Metabolic syndrome shows in your waistline

By Bryant Stamford
Gannett News Service

The key element of metabolic syndrome, or prediabetes, is an expanding waistline. Gannett News Service

Metabolic syndrome also is often referred to as prediabetes, because if not corrected, it can and often does result in type 2 (maturity onset) diabetes.

The key element is an expanding waistline — abdominal fat, which causes the body to resist the effects of insulin. Insulin is a hormone produced in the pancreas that escorts sugar (glucose) into the body's cells. Without insulin, glucose would accumulate in the bloodstream. The chronic condition of too much glucose in the blood is called diabetes.

When there is insulin-resistance, insulin is ineffective and glucose cannot enter the cells. This causes a backlash. The pancreas produces and releases an increased volume of insulin in an attempt to overwhelm the resistance.

While this might seem like an effective way of coping with the problem, it's not. Too much insulin enters the blood, and it causes a different set of health problems that ultimately lead to high blood pressure and increased clogging of the arteries.

With more than 60 percent of the U.S. population considered to be overweight, it's not surprising that an estimated 47 million Americans have metabolic syndrome.

Experts estimate that at least half of all Americans over age 60, and one-third between 40 and 60, have metabolic syndrome. The incidence among children and adolescents, once unheard of, is at approximately 5 percent and growing.

Metabolic syndrome is not easy to diagnose because there is not one definitive test.

Rather, there is a cluster of characteristics involved, and none of them jump out as alarming. In fact, most of them fall into what is considered the "normal range."

For this reason, metabolic syndrome frequently is overlooked during a physical examination, unless the physician is specifically looking for it and puts the pieces of the puzzle together.

There are five established characteristics. If you have at least three of these, you have met the diagnostic criteria for metabolic syndrome. Each characteristic taken separately would not raise a red flag, and most would be viewed as pretty common.

• Waist circumference — greater than 40 inches in men, and greater than 35 inches in women.
• HDL-C in the blood — less than 40 milligrams per deciliter in men, and less than 50 milligrams per deciliter in women.
• Triglycerides (fasting) in the blood — 150 milligrams per deciliter or greater.
• Blood glucose (fasting) — 110 milligrams per deciliter or greater.
• Blood pressure — 130/85 and up.

Is there a genetic link at work here? Hard to say, but typically there is some genetic influence in most of the diseases that attack us.

This doesn't mean that we inherit them directly. Rather, we might have a genetic background that favors development of metabolic syndrome. But even if there is a significant genetic link, odds are good that if you follow a healthy lifestyle, you can offset such a link.

Prevention works

Ironically, although it is one of the most lethal assaults on the health of Americans, metabolic syndrome is one of the most responsive to preventive health measures.

The starting point is reducing the waistline. This should be done through a combination of a healthy low-fat and low-sugar diet and exercise.

Exercise is especially important, because it increases the sensitivity of the cells to the effects of insulin. Exercise works in direct opposition to the effects of metabolic syndrome.

Reducing the waistline should produce a graded effect. This means you don't have to wait until you have lost lots of pounds and inches before seeing improvement in your health profile. You may see immediate improvement before losing any weight, when you begin an exercise program and alter your diet.

Reducing the intake of simple sugars often brings about a dramatic change in those suffering from metabolic syndrome.

A good rule of thumb for detecting simple sugars is to look for fiber. If there is no fiber content, the food is likely to be a processed simple sugar. The reason you want to avoid simple sugars is obvious. Insulin-resistance means you cannot cope with sugar in the bloodstream. The more you take in, and the more quickly it enters the blood (a characteristic of simple sugar), the bigger the challenge to the system.

White-flour products also produce a similar effect and are best avoided.

Complex carbohydrates such as whole grains, vegetables, legumes and beans do not create the same insulin challenge as simple sugars, and therefore they should not, as some diet gurus suggest, be avoided.