Do you have Metabolic Syndrome and What To Do About It
As a naturopathic doctor, my goal is to not only address your health concerns naturally but to really focus on addressing your unique risk factors and work on health prevention. This is something that is unfortunately largely missed but the traditional conventional medical system. Their job is disease management and not disease prevention. That’s why today I wanted to talk about a particular condition you may or may not be familiar with which is known as metabolic syndrome. Metabolic syndrome is a serious health condition that often does not get enough attention. Metabolic syndrome is not a disease itself, it is a collection of disease risk factors that increase your chances of developing heart disease, high blood pressure, and diabetes. It also increases your stroke risk. This is extremely important especially for my 20, 30 and 40 year old patients because although having high cholesterol in your 30s may not seem like a big deal, it can dramatically increase your risk of severe disease in your 50, 60s and 70s. Again, I always like to remind patients you don’t “magically” get diabetes, heart disease or high blood all of a sudden, most of these disease states have been happening for years and eventually get to the tipping point and begin to cause symptoms. But, why should we wait for symptoms in order to address a preventable disease? Unfortunately by the time diabetes, heart disease, or high blood pressure is diagnosed it is often much harder to reverse the damage that has already been done. This is why understanding and addressing metabolic syndrome in your 20s, 30s, and 40s can ultimately reverse and significantly reduce your risk of ever developing more severe health concerns in the future. So, how do you know if you have metabolic syndrome and what can you do to reverse it?
Do you have Metabolic Syndrome?
According to the National Cholesterol Education Program ATP III, the criteria for the diagnosis of metabolic syndrome must include the presence of three of the following five traits:
Obesity, specifically abdominal obesity which is defined as a waist circumference of ≥102 cm (40 in) in men and ≥88 cm (35 in) in females.
Serum triglycerides levels of ≥150 mg/dL (1.7 mmol/L) OR if you are currently on a drug, like a statin (like Atorvastatin (Lipitor), simvastatin and pravastatin), this also meets the criteria.
Serum high-density lipoprotein (HDL) cholesterol <40 mg/dL (1 mmol/L) in males and <50 mg/dL (1.3 mmol/L) in females or OR if you are currently on a drug, like a statin (like Atorvastatin (Lipitor), simvastatin and pravastatin), this also meets the criteria.
Blood pressure ≥130/85 mmHg or you are currently on some form of blood pressure medication (Lisinopril, Amlodipine, Valsartan)
Fasting glucose level ≥100 mg/dL (5.6 mmol/L) OR you are currently on a drug treatment for elevated blood glucose (i.e. Metformin)
The other interesting aspect to metabolic syndrome is this is something I am looking for even before a patient meets the criteria. For every patient we see, we evaluate their comprehensive labs as well as their vitals including weight, blood pressure and comprehensive labs. If for example, I see a 27 year old patient with a fasting glucose of 97 mg/dL and her HDL (“good cholesterol”) that is under 50 mg/dL, I immediately begin to work on addressing her cholesterol and sugar control because if this is her levels at 27 years old, if nothing is done, over time her levels will likely worsen and put her at more risk of metabolic syndrome and more importantly a higher risk of developing diabetes, high blood pressure and heart disease in the future.. The goal is to work with a doctor who is thinking of preventing disease, not only managing your symptoms. So, if after reviewing the criteria for metabolic syndrome you realize that you meet some but not all of the traits, I encourage you to take action today. What you do in your 20s, 30, and 40s will ultimately impact the trajectory of your health in your 50,60, 70s and beyond.
Risk Factors for Developing Metabolic Syndrome
Although researchers believe that obesity is one of the biggest risk factors for developing metabolic syndrome, you don’t have to be obese to be at risk of developing metabolic syndrome. This is particularly important because some people will assume that because they are “skinny” they are not at risk for metabolic syndrome. This is a huge myth and is actually something that needs more attention. It is also the reason why just because you are “skinny” doesn’t mean you are healthy. In fact, patients that have a normal BMI but high cholesterol, and a high fat to muscle ratio are considered to be “skinny fat”. Patients with high fat to muscle ratios have a significant risk of metabolic diseases like heart disease, diabetes, and high blood pressure just like those who are overweight/obese. Researchers have also found that other risk factors associated with metabolic syndrome include being postmenopausal (women are more at risk of developing metabolic syndrome than men), smokers, high carbohydrate diet, alcohol consumption and limited physical activity. In the Framingham Heart Study, soft drink and sugar-sweetened beverage consumption was also associated with an increased risk of metabolic syndrome. Drugs including antipsychotic medications, especially clozapine, were also shown to significantly increase the risk of metabolic syndrome. Cardiovascular fitness, specifically cardiorespiratory fitness, was also a strong predictor of metabolic syndrome. And of course, genetics, researchers believe that genetic factors may account for as much as 50% increased risk of metabolic syndrome. But remember, just because your genes predispose you to a disease, does not mean that you have to let your diet and lifestyle turn those genes “on”. What you do everyday, the routines we hold, the habits we have ultimately impact our health even on a genetic level. Our lifestyle isn’t just a trendy topic but ultimately a switch that can either turn “on” or “off” particular genes associated with disease. Quite fascinating.
