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Have you fallen into metabolic syndrome?



Imagine how our ancestors used to live hundreds of thousands or even millions of years ago. They ate meat, vegetables, fruits, seeds and whatever they could find. There was not much sugar around and no processed foods. Food was not always available.

They would go through periods of food abundance and periods of food scarcity. In periods of food abundance, excess calories were stored in the form of fat to be used in periods of food scarcity. They used to move constantly to find food and look for better places to live. Entertainment didn’t mean to sit down in front of a screen. It probably meant running around. Our genes and metabolism evolved and adapted to be able to maintain metabolic equilibrium (homeostasis) in that type of environment.

We don’t really know exactly how our ancestors used to live but that picture sounds reasonable, doesn’t it? Compare that environment with the way we live now in most modern societies. We have food available 24 hours a day and this food is highly processed with a high sugar content. We move very little and enjoy our sedentary lifestyles in front of screens (in fact I’m writing this in front of a screen and you are probably reading it in front of another screen). The environment in which we live now has changed very quickly and our genes have not been able to keep up with these changes. In our current high-sugar sedentary lifestyles our metabolisms are not able to maintain equilibrium in the long term. When metabolic equilibrium is lost, we fall into metabolic syndrome.

What exactly is metabolic syndrome? We actually don’t know what it is exactly. But we have a pretty good idea. First proposed in 1988 by Gerald Reaven [1], different organisations have provided further definitions of metabolic syndrome and they all agree that metabolic syndrome occurs when a person shows several of these risk factors [2, 3]:

  • Overweight/obesity, particularly fat deposits in the abdominal region
  • High triglycerides
  • Low “good” HDL cholesterol
  • High blood pressure
  • Some form of impaired glucose metabolism (high fasting glucose, glucose intolerance, insulin resistance)

Metabolic syndrome is not a disease. Having several or all of these risk factors doesn’t mean that one is sick…yet. Although metabolic syndrome is not a disease, people with metabolic syndrome have higher risk of type 2 diabetes (T2D), cardiovascular disease (CVD), and other complications [4]. There is no agreement as to what is the initial cause that leads to metabolic syndrome, whether one first puts on weight which leads to insulin resistance, or one first becomes insulin resistant which leads to putting on weight [3]. Other theories are that high fructose consumption starts all the metabolic trouble [5]. In addition, other factors have also been acknowledged as increasing the risk such as family history of T2D or CVD, age, and ethnicity [2]. 

The good news is that because you are not yet sick (unless you already have T2D), you can revert to metabolic equilibrium with changes in lifestyle. The bad news is that because you are not yet sick, you think you are fine and there is no need to change anything. In fact, several animals go into high food consumption and low energy expenditure states, which are comparable to the metabolic syndrome, when they have abundance of food available and are preparing for hibernation or long migratory flights in birds [6]. The difference is that while their environment changes, food becomes scarce and they revert back to metabolic equilibrium, our environment stays the same (we keep preparing for a food scarcity period that never happens). In that case our only way to get out of metabolic syndrome, or prevent it, is by consciously changing our lifestyle. This means eating a healthy diet and exercising so our metabolism stops thinking that it’s time to eat lots and conserve energy and goes back to metabolic equilibrium. This is not easy to do as shown by the fact that different statistics suggest that about one third of the adult population has the metabolic syndrome with some regions being affected more than others [2, 3]. But it can be done. In addition, there are some supplements and certain types of food that can support a healthy lifestyle. But that’s a topic for another article. In the meanwhile, think about this. Are you falling or have you fallen into metabolic syndrome? What changes can you do to your lifestyle to get out of it?

[1] G. M. Reaven, “Role of Insulin Resistance in Human Disease (Syndrome X): An Expanded Definition,” Annu. Rev. Med., vol. 44, pp. 121–131, 1993.

[2] S. M. Grundy, H. B. Brewer, J. I. Cleeman, S. C. Smith, and C. Lenfant, “Definition of Metabolic Syndrome: Report of the National Heart, Lung, and Blood Institute/American Heart Association Conference on Scientific Issues Related to Definition,” Circulation, vol. 109, pp. 433–438, 2004.

[3] M. A. Cornier, D. Dabelea, T. L. Hernandez, R. C. Lindstrom, A. J. Steig, N. R. Stob, R. E. Van Pelt, H. Wang, and R. H. Eckel, “The metabolic syndrome,” Endocr. Rev., vol. 29, no. January, pp. 777–822, 2008.

[4] K. G. M. M. Alberti, R. H. Eckel, S. M. Grundy, P. Z. Zimmet, J. I. Cleeman, K. a. Donato, J. C. Fruchart, W. P. T. James, C. M. Loria, and S. C. Smith, “Harmonizing the metabolic syndrome: A joint interim statement of the international diabetes federation task force on epidemiology and prevention; National heart, lung, and blood institute; American heart association; World heart federation; International atherosclerosis society; And international association for the study of obesity,” Circulation, vol. 120, pp. 1640–1645, 2009.

[5] R. J. Johnson, M. S. Segal, Y. Sautin, T. Nakagawa, D. I. Feig, D.-H. Kang, M. S. Gersch, S. Benner, and L. G. Sánchez-Lozada, “Potential role of sugar (fructose) in the epidemic of hypertension, obesity and the metabolic syndrome, diabetes, kidney disease, and cardiovascular disease.,” Am. J. Clin. Nutr., vol. 86, pp. 899–906, 2007.

[6] R. J. Johnson, P. Stenvinkel, S. L. Martin, A. Jani, L. G. Sánchez-Lozada, J. O. Hill, and M. A. Lanaspa, “Redefining metabolic syndrome as a fat storage condition based on studies of comparative physiology,” Obesity, vol. 21, pp. 659–64, 2013.   

By Dr Pablo German