Reversing Metabolic SyndromeDr. Zoltan P. Rona, MD, M.Sc. June 1, 2015
How to Get Off the Slippery Slope to Type II Diabetes
Approximately 75 million people in North America suffer from Metabolic Syndrome (aka Syndrome X or insulin resistance syndrome), defined by the Mayo Clinic as “a cluster of conditions – increased blood pressure, a high blood sugar level, excess body fat around the waist and abnormal cholesterol levels – that occur together, increasing the risk of heart disease, stroke and diabetes.” High blood levels of triglycerides are also seen in many cases.
It is estimated that four out of 10 people between the ages of 60 and 70 are suffering from some degree of Metabolic Syndrome.
Causes of Metabolic Syndrome
The two main causes appear to be an inflammatory diet and sedentary lifestyle (especially prolonged sitting). There also appears to be a genetic component. Some studies indicate that about 40% of first heart attack victims suffered from metabolic syndrome or Type II diabetes but were unaware of having these.
In regards to diet, studies have shown that people with metabolic syndrome have a great deal of difficulty digesting and metabolizing carbohydrates as fuel for the body. As a result, dietary carbs tend to get stored as fat, mainly around the middle of the body. So whenever abdominal obesity is present, it indicates stored visceral fat caused by carbohydrates that have not been well metabolized.
The biggest but most unsuspected culprits in the diet include breads, pastas, and cereals. Of course, sweets – especially those containing high fructose corn syrup and trans fats – can also be causative. With regular consumption of these items, insulin resistance develops and, in fact, blood insulin levels may become higher than normal in the early stages of metabolic syndrome.
Eventually, the pancreas becomes weaker and insulin production goes lower than normal. Instead of glucose being converted into energy, it gets converted into fats and these in turn are deposited in the liver and the abdominal fat cells. At least 40 million people in North America today suffer from fatty liver disease (NAFLD = non-alcoholic fatty liver disease).
The next stage is that blood sugar levels can become chronically elevated which in turn sets the stage for Type II (adult onset) diabetes. Chronic inflammation is also part of this syndrome and eventually cortisol levels go high in response. If cortisol remains chronically elevated, it leads to obesity and damage to cells, tissues and organs.
As blood glucose levels go higher, so does cholesterol and triglycerides, leaving excess body fat around the mid-section. This is then a risk factor for heart disease and stroke.
Metabolic Syndrome Signs and Symptoms:
– High blood pressure (130/85 or higher)
– High blood sugar levels and insulin resistance
– High levels of blood triglycerides
– High blood levels of LDL (bad cholesterol) and low levels of HDL (good cholesterol)
– Extra body fat around the waist (apple shaped body)
– Thick blood (hypercoagulability)
– Pro-inflammatory state (elevated C-reactive protein in the blood)
– High ESR and fibrinogen blood levels in very obese individuals
– Skin tags that consist of a bit of skin that projects out from the surrounding skin can be seen with insulin resistance, diabetes, and hypoglycemia
– Polycystic Ovarian Syndrome: is the overproduction of male hormones in women resulting in obesity, acne, infertility, and menstrual irregularities
– Acanthosis nigricans: a pigmentation of the skin over the back of the neck and underarms.
– Interrupted sleep and sleep apnea
– Erectile dysfunction
– Higher risk for cancers of the breast, prostate and colon
Treating Metabolic Syndrome
“Think about it: Heart disease and diabetes, which account for more deaths in the U.S. and worldwide than everything else combined, are completely preventable by making comprehensive lifestyle changes, without drugs or surgery.” (Dean Ornish, M.D.)
If you want to avoid the usual drugs prescribed for high cholesterol, high blood pressure and diabetes, you will have to make some major changes in your diet and lifestyle. This can be an arduous task but it is definitely possible. Working with a nutritionist, a lifestyle coach, and a naturopath or holistic medical doctor would be ideal but this may not be in everyone’s budget. Here are the basics steps, but any program should be personalized:
“Our finding of a relationship between sedentary behavior and diabetes incidence suggests that reductions in sitting can translate into a positive health effect separate from improvements to moderate-vigorous activity.” (Dr. Bonnie Rockette-Wagner, PhD)
Sitting in a chair watching TV for hours at a time, and generally being immobile, can slowly steer you into metabolic syndrome and lead you to an early grave. Several studies now confirm this connection.
To overcome your inertia simply requires doing more of what you currently do. Aerobic exercise is preferred. Exercise, in a way, helps burn up the excess sugar and lowers blood pressure. If you haven’t done much exercise in months or years, start with light walks. Ideally, work your way up to at least an hour a day. Get fitness-tested at a gym or by a personal trainer to see what type of program you should be following. It doesn’t have to be strenuous to be successful, so do the exercise at your level of fitness.