When Should my Doctor be Checking for Metabolic Syndrome?
Your doctor should be assessing you for metabolic risk at every routine clinic visit. Even if you do not meet the full criteria for metabolic syndrome but have some of the risk factors, according to the Endocrine Society clinical guidelines, you should be monitored for metabolic risk at least every three years. At NMD Wellness of Scottsdale, we are constantly evaluating this during every visit. Our patients also visit with us quarterly which also allows us to catch metabolic changes more rapidly.
Natural Ways to Reverse Metabolic Syndrome
Metabolic Syndrome is a preventable and reversible disease but it will require some active lifestyle and dietary modifications which are often most effective with proper guidance from your naturopathic doctor and health coach. This is also the reason at NMD Wellness of Scottsdale, all of our patients have access to their own health coach to help them make long-term lifestyle changes that last. Going on a “caloric restricted diet” or telling yourself just to “eat less and exercise more” isn’t going to reverse metabolic syndrome. Instead we need to implement a series of lifestyle modifications that not only involve “calories in and calories out” but more importantly we need to change our mindset, behaviors and habits associated with our everyday practices. So if your doctor just says, “you need to lose weight” and doesn’t give you any practical tools to do so, it’s time you get the support you need with the appropriate team, like your naturopathic doctor and health coach.
Diet: Researchers have investigated a variety of dietary approaches for metabolic syndrome and have found that although some diet styles may be better than others, maintaining your blood sugar is one of the most important ways to reduce your risk of metabolic syndrome. This means eliminating processed foods, artificial sugars and focusing on clean, natural foods including high contents of vegetables, nuts and seeds, omega-3 fatty acids (i.e extra virgin oil oil, oily fish like wild caught salmon, and etc) and protein.. Avoiding gluten-containing grains has also been extremely successful for our patients. It is important to remember just because your doctor may have mentioned you have high cholesterol, doesn’t mean you should eliminate all fats from your diet, it does however mean removing inflammatory and processed foods from your diet and instead focusing on incorporating healthy omega-3 rich fats like (cod liver oil, salmon, avocados, nuts and seeds) is a good idea.. Diets high in fiber (mostly from vegetables) was also shown to significantly improve weight management in patients with metabolic syndrome. Aiming to consume 0.5-1lb of organic vegetables daily is a great way to get enough fiber, feed the healthy bugs in your gut and to help with proper elimination (stay goodbye to constipation).
Exercise- daily exercise is particularly important in those with metabolic syndrome. Researchers have found that not only does exercise help reduce abdominal fat (the type of fat most associated with metabolic syndrome) but it also helps with blood sugar control and metabolism, especially in women. Focusing on moving your body 10-15 minutes every single day has been shown to be more effective than exercising for 45 minutes to1 hour, three times a day. Focus on incorporating some form of movement every day. I generally suggest our patients incorporate both restorative practices like yoga and pilates with weight resistance training. Moderate intensity activity like a brisk walk is also highly recommended as a great source of exercise. If you are new to exercise, have no fear, simply start with 5 minutes a day. Once you have been consistent with 5 minutes a day for 2-3 weeks, you can start incorporating more time into your exercise routine.
Berberine - For patients with metabolic syndrome, metformin is often one of the first pharmaceutical interventions suggested. Metformin has been a glucose-lowering drug that has been used for centuries. Since it was discovered that metformin activated AMP-activated protein kinase (AMPK), and not only lowered glucose levels but could reduce the risk of cancer, it has grown in popularity for many doctors. Metformin, however, does come with side effects including abdominal upset and B12 deficiency. For this reason, researchers have been extremely excited by the new potentially safer alternative known as Berberine. Berberine is an extract from the berberis vulgaris L. (root) and has been used by ancient herbal medicine in the treatment of diarrhea. It isn’t until only recently that researchers have found that not only was Berberine comparable to Metformin in glucose regulation but it also improved lipid metabolism (another big problem for those with metabolic syndrome) and it also was found to reduce cancer growth and inflammation. Berberine has become of particular interest to doctors and is something at NMD Wellness of Scottsdale we have seen significant success with in our patients with metabolic syndrome.
High Quality Sleep - Although we would all like to say we make sleep a priority, with today’s modern life, our busy schedules and the new release of yet another binge-worthy shows, it can be hard to get the high quality sleep our body needs. This is particularly important for patients with metabolic syndrome because researchers have found that our cells are most sensitive to insulin at night. So if you want to help your glucose control, one of the first steps you can do is to make sleep a priority. Dimming the lights, turning off electronics and starting sleep routines are some simple ways you can start getting better sleep.
Ready to optimize your health? At NMD Wellness of Scottsdale, we offer personalized integrative solutions for all your hormone needs.
