Heart disease - Syndrome X: The next epidemic?

The metabolic syndrome, which is sometimes called syndrome X or insulin resistance syndrome, is now a recognized disease. It actually includes a combination of disturbances that are primarily caused by excess weight.

WHAT IS THE METABOLIC SYNDROME?

The metabolic syndrome, which is sometimes called syndrome X or insulin resistance syndrome, is now a recognized disease. It actually includes a combination of disturbances that are primarily caused by excess weight. Individuals are said to have the metabolic syndrome when they have at least three of the following risk factors:

1. Abdominal obesity: waist circumference greater than 102 cm (40 inches) for men and 88 cm (35 inches) for women 2. Insulin resistance: fasting glucose (blood sugar level) above 6.1 mmol/L 3. Elevated triglyceride levels: above 1.69 mmol/L 4. Low levels of HDL cholesterol (“good” cholesterol): below 1.04 mmol/L for men and 1.29 mmol/L for women 5. High blood pressure: above 130/85 Hg.

Individuals with the metabolic syndrome are often not identified by healthcare professionals, since they don’t appear to have a problem when we look at each risk factor individually: in each case, they are in a grey zone that does not necessarily require medical intervention.

Excess weight appears to be the main culprit. People generally consume too many calories and do not burn enough of them, which leads to excess weight. The human body was not designed for sitting at a desk eight hours a day! It still requires that we be very physically active, but our lifestyle is making that increasingly difficult.

IS THE METABOLIC SYNDROME DANGEROUS?

Abdominal obesity: The fat accumulated around our midsection alters the way our bodies process fats. Abdominal fat produces and releases free fatty acids, which contribute to increasing blood pressure. They also promote the formation of blood clots that can block blood vessels and impede the work of insulin. These disturbances increase the risk of developing diabetes and of having a stroke or heart attack (infarct).

Insulin resistance: Insulin is a substance that is produced by the pancreas. It can be compared to a key that can open the doors of cells to let sugar enter from the bloodstream. In other words, it allows our cells to use the sugar in our blood as a fuel.

Insulin resistance appears when cells become insensitive to the action of insulin. Normally sufficient quantities of insulin are no longer able to let sugar enter the cells. The body therefore reacts by producing more insulin. Over time, the cells respond less and less to insulin, so sugar accumulates in the blood. Often, insulin resistance evolves into type 2 diabetes, a chronic disease that can lead to serious complications like heart or vision problems, kidney failure and even amputation.

Elevated triglyceride levels: Triglycerides are fatty particles that circulate in the bloodstream and that are stockpiled in certain types of tissue. They make up the body’s main energy reserves. Having too many triglycerides circulating is known to be damaging and predisposes us to cardiovascular disease. Elevated levels of triglycerides in the blood are usually due to poor management of diabetes, excessive alcohol and sugar intake, and excess body weight.

Low levels of HDL cholesterol: Abdominal obesity tends to lower our levels of HDL cholesterol, which is the “good” cholesterol. HDL cholesterol seems to have a protective effect against cardiovascular disease, but only if there is enough of it in the blood, i.e. more than 1.0 mmol/L for men and 1.3 mmol/L for women.

High blood pressure: The metabolic syndrome disturbances are damaging to our blood vessels, because they contribute to making the blood vessel walls rigid. As a result, the blood does not circulate as well and the heart needs to work harder. High blood pressure is very dangerous for the whole body and is associated with many diseases, including certain heart diseases, strokes and kidney failure.

Blood clot formation: The metabolic syndrome disturbances also lead to the formation of blood clots that can block blood vessels and thus cause heart attacks and strokes.

A SERIOUS SOCIETAL PROBLEM

It is currently estimated that 20 to 30 percent of adults in the western world suffer from the metabolic syndrome. Unfortunately, many of them are unaware of that fact. This growing disease has serious consequences: it can double or even triple the risk of having a cardiovascular event such as a heart attack or a stroke.

The metabolic syndrome is also not sparing the younger population. Studies show that nearly a third of overweight adolescents are affected.

HOW CAN WE REDUCE THE RISKS OF COMPLICATIONS ASSOCIATED WITH THE METABOLIC SYNDROME?

Since excess weight is the leading cause of this disease, the cornerstone of treatment is to lose weight. Losing even a small amount of weight (5 to 10 percent of the initial body weight) can have beneficial effects on all metabolic syndrome complications. Among other things, it can help increase HDL (“good”) cholesterol levels, while decreasing triglyceride levels, blood pressure and insulin resistance.

By making certain lifestyle changes, excess weight can be lost for good, which greatly improves health.

Healthy eating The best way to achieve and maintain a healthy body weight is to eat well. The key is to increase your consumption of fruit, vegetables and whole grain products. Another element is to favour fish, poultry and low-fat milk products. You should also reduce your saturated fat and trans fat intake to a minimum. Instead, opt for polyunsaturated fats, which are found in olive and canola oils, for example. Learn to read the Nutrition Facts on prepared foods; you might sometimes be surprised at what these foods contain.

Drink alcohol in moderation, as it can increase triglyceride levels when consumed in excess. The recommended upper limit is 9 drinks per week for women and 14 drinks per week for men.

Physical activity Physical activity is just as important as a healthy diet. It has beneficial effects on every metabolic syndrome component and helps keep weight off in the long term.

No need to become an athlete! Instead, learn to keep moving: take your dog for a walk, take the stairs rather than the elevator, park your car a little further, get off the bus a stop early and walk the rest of the way… Find activities you enjoy and integrate them into your daily routine.

There is no magic formula for losing weight. Excess calories don’t just disappear – they accumulate and lead to weight gain. The only way to lose weight is to burn more calories than you consume. Changes to your diet must therefore be combined with an increase in your physical activity level in order to result in weight loss.

Smoking Smoking worsens the problems associated with the metabolic syndrome. It makes blood vessel walls more fragile, which exposes smokers to a greater risk of heart attack, stroke, angina and atherosclerosis. Quitting smoking is always beneficial to your health, no matter how many cigarettes a day you smoke or the number of years you have been smoking.

It’s never too late to make lifestyle changes. Everyone can benefit, no matter what their age or health status. However, if you wish to make several changes to your lifestyle, do it gradually, one aspect at a time. If you make too many changes at once, you may get discouraged. In addition, if you suffer from a chronic illness, speak to your healthcare professionals before making these changes. They can help you determine which changes will be the most beneficial and appropriate to your health status.

Give yourself a gift this year: take your health in hand!

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