Large waistline is an indication of Metabolic Syndrome Metabolic syndrome, also referred to as Syndrome X or Insulin Resistance Syndrome, describes a collection of metabolic abnormalities that includes excess belly fat, high blood sugar, high blood fat, low HDL (“good”) cholesterol, and high blood pressure. There is often a host of other abnormalities such as excess liver fat, and higher than normal levels of inflammation, oxidative stress, and vascular dysfunction. To have an official diagnosis you don’t have to have all these problems, just three.
Sugary carbs are biggest culprit
Why has the prevalence of metabolic syndrome shot up in recent decades? One distinct possibility is that we are consuming too many sugary beverages and total carbohydrates relative to our ability to metabolize them efficiently. Survey data indicate Americans have increased carbohydrate intake to the tune of about 200 extra kilocalories per day, much of this in the form of sugar and processed carbohydrates.
Insulin resistance equals carbohydrate intolerance
In the body, excess carbohydrate calories cause insulin to be released which stops the fat burning process. Cells in our muscles and liver (and other tissues) also down-regulate their normal response to insulin causing a condition called insulin resistance. This causes blood sugar levels to increase and other problems associated with metabolic syndrome. In this way, insulin resistance or metabolic syndrome can be more accurately described as carbohydrate intolerance. If you have this condition, you tend to divert a greater percentage of the carbohydrate you eat into fat. Over time, this causes collateral damage that ends up as metabolic syndrome.
When viewed in this context, it becomes clear that the most effective way to prevent or reverse metabolic syndrome is to restrict those sugars and starches that are causing the problem.
The best approach
Similar to other food intolerances like lactose intolerance or gluten intolerance, the most logical approach to treat metabolic syndrome (aka, carbohydrate intolerance) is to limit the offending substance. In this case, restrict dietary carbohydrate to a level your body can manage. Based on genetics, people vary widely in their level of carbohydrate intolerance, and thus they also vary in the level of carbohydrate restriction required to manage the signs and symptoms of metabolic syndrome. Tolerance to carbs also tends to decrease as you age.
My clinical study revealed the best diet to reduce risk
When my laboratory group put a group of men and women with metabolic syndrome on a 3 month low calorie diet low in fat (25% fat) or low in carbohydrate (12% carbohydrate), the results were striking. The subjects assigned to the low carbohydrate diet showed greater improvement in all the markers of metabolic syndrome including greater fat loss, lower triglyceride levels, higher HDL (“good”) cholesterol levels, lower blood sugar levels, lower insulin levels, and lower blood pressure levels. We even observed lower inflammatory markers and improved vascular function.
Change your diet
There are no hard set rules here, but most people with metabolic syndrome will experience significant benefit from limiting their carbohydrate to less than 50g per day. You may be able to tolerate more carbohydrates, but add them back carefully and monitor your signs and symptoms of carbohydrate tolerance. Consume 75-125g of protein a day depending on your weight. Replace some of the calories from carbs with calories from healthy fats like flax oil, olive oil, coconut oil, avocado, nuts and seeds. My lab also did another study that showed if you eat a low carbohydrate diet, the saturated fat found in red meat and other animal products didn’t accumulate in the body; it actually decreased saturated fat in the blood, a highly positive health effect.
Exercise can improve results dramatically
Regular exercise can also significantly improve all the features of metabolic syndrome, especially because it promotes insulin sensitivity. This includes both endurance exercise and resistance training. Did you know that just a single bout of exercise increases insulin sensitivity and the effect can last up to 2-3 days. This means you tolerate carbohydrates better after performing physical activity.
Supplements help target specific problem areas
Reducing sugars and starches, and engaging in regular physical activity is the best approach to decreasing your waistline and improving the other symptoms of metabolic syndrome. However there are other complementary strategies that may target specific problems.
Triglycerides – try to lower them
The omega-3 fatty acids EPA and DHA found in fatty fish are good at reducing blood triglyceride levels on average 25-30%. They may also improve insulin sensitivity and help reduce inflammation. The minimum effective dose is 500 mg/day (EPA + DHA) and you can increase it up to as much as 1-2 grams/day.
