This week our topic is Metabolic Syndrome – this is an ever growing Syndrome that just over a decade ago we hadn’t really heard of. Now though, it seems to be a snowballing phenomenon here in Australia. Unfortunately, our guest practitioner could not be with us today so we have our back up practitioner Wade Stiller in the studio. Wade has a Bachelor of Health Science in Naturopathy, is trained in both herbal and nutritional medicine and currently practices at the Northside Wellness Clinic. How are you today Wade?
Good thanks Jeff – thank you for having me back, it’s always a pleasure to be in here speaking to you and helping better inform our listeners.
Now Wade, just on that – we are living in the information age and subjects like Metabolic Syndrome seem to be fairly complicated, where do you stand with all the information out there? I mean, if I jump on the internet and type in pretty much any disease I can often find all sorts of conflicting information about the same condition and its treatment?
Yeah Jeff you’re right, this is the danger with the internet – there’s a lot of great info out there and also a lot of junk. As far as I’m concerned as a health professional my role is to ultimately educate people to the point where they take control of and responsibility for their own health using diet and lifestyle choices to support their wellbeing as well as getting a greater understanding of how their body works and understanding the signs it gives us when something is out of balance. So to start with I often discourage the crazy midnight surfing some people get caught up with in order to find the magic solution to their problem because literally anyone can go and post information on the internet and some of it may be helpful for one person and yet damaging for the next.
Metabolic Syndrome has a fairly broad umbrella of symptoms so although there is a plethora of symptomatic treatments available, this is one time I would encourage people who have never heard of it before to jump on the net and do a search because it is not a clearly defined, singular condition so it can get a little hairy trying to explain.
Ok, so what is metabolic syndrome then?
Ok, Metabolic Syndrome is a name for a group of risk factors that occur together and increase the risk for coronary artery disease, stroke, and type 2 diabetes. is also known as metabolic syndrome X, syndrome X, insulin resistance syndrome, Reaven’s syndrome (named for Gerald Reaven), and in Australia it has also been given an abbreviated name “CHAOS” (Coronary artery disease, Hypertension, Atherosclerosis, Obesity, and Stroke). Current data suggests that it affects one in five people, and that prevalence increases with age.
So Wade this “syndrome” is actually a collection of conditions that increases a person’s risk of other diseases?
Yes. To break it down further, the International Diabetes Federation have listed the following definition, that is; Central Obesity (or a BMI >30) PLUS any 2 of the following (unless already treated/diagnosed):
Raised triglycerides: > 1.7 mmol/L. Reduced HDL cholesterol: < 1.03 mmol/L in males, < 1.29 mmol/L in females. MRaised blood pressure: systolic BP > 130 or diastolic BP >85 mm Hg. Raised fasting plasma glucose :(5.6 mmol/L), or previously diagnosed type 2 diabetes.
In 1999 the WHO came up with a different set of guidelines to this but at the end of the day we are really looking at people who have multiple chronic disease states including cardiovascular + glucose dysregulation + cholesterol imbalance all combined.
Could you just quickly remind us how to work out our BMI – that’s “Body Mass Index” right?
Sure, you simply multiply your height in meters by itself (ie 1.8 x 1.8 = 3.24) then you divide your weight in kg by that number. So a 180cm, 80kg male = 80/3.24 = 24.7 = within healthy weight range.
So its weight in kg divided by height in metres squared.
So in order to have Metabolic Syndrome a person would have to have what kind of tests first?
Well, the only signs that can be physically measured without blood tests is that BMI or waist:hip ratio which confirms what we call central adiposity or central obesity. Of course that waist:hip ratio is worked out by measuring around that waist (cm) which is the level where your belly button is and dividing that number by the measurement around the hips (cm). For men this sum should = <0.9 and women <0.85.
Ok, so lets give our listeners a couple minutes to quickly go and grab a tape measure and scales to see what their measurements are and after the break we might talk a little bit about just who is at risk and just what can be done to best guard ourselves against Metabolic Syndrome.
Ok, welcome back to Better Health, we are talking today to naturopath Wade Stiller about Metabolic Syndrome – Wade lets talk briefly about who this syndrome is most likely to affect.
