Mission X

Metabolic syndrome, with its army of disorders, is a formidable enemy. We give you effective weapons to fight it tooth and nail...and win

X using fresh vegetables

Perhaps you have heard of metabolic syndrome. Or maybe you’re like millions of others who have never heard of it. Metabolic syndrome could be considered the new “silent epidemic” one of those conditions that affects many people, but one that we don’t hear too much about. Certainly, it has not been a condition that grabs headlines such as cancer or coronary heart disease. But still, it’s a serious health condition. Without lifestyle changes and treatment, it increases your risk of an early death from a heart attack or a stroke.

Perhaps not surprisingly, the incidence of metabolic syndrome is increasing among young people as more and more of the nation’s youth become overweight.

What is metabolic syndrome?

Metabolic syndrome is not actually a disease in the usual sense of the word; rather, it is a cluster of disorders. [It got the name ‘syndrome X’ in the years before the medical community fully understood the condition and the complex relationship between the disorders.] Accordingly, to define it, we must look at the disorders or components that make up the syndrome. Anyone with three or more of the abnormalities listed below is considered to have the syndrome.

High fasting blood glucose: Fasting glucose level greater than 110mg/dL. The glucose levels are high when tested after fasting but are not high enough to be classified as diabetes. High glucose levels are often a sign of insulin resistance, the body’s inability to use insulin efficiently.

  • Abdominal obesity: Waist circumference of more than 40 inches for men; 35 inches for women.
  • Low HDL cholesterol: Men: less than 40mg/dL; Women: less than 50mg/dL.
  • High triglycerides: Triglycerides more than 150mg/dL.
  • High blood pressure: Blood pressure greater than 130/85.

It’s inter-related

Part of what makes metabolic syndrome complex is the way in which each of the disorders influences, or “aggravates,” the others. For example, insulin resistance can cause abnormal blood fats [cholesterol], high blood pressure, and high blood sugar. Similarly, high blood sugar can cause abnormal cholesterol levels. Another component of the syndrome, excessive belly fat, can result in an increase in blood sugar levels and blood pressure. In the end, the combined effect of these disorders further increases the risk of complications, which can be life threatening.

Although the complications from metabolic syndrome can be serious, even life threatening, being diagnosed with the condition is not a death sentence. The syndrome can be reversed. Two of the most important things you can do are lose weight and increase physical activity. The Endocrine Society, an international organization of endocrinologists, has researched the benefits of weight loss and reports that :

  • Loss of 5 per cent – 10 per cent of total body weight can raise HDL.
  • For every two pounds lost, LDL decreases by 1 per cent.
  • Weight loss reduces insulin resistance and the risk of developing type-2 diabetes.
  • Losing just 5 per cent – 15 per cent of body weight can lower your chances for heart disease or stroke, because weight loss improves blood pressure, cholesterol levels, and triglycerides, and decreases inflammation in the body.
  • A weight loss of 10 pounds – 15 pounds [4.5kg – 6.8kg] reduces your chances of developing osteoarthritis of the knee, a degeneration of the cartilage cushion between bones in the knee.

EAT RIGHT

There is not one specific diet for overcoming metabolic syndrome. There is no magic pill. You have heard it before, but the words are still true. In order to lose weight, you need to burn more calories than you take in.

» Find the right food plan

Never choose a food plan that you could not live with for the rest of your life. Choose a balanced, nutritious diet over a fad diet that delivers quick results in the short term but fails you over time. Then, once you choose a good plan, stick to it. Stringing together days of healthful eating will deliver weight loss. You will find that every ounce of energy you put into losing weight is worth it. It can bring improved health, more energy, and a greater sense of well-being.

» Don’t rush yourself

A weight loss of one or two pounds [0.5 or 1kg] a week means you are succeeding. It may not seem like much if you are eager to shed pounds, but the lost pounds add up. Think of it this way: If you lose one pound a week, by the end of the year, you’ll have dropped fifty pounds [about 22kg]. That’s an enormous amount of weight. Remember that crash diets usually result in just that…a crash. Starving yourself, cutting your caloric intake to the minimum, usually results in “falling off the wagon”.

