What is Metabolic Syndrome?
You may have heard the name but there is often some confusion about what exactly is metabolic syndrome, in fact, keyword research shows over 74,000 Google searches for “metabolic syndrome” in just the past 24 hours. Also called syndrome x, metabolic syndrome is the name for a group of conditions that raise the risk of cardiovascular diseases and diabetes. When an individual has three of the five conditions a diagnosis of metabolic syndrome can be made. According to data from the National Health and Nutrition Examination Survey (NHANES) the prevalence of metabolic syndrome has been on the rise since the early 1990s and by 2012 it’s estimated that more than one-third of US adults met the diagnostic criteria.
The World Health Organization (WHO) defines Metabolic Syndrome diagnosis with any three of the following:
- High blood pressure ( systolic reading of 135 mm Hg over diastolic 85 mm Hg or greater)
- Impaired glucose tolerance (fasting blood glucose of 100 mg/dL or greater)
- High waist circumference (greater than 40 inches in men and 35 inches in women)
- High triglycerides (150 mg/dL or greater)
- Low HDL cholesterol (less than 40 mg/dL in men and 50 mg/dL in women)
3 Ways to Reduce Your Risk
Metabolic syndrome is treated by addressing the conditions that contribute to the diagnosis. Interventions with diet and lifestyle can often help to reverse the conditions that make up metabolic syndrome. For example, a weight loss of as little as 3% can lead to improvements in blood lipids and meeting minimum recommendations for daily exercise can help keep blood pressure in check. If you are looking to reduce your risk, try starting with the three tips below:
1. Know Your Numbers
Being an active participant in your healthcare and knowing where you stand can help you better understand your risk. Blood pressure, fasting glucose and blood lipids are tests that should be done each year at your annual check-up visit. Knowing where you stand now and watching the trends year after year can help you take action sooner if one area starts to creep up.
2. Don’t Ignore Your Weight
A prospective study published in the American Journal of Medicine in 2000 estimated that the average American gains and then maintains about a pound of weight annually. This may not seem clinically significant enough to warrant intervention at an annual check-up visit however year after year of gradual gains can become significant and contribute to the development of metabolic syndrome. Your weight may not fit perfectly within the BMI scale but knowing what’s a healthy range for you and watching your trends is important.
3. Strive For 150
Participating in some form of physical activity is well established in the research to have protective effects against the conditions that contribute to metabolic syndrome including lowering blood pressure, maintaining weight and reducing insulin resistance. Check in to see how close you are getting to meeting the minimum recommendations of 150 minutes of physical activity per week. Already there? See if you can reach 300 minutes a week for additional benefits. For more on the benefits of exercise check out my post on the 2018 Exercise Guidelines from the US Department of Health and Human Services.
The 2018 Exercise Guidelines: What the Past 10 Years Have Taught Us
The United State Department of Health and Human Services has updated its exercise guidelines! The 2018 guidelines are an update to the first-ever published recommendations in 2008, which included a weekly goal of at least 150 minutes to 300 minutes of moderate-intensity physical activity in bouts of at least 10 minutes at a time. In this second edition of the Physical Activity Guidelines for Americans what they recommend may not surprise you: most of us need to move more! The Department estimates that at present 50% of Americans are not meeting the current exercise recommendations and 30% of Americans report doing no moderate-vigorous intensity physical activity at all. With the release of the new guidelines maybe what changed most significantly is the growing body of evidence behind the reasons why we should care about this.
A Growing List of Benefits
While some benefits were known and highlighted in the 2008 guidelines the 2018 report continues to add to the list of conditions which benefit from regular physical activity, including:
- Reduced risk of developing or progression of certain chronic conditions including type 2 diabetes, hypertension, and osteoarthritis
- Improvements in brain health including reduced incidence of dementia and improved mood
- Prevention of weight gain
- Improved sleep including a reduction in time to fall asleep and improvements in sleep quality
- Reduced risk of developing gestational diabetes during pregnancy
- Reduction in the incidence of postpartum depression
- Reduced risk of falls and related injuries, in older adults
- Reduced risk of certain cancers including breast, colon, endometrial, esophagus, kidney, lung, stomach and bladder
The report also released new findings that show for individuals who perform little or no moderate-vigorous activity, replacing their sedentary time with light-intensity activity reduces the risk of all-cause mortality, incidence of type 2 diabetes and cardiovascular disease. The evidence in this area was previously lacking.
What’s Else is New?