Thanks Jeff, well Metabolic Syndrome is certainly becoming more common both in the US and here in Australia. Look science is still searching for a given cause for this and in my opinion they will never find one because it is a combination of bad lifestyle and eating habits – one risk factor that is related to every case is obesity. Now there can be a number of reasons for obesity but in the majority of cases the bottom line is either a lack of education relating to exercise and diet OR a choice to ignore what we have been taught about exercise and diet! So to me, the vast majority of Metabolic Syndrome cases should be easily avoided with some simple education and maybe a little accountability from those who know they get lazy with their eating and lifestyle.
Well that’s easy to say but for most of us life really does get in the way of going to the gym or going jogging everyday. Even finding the time to prepare a home cooked meal is sometime a big ask!
Oh look, don’t get me wrong Jeff I understand that completely, I mean when I got married I put on almost 2 stone in the first year because my social life slowed down and all of a sudden I was spending most nights at home eating a lovingly cooked meal with my new bride and it’s been an effort to let go of those kg’s but sometimes we have to ask ourselves which is more important, our lifestyle or our health? Missing that extra hour of TV a day, or walking part the way to work, even cutting back from 60 to 55hrs of work a week in order to look and feel better is nice, but to think that 10years down the track today’s choice will probably have major implications on your health, that’s worth the change!
So is Metabolic Syndrome something that people “grow into”?
Kind of, the risk factors for Metabolic Syndrome include – Aging, hormonal changes, lack of exercise and genes (as some people have genetic weaknesses in the areas of cholesterol production or high blood pressure etc). So the older we get, the higher the risk… and of course we all go through hormonal changes once we pass middle age, so identifying things like an unhealthy waist:hip ratio or high BMI and working toward changing any bad habits we have formed as soon as possible is a really easy and very effective way to lower that one risk factor that was common amounts all sufferers…
That’s it! Obesity…and probably the saddest part when looking at who is at risk, is the fact that the age of people being diagnosed with Metabolic Syndrome is coming down. And there really is no excuse for this here in Australia – we have plenty of money to feed ourselves correctly, plenty of awesome weather to get out and be active and heaps of information available to us, yet we are seeing the numbers of obese children climb every year. You know there was a time when we called Type 1 diabetes “child-hood onset diabetes” but now days type 2 diabetes is becoming so common in children that it’s no longer “adult-onset diabetes”, now we just have type 1 and type 2! Jeff, these are chronic diseases that are affecting children here in a first world country! It just shouldn’t be… and I know some blame genetics but to me it’s all diet and lifestyle.
Right, and you mentioned changes in hormones being a risk factor – how can this make one more at risk of diabetes or high cholesterol etc?
Well, this is a complex issue. The body uses hormones to affect changes through all stages of life – the most obvious being adolescence and menopause or adropause but also for small day to day task – our wake/sleep cycle, our stress response, metabolism, bone density, growth and repair rates… the list goes on but the point I’m trying to make is that basically every thing that comes in contact with our body causes a hormone response in some way, shape or form – hormones aren’t just things us men complain about in women every month or the things that give us acne at high school – they are much more than that and they are influenced by everything around us. Things like plastics, medications, foods, parabens in skin care products even some food preservatives have an effect on oestrogen receptors alone within our bodies – both men and women. Our hormone production is something that we need to nurture and the balance needs supporting all the way through our lives as these hormones interact and mold both our growth and body maintenance.
Of course insulin is another of those hormones that most people these days have some knowledge of. Insulin helps sugar from our blood enter into our cells. We also need magnesium in our cells for this to happen. The more sugar we eat, whether it be because we need an energy burst or maybe we don’t realize what we are eating is high in sugar or heck, we just have a sweet tooth, our body doesn’t care – the reason behind the ‘why’ is irrelevant – when we eat sugar, our body pumps out some insulin to allow that sugar into the cells so the energy can be utilized. If this goes on long term, our cells eventually decrease their number of insulin receptors and we eventually become insulin resistant – so sugar can no longer get into our cells to power them. As a result, our blood sugar levels rise which means our blood pH levels drop (or we become more acidic) and this can play havoc around our body causing all sorts of damage to our kidneys, our eyes, our nerves and brain and our blood vessels.
So does this have an impact on the other factors associated with Metabolic Syndrome?
Absolutely! When our blood sugar and insulin levels rise we often then get a rise in triglyceride levels and our cholesterol levels also change.
Oh, in what way?
Well we have all heard about the ‘good’ and ‘bad’ cholesterol right?
