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Cleaning Up a Metabolic Mess

Thirty years ago, when Nathan Pritikin opened the Pritikin Longevity Center® to help people improve cholesterol levels and prevent heart attacks, he noticed that many people at the Center were struggling not just with high cholesterol but also with hypertension and high blood sugar. Several had full-blown diabetes. Most were also overweight.



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The good news, Nathan observed, was that his diet-and-exercise program seemed to help all these problems. But Nathan, ever curious about the workings of the human body, was perplexed. Why, he wondered, did all these things seem to go hand-in-hand? Could they be linked in some way?

Today, scientists have answers to Nathan’s observations. There is a link, and it’s called the Metabolic Syndrome.

What is the Metabolic Syndrome?

The Metabolic Syndrome, also known as Syndrome X, is not a disease, per se. Rather, it is a cluster of factors (see below) that are an important warning sign because the syndrome can lead to diabetes as well as heart disease. In the next decade, predicts Dr. David Heber, Director of UCLA’s Center for Human Nutrition, roughly 80% of all heart disease will be due to the Metabolic Syndrome and type 2 diabetes. Even if blood sugar levels never go high enough to be classified as diabetes, the Metabolic Syndrome still promotes heart disease.

According to guidelines established by the National Cholesterol Education Program, you probably have the Metabolic Syndrome if you have three or more of the following five risk factors:

Abdominal obesity: a waist of 40 inches or more for men, 35 inches or more for women
High triglycerides: 150 mg/dL or more
Low HDL (“good”) cholesterol: below 40 mg/dL for men, below 50 for women. Most people with the syndrome also have more small, dense LDL (“very bad”) cholesterol particles*
High blood pressure: 130/85 or higher (or if you are taking hypertension medication)
Elevated fasting blood sugar (glucose): 110 mg/dL** or more

* These small, dense LDLs are usually not measured with standard blood lipid profiles. To monitor them, the physicians at the Pritikin Center order specialized blood tests.

** A few months ago, the American Diabetes Association lowered the cut point for elevated fasting glucose to 100 mg/dL, so the Pritikin Center uses 100 – not 110 – to denote elevated glucose.

If you have the Metabolic Syndrome, you’re far from alone. According to new government figures, more than 64 million Americans have it, roughly one in four adults and 40% of adults age 40 and older, an increase of 60% over the last decade.

Alarmingly, growing numbers of kids are now being diagnosed with the syndrome. Newly published research from Yale University found that the fatter the child, the more likely he or she is to have the syndrome, and those who are severely obese have a 50% chance of having it.(1)

What causes the Metabolic Syndrome?

The Metabolic Syndrome usually begins with insulin resistance. Insulin resistance happens when our cells “resist” insulin. Normally, our body changes the sugars and starches we eat into a form of sugar called glucose. The bloodstream carries the glucose to the body’s cells. Insulin, a hormone produced by the pancreas, “ushers” glucose into our cells, where it’s converted to energy. You are insulin resistant if your cells don’t want to “accept” the insulin. Figuratively-speaking, your cells have signs on their doors that say, “Sorry, closed for business. We already have all the glucose we need.” So the pancreas has to pump out more insulin in an effort to “push” those doors open and keep blood sugar levels from going too high.

In about half of all cases, insulin resistance leads to ever-rising blood sugar levels and type 2 diabetes (defined as fasting glucose of 126 mg/dL or more). That’s why insulin resistance is often called a “pre-diabetic” condition. Ultimately, the pancreas may give out. For years, it’s been on overdrive, pumping out more and more insulin, trying to break through the cells’ doors. Eventually, it cannot produce enough extra insulin to overcome the insulin resistance. That’s why people who’ve had type 2 diabetes for many years must often resort to insulin shots.

What causes insulin resistance?

Here’s what we know. Environment plays a key role: the great majority of people with insulin resistance are overweight. But scientists know genetic susceptibility plays a role as well because some normal-weight people are insulin resistant – and some very obese people are not.

Four other factors contribute to insulin resistance: poor diet, inactivity, smoking, and aging. Even in normal-weight people, a diet high in fats and refined sugars is associated with greater risk of developing insulin resistance and all other aspects of the Metabolic Syndrome.

How do you prevent or control the Metabolic Syndrome?

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Pritikin Perspective - Healthy Living Made Easier
Pritikin Perspective is a publication for Alumni of the Pritikin Longevity Center. It is dedicated to helping people make healthy changes in their lives. The articles in this publication should not be considered specific medical advice, as each individual circumstance is different. You are strongly encouraged to seek medical advice before beginning a program of diet and exercise.
Editor/Writer: Eugenia Killoran

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