» Determine how many calories you need

Rowing boat using fresh vegetablesFirst, figure out how much weight you have to lose. Then begin with the number of calories each day it takes to maintain your present weight.

  • Inactive people require 10 to 11 calories per pound. If you’re a 150-pound [68kg] woman and inactive, that means if your diet contains 1,500 calories per day, you will maintain your weight.
  • Mildly active people, those who exercise rarely but are usually on their feet, burn about 13 calories per pound. It works out to 1,950 calories a day for a 150-pound woman.
  • Active people, who do at least three 30- to 60-minute workouts per week, burn 15 calories per pound daily. That’s 2,250 calories daily for a 150-pound woman.

» Balance your food groups

For those with metabolic syndrome, an optimal diet would be made up of about 25 per cent protein, 45 per cent carbohydrate, and 30 per cent fat, but exact percentages aren’t critical. The fat should be primarily unsaturated.

» Choose the right carbohydrates

Many processed carbohydrates contain finely milled grain. With the wheat bran and wheat germ milled out, these products have been stripped of many minerals, vitamins, and fibre. The white flour in these products is rapidly converted to sugar and causes a spike in blood sugar levels. Choose complex carbohydrates—like vegetables, fruits, and whole grains—which will be metabolized more slowly.

» Choose low glycemic index foods

The glycemic index is a valuable tool in helping to avoid spikes in blood sugar levels. Foods with a higher glycemic index dump sugars into the bloodstream, producing an insulin spike. Foods with a lower glycemic index break down slowly and release glucose gradually into the bloodstream, keeping sugar levels more stable so that insulin does not spike. The higher the glycemic index, the greater the glucose and insulin response.

Understandably, individuals with metabolic syndrome benefit from eating foods with a lower glycemic index. Pure glucose is set at a value of 100, which happens to be the same as white bread. It is recommended that you choose foods with a low glycemic index as often as possible.

» Choose low glycemic load foods

In 1997, Harvard University researchers introduced the concept of the glycemic load, which takes into account the volume of fiber in a food item. Foods with higher fiber do not quickly flood the bloodstream with glucose. Why not? When fiber is ingested, it makes you feel full—it makes the stomach swell. This fiber slows gastric emptying, keeping the food in the stomach longer. As a result, blood sugar levels are lower and insulin does not spike.

The glycemic load is obtained by dividing the glycemic index value by 100 and then multiplying that sum by the number of grams of carbohydrate in the serving. Glycemic load below 10 is considered low, that in the range of 11 – 20 is considered intermediate and that over 20 is considered high. The lower a food’s glycemic load, the better it is.

» Develop good eating habits

Part of eating right is developing good eating habits. That doesn’t just mean eating the right foods; it means adhering to a schedule and listening to your body. Eat at set times. Don’t let your body be overcome by extreme hunger or cravings. Eat breakfast, lunch, and dinner at the same time each day, and have a healthful snack at about the same time each day as well.

Choose healthful foods. Do you snack with cookies? Try fruit instead. Do you fill up on bread before a meal? Have a salad. If you’re in a restaurant, order a healthful side dish instead of fries; drink water instead of soft drinks or fruit juices.

» Control portion sizes

mission-x-6In this era of ‘supersizing’, it is easy to overlook the importance of controlling the size of our food servings. Don’t have a measuring cup handy? Use the ‘thumb and fist’ method for measuring. Here’s an easy guide to judging portion size.

Thumb tip: one teaspoon, as in a serving of mayonnaise or margarine

Thumb: one ounce [28mg], as in a piece of cheese

Handful: one or two [48mg] ounces of snack food, as in a handful of nuts

Palm: three ounces [84mg], as in a cooked serving of meat

Fist: one cup of cereal flakes.

Control of portion sizes works in both directions. Most people who diet do not eat enough vegetables and fruits. You should work on increasing your portion sizes of those foods.

When it comes to weight loss, vegetables and fruits should be consumed to excess. The more you eat, the more weight you will lose. Why? Because these miracle foods are high in nutrients, fiber and water, and low in calories. They help you feel full and satisfied without adding extra calories.

The best way to be successful losing weight is to keep yourself full of these healthy foods, so you have less room to eat higher calorie foods.

