Metabolic Syndrome
METABOLIC SYNDROME
Metabolic syndrome is the plague of the 21stCentury. It affects more lives than any infectious agent so far. It is as potentially destructive, and it now affects the old and young alike. The question should be is how we arrived to this point. It is now as American as apple pie, even thought recent surveys from places as far as away as Maori shows that 32% of the population has this syndrome. In the Pacific the estimate is 39%, and 16-40% of New Zealanders of European descent suffers from this.
CONDITIONS
The metabolic syndrome includes high cortisol levels, high blood pressure, high blood sugar, fatigue, and the “spare tire” around the middle. This syndrome causes a fat gain, especially in the belly, and widens the waist. This predisposes a person to diabetes and heart disease. The diagnosis to start is usually pre- diabetes, borderline high blood pressure, raised triglycerides, and higher than normal cholesterol. This is a drug companies dream, and your nightmare. You are now what I call a recyclable patient.
The conditions related to metabolic syndrome are Insulin resistance, obesity, Glucose intolerance, elevated triglycerides, low HDL the good cholesterol, predominance of small dense LDL cholesterol particles. These are the ones that line the arteries, the large fluffy particles of LDL cholesterol go thought and are not a major cause of problems. Also, Hypertension, Oxidative stress, and inflammation are part of the syndrome. These are possible indicators of a predisposition to some serious chronic conditions including type 2 diabetes, cardiovascular disease, stroke, cancer, polycystic ovary syndrome, gout, and asthma.
COSTS
Having the risk factors for metabolic syndrome raises the cost for the patient’s care. It is estimated the cost is about twice as high on average when there is a risk factor for diabetes in people that have metabolic syndrome.
DIAGNOSING
Here is the fun part; there are no well-accepted criteria for diagnosing metabolic syndrome. The criteria proposed by The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) are the most current used criteria.
One of the markers is central obesity which means a waist circumference for men of at least 40 inches or more, and women a waste of 35 inches or more. The HDL which is considered the good cholesterol has to be for men less than 40, and for women less than 50, Then you need to have a fasting glucose 100 or higher, and blood pressure 130/85 or greater.
Here is the problem and where the costs are, these patients are routinely checked for weight, waist circumference, blood glucose, lipoproteins, and blood pressure. The guidelines are to treat risk factors such as cholesterol, hypertension and high glucose levels. Also, according to the guidelines the physician has to choose anti-hypertensive drugs carefully because different agents have different effects on insulin sensitivity.
The American Heart Association states it needs more studies to understand the relationship between metabolic risk factors and the efficacy of drug therapy in people who have the metabolic syndrome. It is also stated that the safest and most effective treatment is to lose weight and increase activity levels.
GUIDLINES
Metabolic syndrome is a troubling diagnosis for a number of reasons. The guiding numbers keep changing, what was a normal reading for glucose, now is a danger sign. Blood pressure readings, and cholesterol levels guidelines keep dropping; again what was once normal is now pre-disaster. Next we will be going for the pre, pre-diabetic. This is where a fasting glucose reading of 85 or over, puts you on a watch list for a possible tendency to having full blown diabetes. It also helps if you can name a family member that had or has the condition.
LARGE PROBLEM
Medicine looks and expects to find the boogie-man every where. You do not have to be in the medical profession to see we have a large scale problem. Our eyes are not deceiving us; we are an overweight nation, getting larger by the day. Common sense seems to be missing, metabolic syndrome, is a new disorder according to the medical profession. Obesity is a disease of the mouth, which does need to be addressed, not by pills, fad diets, or by drawing a food pyramid.
NUTRITIONAL ANSWERS
The only methods that work are the ones that address your nutritional needs. Weight control without regard for your personal nutritional needs, may help you temporarily lose a few pounds. It is a method that will fail in the long term.
With all kinds of food stuffs on the shelves that have never been consumed on a regular basis before, we are now in uncharted territory. To be able to loss weight and stay healthy is going to be a challenge, which will become more complex over time. Our individual nutritional needs are not a multi-vitamin away.
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