METABOLIC SYNDROME X: THE NEW GLOBAL HEALTH INITIATIVE

A Common Medical Scenario
During a recent doctor’s visit, Mr. Smith was warned about his high blood cholesterol, elevated blood pressure and expanding waistline. He left with dietary guidelines for weight loss, and two prescriptions; one prescription was for a water pill (diuretic) to lower his blood pressure and the other was for an expensive drug to lower his cholesterol (statin). Unfortunately, neither he nor his doctor realized that Mr. Smith is one of approximately 70 million Americans who fall into the diagnostic category of Syndrome X (the metabolic syndrome) – “a hidden pandemic.” Many people have Syndrome X but few get a “diagnosis.” Metabolic Syndrome X represents the most important public health initiative facing Western nations. Syndrome X should be treated through nutrition and lifestyle changes, rather than drugs.

Obesity and Syndrome X
Most people attempt to lose weight for cosmetic reasons, but the real need for weight control is the avoidance of premature death and disability. Many weight loss tactics involve fads or fallacies and most popular weight-control books are gobbledygook. While an expanding waistline is annoying, obesity -related diseases are “deadly.” Obesity has rapidly become the number one preventable cause of early death and illness, especially in the US. Modern medicine has defined groups of diseases or disorders that aggregate together in the overweight individual (e.g. blood pressure or cholesterol problems). Tens of millions of people have a disorder called Metabolic Syndrome X which must be understood by everyone and tackled by “healthy living” practices. Syndrome X is a “hidden epidemic” that is maiming and killing people in an unprecedented manner. This disorder is a common forerunner to Type II diabetes mellitus.

The cardinal components of Syndrome X include obesity, abnormal blood cholesterol or triglycerides, high blood pressure, linked by an underlying resistance to the hormone insulin (Figure 1). Insulin resistance is a key issue in Syndrome X. While insulin is well recognized as a control for blood glucose, it has several far-reaching actions on body metabolism. As a consequence of insulin resistance within Syndrome X, more insulin is secreted by the pancreas to overcome the resistance. Excessive amounts of circulating insulin lead to body changes where more fat is stored (obesity), and signals are given for both blood pressure and cholesterol to rise. You can understand why cholesterol blood pressure and weight gain “hang out” as a team of “bioterrorists.”

Obesity and Syndrome X Related Diseases
While the problems shown in Figure 1 are commonly linked to heart disease, Syndrome X is also emerging as a cause of numerous other conditions and diseases, including: infertility, endocrine disorders, Polycystic Ovary Syndrome, irregular menstruation, acne, liver disease, inflammatory disease, osteoporosis and cancer of the breast, pancreas, womb and colon. Metabolic Syndrome X can now be considered a new unifying concept to explain the occurrence of so many common diseases. I have coined the term, Syndrome X, Y and Z to show how many medical problems get “lumped together” with Syndrome X. Many people progress from Syndrome X to Type II diabetes and as the nations weight increases, so does the occurrence of Type II diabetes (Figure 2).

Furthermore, I talk about “obesitis” because of the common occurrence together of obesity and inflammation.

Syndrome X is caused by hereditary tendencies, linked to adverse lifestyle, especially poor nutrition and lack of physical exercise. Excessive dietary intake of refined carbohydrates, made worse by an excessive intake of saturated fat and salt and a deficiency of omega 3 fatty acids, all contribute. So syndrome X appears to be part of our body’s metabolic evolution to our “advanced” Western lifestyle and Standard American Diet (SAD).

Between the years 1988 and 1994, approximately 47 million adults in US survey has Syndrome X. In January 2002, it was reported by government researchers in the Journal of the American Medical Association that “… it seems unlikely that management of the individual abnormalities of this syndrome provides better outcomes than a more integrated strategy.” These are powerful words, which support the future of the food and dietary supplement industries – not necessarily the pharmaceutical industry – in effective management of Syndrome X and its common consequences of Type II diabetes.