What to eat

Chicken and poultry: Chicken and turkey are high in protein and B vitamins. Avoid the skin, which is full of fat.

Fish: Choose cold-water fish, such as halibut and salmon, which are high in protein and omega-3 fats.

Beans: They are high in fiber and full of protein. Kidney beans and soybeans are good choices. Soybeans come in many forms, from soy milk to tofu.

Olive and canola oils: These are monounsaturated fats and contain omega-3 fats. They are still fats, however, watch portion sizes.

Nuts: They contain monounsaturated fats, minerals, fiber, and omega-3 fats. Almonds and walnuts are good choices. Although healthy, nuts are also very high in calories, and you should have only very small portions of them.

Fruits and vegetables: If there is a so-called miracle food for weight loss, this is it. Fruits and vegetables are high in nutrients and fiber and help you feel full. Fresh fruits and vegetables are best, but frozen and canned can also be good.

Whole grains: Grains are excellent sources of fiber, vitamin E, and minerals. Avoid processed, finely milled grains when possible. True whole-grain products are “crunchier” and will be digested more slowly.

Dairy: Milk and other dairy products contain calcium, which is good for bones and for lowering blood pressure; they also contain vitamins A and D. Choose low-fat or fat-free varieties. Use cheese in limited amounts.

Fats: The so-called good fats include monounsaturated fats, which remain liquid at very low temperatures. They’re generally found in oils such as olive oil, peanut oil, and canola oil.

Polyunsaturated fats: They remain liquid at room temperature. They’re found in oils such as corn oil, safflower oil, and soybean oil. They’re also found in fish and fish oil.

Green tea: This beverage contains antioxidants, compounds that protect against cell damage inflicted by molecules called oxygen-free radicals, which are a major cause of disease and aging. Green tea is also believed to lower LDL and triglycerides. Some experts believe that green tea also has an appetite suppressing effect.

Red wine: This lowers cholesterol; however, use it in moderation—alcohol is high in calories and can raise triglycerides and blood sugar levels.

What not to eat

Fatty meats: These meats are usually mass-produced and heavily processed; many red meats contain high amounts of saturated fat.

Fruit juices and dried fruits: These are often high in sugar and high in calories. Fresh or frozen fruit is better.

Soft drinks and energy drinks: Avoid full-sugar drinks. They will spike blood sugar and are full of empty calories.

Beer and other alcoholic beverages: These are high in calories.

Processed carbohydrates: These foods include white bread, mashed potatoes, white rice, pasta, and most snack foods.

Salt: When you ingest salt, the body draws more water into the cells to dilute it. More fluid in the blood means the heart has to work harder and blood pressure may increase on the walls of your blood vessels.

Fats: The “bad fats” include saturated fats, which are solid or almost solid at room temperature. They are found in animal fats, whole-milk products, coconut oil and palm oil. Saturated fats are generally bad for you. They raise LDL cholesterol and triglycerides. Trans fats are even worse than saturated fats. Trans fats are produced when food manufacturers infuse hydrogen gas into oil to convert it to a solid state in order to extend the shelf life of food products. This process is called hydrogenation. Examples of products containing trans fats are margarine, shortening, snack foods, commercial baked goods, and commercially fried foods such as French fries. Avoid all trans fats. They raise LDL and triglyceride levels and lower HDL.

Peanut butter: It is extremely high in calories and fat, should be avoided altogether.

» Keep a food diary

People who keep a daily diary of what they eat lose more weight. A diary is an effective way to become aware of what and how much you’re eating. Often when we operate out of poorly established eating habits, we may take in far more calories a day than we realize. Write down everything you eat and the approximate size of the serving. Note the times you had a meal or a snack. You can keep track of the calories, too, but if you’re eating the right amounts of healthful foods, that shouldn’t be necessary, at least not after the initial few days, when you’ve established your setup.

After a week, look over your notes. Are you eating good foods? Are you varying your diet so it doesn’t get boring? Are you “slipping”? If so, don’t berate yourself. Pick yourself up and return to your plan.

