Abdominal obesity in combination with one or few of the following parameters- elevated blood pressure, low HDL (good cholesterol), high LDL (bad cholesterol), high triglycerides, impaired fasting or elevated blood sugar and a family history of diabetes, is referred to as metabolic syndrome, also called “Syndrome X”. The early stages of metabolic syndrome include weight gain, waist size increase and hypertension. Most of the susceptible people have atleast 2-3 components of the metabolic syndrome and with advancing age they develop into full blown disease, if not addressed.
Simply put, metabolic syndrome is not a disease, rather is a combination of risk factors leading to obesity, diabetes and cardio-vascular disease. Over the last 3 decades, substantial research has been done to explain the root causes and inter-relationships of obesity, diabetes and cardiovascular disease. Dr. Gerald Reaven in 1988 provided the basis for the concept of metabolic syndrome and insulin resistance as its underlying cause.
Being insulin resistant means, the body does not respond to the affects of the given quantity of insulin (the blood glucose regulating hormone), the way a normal body should. This means that your pancreas (insulin secreting glands) need to produce more insulin than normal to control your blood sugars when you eat carbohydrates (sugar or starch) or excessive calories. It results from an excess of insulin in blood (hyperinsulinemia), and resistance to its actions. Hyperinsulinemia and insulin resistance causes a cluster of risk factors including central obesity, abnormal cholesterol levels (high triglycerides, high LDL and low HDL), glucose intolerance, high blood pressure, high uric acid, which predispose individuals to cardio-vascular disease. High uric acid in the blood can lead to gout and certain types of urinary stones, but is not felt as a risk factor for cardio-vascular disease. People with insulin resistance also have a tendency for preferential deposition of fat in abdomen- the “abdominal, or central obesity”. All obese people, to some degree are insulin resistant, however, people with abdominal obesity are far more insulin resistant. It has been shown that poly-cystic ovarian syndrome (PCOS) in women is also an insulin resistant state which results in irregular menstrual periods and infertility.
Besides central obesity, other visible manifestations of metabolic syndrome include darkening & thickening of skin in certain areas ( behind the neck, under arms, thigh folds), skin tags, buffalo hump, abnormal breast development in boys, excessive hair growth in girls and women, to name a few.
A combination of environment and genetic factors act together to cause metabolic syndrome. Obesity, insulin resistance, diabetes and cardio-vascular disease are all about interaction of genes with environment. Although genes are very important in determining metabolic syndrome, however, over the past half century, increased sedentary lifestyle and unlimited access to calories have blossomed the genes of insulin resistance into an epidemic of metabolic syndrome.
Screening for metabolic syndrome is important because of its relationship with cardio-vascular disease, hypertension and diabetes as it increases the risk to suffer a heart attack.
On the more positive side, there is evidence that it can be completely reversed with healthy eating, physical activity and stress management. It could be done by aiming to:
· Achieve or maintain ideal body weight: Balance “in-take” with physical activity or by eating light in the subsequent meals. Consume plenty of whole grains, pulses, nuts, seeds, fruits and vegetables. Limit intake of sweetened beverages and alcohol.
· Eat a healthy & nutrient rich diet providing good calories, include complex carbohydrates, good fat, high quality proteins and fiber. Consume plenty of whole grains, pulses, nuts, seeds, fruits and vegetables. Limit intake of sweetened beverages and alcohol.
· Restrict intake of high calorie, low nutrient, oily, sugary and salty foods (packaged and convenient snacks like biscuits, fried namkeens, burgers, pizzas etc.).
· Shop and snack smart: Choose roasted/ baked snacks, low fat dairy products, fresh fruits and vegetables etc.
· Encourage physical activity: Engage in minimum of 30 minutes to 1 hour of moderate intensity physical activity on most days of the week. Regular physical exercise, besides helping in maintaining good weight, has been shown to improve hypertension, blood lipid levels and insulin resistance.
· Manage your stress: The best time to learn how to manage your stress is before stress strikes you. Being optimistic, regular mediation, deep breathing exercises and yoga are some simple ways to manage our stress.
Lifestyle changes including a low fat diet with restriction of free sugars & refined carbohydrates and regular aerobic exercise can save you many health problems in future.
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