METABOLIC SYNDROME: THE DISEASE OF THE NEW MILLENIUM

We now have a medical term in common usage for the cluster of problems caused by poor diet and obesity: metabolic syndrome. The term has actually been in use in medical research since the mid-1960s, but wasn’t widely recognized or accepted by the medical community until a few years ago.

Metabolic syndrome describes an obese person with central or abdominal obesity (a fat stomach) who also tends to have a poor cholesterol profile, high blood sugar and insulin and the attendant insulin resistance, high blood pressure, and clogged arteries. In other words, diabetes and/or heart disease waiting to happen.

Hormonally, a woman with metabolic syndrome tends to have high androgen (male hormone) levels, high estrogen levels (the fat cells are making estrogen from androgens), high cortisol and low thyroid. In other words, breast cancer waiting to happen.

Men with metabolic syndrome tend to have low testosterone and high estrogen. In other words, prostate problems waiting to happen.

Both men and women with metabolic syndrome are more prone to inflammation, which predisposes one to heart disease, arthritis and headaches.

The Mediterranean Diet

A group of European countries participated in a 12-year study of the effects of a Mediterranean diet and healthy lifestyle on metabolic syndrome symptoms. Associated with that study, a group from Italy recruited people who actually had metabolic syndrome and instructed them to adhere to a Mediterranean diet for about two years. The results of both were published in JAMA in September.

Not surprisingly, the two-year diet researchers concluded that, “A Mediterranean-style diet might be effective in reducing the prevalence of the metabolic syndrome and its cardiovascular disease,” which is a roundabout way of saying that most of the participants were healthier at the end of the study.

The large 12-year study concluded that, “Among individuals aged 70 to 90 years, adherence to a Mediterranean diet and healthful lifestyle is associated with a more than 50% lower rate of all-causes and cause-specific mortality.” In other words those who didn’t smoke, got some exercise, used alcohol in moderation, and ate plenty of whole grains, vegetables, fruits, legumes and olive oil had half the chance of dying as those who didn’t lead a healthy lifestyle. More specifically, those who maintained all four low risk factors had a 65 percent lower death rate.

Insulin, Androgens and Women’s Health

And speaking of metabolic syndrome, one of the key issues addressed in the “…Breast Cancer” book is the role of excess sugar and carbohydrates in setting the stage for breast cancer. A study published in September 2004 in Cancer Epidemiology Biomarkers & Prevention showed that women who ate the most carbohydrates had more than double the risk of breast cancer compared to women who ate the least carbohydrates.

Excess glucose (from sugar and carbohydrates) in the bloodstream, raises insulin levels which increases androgen (male hormone) levels in women. In plain English this means that if you eat excess sugar and carbs you’ll make excess male hormones. This was underscored in a Johns Hopkins study published in the American Journal of Epidemiology in September 2004 which showed that women with metabolic syndrome have high androgen levels.

An aside: This study is particularly interesting because it showed that only excess “free” or bioavailable androgens were strongly associated with metabolic syndrome, which means that conventional blood tests didn’t show this effect. “Free” hormones are what is measured by saliva hormone testing. In the few years before his death, Dr. Lee lobbied hard to get across the point that conventional blood tests of hormone levels are almost meaningless in assessing hormone status because they don’t measure bioavailable hormones.

High insulin and the resulting high androgens are the underlying cause of polycystic ovary syndrome (PCOS) which can cause terrible ovarian pain, PMS and excess hair growth. The typical doctor will give women with PCOS potent diabetes drugs to help control insulin levels, but a much simpler, healthier and more direct solution is to eat differently and get some exercise.