You have likely heard the term “metabolic syndrome” (MetS) and may feel it’s a bit nebulous. What exactly is it? How can it hurt me?
First, it’s a good idea to review the definition of what is a “syndrome.” According to Merriam-Webster, a syndrome is a group of symptoms that consistently occur together like a cluster, or a condition characterized by a set of associated symptoms. Further, a syndrome is so named when the medical community cannot find a clear cause of the varied, disparate symptoms. After awhile, though, even when causality is discovered, the name remains. This includes Metabolic Syndrome, as well as others such as Down Syndrome, Chronic Fatigue Syndrome, etc.
There are five risk factors that comprise Metabolic Syndrome, and clinical diagnosis of the syndrome is when at least three are present. These are:
- Abdominal spread/a large waistline. This also is called abdominal obesity or "having an apple shape."
- A high triglyceride level.
- A low HDL cholesterol level -- HDL is known as the "good" cholesterol.
- High blood pressure
- High or mildly high fasting blood sugar.
These concurring traits are risk factors develop over time and the development is squarely due to poor diet and lifestyle maintained for years. Each risk factor is a number that reflects how you treat yourself – and if not progressed may be adequately reversed through diet and appropriate exercise. That said, just simply getting older does increase risk of developing MetS and another uncontrollable factor is genetics.
Recent research shows that one doesn’t have to be obese to present with characteristics of MetS. Analyzing data from 12,047 adults, researchers sought prevalence of MetS in disparate weight/BMI groups and found that while the prevalence of MetS was61.6% in the obese group, it was 8.6% in the normal/healthy weight group. They concluded, rather ominously, “ In our study, normal-weight adults with MetS had the highest mortality among the 6 groups studied, suggesting that interventions should also focus on MetS patients with normal weight.”
Here’s the thing about MetS: although an expanded waistline will annoy or depress you you really do not feel MetS as those trait numbers are climbing high. The typical solution is several pharmaceuticals developed to lower those numbers with, of course, the admonition to eat a healthy diet and get moving.
But there may be yet another component that you may be unable to directly control. A recent murine study has identified specific cells in the gut -- intraepithelial T lymphocytes (or natural IELs) -- may slow down metabolism and contribute to development of high blood pressure, high blood sugar, obesity and heart disease, all conditions of and related to MetS. Here’s how it works: natural IELs limit the availability of a hormone, incretin GLP-1, that help speed up metabolism. By limiting GLP-1, the natural IELs, in effect, slow down the body’s metabolism and conserve the energy it gets from food.
When natural IELS are not present, the metabolism “goes into overdrive. The mice become metabolically hyperactive and, even when consuming a diet very high in fat and sugar, are able to resist metabolic diseases such as obesity, hypertension, hypercholesterolemia, diabetes, and atherosclerosis,” the authors wrote. They noted that this study may provide outstanding opportunities to develop new therapeutic avenues. Until then, though, there are ways to boost the MetS delay along with the de rigeuer healthy diet and exercise regimen; and one is to mind your microbiota.
One team of researchers described it this way: “Gut microbiota has recently been proposed as a crucial environmental factor in the development of metabolic diseases such as obesity and type 2 diabetes, mainly due to its contribution in the modulation of several processes including host energy metabolism, gut epithelial permeability, gut peptide hormone secretion, and host inflammatory state.”
Weight/Fat: Everything in proportion, right? Well, this also includes the balance (or imbalance, “dysbiosis”) of the two major phyla of gut bacteria – firmicutes and bacteroidetes (a third is called Actinobacteria). According to one study, in overweight/obese individuals, there is less bacteroidetes but they increase as people lose weight. The researchers noted that “obesity has a microbial component.”
One study showed that Lactobacillus paracsei F19 could inhibit fat storage by increasing angiopoietin-like 4, a lipoprotein inhibitor that controls deposit of triglycerides. Another found that the strain Lactobacillus gasseri BNR17 “can prevent diet-induced overweight.” A third showed that consuming Lactobacillus plantarum No. 14 reduces the white adipose tissue cells.
Blood Pressure: There is a platform of research showing an association between probiotic consumption and improved blood pressure levels. One meta-analysis of nine studies found that probiotic consumption significantly changed systolic blood pressure by -3.56 mm Hg and diastolic blood pressure by -2.38 mm Hg compared with placebo groups. Probiotic blends seemed to outperform single strain consumption, as they found that a greater reduction in systolic and diastolic blood pressure occurred in multi-strain probiotic groups over single strain groups.
Dyslipidemia (cholesterol imbalance): In one animal study, subjects on a high-fat diet and given the strain Lactobacillus reuteri GMNL-263 had anti-hyperlipidemia effects while the control group on a high-fat diet only did not. Similar effects were seen in rodents on a high-cholesterol diet that were given Lactobacillus reuteri LR6. In a meta-analysis of 15 trials with 976 human subjects, the researchers found that supplementing with Lactobacillus species L. reuteri and L. plantarum, “could reduce total cholesterol and low-density lipoprotein cholesterol significantly. The study also suggested significantly beneficial effects on triglycerides and high-density lipoprotein cholesterol by consuming synbiotic food containing L. sporogenes and inulin.”
Blood Sugar: Similar work was performed on the microbiota profile in individuals with diabetes types1and II. A recent clinical investigation in an Egyptian population (ranked 9th in the world for number of diabetes cases, 15.56% of adults), found a dramatic rise in amounts of gram negative, potentially opportunistic pathogenic taxa (Pseudomonas, Prevotella) as well as in gram-positive Gemella (associated with increased risk of diabetes) in all diabetic groups, compared to the control.
This study supports previous research looking at the link between the gut microbiota and 36 males of varied BMIs, half of which (18) with diabetes type II. Here, those with diabetes exhibited significantly lower proportions of Firmicutes and class Clostridia than in the microbiotas of those in the control (non-diabetes or MetS) group. The authors write, “The results of this study indicate that type 2 diabetes in humans is associated with compositional changes in intestinal microbiota. The level of glucose tolerance should be considered when linking microbiota with metabolic diseases such as obesity and developing strategies to control metabolic diseases by modifying the gut microbiota.”
Take into account if you have a family history of MetS (as well as diabetes type II and cardiovascular diseases, which usually result). The sooner you begin to be mindful of this condition and work to reduce your chances of it permeating your wellness, the better. MetS is a syndrome that, as stated, can be dramatically marginalized and controlled. And when you begin to hear your physician proclaim how “great” your numbers are, you’ll be more motivated to keep MetS from invading the precious vessel that is you.