By Jack Challem
The biggest epidemic in America hasn’t come from birds, Asia, or germs. It’s caused by the food we put in our mouths, and it has already affected some 70 million to 100 million American adults.
Doctors refer to the condition as metabolic syndrome, Syndrome X, or insulin-resistance syndrome. If you have it and don’t do anything about it, you’ll be on the fast track to diabetes and heart disease and a constellation of other health woes, including cancer, prostate disorders, and stroke.
“You can diagnose the telltale sign—a pot belly—all by yourself, standing in front of a mirror,” says Fred Pescatore, MD, a nutritionally oriented physician in New York City. “The bigger your belly, the worse off you probably are.”
In addition to abdominal obesity, the other key signs of metabolic syndrome include high blood pressure, high levels of triglyceride (a type of blood fat), low levels of the “good” high-density lipoprotein (HDL) cholesterol, and high levels of either blood sugar or insulin. (See “Diagnosing Metabolic Syndrome” on page 36 for details.) High insulin levels point to insulin resistance, a characteristic of glucose intolerance, which hamstrings the body’s ability to properly use the hormone to burn sugars and carbohydrates.
One Long Sugar Rush
Consider the case of Richard, a high-powered East Coast business executive. In December 2005, he was 50 pounds overweight, his blood pressure was inching up, and his blood fats were skyrocketing. Richard (whose name we’ve changed) turned to Pescatore, who coached him on better eating habits and recommended several nutritional supplements. Six months later, he had lost 40 pounds, and his blood fats and blood pressure were back to normal.
“Most of the signs and symptoms of metabolic syndrome will correct themselves just with changes in the diet,” says Pescatore.
He ought to know. Pescatore, author of The Hamptons Diet (Wiley, 2004), grew up as chubby kid, and he would have stayed overweight had he not realized how contemporary American eating habits pack on the pounds and sabotage people’s health.
“Metabolic syndrome results from eating too many sugars and simple carbohydrates, including fruit juice and soft drinks,” he says. “Look at the typical fast-food meal, with simple carbs in the bun, unhealthy fats in the fries, and sugars in the soft drinks. It all boils down to unnutrition.”
What exactly happens? Sugary foods and refined carbohydrates—candy bars, desserts, bread, pizza, pasta, and soft drinks—break down rapidly in the body, leading to a surge in blood sugar levels, followed by a rush of insulin. Insulin helps cells burn blood sugar for energy. But after years of dealing with high insulin levels, the body becomes resistant to it. That’s when both blood sugar and insulin levels stay elevated, leading to a diagnosis of diabetes.
But eating too many sugars and refined carbs also does a number on the liver, which regulates blood sugar in tandem with the pancreas (which makes insulin). “The liver itself can become insulin resistant,” says Frank Shallenberger, MD, author of The Type 2 Diabetes Breakthrough (Basic Health, 2006). “At this point, the liver becomes fatty and liver function decreases, and it has trouble regulating blood sugar levels.”
Reversing the Syndrome
Shallenberger, who practices alternative and integrative medicine in Carson City, Nevada, criticizes the American Diabetes Association’s dietary recommendations for including far too many carbohydrates. “We actually do better using healthy fats instead of carbs for energy.”
You can reverse your risk of metabolic symptom by focusing on your eating habits, supplements, and physical activity.
Eating Habits. Loren Cordain, PhD, an expert on Paleolithic diets, believes that metabolic syndrome results from a collision between ancient genes and modern refined foods. “The average American eats around 150 pounds of refined sugars and 400 pounds of refined carbohydrates each year,” he says. “These foods did not exist during most of our time on Earth. Our genes don’t know how to deal with them.”
Cordain recommends adopting a modern version of that ancient diet, with an emphasis on fresh broiled fish, baked chicken, and such high-fiber vegetables as salads, broccoli, and cauliflower. Small amounts of olive oil and complex carbs, such as yams, get the nod as well.
“Protein stabilizes blood sugar levels, and so do high-fiber veggies,” says Cordain. “Vegetarians can be in a bind, because they tend to eat too many carb-rich grains, and legumes are fairly high in carbs.”
