Metabolic syndrome – A health time bomb

In the US, an estimated one in five adults has metabolic syndrome a condition that has been described as a cardiovascular time bomb. Could you be at risk?

Before reading any further, find a tapemeasure and check the size of your waist in centimetres. If its greater than 80cm and you are female, or if its larger than 94cm and you are male, then the chances are you may have metabolic syndrome. The good news is, if you do, there are lots of things you can do to improve your health before it deteriorates any further. The bad news is, if you ignore the warning signs and carry on with your current diet and lifestyle, you are at increased risk of developing diabetes and of having a heart attack or stroke. In fact, 80% of people with metabolic syndrome will develop type 2 diabetes if they dont take steps to avoid it.

WHAT IS METABOLIC SYNDROME?

It is associated with several abnormal findings, but the most easily identified is central obesity in other words, having a large waist or beer belly. Compared with fat cells elsewhere in your body, those packed around your internal organs are unusually active. They leak fatty acids into the circulation and produce a number of hormones that are associated with insulin resistance. Once cells lose their sensitivity to insulin hormone, your blood-glucose levels stay higher than normal after eating carbohydrates. Your pancreas tries to overcome this by making more and more insulin to help push excess glucose into fat cells for storage. This sets the scene for a vicious circle in which your waistline gets bigger and bigger, your cells become less and less sensitive to insulin and your insulin and glucose levels keep rising. Eventually, your glucose levels may rise enough for your doctor to diagnose type 2 diabetes. Paradoxically, this form of obesity-related diabetes is often associated with high insulin levels, although eventually your pancreas may become fatigued, so that insulin production stops and type 1 diabetes (associated with lack of insulin) develops.

big belly of a fat man isolated on white

SYMPTOMS AND SIGNS

As well as having central obesity, high insulin levels and glucose intolerance, people with metabolic syndrome can develop high blood pressure, abnormal blood-fat levels (raised triglycerides but low levels of beneficial HDL-cholesterol), increased blood stickiness and even liver problems as a result of their increasingly abnormal metabolism.

Metabolic syndrome may well prove a helpful signpost to identify those who can make dietary and lifestyle changes that can potentially prolong their life.

You are also likely to have difficulty losing weight on low-fat diets, to feel tired all the time and to develop sugar cravings. Although metabolic syndrome has been described as a cardiovascular time bomb it may well prove a helpful signpost to identify those most at risk of developing type 2 diabetes, heart attack and stroke and who can make dietary and lifestyle changes that can potentially prolong their life.

DEFINITION

As it represents a cluster of symptoms and signs, metabolic syndrome is diagnosed when three or more risk factors are present. Although there is no firm consensus on diagnosis, the European Group for the Study of Insulin Resistance suggest the following definition:

  • fasting blood-insulin levels in the highest 25% for the population.

PLUS any two of the following:

  • glucose levels great than or equal to 6.1 mmol/l (but less than 7.0mmol).
  • high blood pressure greater than, or equal to 140/90mmHg.
  • abnormal blood-fat levels (high fasting triglyceride levels of greater than 2.0mmol/l or HDL-cholesterol of less than 1.0mmol/l).
  • central obesity: waist circumference greater than or equal to 94cm in men and 80cm in women.

Because insulin levels are not routinely measured, a simpler definition that uses just two factors waist circumference (greater than 90cm) and elevated blood triglyceride level (greater than 2mmol/l) has also been suggested.

SELF-HELP

If you are overweight with a big waist, it is important to see your doctor, who can screen you for raised blood pressure and check your blood-fat and glucose levels. He or she may need to prescribe a number of drugs to improve your health and it is important to take these as prescribed. There are also things you can do yourself that have the potential to reverse metabolic syndrome altogether. Although the tendency towards insulin resistance may be inherited, it is usually acquired due to lifestyle factors such as obesity, lack of exercise and eating excessive amounts of refined carbohydrates.

