Metabolic Syndrome: Focus on the Underlying Culprit
Metabolic Syndrome has been written about and talked about for the last 25 years or so as the next public health crisis. This article is intended to get the attention of those who, after all these years, are unaware of it’s existence and what it may very well mean to their own personal health. First, a clear definition of Metabolic Syndrome, second, some data regarding it’s prevalence and the diseases that are associated with it, third some statistics on the leading causes of death in the United States and lastly a look at what might be considered the common link to metabolic syndrome diseases.
Metabolic Syndrome was previously coined “Syndrome X” back in the late 1980’s. It is still defined as a syndrome of diseases, but is now more clearly defined as metabolic in nature. There are at least 2 bona fide sets of criteria set forth by two separate organizations that define the presence of Metabolic Syndrome. One organization is the National Cholesterol Education Program (NCEP) and the other is the World Health Organization (WHO). According to the definition used by NCEP, at least 3 of these must be present 1) fasting glucose of 110mg/dL or greater, 2) waist girth of greater than 94 cm (37.6 in.), 3) serum triglycerides 150mg/DL or greater, 4) serum HDL 40 or less, and 5) blood pressure greater than 130/85.
According to the Third National Health and Nutrition Examination Survey: 1988-1994, 47 million U.S. adults had metabolic syndrome. The classic diseases of Metabolic Syndrome are: Type II Diabetes, Hypertension, Coronary Heart Disease (CHD), Dyslipidemia (i.e. reduced HDL, elevated cholesterol, triglycerides and bad cholesterol), and Obesity. The top 5 leading causes of death in the United States for the year 2000 are: 1. Cardiovascular Disease 2. Cancer, 3. Chronic Lung Disease (for both men and women), 4. Accidents and Alzheimer’s Disease for men and women respectively, 5. Type II Diabetes and Influenza and Pneumonia for men and women respectively. The percentage of deaths cited for each category revealed that approximately 64% of these total deaths were related to Metabolic Syndrome. A closer look at the classic diseases associated with metabolic syndrome (Type II Diabetes, Hypertension, CHD, Dyslipidemia and Obesity) reveals the existence of a common physiological dysfunction in the body called insulin resistance.
Insulin is a hormone that is released from our pancreas when we consume food. It’s job is to cause glucose, the sugar in our blood, to be taken up into the muscles so they can get energy to work. Insulin resistance occurs when the skeletal muscles of the body “resist” or no longer respond to the insulin that is present in the blood stream. Why does insulin resistance occur? It can occur in a few different ways, but one in particular is the over consumption of foods that have a higher tendency to raise the blood sugar level (i.e. processed foods) or foods that have a high glycemic load. The actual scenario is quite complicated, but it suffices to say that if the body is bombarded with these types of foods repeatedly, more and more insulin will be released. If the muscles continue to encounter high levels of insulin, they eventually loose their responsiveness. When this happens the blood sugar levels rise causing the pancreas to release even more insulin to get the blood sugar down. If this scenario continues, over time it will require more and more insulin to do the same job of getting the glucose out of the blood and into the muscle. Although beyond the scope of this paper, be aware that there are a whole host of other events that occur due to this hormonal dysfunction.
How does this scenario of high consumption of high glycemic load foods and high circulating insulin impact Metabolic Syndrome? Again, the classic diseases of Metabolic Syndrome all have some association with insulin resistance. For example, high glycemic load carbohydrates reduce HDL and elevate triglycerides and bad cholesterol. They also cause elevated insulin levels which causes fat storage leading to obesity. Insulin resistance is also associated with worsened hypertension and decreased insulin sensitivity in diabetics. The classic diseases of Metabolic Syndrome do have both genetic and environmental causes, however, the over consumption of high glycemic load foods have a major impact on the development of insulin resistance and thereby the development of Metabolic Syndrome.