Metabolic Syndrome Recovery Diet
Weight loss is very important in most cases. This is controversial but, over the years, I have learned that the optimal diet to reverse metabolic syndrome is the Paleo Diet. No grains, gluten-free or otherwise (including spelt, quinoa, buckwheat, kamut, ancient grains, etc.) are allowed. Cutting back on fats does not work. Cutting down on the carbs does work. The basic rules of the Paleo diet are:
The following foods are allowed:
• Lean meats (choose organic and/or grass-fed)
• Eggs – maximum 7 per week (organic and/or grass fed)
• Vegetables (organic whenever possible)
• Fruits – maximum 2 per day (organic)
• Healthy oils (coconut, olive, flax, omega-3, hemp)
• Nuts and Seeds (walnuts, almonds, pine nuts, hemp are best)
The following foods are not allowed:
• Avoid everything else (except the above-mentioned items)
“Protein stabilizes blood sugar levels, and so do high-fiber veggies. Vegetarians can be in a bind, because they tend to eat too many carb-rich grains, and legumes are fairly high in carbs.” (Loren Cordain, Paleo Diet expert)
A note about fish: Many versions of the Paleo Diet advise eating fish and seafood. But I do not. The reason for this is that I see a large number of people in my private practice daily who are heavy fish and seafood consumers and who have sky-high mercury blood levels. Mercury is a neurotoxin at any level. Whether organic, farmed, wild or raw, there is not a single fish that is not contaminated with mercury. Even the smaller fish (sardines, anchovies, etc.) are mercury contaminated. If you consume omega-3 oils from fish, however, the mercury, by law in Canada, has had to be removed. Omega-3 fish oils are therefore mercury-free. The fish are not.
Also to be avoided is alcohol, especially beer which can rapidly raise triglyceride blood levels.
Vitamin C – 1000 – 6000 mg daily will increase metabolism, promote weight loss, and boost energy. Vitamin C increases the conversion of L-Lysine to L-Carnitine, which is responsible for transporting fat to the mitochondria of the cell to convert it to energy. L-Carnitine is one of the most important nutrients that supports overall cardiovascular health.
Probiotics – 50 million live cells daily improves absorption, elimination and metabolism and can also be an important factor in weight loss. It helps produce some of the B vitamins, most importantly Biotin and B12.
B Complex – 100 mg daily will help with glucose metabolism at many biochemical levels.
Niacinamide – 1000 to 3000 mg daily is needed by the body along with chromium to manufacture insulin in the pancreas and will help boost insulin levels if they are low.
Coenzyme Q10 (ubiquinone) – 200 to 400 mg daily is effective at lowering high blood pressure and boosting energy due to its benefits on the mitochondria.
Cinnamon – 1000 to 6000 mg daily lowers blood sugar levels almost as well as some drugs prescribed for diabetes.
Berberine – 1000 to 3000 mg daily is an extract of several herbs including goldenseal and has been shown to be as effective as the drug Metformin in improving blood sugar levels as well as insulin resistance.
Vitamin D – 10,000 to 30,000 IU daily orally (unless you are getting lots of sun exposure) has been demonstrated to lower blood sugar levels, reverse obesity, and improve insulin resistance in numerous studies. The lower your blood level of D, the more difficult it is for your pancreas to manufacture insulin.
Omega-3 fatty acids – 4000 mgs daily of combined DHA and EPA is anti-inflammatory and can help with many of the signs and symptoms of metabolic syndrome, preventing primarily cardiovascular disease.
Chromium picolinate – 1200 to 3600 mcg. daily can lower high blood sugar levels in diabetics and improve insulin resistance, obesity and lower triglycerides. Chromium makes insulin 100 times more efficient at getting glucose converted into energy.
Alpha lipoic acid – 600 to 1200 mg daily can reduce the kidney and nerve damage seen in diabetes. The nerve damage is often diagnosed as peripheral neuropathy and responds nicely to alpha lipoic acid.
Magnesium glycinate – 400 to 800 mg daily because research shows that it reduces the incidence of metabolic syndrome. The best food source of magnesium is from greens (especially spinach, kale and broccoli).
Silymarin (Milk Thistle) – 1000 mg daily improves liver function, blood sugar, and insulin levels.
Curcumin (BCM-95) is a highly absorbable extract of turmeric and is strongly anti-inflammatory, liver protective, reduces LDL-cholesterol while raising the good (LDL-cholesterol).
These supplements can be taken for as long as necessary in the reversal of metabolic syndrome. Not every situation will require such a long list of nutrients, and everyone is unique in their requirements. For a personalized program to reverse metabolic syndrome, see a natural health care practitioner.
