There are numerous people and influences in my life that need to be acknowledged for the success of my career and the development of this book. Most importantly, none of this would have happened without my steadfast faith in Godthrough Him all is possible. To my dad, who passed away 11 years ago from cancer, your memory continues to motivate and inspire me. To my family, who are my biggest fans, thank you for your continued support. To Gaetano, my husband to be, you are my rockyou have taught me so much, thank you for loving me and encouraging me to be the best person and nutritionist I can be. The greatest blessing is having a partner who shares so many of the same passions in life.
A special thank you to Natures Way for supporting me and giving me the honor of representing your company and brand in the health and nutrition industry. It is a pleasure to have formed this relationship with such a high-quality, respectable brand.
For those in my professional life who believed in me from a very young age, especially Dean Yachison, Marc Vaugeois, Jason Mitchell, Jan Summerfeldt, and Dr. Rakesh Kapoor, I will never forget the support, opportunities and teaching you have given me.
To Joan Whitman and Valerie Ahwee for your literary expertise and the countless hours spent in making this book a success.
A book on metabolic syndrome would not be possible without the researchers and scientists in this field, especially Dr. Gerald Reaventhank you for sharing your knowledge and expertise.
Metabolic Syndrome: A Weighty Issue
Alex Mariner, 48, has known for years that he needs to lose weight and figured he was in for another lecture when he went to see his doctor for his annual checkup. He wasnt expecting to hear that he had some strangesounding syndrome. Alex has always been worried about developing type 2 diabetes because it runs in the family, but he never expected the doctor would tell him that he had metabolic syndrome.
Metabolic what? Alex has joined the growing number of people who have metabolic syndrome, a precursor to diabetes, a diagnosis that is becoming increasingly common, primarily because of the obesity epidemic.
An estimated 25% of the U.S. population is said to have metabolic syndromea mere 70 million adults age 20 and olderand the rate approaches 50% among the elderly. Mexican Americans and African-American women appear to be especially prone. Yet I would bet that most of you reading this book have never even heard about it. Why is this? There is no logical explanation for the lack of public education on the pernicious health effects of metabolic syndrome, formerly known as Syndrome X. However, it takes a while for new concepts, such as Syndrome X, first described by endocrinologist Dr. Gerald Reaven in 1988, to become mainstream among the modern medical community. Early responses from the medical community to Dr. Reavens definition were not overly positive, there are still skeptics, and experts who disagree about how dangerous it is and how intensively it should be treated. But many experts feel the metabolic syndrome approach is very useful. It has crystallized thinking about how fat causes illness, motivating people to lose weight and exercise, and prompting doctors to identify and treat people sooner.
Dr. Reaven paved the way for further research. The underlying root cause of metabolic syndrome is insulin resistance, which leads to increased cardiovascular disease and precedes type 2 diabetes. Dr. Reaven proposed that there is a metabolic defect that causes the cells resistance to insulin. The metabolic defect is caused by a combination of heredity and lifestyle factors. In other words, insulin is present, but it does not do its job properly. This resistance to insulin sets the stage for obesity, high blood cholesterol, and hypertension.
Figure 1.1: Metabolic Syndrome
The time has come to take action. Doctors around the globe are paying attention to metabolic syndrome, which has emerged as the primary culprit of type 2 diabetes and cardiovascular disease. Soon, metabolic syndrome will overtake cigarette smoking as the number-one risk factor for heart disease among the U.S. population. With rates of diabetes expected to reach the three hundred million mark in the next two decades, and with cardiovascular disease still ranking as the number one killer in North America, metabolic syndrome has gone from being relatively unheard of to a worldwide emergency.
METABOLIC SYNDROME: THE CONCEPT
A syndrome is a collection of symptoms that make someone prone to disease. Dr. Reavens defi nition of Syndrome X focused on the cluster of symptoms, in which he included insulin resistance and glucose intolerance (poor blood sugar control), obesity (although not strongly emphasized), blood-fat abnormalities (high levels of cholesterol and triglycerides), and high blood pressure. He described syndrome X as a condition triggered by an inability to respond properly to insulin, which controls blood sugar levels. He realized that instead of regarding each of the risk factors for diabetes and heart disease as separate entities, they should be viewed as connected to one another.
Clustering the components of metabolic syndrome has advantages over analyzing each of the components individually. Each factor by itself may not be highly dangerous, but together they appear to sharply boost the danger of major health problems, notably heart disease and diabetes. The risk for having coronary heart disease (CHD) is significantly greater in cases with the metabolic syndrome compared to the risk associated with each component alone. This is true in those people who have impaired glucose tolerance (prediabetic) and in patients with type 2 diabetes. Compared with non-insulin-resistant people, those with higher levels of insulin have twice as much chance of developing hypertension, three times as much chance of developing the abnormal cholesterol patterns, and fi ve times greater chance of developing diabetes. All these are risk factors for CHD, doubling your risk of developing cardiovascular disease, with heart attack being the ultimate result if the risk factors are left untreated.
PREDIABETES AND TYPE 2 DIABETES: WHEN ONE BECOMES THE OTHER
You may have heard the term prediabetes, which is an important concept to understand when discussing metabolic syndrome and diabetes. Prediabetes, which used to be called impaired fasting glucose, is a precursor or intermediate stage in the natural development of diabetes. If you have blood glucose levels higher than what is considered normal but below what is considered the level for a diagnosis of diabetes, you have prediabetes. It is like the warning light in your car that comes on telling you how many miles you have to go before you run out of gas. It means that something needs to be done (you have to get gas) or you will be in trouble. Prediabetes is the same thing. It signals danger that could potentially lead to type 2 diabetes unless treated.