- Removal of the 10-minute bouts minimum- all movement now counts toward the daily goal
- New recommendations to include preschool-aged children (ages 3-5 years old) and the benefits seen in bone health and reduced risk of excessive weight gain
- A new Move Your Way campaign to help promote and inspire regular exercise
Individuals who move more tend to feel better, sleep better and have reduced risks of certain diseases! For the most benefit, Americans are encouraged to participate in some form of moderate to vigorous physical activity for 150 minutes to 300 minutes per week, plus 2 days of strength exercises. If that is not possible exercise appears to provide benefit in a dose-dependent manner, even including light-intensity movement, so any amount of movement is better than none. If you are looking for support to start, check out the interactive Activity Planner on Move Your Way, set a goal on your wearable fitness tracker or schedule it into your calendar. If you set a goal, rather than leaving it to chance, you’re more likely to follow through.
Mediterranean-DASH Intervention for Neurodegenerative Delay
Are there choices that you could be making in your diet now that could slow cognitive decline and even reduce your risk of developing Alzheimer’s disease? A growing body of evidence is showing that this might be the case. Researchers from Rush University in Chicago created a hybrid of the Mediterranean diet and the Dietary Approaches to Stop Hypertension (DASH) diet resulting in the MIND diet or Mediterranean-DASH Intervention for Neurodegenerative Delay.
The study followed over 900 participants ages 58-98 for a period of 4.5 years and in that time researches saw a reduced risk of Alzheimer’s in 53% in those strictly following the diet. Not ready to commit? Even in those participants following the diet only moderately well had a 35% risk reduction.
What’s Included in the Diet?
The MIND diet identifies 15 main components: 10 brain-healthy foods to include and 5 foods to avoid. As you would expect being rooted in the Mediterranean and DASH diets, the MIND diet emphasizes plenty of vegetables, whole grains, and heart-healthy fats. It limits added sugars, refined flours, and saturated fats.
10 Brain-Healthy Foods:
- Leafy greens – 6 servings a week- With at least one additional serving of vegetables a day
- Berries- 2 servings a week
- Beans – 4 servings a week
- Nuts – 5 servings per week
- Whole grains – 3 servings a day
- Fish – once a week
- Poultry -twice a week
- Red wine- one glass a day
5 Foods to Avoid While Following the MIND Diet:
- Red meat – no more than 4 servings a week
- Butter – no more than 1 ½ teaspoons a day
- Pastries and sweets – no more than 5 servings a week
- Fried and fast foods – less than 1 serving a week
- Cheese – less than 1 serving a week
What Can You Do?
My take home from this? Next time you are working on putting together your weekly shopping list think about these 15 foods. How often are you incorporating the “foods to avoid” and how often do you come close to meeting the recommendations for the “food to include”? If your ready to make some changes, start slow and focus on 1-2 things that you could add. Maybe picking up some frozen berries that you can work on adding to yogurt or oatmeal a couple mornings a week. Or try my 3 bean turkey chili recipe for a serving of both beans and poultry. Starting slow and picking one or two things to focus on at a time can help ensure you keep up the habit long term and that is likely what is going to make the largest difference.
Estimating Hydration Needs:
When talking about health and diet, the topic of hydration often comes up, and rightly so if you think about the fact that the average human body is comprised of 55-70% water. Water is so essential to human life that without it humans cannot survive more than a few days, so it’s no surprise that there would be questions about optimizing intake. But how much do we need?
We have all heard the advice to drink 8 glasses of water per day, which converts to just under 2 liters. Other proposed ways to estimate needs include the Holliday-Segar method which is a weight based calculation and, for example, works out to be approximately 2.7 L per day for a 180-pound individual. Another popular method is calorie based with a starting point of 1 ml of fluid for every kcal consumed. To investigate this further the Food and Nutrition Board of the Institute of Medicine (IOM) gathered a panel of experts to evaluate the data. In their 2004 consensus report, they concluded that the majority of healthy adults are able to meet hydration needs by responding to their thirst cues. The panel also set an Adequate Intake of water for men and women of 3.7 L and 2.7 L respectively which they estimate would meet the needs of most healthy adults. The IOM report highlighted that fluid needs would be individualized to account for activity level, environmental temperature, physical fitness, body size, and health conditions.
If you’re looking at your own intake and thinking you are not likely meeting this don’t panic yet. The AI for water is coming from all sources in the diet, not just plain water consumption. This means that food sources contribute and population data suggests that Americans typically meet 20% of this daily fluid needs from foods. Non- water beverages count too, yes, even coffee! Coffee often comes into question due to the diuretic effect of caffeine however in the IOM report they concluded that for individuals with habitual intakes of significant caffeine, the caffeinated beverages appeared to contribute to total water intake similar to non-caffeinated beverages. That’s good news for us coffee drinkers and one more reason to continue eating plenty of fruits and vegetables.
Fluid content of common foods:
For the majority of healthy adults drinking when you are thirsty will likely ensure you are meeting your daily hydration needs, but remember to be mindful of increasing you intake when outputs might be greater, for example, warmer temperatures and increased physical activity. And pay attention to some of the common signs of dehydration including:
- dark colored urine
- dry mouth
- a headache