“According to the surgeon general, obesity today is officially an epidemic; it is arguably the most pressing public health problem we face, costing the health care system an estimated $90 billion a year. Three of every five Americans are overweight; one of every five is obese. The disease formerly known as adult-onset diabetes has had to be renamed Type II diabetes since it now occurs so frequently in children. A recent study in the Journal of the American Medical Association predicts that a child born in 2000 has a one-in-three chance of developing diabetes. (An African American child's chances are two in five.) Because of diabetes and all the other health problems that accompany obesity, today's children may turn out to be the first generation of Americans whose life expectancy will actually be shorter than that of their parents.
The problem is not limited to America: The United Nations reported that in 2000 the number of people suffering from over-nutrition (a billion) had officially surpassed the number suffering from malnutrition (800 million).” (Michael Pollan, ‘The Omnivore's Dilemma: A Natural History of Four Meals')
A Note to Vegans and Vegetarians
For high quality protein, vegans can eat more hemp seed protein (hemp hearts) and perhaps chia seeds, sunflower, pumpkin seeds, other seeds, almonds, walnuts, pine nuts, pistachios, coconuts, other nuts, cassava, sprouted grains and legumes like ezekiel, manna, lentils, and various algae proteins (spirulina, chlorella, and blue green algae). As well, Non-GMO cultured soy products (if you can find these anywhere on the planet) are yet another alternative vegan protein source. I recommend these can all be juiced, or mixed into salads or stir-fried dishes.
Vegetarians could do the same but eat more organic, free range eggs and unpasteurized (raw milk) cheeses – provided no allergy exists for these.
Generally speaking, many soy products on the market are GMO, and therefore best avoided. However, certain health food stores carry Canadian brands of a cultured soy product called tempeh that is a good source of protein for vegans. One recommended brand is Noble Bean tempeh (http://www.noblebean.com/), made in Montreal from organic soybeans, which can be sliced up and grilled on the barbecue just like meat. Also recommended is Henry’s tempeh (http://www.tempeh.ca/), made in Kitchener-Waterloo, Ontario, from organic soybeans.
There are also some excellent protein powders now available in health food stores, which can be added to soups and smoothies:
• Kaizen Vegan Protein – is an all natural plant-based protein powder that is dairy-, gluten-, and soy-free. One rounded scoop (39 grams) provides 25 grams of protein. (Sold in a compostable container.) For more information visit: www.kaizencanada.com, or call toll-free: 1.866.778.4633
• Vege-Pro® – As a 100% organic plant-based protein, each single serving (2 Tbsp) of Vege-Pro® provides 19 grams of complete protein sourced from brown rice, hemp, and eight different types of medicinal mushrooms including reishi, maitake, cordyceps, and lion’s mane. For more information visit: www.organika.com, or call toll-free: 1.800.663.8880
1) Dr. Andrew Weil. Metabolic Syndrome: http://www.drweil.com/drw/u/ART03193/Metabolic-Syndrome.html
2) Healing Food – Metabolic Syndrome: http://www.alternativemedicine.com/food-recipes/healing-food—metabolic-syndrome
3) Metabolic Syndrome: http://naturopathconnect.com/articles/syndrome-x/
4) Dr. David Williams. Beating Metabolic Syndrome: http://www.drdavidwilliams.com/nutrients-for-metabolic-syndrome
5) Mayo Clinic. Metabolic Syndrome: http://www.mayoclinic.org/diseases-conditions/metabolic-syndrome/basics/definition/con-20027243
6) Ancestral Diets Benefit Metabolic Syndrome: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3402009/
7) Loren Cordain. Cereal Grains: Humanity’s Double Edged Sword: http://www.2ndchance.info/birdlover-cerealsword.pdf
8) Paleo Diet: http://volneywillettmd.com/metabolic-syndrome-diet/
9) Paleo Diet Study: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2787021/
10) Loren Cordain. What to Eat on The Paleo Diet: http://thepaleodiet.com/what-to-eat-on-the-paleo-diet/
11) Too Much Sitting Linked to Heart Disease, Diabetes and Premature Death: http://www.health.harvard.edu/blog/much-sitting-linked-heart-disease-diabetes-premature-death-201501227618
12) Effects of Sitting and Inactivity: http://www.medscape.com/viewarticle/842489
Dr. Zoltan P. Rona practises Complementary Medicine in Toronto and is the medical editor of The Encyclopedia of Natural Healing. He has also published several Canadian best-selling books, including Vitamin D: The Sunshine Vitamin. Visit his website at: http://www.highlevelwellness.ca For appointments, call (905) 764-8700; Office: 390 Steeles Ave. W. Unit 19, Thornhill, ON