Metabolic Syndrome

June 2014

Metabolic Syndrome

Syndrome X

Identified less than 20 years ago

Increasingly common

Runs in families

The risk of it increases with age

Sufferers are overweight or obese

A risk factor for:

Cardiovascular diseases and type 2 diabetes

Certain cancers, liver disease and Alzheimer’s

What is Metabolic Syndrome?

It is a cluster of metabolic disorders:

Insulin Resistance

High Blood Pressure

An increased risk of blood clotting

High blood sugar

Low HDL (good) cholesterol level

High blood triglyceride (fat) level

Excess abdominal fat

Any three of these clinches the diagnosis

What causes Metabolic Syndrome?

The causes are complex

Poor lifestyle choices play a major role:

Eating too much sugar and other refined carbohydrates

Lack of exercise

Insufficient sleep

High stress levels

What causes Metabolic Syndrome?

However,

of all the influencing factors,

poor food choices,

in the form of sugar

and refined carbohydrate,

contribute between 80% and 90%

of the total effect.

How does Sugar causeMetabolic Syndrome?

Excess sugar makes us fat, and people with metabolic syndrome are all overweight or obese

There are two mechanisms:

Excess sugar is stored as fat

Leptin, produced in fatty tissue, is a hormone that regulates appetite. But fructose causes leptin resistance

Fructose Also Increases

Blood fat levels:

Triglycerides

Total blood cholesterol

LDL (bad) cholesterol

The prevalence of:

Type 2 diabetes

High blood pressure

Abnormal blood clotting

Heart disease

The very conditions that constitute

metabolic syndrome!

Positive energy balance

DoH ’98, USDA ’02, NIH ’03, NCHS ‘04

1940 50 60 70 80

What we eat

What we need

Obesity

A modern problem - statistics for it did not exist 50 years ago

A major factor in the development of Metabolic Syndrome

Your BMI is your weight in kilograms, divided by your height in metres, divided again by your height in metres

Healthy - a BMI between 18.5 and 24.9

Overweight - a BMI between 25 and 30

Obese - a BMI over 30

e.g. Weight 80kg, height 1.60m, BMI is 80 / 1.6 / 1.6 = 31.25 = obese

Scary Global Statistics

Obesity prevalence has doubled worldwide in the past 25 years

In 2005, 1.6 billion adults were overweight and 400 million of them were obese

By 2015, WHO predicts there will be 2.3 billion overweight adults and 700 million of them will be obese

Scary UK Statistics

By 2011, the proportion of adults with a healthy BMI (18.5 - 24.9) had fallen to 34% (men) and 39% (women)

There had been a marked increase in obesity rates over the previous 18 years:

In 1993, 13% (men) and 16% (women) were obese

By 2011, this had risen to 24% (men) and 26% (women)

For children attending reception classes (aged 4-5) during 2011-12, 9.5% were obese

Consequences

2011 - 11,736 hospital admissions for obesity - an 11-fold increase in 10 years

2011 - 53% of obese men and 44% of obese women had high blood pressure

Type 2 diabetes

Occurs where there is insulin resistance - the common factor in metabolic syndrome

Currently afflicts 4 million people

Expected to rise to 6 million by 2020

‘Management’ will then account for 25% of the health budget

A Typical Scenario

Weight gain - The GP suggests a ‘balanced diet’

‘Isn’t it my glands, doctor?’ - The GP prescribes thyroid hormone - further weight gain

High blood pressure and diabetes. The BP is treated with pills which often make the diabetes worse – further weight gain

The diabetes cannot be controlled without diet and weight loss, but medication is prescribed anyway

High blood cholesterol – a statin is prescribed

The Saga Continues

Obesity causes low back and knee pain - anti-inflammatories are prescribed

These cause indigestion and acid reflux, which makes sleeping difficult - a proton pump inhibitor and sleeping tablets are prescribed

The patient is now so unhappy that the GP prescribes an anti-depressant

Our patient is now incapacitated by increasing pain, and eats even more for consolation

Further weight gain

The Denouement

Our patient is taking up to twelve different medications, often with unpleasant side effects

A stroke, or a heart attack, is imminent

They may be using an inhaler for angina and a positive pressure ventilator for sleep apnoea

The joint pains worsen – the consultant confirms that nothing surgical can be done

Ever stronger pain killers are prescribed, to which tolerance quickly develops

Drug dependency, loss of job and loss of self esteem are added to our patient’s woes

Some Observations

It is interesting that such patients frequently claim to eat very little

They are in denial

They should be furious with a health service that has not served them well

The cost of their treatment is astronomical and would be unaffordable if it had to come out of their pocket

People in Africa used to know how to feed themselves:

Millet, sorghum and – more recently -maize, grown and milled at home

Ground nuts, sweet potato, pumpkin, cabbage

Gathering herbs, roots, shoots, fruits and wild spinach

Moderate intake of fresh, free range meat, eggs and milk

Hidden Hunger

In Southern Africa, today, the staples are

Refined maize meal (empty calories)

Bread (mostly refined)

White sugar (empty calories)

Soft drinks

Sweets

Most processed foods

Traditional margarine (trans fats)

Cooking oil

A Strategy of Empowerment

We challenged the denial, the addictive behaviour and any claim to victimhood, using cognitive behavioural therapy (CBT)

We educated our patients so that they could fully understand their condition

We set targets

We empowered them to heal themselves

We started a support group, and called it Waist Disposal

My physiotherapist wife opened a gym and ran exercise classes

An Alternative Scenario

Patients are seldom capable of making minor lifestyle adjustments, but they can make major ones

Patients with metabolic syndrome are challenged to adopt a fat-free, wholefood, vegan diet

No meat, no fish, no eggs, no dairy, no fat, no oil, no sugar, no refined carbohydrate, no fruit juices and no alcohol

Weight loss is sufficiently rapid to encourage continued compliance

The Result

Once a healthy weight is reached, most patients require no medication at all

High blood pressure, type 2 diabetes and raised blood cholesterol all disappear or greatly improve

Nor do patients need to stay vegan or teetotal

They have discovered the wisdom of moderation in all things

And there is nothing more empowering than the realisation that you can, and should be, responsible for your own health

Challenging Myths

This is no fad diet - there are millions of healthy vegans in the world

It is not difficult to change eating habits -ask McDonald’s, KFC and Pizza Hut

Radical lifestyle change is easier than minor adjustments

Fasting is the key to controlling IGF-1, which is linked to the development of disease and the ageing process. This is the basis of the 5:2 diet

The Pharmaceutical ModelIs it still relevant?

100 years of research has generated a wide range of potent & specific drugs

Anti-microbials

Pathogens allow differential metabolic targeting – ‘weak link’

Wide therapeutic index, curative

But resistance is now widespread

The Pharmaceutical ModelIs it still relevant?

Almost all drugs for CDDs are designed to suppress symptoms, and do not treat the underlying disease

Narrow therapeutic index, palliative

Iatrogenic illness is now a major cause of morbidity and mortality

The CDDs still have no cures … They are increasing in frequency

The age of onset is falling

Thank You for Your Interest

Health Empowerment Through Nutrition is a

UK Registered Charity concerned with the

alleviation of Hidden Hunger

www.hetn.org