulin
A hormone secreted by the pancreas in response to elevated blood glucose levels. Insulin stimulates the liver, muscles, and fat cells to remove glucose from the blood for use or storage.
Carbohydrates
The sugars and starches in food. Sugars are called simple carbohydrates and found in such foods as fruit and table sugar. Complex carbohydrates are composed of large numbers of sugar molecules joined together, and are found in grains, legumes, and vegetables like potatoes, squash, and corn.
Hormones
Chemical substances secreted by a variety of body organs that are carried by the bloodstream and usually influence cells some distance from the source of production. Hormones signal certain enzymes to perform their functions and, in this way, regulate such body functions as blood sugar levels, insulin levels, the menstrual cycle, and growth. These can be prescription, over-the-counter, synthetic or natural agents. Examples include adrenal hormones such as corticosteroids and aldosterone; glucagon, growth hormone, insulin, testosterone, estrogens, progestins, progesterone, DHEA, melatonin, and thyroid hormones such as thyroxine and calcitonin.
Hypertension
High blood pressure. Hypertension increases the risk of heart attack, stroke, and kidney failure because it adds to the workload of the heart, causing it to enlarge and, over time, to weaken; in addition, it may damage the walls of the arteries.
Metabolism
The chemical processes of living cells in which energy is produced in order to replace and repair tissues and maintain a healthy body. Responsible for the production of energy, biosynthesis of important substances, and degradation of various compounds.
Menopause
The cessation of menstruation (usually not official until 12 months have passed without periods), occurring at the average age of 52. As commonly used, the word denotes the time of a woman's life, usually between the ages of 45 and 54, when periods cease and any symptoms of low estrogen levels persist, including hot flashes, insomnia, anxiety, mood swings, loss of libido and vaginal dryness. When these early menopausal symptoms subside, a woman becomes postmenopausal.
Glucose
A sugar that is the simplest form of carbohydrate. It is commonly referred to as blood sugar. The body breaks down carbohydrates in foods into glucose, which serves as the primary fuel for the muscles and the brain.
Stomach
A hollow, muscular, J-shaped pouch located in the upper part of the abdomen to the left of the midline. The upper end (fundus) is large and dome-shaped; the area just below the fundus is called the body of the stomach. The fundus and the body are often referred to as the cardiac portion of the stomach. The lower (pyloric) portion curves downward and to the right and includes the antrum and the pylorus. The function of the stomach is to begin digestion by physically breaking down food received from the esophagus. The tissues of the stomach wall are composed of three types of muscle fibers: circular, longitudinal and oblique. These fibers create structural elasticity and contractibility, both of which are needed for digestion. The stomach mucosa contains cells which secrete hydrochloric acid and this in turn activates the other gastric enzymes pepsin and rennin. To protect itself from being destroyed by its own enzymes, the stomach’s mucous lining must constantly regenerate itself.
Testosterone
The principal male sex hormone that induces and maintains the changes that take place in males at puberty. In men, the testicles continue to produce testosterone throughout life, though there is some decline with age. A naturally occurring androgenic hormone.
DHEA
Dehydroepiandrosterone (DHEA) is a steroid produced by the adrenal glands and is the most abundant one found in humans. DHEA may be transformed into testosterone, estrogen or other steroids. It is found in the body as DHEA or in the sulfated form known as DHEA-S. One form is converted into the other as needed.
Diabetes Mellitus
A disease with increased blood glucose levels due to lack or ineffectiveness of insulin. Diabetes is found in two forms; insulin-dependent diabetes (juvenile-onset) and non-insulin-dependent (adult-onset). Symptoms include increased thirst; increased urination; weight loss in spite of increased appetite; fatigue; nausea; vomiting; frequent infections including bladder, vaginal, and skin; blurred vision; impotence in men; bad breath; cessation of menses; diminished skin fullness. Other symptoms include bleeding gums; ear noise/buzzing; diarrhea; depression; confusion.
Cardiovascular
Pertaining to the heart and blood vessels.