Liberally using vinegar, such as in homemade balsamic vinegar and olive oil salad dressings, lowers blood sugar and insulin levels and also curbs appetite, says Carol Johnston, PhD, a professor and researcher at Arizona State University, near Phoenix. Cinnamon—sprinkle it on nonstarchy fruit, such as raspberries and blueberries—can also lower blood sugar levels, according to a US Department of Agriculture study.
Supplements. Several supplements help improve insulin sensitivity (the opposite of insulin resistance), enabling the body to use less insulin to control blood sugar levels. You probably won’t need to take more than two or three of these supplements.
Alpha lipoic acid. German doctors have used this antioxidant for decades to treat diabetic nerve disease and im-prove insulin function. It might also help reduce appetite. Take 300 to 600 mg daily.
R-alpha lipoic acid and biotin. The “R” isomer of alpha lipoic acid appears to be the most active form of the antioxidant. Combined with the B-vitamin biotin, it may be especially beneficial. As an alternative to regular alpha lipoic acid, take 100 to 200 mg of R-alpha lipoic acid and 750 to 1,500 mg of biotin before meals.
Chromium. This essential mineral helps insulin control blood sugar levels, and studies have found that it can significantly improve glucose tolerance. It is especially helpful when glucose intolerance is associated with overeating and depression. Take 400 to 1,000 mcg of chromium picolinate daily.
Silymarin. An antioxidant extract from the herb milk thistle, silymarin can improve liver function along with blood sugar and insulin levels, as well as other signs of diabetes. Take 200 to 600 mg daily.
Magnesium. High intake of magnesium may improve glucose tolerance and diabetes. Take 300 to 400 mg of magnesium citrate daily.
Vitamin D. Vitamin D supplements may reduce the long-term risk of diabetes. Take 800 IU of vitamin D, plus 1,200 mg of calcium daily.
Physical Activity. The high or erratic blood sugar levels associated with metabolic syndrome and related blood-sugar disorders often zap people’s energy levels, but engaging in physical activity can actually boost energy and impact a number of metabolic syndrome factors.
“Exercise reverses insulin resistance, even when it doesn’t lead to weight loss,” says Scott Isaacs, MD, of the Intelligent Health Center in Atlanta, Georgia. “It builds muscle, lowers triglyceride levels, and boosts HDL levels.”
“Think in terms of physical activity, not exercise,” adds Isaacs, coauthor of Overcoming Metabolic Syndrome (Addicus, 2006). “You don’t have to run a marathon. I encourage out-of-shape patients to start with a five-minute daily walk, increasing it each week by one minute. I want them to eventually walk 45 minutes a day, five or six days a week.”
Jack Challem, aka The Nutrition Reporter, is the author of several books, including Feed Your Genes Right (Wiley, 2005) and The Inflammation Syndrome (Wiley, 2003).
Conditions Associated with Metabolic Syndrome
* Food cravings
* Inflammatory diseases
* Heart attack
* Sleep apnea
* Cancers of the breast, prostate, and colon
* Polycystic ovary disease (PCOD)
Eating to Beat Metabolic Syndrome
To reverse or prevent metabolic syndrome, you need to emphasize nutrient-dense, quality protein (fish, chicken, eggs), and fiber-rich vegetables (salads, broccoli, cauliflower). You also want to avoid eating empty starches (bread, pasta) and sugary foods (anything tasting sweet). This approach helps stabilize blood sugar and insulin levels. Eggs make for a protein-rich breakfast that will stabilize your blood sugar and leave you less hungry for a day and a half. Free-range “omega-3” eggs are especially good. By following this type of eating plan, your energy levels and overall sense of well being will likely improve in three days—and in many people on the first day. Yes it’s a diet, but you’ll find this plan easier to follow than you might think.
Breakfast | Omelet (2 to 3 eggs) with a filling of sauteed mushrooms and red bell peppers. Blueberries and kiwi fruit on the side. Low-cal “greens” drink made from powdered phytonutrients and green plants.
Lunch | At a restaurant, order a grilled chicken breast without the bun. Ask to substitute steamed vegetables for fries. Iced green or black tea.
Dinner | Salmon fillet seasoned with basil and oregano and pan-fried in extra-virgin olive oil. On the side, grilled vegetables sprinkled with diced garlic sauteed in a bit of olive oil, and three tablespoons of brown rice. Sparkling mineral water with lime wedge.
