Syndrome X: What It Is and How to Prevent It

What if no one had invented a pill to lower blood pressure? What if there was no medication for type 2 diabetes? Perhaps we’d be less cavalier about our health, and take prevention much more seriously.

Nearly 50 million Americans have a cluster of symptoms known as metabolic syndrome. The syndrome appears mostly in adults, but even some schoolchildren (as many as one in eight) are now displaying symptoms. The good news is, if you or someone you know has these symptoms, there is hope! Hundreds of my clients have lost weight and significantly lowered their cholesterol, triglycerides, and blood pressure simply by changing their lifestyles.

The National Cholesterol Education Program defines metabolic syndrome, also known as syndrome X or insulin resistance syndrome, as the presence of three or more of the following symptoms:

• Waist size greater than 35 (women) or 40 inches (men). In the presence of a genetic predisposition (indicated by Hispanic or Asian descent or a family history of diabetes), waist size greater than 31 (women) or 37 inches (men).
• Triglycerides equal to or greater than 150, or use of triglyceride medication
• HDL equal to or less than 40 (men) or 50 (women), or use of cholesterol medication
• Blood pressure equal to or greater than 130/85, or use of blood pressure medication
• Fasting blood sugar equal to or greater than 100, or use of blood sugar medication

Having only one of these symptoms doesn’t indicate metabolic syndrome; however, the more of them you have, the greater your risk of heart disease, stroke and diabetes. If you have at least one of these symptoms, such as high blood pressure or an apple-shaped body, visit your doctor; you may have others as well and not realize it.

What’s the correlation between these varied symptoms? Here’s a (very) basic physiology lesson: Your digestive system breaks your food down into sugar, or glucose, which your cells need for energy in order to perform the most basic functions. As glucose is released into the bloodstream, your pancreas produces insulin which acts like a key to let the glucose into your cells. If you are insulin resistant, your cells don’t respond to insulin the way they should and the glucose can’t get in. Your pancreas doesn’t understand this, however, so it simply produces more insulin. High levels of both blood sugar and insulin in the bloodstream are problematic; even a slightly high blood sugar interferes with your body’s normal functioning. Too much insulin, a storage hormone, elevates triglycerides and cholesterol levels and makes weight loss difficult. It also affects kidney function, in turn raising blood pressure. Combined, these conditions seriously increase your risk of heart disease, stroke and diabetes.

Metabolic syndrome is still not completely understood on a molecular level so it’s difficult to say what causes the cluster of symptoms. Race and age may play a role; Hispanics and Asians seem to be more susceptible, as are people in their 60s versus those in their 20s. There also appears to be a correlation between polycystic ovary syndrome and the risk for metabolic syndrome. Ironically, some blood pressure medications can decrease insulin sensitivity. Those with a history of diabetes during pregnancy or a family history of type 2 diabetes are also at greater risk. However, while a genetic component may exist, remember that heredity may load the gun, but lifestyle pulls the trigger!

Physical inactivity, a high fat diet and obesity activate any pre-existing genetic predispositions, and in fact may cause the syndrome in individuals without a genetic predisposition.

Thus, make lifestyle change the first line of treatment. If you have been diagnosed or suspect you may have the syndrome, address your individual symptoms. Conveniently, the same lifestyle changes that work for weight loss will help you lower your blood pressure and triglycerides, raise your HDL, control your blood sugar, and prevent metabolic syndrome from developing in the first place.

• Get at least 30 minutes of vigorous aerobic activity five to seven days per week.
• Eat whole foods, primarily vegetables, fruits, beans and whole grains.
• Eliminate added salt.
•  Avoid processed and fried foods, the primary sources of trans fats.
• Eliminate or strictly limit saturated fat and cholesterol, found exclusively in meat and dairy products.
• And if you smoke, stop.

Don’t underestimate these lifestyle changes in importance or effectiveness! The best way to reduce insulin resistance is through weight loss and increased physical activity. Don’t use medication as an easy out; tell your doctor you’d like it to be a last resort, then go home and take your lifestyle change seriously.