There is additional research available that seems to suggest that there are a host of other diseases or health issues that are related to insulin resistance. The fact that it is associated with the diseases that are the leading causes of death give us quite a bit to deal with already. What solutions can be implemented? The simplest on paper is to make dietary interventions. First, in order for positive change to take place, a dramatic decrease in the consumption of processed foods must occur. In other words, remove the offender. Next, is to significantly increase the intake of fruits and vegetables. Most fruits and vegetables have a relatively low glycemic load. There are also a number of nutraceuticals that have profound effects on improving blood sugar and insulin responsiveness such as chromium, alpha lipoic acid and omega 3 fatty acids; and don’t forget exercise. There are a number of books and articles written on various aspects of this subject. In particular are Syndrome X : The Complete Nutritional Program to Prevent and Reverse Insulin Resistance and The Glycemic Load Jack Challem etal
SPICE RACK: "CINNAMON"
If you haven't heard already, cinnamon is being touted by many as a very effective natural agent to lower blood sugar. Researchers in Maryland were very surprised to find that apple pie, spiked with cinnamon, actually lowered blood sugar instead of the raising blood sugar as they had anticipated. In 2003, the researchers conducted a study on a small group of 60 patients in Pakistan. These were all long term diabetics being treated with insulin lowering medication. None of the patients were on insulin. Each patient received from 1/2 to less than 2 teaspoons of cinnamon per day over a 40 day period. The results showed a lower blood sugar level, better insulin production and a lowering of the blood cholesterol. These effects were continuous even 20 days after the cinnamon treatment had ended. The blood sugar was decreased by 18 to 29 percent. These results were published in Diabetes Care in 2003. A number of people have begun to use cinnamon spice or the extract to control blood sugar. This is potentially great news for the many sufferers of Type II Diabetics and for those with Metabolic Syndrome and Obesity. It is not surprising to hear of persons experiencing loss of abdominal fat with the addition of cinnamon due to its insulin effects. Due to cinnamon's potential ability to significantly effect blood sugar, a primary healthcare practitioner should be consulted prior to its use if on glucose lowering medications. The dose of glucose lowering medications may very well require adjustments. Cinnamon can be added to baked fruits, tea, or sprinkled on cereal. It is also available as a supplement. Make sure the spice is fresh and always make sure your supplement source is documented pure and shown to be effective.
STAR NUTRIENT: "ZINC"
Zinc 30 Zn 65.409(4)
The Function of Zinc in the Body: Who Needs It the Most?
Pure zinc exists as a bluish-white metal. It’s essentiality in plants and animals was recognized as far back as 1839 and 1934 respectively. But, in humans, the likelihood that zinc deficiency could occur was not known until about 1956. Zinc is present in all organs, tissues, fluids and secretions of the body. It is primarily found inside the cells. Zinc is absorbed primarily along the small intestine. Other minerals such as iron and calcium can interfere with its absorption, however, the calcium interaction seems to be insignificant. Large doses of zinc can interfere with copper absorption, but not vice versa. Large doses of zinc should be balanced with copper supplementation. The dietary intake of zinc will vary greatly depending on food choices. Zinc has been reported to be involved in over 300 enzymatic reactions, however, this discussion will be limited to a select few with a particular focus on deficiencies and specific physiological functions.
Zinc deficiencies in Humans: Mild zinc deficiencies can impair the velocity (growth rate) in children. Various studies on growth-retarded children, zinc supplementation increased the mean height and height-for-age percentile
Severe deficiencies in Humans: Severe zinc deficiencies have been seen in patients with acrodermatitis enteropathica (AE), in patients fed intraveneously with solutions lacking in zinc and in experimental cases. See Table 1 for a list of clinical signs and symptoms of zinc deficiency.
Clinical Manifestations of Severe Human Zinc Deficiency
Growth Retardation Night blindness Delayed sexual maturation and impotence Impaired taste and smell Alopecia Delayed healing of wounds, burns and decubitus ulcers Skin lesion Impaired appetite and food intake Immune deficiencies Eye lesions, including photophobia and lack of dark Behavioral disturbances adaptation
The occurrence of isolated zinc deficiency in normal healthy individuals is unlikely to occur because of the remarkable ability of individuals to reduce zinc losses and to reestablish a balance with the dietary supply is low. However, infants, children, pregnant and lactating women have a greater potential for developing a deficiency if the dietary intake is low. Old age, malabsorptive disorders, alcoholism, diabetes, and AIDS are also considered high risk conditions for zinc deficiency. In developing countries, zinc deficiency is ranked the 5th leading risk factor in causing disease, especially diarrhea and pneumonia in children. Lukaske, a physiologist, reported that low levels of zinc causes carbon dioxide to back up all the way to the muscles causing decreased efficiency during exercise.