Breakfast | Scrambled eggs with diced turkey, scallions, and water chestnuts. Melon and berries on the side. Herbal ice tea, such as mint, chamomile, or raspberry leaf.
Lunch | Brown bag tuna salad, made with canola mayonnaise, on a bed of romaine lettuce with a few cherry tomatoes and cucumber slices. Scoop up some of the tuna with a few wheat-free nut crackers. Rooibos iced tea.
Dinner | Baked Cornish game hen rubbed with diced garlic and rosemary. On the side, mushrooms and spinach leaves sauteed in olive oil. Homemade lemonade, made by squeezing juice from one lemon into
a glass of cold water, sweetened with stevia drops.
Breakfast | Breakfast burrito, using a low-carb (3 to 4 grams) whole-wheat tortilla stuffed with scrambled eggs and melted Brie. On the side, mix raspberries into unsweetened Greek yogurt. One cup mild organically grown coffee.
Lunch | Chicken Caesar salad (no croutons). Iced herbal tea.
Dinner | Stir-fry shrimp in extra-virgin olive oil, adding a little pesto when almost done. For a side dish, bake asparagus tips covered with a few onion slices and diced sage. Small amount of purple (or brown) rice. Sparkling water with lemon wedge.
Ten Dietary Principles to Live By
Because metabolic syndrome is a nutritional disease, the most straightforward way to prevent or reverse it is by improving your eating habits. This may call for a wholesale revision of your diet, and that may present a challenge to your willpower. But if you tackle each change a step or two at a time, you’ll find yourself on the way to better health in a few weeks.
1. Emphasize fresh foods and condiments. Fresh is better than frozen, but frozen foods are better than packaged foods (e.g., those sold in boxes, bottles, jars, or bags).
2. Stick with healthy proteins, such as fish, chicken, and turkey. Small amounts of legumes are all right, but they’re high in carbohydrate calories.
3. Eat a lot of high-fiber, nonstarchy vegetables, such as salads, broccoli, cauliflower, and spinach. Similarly, stick to nonstarchy fruits, such as raspberries, blueberries, and kiwi.
4. When cooking, use olive, macadamia, or avocado oils. Occasional use of canola oil is fine.
5. Drink mineral waters and herbal iced teas instead of soft drinks, juices, energy drinks, or alcoholic beverages.
6. Reduce portion sizes. Large amounts of foods, particularly carbohydrates, have a greater impact on glucose tolerance.
7. Limit your intake of whole-grain carbohydrates, but some colored rice (brown, red, or purple) and an occasional yam are probably all right for most people.
8. Avoid foods made with refined sugars and simple carbohydrates, such as white bread, pasta, pizza, sugary soft drinks, and desserts.
9. Avoid corn, soybean, and safflower oils, as well as partially hydrogenated vegetable oils.
10. When snacking include a little protein, such as chicken, hard cheese, or home-made trail mix.
Finally, know that except in severe cases, the cure for metabolic syndrome rests with you and you alone. Your health care provider can help you, but only you can get yourself back on the road to good health.
Diagnosing Metabolic Syndrome
Metabolic syndrome and other blood-sugar disorders frequently go undiagnosed. Frank Shallenberger, MD, says he often treats metabolic syndrome patients who, for inexplicable reasons, had never been diagnosed by endocrinologists or diabetologists. A recent study found that more than half the patients hospitalized for heart problems had glucose intolerance or full-blown diabetes.
Each symptom of metabolic syndrome is associated with an increased risk of diabetes and heart disease. Combined, the risk becomes even higher. You have metabolic syndrome if you have three or more of the following signs:
•A waistline of more than 40 inches if you are a man or 35 inches if you are a woman. (Use a tape measure placed over your belly button. Bear in mind that an estimated 25 percent of thin people also have insulin resistance.)
•Elevated fasting glucose (blood sugar) above 100 mg/dl.
•Fasting insulin levels above 10 mcIU/ml.
•Blood pressure above 140/90 mm Hg.
•Triglyceride above 150 mg/dl.
•LDL (low-density lipoprotein cholesterol) above 130 mg/dl.
•HDL (high-density lipoprotein cholesterol) below 35 mg/dl.