Metabolic Syndrome (MetS) is an insidious inflammatory state, with impaired inflammation, endothelial function and coagulation, predisposing individuals to cardiovascular disease (CVD).
Criteria for Diagnosing Metabolic Syndrome
The World Health Organisation (WHO) defined Metabolic Syndrome in 1998 as a series of risk factors, of which a combination of any three in the table below is diagnostic.
Criteria | Measurement |
Central Obesity | ​ |
Waist to Hip Ratio | >0.8 |
Waist Circumference | >80cm |
Atherogenic Dyslipidaemia | ​ |
Triglycerides | ≥ 1.6mmol/L |
HDL | <1.2mmol/L |
Hypertension | ≥ 130/85 mm Hg |
Insulin Resistance | ​ |
Fasting Blood Sugar | ≥6 mmol/L |
Prothrombotic State - presence in blood of: | ​ |
High Fibrinogen | Elevated |
Plasminogen Activator Inhibitor | Elevated |
Proinflammatory State | ​ |
hsCRP | Elevated |
Table highlighting diagnostic criteria for Metabolic Syndrome
What causes Metabolic Syndrome?
Metabolic Syndrome emanates from:
• A diet high in refined starches and sugar
• A diet high in saturated fats
• Overeating
• Lack of exercise
• Abdominal weight gain
• Hormonal imbalance
• Inadequate sleep
• Nutritional deficiencies
• Sedentary lifestyle
Metabolic Syndrome, if not treated, predisposes the individual to atherosclerosis. A sedentary lifestyle is a major risk factor for cardiovascular disease (CVD), and activity protects against it.
Dietary Exclusions
Reduce refined carbohydrates foods
Remove sugar-sweetened beverages
Reduce saturated fats, trans fats, cured meats, processed foods
Limit overeating and the frequency of eating to 3 meals per day with 4-5 hours between meals
The underlying metabolic denominator is hyperinsulinemia (elevated insulin levels) from a high intake of refined carbohydrates.
Specific Nutrients recommended for Metabolic Syndrome
Vitamin B3 - Niacin
Increases the weight loss hormone adinopectin secreted by fat cells.
Niacin effectively lowers the highly atherogenic Lp(a) by decreasing its rate of synthesis in the liver. Niacin is part of Glucose Tolerance Factor which facilitates insulin binding.
Vitamin B5 - Pantothenic Acid
Lowers body weight by activating lipoprotein lipase that burns fat cells.
Has also been shown to reduce hunger when dieting.
Favourably alters low density lipoprotein (LDL) metabolism and reduces triglycerides after 4 months.
Vitamin B6 - Pyridoxine
Lowers homocysteine.
Low B6 is strongly linked to hypertension.
It lowers CRP (C-Reactive protein) and systemic inflammation.
Vitamin B7 - Biotin
Relaxes smooth muscles thereby reducing systolic blood pressure.
It also improves glycaemic control and lowers insulin thereby reducing fat formation.
Vitamin B8 - Inositol
Supplementation may increase adinopectin levels that increases weight loss.
Decreases small, dense, LDL especially in patients with metabolic syndrome.
Lowers triglycerides.
Vitamin B9 - Folate
Lowers Blood Pressure by vasodilation.
Vitamin A
Suppresses growth of vascular smooth muscle so keeps our blood vessel lumen clear and wide. Regulates our immune response to inflammation.
A deficiency increases the severity of chronic inflammation.
Reduces size of fat cells and enhances gene expression that reduce a person’s tendency to store food as fat.
Vitamin C
Increases Nitric Oxide to help vasodilation.
Low Vitamin C levels are inversely linked to high CRP levels.
Increases Glutathione levels.
Protects LDL from oxidation making it less ‘sticky’ and preventing monocytes and oxidised LDL sticking to blood vessels.
Lowers HbA1c in Type 2 Diabetes Mellitus.
Vitamin D
Low Vitamin D is strongly linked to hypertension.
Keeps blood vessels smooth and healthy.
Potent modulator of inflammation.
Inhibits pro-inflammatory cytokine production.
Deficiency is strongly linked to poor metabolism of carbohydrates.
Suppresses 'foam cell' formation thereby reducing lipid-related arterial blockages.
Lowers the risk of type 1 and 2 diabetes.
Suppresses pancreatic B-cell inflammation.
Vitamin E
Increases nitric oxide synthase assisting vasodilation and protects blood vessels from damage. Deficiency predisposes to inflammation-related diseases.
Reduces damage from TNF-a.
Limits destructive cell behaviour from inflammation.
Reduces body fat by inhibiting pre-fat cells maturing.