People with metabolic syndrome need to lose excess weight, exercise regularly (which in itself can lower glucose levels, blood pressure and blood-fat levels) and switch to a diet that does not cause spikes in blood-sugar levels. This means eating foods with a low rather than a high glycaemic index. Research shows that following a controlled-carbohydrate diet can reverse ALL the clinical findings associated with metabolic syndrome, helping you lose weight, lower a raised blood pressure, lower triglyceride levels and increase beneficial HDL-cholesterol. Some people may prefer to follow a very low-calorie diet, under the supervision of a trained counsellor. While the traditional low-fat, calorie-controlled diet is also an option, people with metabolic syndrome tend to find it very difficult to lose weight following this approach which encourages a high carbohydrate intake the very macronutrient that triggers insulin release in the body.

SUPPLEMENTS

A number of supplements can help people with metabolic syndrome. As a basic rule, most people benefit from taking a multivitamin and mineral supplement because magnesium, selenium, copper, zinc, vitamin C and vitamin E are all important for improving glucose tolerance. Depending on how well your blood glucose levels are controlled, you may wish to add in a supplement such as:

  • Chromium, which helps to regulate bloodsugar levels by improving insulin resistance in muscle cells. It may help only people who are chromium deficient but, as this is relatively common, there is little harm in trying a chromium supplement at a dose of 200-400mcg daily (dont forget to factor in any chromium included in your multivitamin and mineral supplement) for a few months to see if it helps.
  • Alpha-lipoic acid, which helps to improve insulin sensitivity and glucose uptake into muscle cells.
  • Conjugated linoleic acid, which helps to improve insulin resistance in fat cells.
  • Co-enzyme Q10, which may improve the function of insulin-producing cells in the pancreas.
  • Pycnogenol which can significantly improve glucose tolerance through a mechanism that is not yet fully understood.

Interestingly, drinking green tea can also improve glucose control and you may wish to enjoy this regularly or, if you dont like it, take green tea supplements.

Garlic extracts have a number of beneficial actions that help to maintain a healthy heart and circulation.

Taking omega-3 fish oils will provide an additional useful protective effect on the heart and circulation and help to reduce the inflammation associated with metabolic syndrome.

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NB: Supplements should always be used to complement the medical treatment your doctor has recommended and should never be chosen instead of normal medical care. Never stop taking any prescribed medications except under the advice of your doctor.

DHA – Brain Food

Short for docosahexaenoic acid, it is one of the most important omega-3 fatty acids needed for optimal health.

The brain is 60% fat, of which DHA is one of the most important components essential for brain and eye function. DHA is also present in every other cell in your body, in the membrane of the tiny structures (mitochondria) that make energy. These are especially concentrated in heart muscle cells.

Why it is important

DHA is a highly unsaturated, long-chain polyunsaturated fatty acid (LCP). In chemical terms, this means there are lots of gaps in its molecular structure where hydrogen atoms are missing. These gaps make DHA very flexible and, when optimum amounts are present in cell membranes, it allows electrical signals to pass more easily from one brain cell to another. Because of its structure, DHA also keeps the membranes surrounding each synapse – the communication gap between two nerve cells – in a more fluid state. This helps nerve cells release chemicals into the gap more quickly, and for the detector sites (receptors) on the other side of the gap to recognise messenger chemicals more readily. Brain cells whose membranes are rich in DHA therefore seem to communicate more quickly with each other.

When DHA is in short supply, other fatty acids – especially saturated fats – are incorporated into the nerve cell membranes instead. As these are more rigid, however, nerve cell membranes become less flexible and less efficient in passing on electrical and chemical messages. As a result, the speed of communication between one brain cell and another is slowed.

Sources

Very small amounts of DHA may be made in the body from an essential fatty acid, linolenic acid, but the amount made is probably low and most DHA comes from our diet. DHA is mainly found in animal products such as fish, eggs and meats.

Oily fish, such as mackerel, herring, salmon, trout, sardines, pilchards, are the richest dietary source of EFAs, containing 10 to 100 times more DHA than non-marine food sources such as nuts, seeds, wholegrains and dark green, leafy vegetables. Those who follow a strict vegetarian are most likely to have a low DHA level. The only rich vegetable source of DHA is algae.

People who follow a low fat, low fish diet often also miss out on beneficial LCPs. The fact that intakes are low is illustrated by the finding that average DHA concentrations in the breast milk of British Mothers is only 0.2%, six times lower than that of North American Inuit women (1.2%) who eat plenty of fish. Pure DHA can now be extracted from algae to yield a highly purified form that does not contain other LCPs present in fish – this is ideal as another LCP found in fish (eicosapentaenoic acid, EPA) may not be as suitable for pregnant women. DHA extracted from algae is also free of pollutants that may be present in certain fish oils.