Obesity or Overweight (200 Million Americans)

Metabolic Syndrome X or Pre-diabetes (70 Million Americans)

Type II Diabetes Mellitus (20 Million+ Americans)

Managing Obesity and Syndrome X
Successful, sustained weight control involves a balanced, calorie-controlled diet, behavior modification and exercise that can be assisted by evidence-based dietary supplements. Key nutritional factors for Syndrome X contain extracts of soluble oat fiber with antioxidants and essential nutrients, such as chromium. Table 2 highlights dietary supplements that may be valuable in the nutraceutical support of Syndrome X.

NUTRITIONAL FACTORS FOR SYNDROME X

FACTOR THERAPEUTIC EFFECTS
Soluble fiber e.g. oat beta glucan
Soluble fiber reduces post-prandial blood glucose, reduces blood cholesterol, improves glucose tolerance, regulates bowel function, primes the immune system, probably by a prebiotic effect. In addition, soluble fiber promotes satiety and it has other intrinsic metabolic effects. Plays a pivotal role in nutritional management of syndrome X and weight control, especially in children.

Soy Protein (25 g/day)
Soy protein reduces blood cholesterol and its isoflavone content may reduce platelet “stickiness” and exert valuable antioxidant functions. Value of vegetable protein rotation in diets. Soy has many other health benefits and it is an ideal dietary substrate for use in diabetes mellitus and syndrome X. Soy is not toxic.

Omega 3 fatty acids (EPA)
Omega 3 fatty acids are best taken in fish oil concentrates, high in EPA, presented in enteric coated capsules for greater compliance and bioavailability. Plant precursors of omega 3 fatty acids (e.g. flaxseed oils, walnut oils, macadamia etc. are not reliable sources of active fatty acids). Fish oil sensitizes insulin by acting on PPAR receptors and it has multiple health benefits including: cardiovascular benefits, anti-inflammatory actions etc. Chromium Several studies imply that chromium in various forms may assist in blood cholesterol reduction, weight control and they may sensitize the actions of insulin.

Alpha lipoic acid
A powerful anti-oxidant which plays a specific role in combat against advanced glycation end-products (AGES), with possible reduction in tissue complications in states of dysglycemia. Has a specific insulin sensitizing role, but should not be given by parenteral administration.

Vanadium
An insulin sensitizer of variable value.

Antioxidants
Including but not limited to anthocyanadins, ellagic acid, turmeric, bioflavonoids, direct or indirect anti-oxidant vitamins or minerals e.g. Vitamin E, C, A, selenium, zinc etc. Anti-oxidants are often misused and mis-formulated. Anti-oxidants should be given with REDOX balance to access all body tissues, hydrophilic and lipophilic properties. Single high dose antioxidants are best avoided, especially by unopposed intravenous administration.

Starch blockers
and fat blockers White kidney bean extract, soluble fiber, chitin of variable value.

Cinnamon An insulin mimetic.
Maitake Weak insulin sensitizing effect with both whole mushroom powder and fractions. Not a stand-alone weight control or syndrome X nutritional factor. Green coffee bean extract Polyphenols e.g. chlorogenic acid assists in correction of dysglycemia, with specific effects on hepatic glucose synthesis. Green tea Very potent antioxidant with widespread health benefits, including effects on glucose metabolism. Distinguished content of catechins, especially EGCG.

Hoodia gordonii
Proposed as a non-stimulant appetite suppressant due to its content of steroidal glycosides.

Exercise and a diet low in simple sugars also provide the nutritional support necessary to potentially prevent and manage Syndrome X. Several non-stimulant weight control supplements have adjunctive roles in Syndrome X management. Seaweeds contain fucoxanthin that has desirable effects on body metabolism in Syndrome X; and Hoodia gordonii may help control appetite and calorie intake.

Conclusion
The best initial approach to combating Syndrome X and obesity in many mature people may be simple and gentle remedies of natural origin, rather than drugs. If you or you loved ones are overweight, decide if they have Syndrome X? The nation must get serious about weight control and combat Syndrome X.

References
1. Holt S, Combat Syndrome X, Y and Z, Wellness Publishing, Little Falls, NJ, 2002
2. Holt S, Enhancing Low Carb Diets, Wellness Publishing, Little Falls, NJ, 2004
3. Holt S, Wright J, Syndrome X Nutritional Factors, Wellness Publishing, Newark NJ, 2003

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