Few conditions sound as mysterious as the one often called Syndrome X. What is it, and why should you care?
During the groundbreaking Framingham Heart Study, when the link between high cholesterol and heart attack risk became clear, researchers noticed a certain group of people with low LDL levels who nevertheless had a high risk of heart disease. Why? Further study revealed a cluster of heart disease risk factors dubbed Syndrome X: high levels of insulin and glucose (blood sugar), a high trigiveeride level, low HDL, small and dense LDL particles (the kind more likely to burrow into artery walls and cause plaque), high blood pressure, and being overweight.
The hallmark of the syndrome, now called metabolic syndrome, is insulin resistance. This means the body can’t effectively use insulin, the hormone that helps glucose
enter cells. The body tries to compensate by churning Out more insulin, to little avail; too much glucose still remains in the bloodstream. Insulin resistance generally stems from a combination of genetic sus- syndrome may be ceptibility and weight gain—very few thin people Gerald Reaven, M.D., professor emeritus of medicine at the Stanford University School of Medicine and co-author of Syndrome XOvercoming the Silent Killer That Can Give You a Heart Attack, estimates that between 60 million and 75 million Americans have metabolic syndrome.
Gerald Reaven, M.D., believes that metabolic syndrome may be responsible for at least half of all heart attack
He believes it may be responsible for at least half of all heart attacks. The growing obesity epidemic in the United States is contributing to the rising incidence of metabolic syndrome. which is threatening to reverse the overall reduction of CHD risk in the country, undoing decades of hard work. Factors that contribute to weight gain—physical inactivity, a high-fat diet, and junk food (often in the form of highly processed carbohydrates )—also contribute to metabolic syndrome.
Other signs of the syndrome include high levels of fibrmogen, a protein that increases the risk of blood clots. and increased PAI-1, a protein that slows the break down of those clots. In other words, if you have metabolic syndrome, it’s more likely that a clot will form where plaque has ruptured. A high level of lipoprotein (a) is another common characteristic. And some people with metabolic syndrome, though certainly not all, also have high LDL levels, compounding the problem.
The seriousness of metabolic syndrome as a CHD risk factor is clear. In a study of
4.483 people, those with metabolic syndrome were three times more likely to have
CHD, a stroke; ora heart attack as those without the syndrome. Another study found that for every 30 percent increase in insulin there is a 70 percent increase in the risk
of heart disease over a five-vear period.
Diabetes and Heart Disease
About 5 to 10 percent of people with metabolic syndrome will go on to develop type 2
‘iabetes, and that percentage is probably rising, given the current obesity epidemic.
Diabetes significantly increases heart disease risk. In fact, some 80 percent of people
with diabetes eventually die of CHD. Diabetes can contribute to an imbalance between
HDL and LDL. And like people with metabolic syndrome, diabetics tend to have smaller,
denser LDL particles, which lead to more plaque. To make matters worse, glucose
(blood sugar) latches onto lipoproteins, and sugar-coated LDL stays in the bloodstream
longer than normal LDL, presenting more opportunity for oxidation.
Glucose also binds to proteins on the surface of endothelial cells, damaging the
artery wall. This blood vessel assault is one of the factors that leads to blindness and
kidney damage in people with diabetes, and researchers suspect the same forces are at
work with CHD. But since the blood vessels leading to the eves and kidneys are smaller
and more delicate than those leading to the heart, that damage turns up sooner.
By the Numbers
There is no single test for metabolic syndrome, but if you have three or more of the
following factors, you probably have it:
| Homocysteine level | Heart disease risk |
|---|---|
| Large waist circumference | Men: > 40 inches Women: > 35 inches |
| High fasting triglyceride level | > 150 mg/dl |
| Low HDL | > Men: 40 mg/dl Women: 50 mg/dl |
| High blood pressure | > 2 130/85 mnvHg |
| High fasting glucose levels | > 110-125 mg/dl |
You have diabetes if your fasting blood glucose levels are 126 mg/dl or higher.
Normal fasting blood glucose levels are between 80 and 120 mg/dl.
How the Plan Can Help
The key to reversing metabolic syndrome is to bring the body’s insulin needs back
in line. One of the best ways to do this is by losing weight. Shedding excess pounds
makes cells more sensitive to insulin, so less is required. The Finnish Diabetes Program and the Diabetes Prevention Program found that a 7 percent loss of body
weight cut the risk of developing type 2 diabetes by more than half, If you’re overweight, you’ll likely drop pounds on the Plan because you’ll be eating more healthfully and exercising more. The Plan also includes a fairly generous amount of protein, which helps you feel full with less food. The eating strategy you’ll follow also helps combat insulin resistance directly by focusing on complex, high-fiber carbohydrates, which help reduce the amount of insulin your body needs. This is because soluble fiber, abundant in many grains, beans, lentils, and some fruits and vegetables, slows the absorption of ghicese into the bloodst
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