Metabolic Syndrome and wellness — ‘Stay off the farm!’

Joseph R. Anticaglia MD
Medical Advisory board

Early on in my medical education, part of my internship was spent in the E.R. and with doctors who specialized in Internal Medicine and Cardiology. There was one Cardiologist I particularly enjoyed working with and noted how he cared for his patients.

He explained to them that their heart problem was due to a combination and accumulation of unhealthy lifestyle decisions. The person described below was a 48 y/o male who had a heart attack. There is a recurrent theme to these patients.

“You’re overweight, the tests show you have diabetes, hypertension and your cholesterol level is elevated. I want you to stop smoking, exercise more and stay on this diet.” He handed a diet sheet to the patient.
The patient read the diet sheet that was handed to him and half way through said “You mean I have to cut out chocolates, all sweets, fried foods, no drinking and cut down on salt? No pastrami? Come on Doc, you’re killing me.”

“No, you’re killing yourself. You must follow the diet. One last thing: “Stay off the farm!”
“What do you mean? I work at G.M. I’m on the assembly line”

“What I mean is to reduce you’re intake of beef, pork, and dairy products such as cheese. These suggestions are important to reduce the likelihood of another heart attack.”

He was ahead of the times. The term “metabolic syndrome” was not coined until many years later.

What Is Metabolic Syndrome (MeS)?

Thirty-four percent or about one in six of adult Americans are classified as having findings consistent with Metabolic Syndrome.

Metabolic syndrome (MeS) is not a disease. It’s the result of a combination of the unhealthy lifestyle choices you make (e.g. eating unhealthy fats, too much sugar, lack of exercise). This puts you at a greater risk to become overweight, to develop heart disease, type 2 diabetes and stroke.

Because of the combination of these habitual, unwise, health choices we’re more likely to have high cholesterol, high blood sugar, high blood pressure and a bulging waistline. Our metabolism and health suffer and people moan: “I was never sick a day in my life until I hit my forties.”

Not everyone agrees on the cause and definition of MeS. Hereditary traits, the environment and lifestyle choices can put us at greater risk for disease. One worrisome trend is an increase in insulin resistance.

What Is Insulin Resistance?

Insulin Resistance is a condition associated with weight gain and physical inactivity in which the body stops using insulin properly. When digestion breaks down sugars into glucose (a form of sugar), the hormone insulin is released by the pancreas into the bloodstream. Insulin and glucose travel together in the blood zeroing in on various cells in the body. Insulin’s main job is to get glucose from the blood into the cells. This cellular absorption of glucose helps convert food into energy needed by our bodies.

If we habitually eat too much sugar or the wrong kinds of sugar, the cells do not respond to insulin. The body prevents or resists the entrance of glucose into their cells. The pancreas tries to compensate for the excess sugar intake by producing more insulin. But eventually it fails. The blood glucose levels become elevated and this leads to prediabetes, type 2 Diabetes and other problems.

How is MeS Diagnosed?

Your doctor will obtain a medical history, perform a physical examination and order blood and other tests as indicated.

According to the NIH, you must have three of the five Risk Factors listed below to be diagnosed with Metabolic Syndrome.

  • High blood pressure
  • High fasting blood sugar, too much sugar in the blood (or you’re on medication to treat blood sugar)
  • A large waistline. For men, a waist that measures greater than 40 inches around and for women greater than 35 inches around. This is also called abdominal obesity or having an “apple shape” abdomen.
  • A high triglyceride level, means having too much fat in the blood (or you’re on medicine to treat high triglyceride).
  • A low HDL cholesterol level (or if you’re on medication to treat low HDL). HDL is at times called “good or healthy” cholesterol.

Wellness — Treatment

  • Enjoy a healthy diet
  • Exercise more
  • Get a good night’s sleep
  • Don’t smoke
  • Reduce stress
  • Maintain a healthy weight
  • Address risk factors with lifestyle changes and/or medications.

MeS increases your risk for disease and insulin resistance. Maintaining a healthy weight, routinely exercising and eating a healthy diet are keys to wellness and a healthy lifestyle. Yes, we’ve heard this before. We know what to do but it’s: “Easy to do — Easy not to do!”


References

NIH, National, Heart, Lung and Blood Institute; What Is Metabolic Syndrome? June 22, 2016.
Hiram Beltram-Sanchez et al; Prevalence and Trends of Metabolic Syndrome in the adult US Population, 1999—2010; Jam Coll Cardiol.; Aug 20, 2013
American Heart Association; What is Metabolic Syndrome?

GLOSSARY

Metabolism — how the body functions to convert food into energy that we can use.
Syndrome — a set of signs and symptoms
Triglycerides are a type of fat found in the blood

Other Names for Metabolic Syndrome

Insulin Resistance Syndrome
Syndrome X
Obesity Syndrome
Dysmetabolic Syndrome

This article is intended solely as a learning experience. Please consult your physician for diagnostic and treatment options.