Pregnancy

DHA is vital for development of a baby’s eyes and brain, especially during the last three months of pregnancy. DHA makes up 10% – 15% of the weight of a baby’s cerebral cortex. DHA is also concentrated in the light-sensitive cells at the back of a baby’s eyes where it makes up 50% of the weight of each retina. DHA is so important to a developing baby that, during late pregnancy, the placenta extracts it from the mother’s own blood and concentrates them in her baby’s circulation. As a result, a baby’s levels of DHA are twice as high as his mother’s. If maternal levels of DHA are low, some DHA is also obtained from the mother’s richest store – her own brain. This may account for the slight shrinkage (2% – 3%) in maternal brain size seen in some pregnant women, and account for the poor concentration, forgetfulness and vagueness that many women experience during the last few months of pregnancy. A newborn baby is unable to produce DHA from essential fatty acids until he is at least 4 months old. He therefore depends on what he can obtain from breast milk or enriched formulas. Research has shown that, by the age of nine months after birth, babies fed on mother’s milk or a formula milk enriched with LCPs have better visual acuity than those receiving formula that does not contain LCPs.

Recent research suggests the benefits of early LCP enrichment may last into childhood. A group of 6 year olds were asked to find a picture identical to the one they were given among several that were slightly different. While there was no difference in the number of mistakes made, children who had received LCP-enriched formula during the first 4 months of life were able to perform the task more quickly than those not receiving enriched formulas. For example, in a test that took an average of 8 seconds, those who had received LCPs were able to complete it around one and a half seconds faster. Other tests also found that those who had received LCPs as babies were able to perform other mental tasks more quickly, although overall there was no difference in IQ.

DHA and mental performance

In older people, low levels of DHA have been linked with memory loss, mood swings and conditions such as dyslexia, attention deficit hyperactivity disorder and autism. Dyslexia is a common condition in which there is difficulty in learning to read and write plus impaired night vision (dark adaptation), poor peripheral vision and difficulty in processing rapid changes in visual stimulation (eg flicker, motion). Although the exact cause is unknown, it is believed to be linked with deficiency of certain essential fatty acids so that nerve cells in the brain transmit certain information more slowly. Research is under way to see if giving DHA-rich supplements to pregnant women with a family history of dyslexia can help to prevent the condition. Researchers have already found that fatty acid metabolism is abnormal in people with dyslexia, with increased turnover of two lipids – phosphethanolamine and phosphocholine. This may be a genetic difference which is made worse by lack of dietary EFAs and improved by a diet rich in EFAs.

DHA and the heart

DHA is one of the omega-3 fatty acids that makes fish oils so beneficial for heart health. It has beneficial effects on cholesterol and triglyceride levels and may also have beneficial effects on blood pressure and heart rhythm. Ideally we should all eat fish at least twice a week. Sadly, however, because of the levels of pollutants such as mercury, dioxins and PCBs, the Food Standards Agency recently advised that only one of these portions should be oily fish. Taking a fish oil or DHA supplement that is known to have low levels of pollutants is one way to obtain the benefits of a fish-rich diet. Another option is to eat fish that is classed as organic (Currently organic salmon and trout are available).

Recommended daily amounts:

  • For adults who obtain some DHA from their diets: 100mg daily.
  • For adults who obtain little dietary DHA: 200mg daily (eg vegetarians, those following a low fat diet).
  • Breast-feeding: 200mg DHA daily.
  • Children: 100mg DHA daily.

Did Einstein’s mother eat fish?

The size of a baby’s brain, and its head circumference are linked to its blood levels of DHA during the first year of life. By the age of nine months after birth, babies fed on mother’s milk (which contains DHA) or formula enriched with DHA seem to have significantly better visual acuity than baby’s receiving formula that does not contain DHA. As a result, most formula milks are now enriched with long-chain polyunsaturated fatty acids.

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Magnesium for High Blood Pressure

Studies have shown a strong correlation between high magnesium intake and lower blood pressure. However, studies using magnesium to treat hypertension (elevated blood pressure) have had mixed results. It seems to work best for hypertensive people who are on diuretics, those with high levels of renin in the bloodstream (causing blood-vessel constriction), or those with high intracellular sodium and low intracellular potassium. Dosages used in the studies ranged from 480-600mg per day. The RDA for magnesium is 300-400mg per day. Optimal intake is 3-6mg per pound of body weight.