» Plan before you shop

Don’t go into a supermarket unprepared. Make a shopping list with appropriate food choices, and stick to it. You don’t want to fall victim to impulse buying. Products in supermarkets are strategically arranged to maximize customer purchases. You’ll notice certain products are at eye level, while others are placed on lower shelves and are not as easy to notice. Buy exactly what you need and nothing more. You’ll find that not only is this good for your diet; it’s also good for your wallet.

» Cook healthy

ExercisingAt home, you have total control over your meal.

  • Cut all liquid calories except skim milk. [Diet soda and other diet beverages, which have fewer than ten calories per serving, are okay.]
  • Eat fruits and—especially—vegetables whenever you can; eat them before a main meal, to calm your appetite. When it comes to fruits and vegetables, “more is better!”
  • Balance your meals and snacks. Include a little low-fat protein with each meal and snack whenever you can.
  • Add spices to your dishes. Just because your meals are good for you doesn’t mean they have to be bland.
  • Cut visible fat on meats and chicken.

» Find support

Losing weight is often difficult to do all alone. Give yourself the benefit of emotional and educational support. You will find emotional support especially helpful if your emotions are one reason you overeat. Educational support means learning about good nutrition and ways to avoid the disease risks that come with metabolic syndrome.

Weight loss programs can be invaluable in urging you on. Also, working with a dietician can be helpful; a dietician can be supportive, help you stay accountable to yourself, and help you continually shape your diet when you feel like you’re getting into a rut. Remember, the goal isn’t only to lose weight; it’s to build a better, healthier life.

» Do a self-inventory

After the first few weeks, take an inventory of your weight loss plan. How do you feel? Thanks to improved nutrition, you probably feel better, in addition to having lost weight. Are you sleeping better? Do you have more energy? If so, give yourself a pat on the back.

STAY ACTIVE

When it comes to reversing metabolic syndrome, exercise is one of the best medicines. Combined with a proper diet, it can help to reduce the effects of or even eliminate the disorders that make up metabolic syndrome.

If you’re not physically active now, you know it takes effort to develop a more active lifestyle. Be certain to consult your physician about exercise programs that are right for you. Is it safe for you to exercise? Metabolic syndrome puts you at risk for a heart attack, and beginning a new exercise program can be physically strenuous. Most doctors recommend that patients with metabolic syndrome have a treadmill stress test, to gauge the strength of your heart, before beginning a vigorous exercise program.

» Decide on your exercise regime

While you’re planning, consider your current physical condition—age, current level of fitness,
and any physical injuries. For example, do you have a knee problem? If so, jogging may not be a good choice for you. However, biking or swimming could be. You’ll need to think about your fitness goals, the types of exercise you can do or would like to learn, your budget constraints, and how much time you’ll be able to allocate.

» Set realistic goals

We all tend to do a bit of dreaming when we’re goal setting. The reality is, though, that what you’d like to do and what you may be able to do may have to be scrunched a little to make them agree. Identifying obstacles to your goals and coming up with a plan B will make your goals that much easier to achieve. For example, you may decide that your fitness goal of increasing flexibility can be met by attending two-hour sunrise yoga classes four times a week. Sounds good, but be realistic. Are you really going to make it to the class four mornings a week before work? Do you think you’ll really enjoy a two-hour class that starts at five in the morning and leaves you 30 minutes to shower, change, and get to work? If the answer is yes, then go for it. If the answer is probably not, then think through plan B. Perhaps there are after-work classes that fit the bill. Perhaps you can take a class or continue flexibility training on your own with videotapes or DVDs.

A well-thought-out plan is helpful. So, set your fitness goals, check them out with a health care professional, and then start working toward them.

» Exercise, every day

ExercisingYou can accumulate thirty minutes in ten or fifteen-minute sessions throughout the day. What’s important is to include physical activity as part of a regular routine. However, don’t get pulled into thinking that all exercise should be high-intensity activity. Even moderate-intensity activities, when performed daily, can have long-term health benefits. Here are some examples: gardening and yard work, housework, dancing, playing frisbee, playing catch with the dog, horseback riding.

But don’t overdo it. Too much exercise can give you sore muscles and increase the risk of injury.

