Metabolic SyndromeTuesday 23 July 2019
At the end of June 2019 I attended the Seminar of Chiropractic Excellence hosted by SOTO Europe. The speaker was Dr Ann McDonnell DC, CCSP, FCC, FRCC and the subject matter covered several aspects of nutrition that do not feature on the radar of most medical practitioners.The information imparted by Dr McDonnell that I want to share here relates to "metabolic syndrome" and how to avoid or treat it through nutrition and exercise.
For a diagnosis of metabolic syndrome medics require the co-occurrence of at least three of the following cardiovascular risk factors:
- insulin resistance
- high LDL cholesterol
- low HDL cholesterol
- hypertension symptoms
As will be discussed later, insulin resistance can cause all of the other conditions that form metabolic syndrome and its relevance to Jersey, now and in the near future has been quantified. In 2016 there were approximately 3600 registered diabetics in Jersey. That figure is predicted to increase by 42% by 2036. Over the same period, heart failure is predicted to increase by 72%, obesity by 29% and hypertension by 46%
Dr McDonnell referred to the National Health and Nutrition Examination Study (NHANES III) which concluded that excessive waist circumference appeared to be more of a risk factor for metabolic syndrome than BMI. In simplistic terms, it was concluded that your waist circumference should not exceed half of your height.
Insulin resistance and obesity go hand in hand as insulin promotes fat storage and if you are insulin resistant your blood glucose levels will be elevated, triggering insulin release. This viscous circle that many diabetics are trapped in requires a change in mindset. It is paramount that diabetics understand that they are carbohydrate intolerant and therefore need to remove rich sources of carbohydrate from their diet- such as fruit and grains (including rice) and replace with protein, fat and green leafy vegetables.
Dr McDonnell suggests that rather than tracking blood glucose levels, one should be aiming to keep serum (blood) insulin levels low. This is most important and is not the same as keeping blood glucose levels low. A Type 2 diabetic already has elevated insulin levels because they are resistant to it, so it makes no sense to increase insulin levels. Instead, one needs to remove the trigger for insulin release. Not to mention that it is the elevated insulin levels that cause the diabetic neuropathy.
High LDL versus High HDL cholesterol
Bad cholesterol does not exist. About 90% of the cholesterol in the body is produced by the liver as it is required. 20% of the body's cholesterol is found in the nervous system (white matter of the brain and myelin sheaths around nerves), it is a major component of all cell membranes, is used to make hormones, fat soluble vitamins and bile. LDL cholesterol which has been termed "bad" is simply cholesterol that is being transported out to the tissues where it is needed for cell repair. LDL cholesterol is NOT BAD. What is bad are the fissures that can develop in arteries due to constantly raised insulin levels. These fissure which weaken the arterial lumen have to be filled and cholesterol is the body's chosen material. Plaques and 'furring' of the artery can occur around the repair site, but cholesterol is simply the repair material, not the cause.
Hypertension has several causes, dietary, environmental and physical. Salt is commonly associated with hypertension, but another white crystaline substance is also known to be a cause. Sugar, due to its associated effects on insulin is now thought to be a significant cause of hypertension. Diabetes.co.uk explains the link between sugar, insulin and hypertension thus:
It is thought that when the body produces too much insulin and leptin in response to a higher-carb diet, it causes blood pressure to increase. Hyperinsulinemia raises blood pressure, in part, by decreasing sodium and water excretion in the kidneys, and directly vasocontristing blood vessels.
Hyperinsulinemia may play a direct role in atherogenesis and, by extension, atherosclerosis through the interaction of receptors on the blood vessel wall. Hyperinsulinemia is also known to alter lipid metabolism unfavourably, which promotes inflammation and oxidative stress.
As insulin levels rise, insulin resistance eventually develops. If insulin receptors are blunted and the cells grow resistant to insulin, magnesium can no longer be stored, so it passes out of the body through urination. When magnesium levels are too low, blood vessels are unable to fully relax, and this constriction raises blood pressure.
#3: Nitric oxide
Fructose sugar, specifically, elevates uric acid, which drives up blood pressure by inhibiting the nitric oxide (NO) in blood vessels. NO is regarded as the most important vasodilator and helps blood vessels maintain their elasticity. NO suppression leads to increases in blood pressure.
Advanced glycation end products (AGEs) are the direct result of exposure to sugars. This is one of the major pathway involved in the development and progression of different diabetes-related complications. They are believed to play a role in vascular complications by triggering processes that cause vascular stiffening and the narrowing of blood vessels, contributing to atherosclerosis."
So, how does one avoid developing metabolic syndrome and/ or diabetes?
In a sentence: avoid carbohydrate rich foods especially grains. Dr McDonnell recommended a diet rich in protein (especially animal sources), fat (animal and vegetable) and green leafy vegetable. You will note that the absence of grains from the diet means that you will also be benefiting from excluding gluten. I would call this a way of life rather than a diet as it is in effect a complete reversal of the nutritional advice that has been fed to the public since the 1960s. For further research, I would suggest reading about the Paleo diet and Keto diet.
Links to tasty alternatives to grain based dishes can be found on the Orchard Chiropractic Centre website under Food Ideas.