You should not take magnesium supplements if you have kidney disease or severe heart disease. Magnesium sulfate, hydroxide or chloride can cause loose stool. The forms that are most easily absorbed and used by the body are aspartate, citrate and malate. Include some vitamin B-6 along with the magnesium, since they work together in the body. If magnesium is going to help with lowering your blood pressure, you should see improvement in a month.

Magnesium is a very important mineral, necessary for hundreds of cellular enzyme reactions, especially those that produce energy. Other conditions that can benefit from magnesium supplementation include elevated cholesterol and triglyceride levels, angina that occurs at rest, asthma, fibromyalgia, tension headaches, osteoporosis, PMS and menstrual cramps.

Omega 3 – Essential for healthy living

Did you know that some fatty acids in the food that we eat are “essential” just like some vitamins are? This means that they cannot be made by our bodies and have to be provided in our diet.
Our cells recognise the shape of these polyunsaturated fatty acids when they are eaten, so that they are used directly by the tissues that need them for important functions related to the cardiovascular system, immune system, brain functions and many others besides. There are two types of these important polyunsaturated fatty acids – omega 3 – like EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid) and omega 6 – from seeds and red meat. Even if certain omega 3 and 6 fatty acids are used in the same body cells, they have different, mostly opposite actions which means we need to balance our intake of the two types. Due to the fact that the food industry today uses omega 6 containing oils like soy and corn-oil in almost every product, a dangerous imbalance has been creeping in during the last 30 years. And this has not been compensated for by an increased intake of fish. On the contrary, we eat less oily fish than ever before. This has created a need for the omega 3 fatty acids EPA and DHA which can only be addressed by changing the design of our diet.

THE BENEFITS OF EPA

Due to its shape, EPA acts in the cells in the cardiovascular system where it has important benefits in preventing blood clotting and formation of atherosclerosis, the arterial disease responsible for myocardial infarction and stroke. Clinical studies from the UK and the US have shown that omega 3 fatty acids can prevent development of atherosclerosis and even reduce the risk of established atherosclerosis. The American Heart Association recommends a daily intake of 750mg of omega 3 fatty acids to prevent the development of cardiovascular disease which takes more than half a million lives each year in the US.

EPA is also important for the normal function of the immune system as it has a fine-tuning effect on different immunological events. Did you know that an overactive or false-programmed immune system is responsible for conditions like rheumatoid arthritis, psoriasis and inflammatory bowel diseases as well as allergies? Clinical studies from Europe and the US have demonstrated that omega 3 fatty acids have important effects in the treatment of these types of diseases.

What about DHA?

This molecule is integrated in all brain cell membranes where it exerts important functions, relating to memory for example. People with a poor memory have low concentrations of DHA and patients with Alzheimers dementia have very low levels of DHA in the brain. Several studies have shown that people with a regular intake of omega 3 fatty acids do not develop dementia to the same extent as those who dont eat fish.

A clinical study from Sweden, to be published later this year, has demonstrated positive effects of omega 3 on memory in patients with established Alzheimers disease. So it seems that a regular intake of oily fish or a daily food supplement containing about 1g of omega 3 fatty acids has a preventive effect on the development of memory loss and even dementia.

The tissue with the highest content of DHA is the retina of the eye. DHA is important for the conversion of light to electrical signals which are conducted to the rear part of the brain where these signals are processed and stored. Loss of eyesight in the elderly, due to degenerative changes in the retina, is getting more common due to the fact that the average life expectancy has increased.

This disease, called age-related macular degeneration, is more common in people who dont eat fish. An ongoing study in France is seeking to establish whether a DHA supplement can alleviate symptoms in these patients.

So it seems that even if people today eat an inferior diet, with processed food instead of organic food and lots of lean products containing high amounts of omega 6 plant oils, there may be much to gain by increasing the intake of oily fish or taking an omega 3 supplement.