Here are some tips to help you build physical activity into your daily routine:

  • Put your exercise in your planner or handheld device like any other appointment.
  • Put on your exercise clothes first thing in the morning. If you are not wearing your street clothes, you are much more likely to get some exercise.
  • Make plans with a friend to exercise.
  • Squeeze a tennis ball to help strengthen your hands and wrists.
  • Get up and walk around when you are talking on the telephone.
  • Go walk at the mall.
  • Go dancing.
  • Tap your feet up and down while you are seated at your desk.
  • Take five-minute walk breaks several times during the day.
  • Walk during some or all of your lunch break.
  • Get up early and take a walk before going to work.
  • Take the dog for a walk.
  • Take the baby for a stroll.

Remember, start slow. You can build up by increasing either the duration or the intensity of the workout.

» Understand how calories burn

Everything you do burns calories. Even sleeping burns calories. The more intense the exercise, the more calories you burn. The other factor that affects how many calories you burn with exercise is how much you weigh. The more you weigh the more calories you burn.

» Walk as much as you can

You can always take a walk. It’s cheap. It’s easy. And it’s good for you. You’ll burn about the same number of calories walking as you would running a mile. It’s also easier on your joints. And here’s one of those times that being heavier pays off. Heavier people burn more calories walking the same distance than do lighter people. And according to President’s Council on Physical Fitness [PCOPF], it’s the only exercise activity that doesn’t exclude people as they get older.

To get the benefits of walking, you just need to start.

Don’t forget to warm up and cool down both before and after walking. Fitness trainers recommend that you try to work your way up to about forty-five minutes three to four times a week. That should be the goal, not something you do right away. Shorter distances and less time are the watchwords when you’re starting out. You can keep up your walking program even when you are travelling. Just plan to walk on a regular basis and be flexible about your walks. If it’s raining, too hot, or too cold, you don’t need to skip your walk today—walk indoors.

There are some things you should be careful about with your walking program. A good pair of shoes that provide a lot of support and have nonskid soles are very important. In addition to good shoes, you should:

  • Dress appropriately for the time of year, in layers so you can shed layers if you get too warm.
  • Walk in daylight or well-lit areas at night.
  • Wear reflective clothes if you do walk at night.
  • Walk with someone else.
  • Don’t wear headphones that block all outdoor sounds. It could prevent you from hearing a car.

Exercise express

SkippingFor most healthy people, the American Heart Association recommends exercise that will provide benefits to the heart, lungs, and circulation. That involves performing any moderate-to vigorous-intensity aerobic activity for at least thirty minutes on most days of the week at 50 to 75 percent of your maximum heart rate, the greatest number of times per minute the heart is capable of beating.

Aerobic exercises that condition the heart and lungs include activities such as dancing, bicycling, cross-country skiing, uphill hiking, ice hockey, jogging, jumping rope, rowing, running in place, and stair-climbing.

More moderate aerobic exercises include downhill skiing, basketball, field hockey, calisthenics, handball, racquetball, soccer, squash, and tennis.

Higher-intensity activities—such as swimming, cycling, and running—will help build endurance and will also help to strengthen muscles.

To make the most of your exercise:

  • Establish short-and long-term fitness goals.
  • Choose activities that you enjoy.
  • Choose convenient workout locations.
  • Have a regularly scheduled time to exercise.
  • Keep your enthusiasm and motivation up: read articles about your chosen exercise, hang out with people who do the same exercises, exercise with a friend, etc.
  • Adjust your goals and routine to suit your schedule and your body’s needs.
  • Keep an exercise journal that charts your progress. Share your journal with your physician and use it as a gauge of your strengths.

Get enough sleep. Using the old “I’ll sleep on my day off” won’t work. Many studies have shown that there is no way to “catch up” on sleep. The best way to guarantee that you get all the benefits from your sleep time is to keep as regular a schedule as possible, going to sleep and waking up at the same time each day. Remember that sleep is tied to particular hormones in your body that ebb and flow at certain times of the day and night.

SUPPLEMENTS: THE EXTRA

When added to a proper diet and regular exercise, vitamins and minerals can help diminish some effects of metabolic syndrome.

» Chromium

This mineral, required in trace amounts, works with insulin in assisting cells to take in glucose and release energy [that is, it improves metabolism of glucose]. Chromium deficiency is a cause of insulin resistance, and correcting the deficiency improves insulin sensitivity. However, there is no proof that chromium supplementation helps people that do not have chromium deficiency, and it has not been shown to cause weight loss.