Protects against diabetes by protecting pancreatic B-cells from oxidative stress.
Vitamin K
Poor Vitamin K status linked to excess fat tissue.
Vitamin K helps metabolise sugars.
Magnesium
Promotes dilation of blood vessels and depletion causes hypertension, cytokine release that starts the damaging macrophage immune response.
Low levels impair utilisation of glucose as fuel, instead storing it as fat.
Deficiency reduces insulin sensitivity while supplementing with magnesium increases insulin sensitivity and stimulates metabolism and inhibits fat absorption.
Protects LDL from being oxidised.
Zinc
Regulates the enzymes angiotensin and endothelin, that affect BP.
Deficiency causes blood vessel constriction.
Zinc depletion lowers Vitamin A.
Inflammation raises the demand for zinc, and cytokines which are pro-inflammatory decrease with zinc repletion.
Deficiency reduces leptin that regulates appetite.
Low levels raise inflammatory lipoproteins and the risk of arterial plaque formation.
Cellular zinc makes HDL which is protective.
Zinc is needed in the synthesis, storage, and excretion of insulin.
It protects pancreatic B-cells.
Chromium
Chromium makes the body more sensitive to Insulin, and helps reduce body fat and increase lean muscle.
Specifically improves dyslipidaemia that accompanies insulin resistance
May increase HDL.
Synergistic effect with Niacin for dyslipidaemia.
Helps insulin attach to cell’s receptors increasing glucose uptake into cells.
Deficiency can cause insulin resistance.
Supplementation shows dose-dependent benefits for T2DM (Tyle 2 Diabetes Mellitus).
CoQ10
Randomised control trials have shown statistically significant reductions in systolic and diastolic blood pressure.
Deficiency is highly correlated to hypertension.
Decreases CRP and IL-6 (Interleukin-6) and affects genes that control inflammatory response.
CoQ10 lowers Lp(a).
Improves glycaemic control and prevents kidney damage in diabetes.
Lipoic Acid
Improves vascular tone and causes vasodilation
Works like calcium channel blocker medications, r
Regenerates Vitamins C, E and Cysteine.
Neutralises free radicals
Protects endothelial cells from inflammation, and oxidised cholesterol.
Reduces LDL
Improves cellular utilisation of glucose.
Enhances glucose uptake in skeletal muscle.
Improves glucose tolerance in T2DM
Very effective with diabetic neuropathy.
Cinnamon
Significantly reduced blood glucose, systolic blood pressure, increased lean mass, and small decreases in body fat.
Improving your nutrition and diet, along with gentle exercise, can radically turn Metabolic Syndrome around. Small changes can lead to significant improvements in health outcomes. For example:
Have breakfast -protein based, with fibre, like leafy greens, and unsaturated fats. Protein blunts the sugar response (glycaemic response), meaning less insulin is required to bring it back in control.
Drink Apple Cider Vinegar prior to meals to blunt the glucose spike
Seperate meals by 4-5 hours to allow glucose and insulin levels to return to baseline
Get good, consistent sleep. Lack of sleep, increases our stress response, that increases cortisol, that increases insulin.
Lower inflammation - Omega 3 foods (fish, nuts, seeds) and probiotics help.
Drink adequate water - don't stress you body by being dehydrated
Increase moderate exercise.
Incorporate relaxation or meditation practices. When we are stressed we increase our cortisol levels which hinders insulin from working.
Don't have artificial sweeteners as our bodies don't know the difference, and insulin rises to combat it.
Complete a food diary - take photos of everything you put in your mouth. It may surprise you!
Monitor your HbA1c - values between 5.7-6.3% are pre-diabetic.
If you would like to discuss your personal circumstances, feel free to make a booking with me on the bookings tab on my website.
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References
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Duffo M, (2015), Magnesium in Metabolic Syndrome: Review of Studies, Endocrinology & Metabolism, 5:1
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Georgousopoulou E et al, 2016), Anti-inflammatory diet and 10-year (2002-2012) cardiovascular disease incidence: The ATTICA study, Int J Cardiol. Nov 1, 222:473-478
Hechtman L, (2019), Clinical Naturopathic Medicine (2nd Ed), Elsevier Australia
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Hoyas I, (2019), Nutritional Challenges in Metabolic Syndrome, Journal of Clinical Medicine, 8, 1301
Hyde P et al, (2019), Randomised Controlled Trial: Dietary carbohydrate restriction improves metabolic syndrome independent of weight loss, JCI Insight, Jun 20:4(12)
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Maria Patti A et al, (2018), Natural approaches in metabolic syndrome management, Arch Med Sci Mar; 14(2): 422-441
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