Metabolic Syndrome

Let’s talk about metabolic syndrome. It’s a question that I hear A LOT! Is it affecting you? Metabolic syndrome is very common. This was a diagnosis that came about over the past 30 years or so. I’ll talk about the history of it and what’s involved with the syndrome.

Metabolic Syndrome affects over 64 million people in the United States. That’s about 1/3 of all adults. It describes a collection of metabolic abnormalities. The metabolic abnormalities are what tend to lead to Type II Diabetes and/or Cardiac Disease. It’s important to recognize it and treat it.

It was first described in 1988 by Dr. Gerald Reaven. He noted that people with insulin resistance showed common metabolic disturbances that increase their risk for cardia disease. Originally it was called “Syndrome X, later “Insulin Resistance Syndrome (which is the more accurate name),” and finally “Metabolic Syndrome.” It really all back up to insulin resistance. Insulin resistance is a common theme for all the parameters that are here. It’s used as a diagnostic tool to identify risk of coronary vascular disease (heart disease). Dr. Reaven noted that a “low fat diet” (it was the diet being preached at the time), makes the syndrome worse.

Metabolic Syndrome is a cluster of different things if you have at least 3/5. The first is waist circumference: >40 inches for men and >35 inches for women will put you at risk. That’s abdominal obesity. It doesn’t necessarily mean you have to be obese. It’s just waist circumference. It looks at fasting triglycerides: >150 mg/dl. Is too high. Next is HDL (the good cholesterol) : <40 for men and <50 for women puts you at risk. Blood pressure should be >135/85. Lastly is fasting glucose which should not be >100mg/dl. Notice that only one of these has to do with weight. You could have a large belly but not be that much overweight.

Metabolic Syndrome really means insulin resistance.

Insulin resistance is a state that your body requires more insulin than normal to try and keep blood sugars normal. It has long been known that a “low fat diet” makes this worse. This obviously implies that a “low carb diet” improves these metabolic derangements. A low carb diet will allow insulin levels to come down. A low carb diet will improve each of the 5 metabolic abnormalities.

How does a low carb diet improve the 5 metabolic abnormalities? It improves waist size. Insulin turns on fat storage. Carbohydrates stimulate insulin release. Low carb decreases insulin release. This improves fat mobilization (weight loss) leading to decreased waist size. Insulin is one of the hormones we have control over. Most hormones we have no control over. Insulin only goes up when we have carbohydrate.

It improves fasting blood sugar. Carbohydrates make the blood sugar increase. If we decrease carbohydrates, we can lower the blood sugar. That will lead to lower insulin.

A low carb diet improves fasting triglycerides. They are made from glycerol. Glycerol is made from sugar. Fatty acids come from both the fat you eat and the carbs. You can’t actually put together the triglycerides without the glycerol molecule which come from the carbohydrate. The fatty acids that are not made in triglycerides can be utilized as an energy source. If we get rid of the carbohydrates (sugar) we can’t make the glycerol molecule needed to make the triglycerides.

The HDL is the good cholesterol. When you restrict your carbohydrate intake, you automatically increase your fat intake. Calories have to come from somewhere. By taking in more fat, you’ll automatically improve your HDL. It’s one of the easiest ways to make your HDL go up. Contrary to popular belief, cholesterol is made from carbs and insulin stimulates the making of cholesterol. Insulin turns on the making of the cholesterol molecules. That will make your total cholesterol go up. You want your HDL to go up. The biggest thing that affects HDL is exercise.

Low carbohydrates improve blood sugar in many ways. Insulin causes sodium retention (salt), leading to water retention, leading to increased blood pressure. If you have a weekend where you eat a lot and gain 5 pounds, it’s not the food you ate, its water. The insulin causes sodium retention. Sodium retention means water retention. Water retention leads to increased blood pressure. Lower insulin levels are going to reverse this. Insulin also stimulates the release of a potent vascular constrictor (endothelin-1). This means the blood vessels themselves are tightening down. If they’re tightening down, that means your blood pressure is going to be higher. Insulin also inhibits the production of a vasodilator (nitric oxide). That means the vessels themselves would relax. The nitric oxide lowers blood pressure. Because insulin inhibits this, it works against lowering blood pressure.

Low carbohydrate decreases insulin levels reversing each of these. We want to manipulate insulin and lower it. We don’t want insulin at zero. It’s a hormone you can’t live without. Keep it as low as possible because insulin tends to cause these other problems.

In summation, Metabolic Syndrome is extremely common affecting >1/3 of the adult population.

It isn’t just people who are way overweight. It includes: abdominal obesity, increased triglycerides, low HDL, high B/P, and high blood sugar. If you have any 3 out of the 5, you have metabolic syndrome. Insulin resistance is the common denominator. If you have metabolic syndrome, you have a significant risk of developing heart disease. A low carb diet will improve each of these factors by improving insulin. This will decrease you risk of developing cardiovascular disease and type II diabetes.

Call or text to schedule a lab consultation to find out if you have metabolic syndrome or for more information on your weight loss options. 757-873-1880