Ok, so one of the jobs the ‘bad’ cholesterol does is patch up any damaged areas on our artery walls. Now I just mentioned that raised blood glucose levels can play a part in this, we also know that eating too much saturated fat can cause hardening of these artery walls too… well our ‘bad’ cholesterol or LDL starts off the healing process when our blood vessels get damaged – see it’s a very important compound in our body – when the healing process is underway, our ‘good’ cholesterol or HDL then comes along and mops up the LDL along with any damaged cell fragments and they get filtered out by the liver.
So the more damage our arteries have – the more LDL we make in order to repair and recover. It’s like a protective mechanism?
Spot on Jeff! That’s why our LDL:HDL ratio is so important – if there is not enough HDL to scavenge the LDL, our arteries clog up and we end up with a stroke or what not. What intrigues me though is that rather than this ratio being viewed as a marker of systemic health, it is sold to us as something that needs controlling. Why not just work out why the balance has occurred rather than block the production of LDL?
Now you are getting a little controversial! So Wade, what treatments are available?
Well, medically there are a few things you can do once you have the conditions we have already spoken about. Statins for lowering cholesterol, hypotensives to lower blood pressure and type 2 diabetes can be controlled a couple different ways but at this stage there are no drugs that can prevent Metabolic Syndrome, they can just control the symptoms once you have it. Now that may sound like I’m bashing the medical system but I’m not – in fact if it weren’t for the medical system I would only have 2 children rather than the 3 I have today but in all honesty the pharmaceutical treatments available today are excellent at treating acute, emergency type situations but not so hot when it comes to chronic disease. Complimentary medicine however is the opposite – because our focus is to allow the body to heal itself, that process can take some time. In an emergency there is no time and that where drugs are awesome at simply taking over and making the body to what it needed.
So does complimentary medicine have any complete formulations to treat something like Metabolic Syndrome?
No, Jeff there is no 1 tablet that can balance cholesterol, blood sugar levels, blood pressure, obesity and triglycerides in one hit. I know there had been a couple natural products lately that have research to back up claims like this but the fact is, not everyone has the same triggers for these symptoms.
As an example, I have spoken to many patients who have used a particular oil that is, well I saw an ad for it last night actually, and it’s being used for its “Cardio” effects and cholesterol lowering attributes. This product has research showing that it can lower total cholesterol by around 2 points in 3months. Some patients have experienced this even with only moderate diet changes but one guy I treated in particular was on a high dose of this oil for a good 6months and his cholesterol just would not budge! He increased his exercise, his diet was great, but his total cholesterol just lingered around 7. So I gave him some herbs to increase his bile output (which is a way the liver excretes cholesterol) and in a few months we saw a drop to 6 and then 5 shortly after. Now this patient couldn’t take statins due to the side effects and lack of energy so we had to sort him out and for him, that one product was not right.
So you would suggest a range of products to cover all bases?
Yes and no, I think you are better off spending some money and going to see a qualified practitioner so you can focus your treatment rather than just buying up a complete range of products but having said that there are a few things that can be done and taken to help prevent most of the imbalances that Metabolic Syndrome presents.
First and foremost – exercise! It only needs to be moderate and for around 30mins most days. This is something your GP will tell you but it is so obvious even your milkman knows we need it…and if you are a smoker, I don’t need to tell you – just stop it now because it increases your risk of almost every disease known, not all but most – as well as those around you.
Secondly, sleep! We haven’t even touched on this but 7-8hrs sleep a night is incredibly important in keeping our hormones in check as well as our liver, insulin and stress response healthy.
On 28 February 2011, Naturopath, Wade Stiller discussed Metabolic Syndrome with Jeff Croucher from Pure Health Direct on 99.7 fm local radio. Click on the video links to watch a video recording of the session or read the transcript of the discussion below.
Next is diet – you know, NONE of us need sugar. It is a treat and a substance that our body can get from whole foods that available from nature. Most of us do not eat enough good fat, all our hormones and cell membranes are made from fat so getting this balanced in our diets is crucial and cutting fat out of our diets is very dangerous indeed. Most Australians need a high quality fish oil supplement to balance out our diets. Of course we need plenty of protein as well.
A good multivitamin/mineral, plenty of magnesium and often high amounts of antioxidants are also typical products that would be used for people who are heading down the Metabolic Syndrome path but as we said earlier – prevention is the best treatment so if you are seeing some of those signs like a high waist:hip ratio or BMI >30, NOW is the time to do something about it. Not tomorrow, but now!
Hmmm, challenging words Wade. Unfortunately that is all we have time for this week. Once again, naturopath Wade Stiller thank you for speaking with us today.
That’s my pleasure – thanks Jeff.