Functions of Zinc in the Body: Some of the important functions of zinc are: • Growth development • Protection of the prostate from infection and enlargement • Increased sperm count • Improve taste and smell • Improve PMS symptoms • Improve skin, hair and nails • Increase immune system function (decrease severity of cold symptoms) • Accelerate wound healing • Functional role in carbohydrate metabolism • Anemia
Zinc is found in common over-the-counter preparations such as skin protectants in the form of zinc oxide used for diaper rash, sun burn, poison ivy and blisters. Zinc is an important ingredient in supplements designed for the eyes. It can be helpful in protection from cataracts, night blindness and age-related macular degeneration. The prostate is a rich reservoir for zinc stores as it is a primary nutrient required for a healthy prostate. Zinc lozenges is one of the preparations designed to help minimize cold symptoms when taken at the first sign of a cold.
Sources of Zinc: The highest sources of zinc can be found in red meat, poultry, fish, and seafood with oysters containing perhaps the highest content (about 5 times higher than meat). Other sources include whole cereals, dairy, and nuts. Ingestion of grains tend to decrease the absorption of zinc due to its fiber and phytate content. So vegetarians may be at risk for low zinc levels and may need to supplement their diet.
Dosages and Daily requirements: Males 15mg/day Females 12mg/day Infants 5mg/day Children 10mg Pregnancy 15mg/day Lactation 16mg/day
Supplementing with zinc usually ranges between 15mg – 25mg per day. A dose of 40mg is considered the upper limit for adults. However, doses of 50mg or more have been used for prostate enlargement. Supplementing with higher doses should only be done under the supervision of a physician. Higher doses may cause nausea, vomiting and cramps. Other adverse effects include headache, metallic taste and drowsiness. Doses larger than 25mg need to be balanced with 1-2mg of copper. Iron supplementation can also interfere with zinc absorption and this might be a problem during pregnancy and lactation. Some experts advise supplementing with zinc if the iron supplementation is greater than 60mg/day.
Evaluation of Zinc Status: Plasma levels of zinc have been used to monitor zinc status in hospitalized patients, however, this method is not reliable in measuring the true zinc status with regard to dietary stores. An often used function taste challenge test is utilized to ascertain the need for zinc based on loss of taste as a sign of deficiency.
SPIRITUAL FOOD
Jesus was and is our example of what we are expected to do with our lives. When he was on the earth he completed what he was sent here to do. He did many other things, but, his WILL or ultimate goal was to complete his Father’s will which was to give his life for mankind. He did miracles, he preached, he prophesied, he taught his disciples and much more. So he had a ministry, he read and taught the Word and lived an exemplary life. But if had had only done those things and not completed the ultimate call on his life he would have failed. It’s interesting that in order to accomplish his mission he encountered many things. He left his position in heaven, he decreased to the level of a man—he actually had to be born into this world, he was humiliated by the very people he came to save, and he died “…even the death on a cross”. We, as God’s children, are also called for a specific and ultimate purpose in this life. We utilize our gifts and talents, we carry out our ministries, we go to church, we give our tithes, we help the poor and widows, we preach in the pulpits and so on. But, before Jesus left the earth he commissioned us to do one thing and that was to preach the gospel of Jesus Christ. Many times we are stuck on the religious things that we do or the good deeds that we carry out. But, if we have left the ultimate goal out of the picture we have missed the boat. So what then should our lives be like? An extrapolation of >< would suggest that because the spirit of God dwells within in us, then wherever we set our feet should be a holy place. What does this mean? The light of Christ should so exude from our lives that anyone we encounter at any place and time should sense the presence of God in us. Jesus literally gave his life—the ultimate expression of love. God has not asked us to that, however, our expression of love which is the giving of the gospel will indeed have the same effect that Jesus had on our lives. How do we accomplish this? Well, he suffered unto death to accomplish his ultimate goal. We only need to sacrifice our lives in the sense that we no longer live to please ourselves but have a willingness to yield our lives for the sake of others. We accomplish this by yielding to the spirit day by day, moment by moment to allow the love of Christ to come through us and touch the lives of others without regard for our own needs, wants or desires. Ultimately they will experience the love of Christ and we can then share the gospel. This may require that we lose our position, possessions, and be jolted from our comfort zone. But that is truly what it’s all about. Our duty in this life is to carry out the great commission out of love for God. For Jesus’ obedience, God promised him that his name would be a name of all names and that every knee would bow to him, whether in heaven, on earth or beneath the earth. Phillipians 2: Who knows what blessings God will bestow upon us as we seek to obey him.