Used in traditional Chinese medicine, red yeast rice has been shown to decrease blood triglycerides. In one study, subjects given 1,200 mg/day reduced the triglyceride response to a fat-rich meal by nearly one half.
Other ingredients to consider include pantethine (a form of vitamin B-5) and many others shown below that are good for HDL cholesterol.
HDL (“good”) Cholesterol – try to raise it
Decreasing carb intake and increasing fat intake reliably raises HDL (“good”) cholesterol, but certain fats raise HDL more. Coconut oil, which is rich in medium chain fatty acids, consistently increases HDL cholesterol.
Other ingredients to consider to help with healthy cholesterol levels include niacin, tocotrienols, citrus polymethoxylated flavones (Sytrinol), plant sterols, coQ10, green tea extract and vitamin D among many others.
Blood Sugar – try to lower it
Including more soluble fiber can minimize the impact on blood sugar and insulin levels. Glucomannan is a soluble fiber from the konjac plant. A number of placebo-controlled studies have shown that small amounts of glucomannan (1 to 4 grams/day) enhance weight loss and decrease the fasting and 2-hour glucose levels by approximately one quarter.
Other fibers like psyllium and oat bran also help slow the normal rise in blood sugar in response to eating carbohydrates. Adding omega-3 rich flaxseed oil or other healthy fats to a protein shake also dampens the rise in blood sugar that also occurs even when eating just protein.
Chromium is an essential trace mineral that is often low in the diet. Several studies have shown that chromium can normalize blood sugar levels, improve blood sugar utilization and decrease insulin requirements in individuals with carbohydrate intolerance and insulin resistance. In one recent study, blood sugar responses to a carbohydrate meal of white bread were measured with and without a single dose of chromium (400 micrograms). The addition of chromium resulted in a 23% reduction in blood sugar after the meal.
Alpha lipoic acid, curcumin (turmeric), cinnamon, fenugreek, gymnema and other supplements can also help support healthy blood sugar levels.
Blood Pressure – try to lower it
Peptides from whey have been shown to lessen vasoconstriction (narrowing) by inhibiting an enzyme called angiotensin-converting enzyme (ACE). In one study, supplementation with whey (20 grams/day) for 6 weeks reduced systolic blood pressure by 8 mmHg and diastolic blood pressure by 6 mmHg compared to control. In a more recent study, overweight subjects who supplemented with 60 grams/day of whey for 12 weeks showed a decreased systolic (5 mmHg) and diastolic (2 mmHg) blood pressure, as well as an improved augmentation index, a measure of the stiffness of blood vessels.
Flowers and berries of the hawthorn plant contain several bioactive compounds and have been used in traditional medicine to treat a variety of cardiovascular conditions. The most well documented effect of hawthorn is to cause vasodilation and increased blood flow. A recent randomized study showed that 1,200 mg/day hawthorn extract for 16 weeks significantly reduced blood pressure in patients with diabetes compared to placebo.
CoQ10, fish oil, green tea extract, green coffee extract, vitamin D, soy protein, pycnogenol, calcium, magnesium, garlic, quercetin and numerous other supplements may also have an impact on healthy blood pressure.
Body Fat – try to lower it
Since a higher body fat level tends to trigger the complications associated with metabolic syndrome, supplements that can help you lose body fat may also be beneficial. They can include low-carb protein powders, green tea extract, CLA, thermogenic ingredients like bitter orange (synephrine) or caffeine, carb inhibitors like white kidney bean extract, most fibers and many other supplements.
Reversing metabolic syndrome is in your control
If you are one of the growing numbers of people with metabolic syndrome, the good news is that you can do something about it. Not only can you slow it down, you can completely reverse it and keep it away for good. Paying close attention to reducing the amount of sugar and starch has a profound benefit on all the metabolic problems. This should give you more energy so you actually have the desire to exercise, which further helps improve the condition. There are also a number of supplements that can support your diet and exercise plan.
Dr. Jeff Volek is a registered dietitian and Full Professor in the Department of Human Sciences at The Ohio State University. He has published 270 articles examining health and performance effects of low-carbohydrate diets and other dietary supplements including seminal work on creatine, carnitine and whey protein.
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