» Red yeast rice

Made from fermenting a kind of yeast [Monascus purpureus] over rice, this simple dish is used in China as both food and medicine. It works against an enzyme called HMG-CoA reductase, the enzyme that the statin drugs block.

Source: Available as a supplement in pill form.

» Garlic

This root plant has antioxidant properties and it helps lower cholesterol. It also appears to work as an antibiotic.

Sources: In addition to your local grocery store, garlic is available as an odourless, tasteless pill.

» Soy

RunningThe soybean [or soya bean, in Asian cultures] is a rich source of nutrients, including protein, fiber and isoflavones, which may have positive effects in humans, such as cancer inhibition, increased bone strength, and a decrease in heart disease. Isoflavones help cut LDL cholesterol.

Sources: Soybeans, soybean oil, tofu, and soy milk.

» Guggul [Gugulipid]

Indian cultures have used this ancient herb for centuries. Not only does it raise HDL and lower LDL; it also cuts triglycerides, has antioxidant properties, and acts against blood clots.

Sources: Guggul comes from the gummy resin of the mukul myrrh tree. It’s available as a supplement in pill form.

» Capsaicin

This substance—which makes hot peppers hot—has been found to boost metabolism and may lower cholesterol and blood pressure.

Sources: Available as an herbal supplement and in spicy foods such as chili peppers.

» Caffeine

Caffeine stimulates metabolism and should be used in moderation. Studies have linked coffee consumption to a decrease in diabetes risk.

Sources: Coffee, green tea, and black tea.

» Plant phytosterols [Beta Sitosterol]

Phytosterols closely resemble cholesterol, and it is believed that they can actually block food-based cholesterol from being absorbed into the bloodstream. The result is that both phytosterols and dietary cholesterol end up excreted in waste matter.

Sources: Rice bran, wheat germ, corn oils, vegetable seeds, avocados, and soybeans.

» Oat fiber

A powerful fiber source, oats lower the risk of cardiovascular disease.

Sources: Oats are best in rawer forms, such as oat bran and steel-cut oats, and are readily available at grocery stores.

» Ginseng

The species Panax Ginseng contains chemicals that are thought to lower blood sugar levels and improve insulin resistance.

Source: The herb ginseng.

» Fenugreek

The seeds of fenugreek, an herb, are thought to have glucose-lowering properties and to decrease appetite.

Sources: Available as a seed, as a tea, or in the form of sprouts.

» Bitter melon

This herb is widely used in Asia and South America to treat diabetes because of its ability to alleviate insulin resistance.

Sources: Squash, watermelon, muskmelon, and cucumber.

If you make these lifestyle changes, along with taking appropriate medications, you have a good chance at overcoming metabolic syndrome. You are already armed with a basic understanding of the syndrome and what you need to do to reverse it. Develop a plan, put it into action, and stay with it—a day at a time. Research shows that even modest weight loss and increased physical activity can produce significant gains in the way your body’s metabolism works.

Excerpted with permission from Overcoming Metabollic Syndrome by Scott Isaacs, Frederic J Vagnini; published by Addicus Books, Inc; ISBN: 1-886039-73-9

P.S. To maintain sanctity of the source, this article follows American English.


A version of this was first published in the September 2011 issue of Complete Wellbeing.

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Frederic J Vagnini
Frederic J Vagnini, MD, a cardiovascular surgeon, is medical director of the Heart, Diabetes, and Weight Loss Centers of New York City. He is a reputed heart, lung, and blood vessel surgeon and has performed surgery on thousands of patients with heart and blood vessel disease. He is a frequent guest speaker and has appeared numerous times on local and national radio and television. He has authored several books one of which was a New York Times bestseller.
Scott Isaacs
Scott Isaacs, MD, FACP, FACE, is a board-certified endocrinologist in Atlanta, Georgia, where he is Medical Director at Intelligent Health Center. He has done extensive research on obesity, stress, and diabetes and has published many articles in peer-reviewed medical journals. He gives talks on the subject of hormones and obesity at major events and conferences throughout the United States. He also trains other doctors in the field.

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