Prevention is important before diseases develop. This also has an impact on the amount of omega 3 fatty acids necessary to obtain positive effects. Significant effects on cardiovascular and brain health can be obtained by eating oily fish a couple of times per week or by taking at least 600mg of omega 3 fatty acids daily. If you are considering a daily omega 3 supplement, you should choose a concentrated product which is purified from environmental pollutants regularly found in oily fish.

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Omega 3 – The facts

Few years ago hardly anyone had heard of omega oils and yet now theyre everywhere not only in their natural form, but in capsules, in enriched milks and in some breakfast cereals, as well as lined up with the other oils on supermarket shelves.

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The reason why everyones going mad about them is easy to see: the results of nutritional research into their benefits are all positive. Taking omega oils really can change the way we look and feel. Skin appears younger and conditions such as eczema and psoriasis improve dramatically. The ability to concentrate and feel in control of moods is enhanced. There is even strong evidence to suggest that these oils protect the heart and make joints more supple, meaning that they are less likely to succumb to inflammatory diseases such as arthritis. Research carried out by the eminent specialist Dr Alexander Richardson has also shown how wonderful they can be in the treatment of attention deficit hyperactivity disorder.

A large study has confirmed that the influences on brain function can be traced back to earlier in a childs life, hence headlines such as Oily Fish Makes Babies Brainier. This major study of 9,000 mothers and their children, looking at the effects of the essential fatty acid omega 3, found that mothers with the highest consumption of mackerel and sardines and other sources of omega 3 had children who, at the age of three and a half, had the best measures of fine-motor performance. Those with the lowest intake had youngsters with a verbal IQ six points below average. Parents reported that after just six weeks of daily doses of omega 3, they noticed a change in the behaviour and learning abilities of children as young as twenty months.

Another study carried out in Durham looked at the behaviour of pre-school children and found there were dramatic improvements when they took a daily dose of fish oils. This was particularly obvious among underachieving toddlers, many of whom had been disruptive and unable to concentrate. They were assessed for motor skills, IQ, reading, spelling and behaviour and the study identified a huge reduction in symptoms of the sort associated with ADHD.

Although omega 3 isnt the only important fatty acid, most of us already get enough of the others, such as omega 6, in our diet, so its omega 3 we need to concentrate on boosting. How our bodies use omega 3 might sound a little complicated initially, but in fact its a simple process that begins when we eat foods containing linolenic acid (LNA). This is found mainly in oily fish such as kippers, herring, mackerel, salmon (preferably organic, wild, not farmed), sardines and fresh tuna (tinned tuna doesnt count, although tinned versions of the others do). Our enzymes slowly turn this linolenic acid into docosahexanoic acid (DHA)and eicosapentanoic acid (EPA).

So, on the menu to boost omega 3 fatty acids, how about trying smoked mackerel pt on wholemeal toast or poached organic salmon in white wine and fresh herbs such as dill or seared tuna loin drizzled with fresh lime a cool place, as this will help prevent the oils within them becoming rancid that would not only make them bitter and unpleasant to eat but can also be damaging to health. Talking of not-great fats, since saturated ones, such as those in butter, cream, cheese, red meat and its products, block the production of beneficial DHA and EPA, its best to keep intake of saturated fats down.

Finally, there is always of course the supplement option, which I have to say is very convenient and particularly useful when it comes to kids with behavioural difficulties, such as ADHD. Parents should bear in mind that although I have seen some improvements within just a few days of starting omega supplements, it can take up to three months for the maximum benefits to become apparent. I usually suggest that parents think about a three-month trial period to see whether omega oils are having any positive impact on their youngsters.

Whether you are taking an omega 3 supplement to improve skin problems, concentration or moods, or as a preventative to help keep heart and joints healthy, I would usually recommend taking a daily fish oil which contains at least 500mg of omega 3 . And remember to check the sell-by date to avoid encountering any rancid oils.

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10 Things to Eat or Drink to Make Your Skin Look Fabulous

Be your own esthetician – here are 10 things you can eat or drink to help keep your skin looking great. Though many of the foods and beverages suggested here have not been proven effective though scientific studies, some dermatologists and estheticians believe they will help. Other dermatologists, however, believe what you put on your skin is more important than what you put in your body.

Water – Water, water everywhere, but what a bore to drink. Do we have to? Some skin care experts say yes, some no, but the consensus is that drinking a glassful every two hours or so will help carry nourishing elements around our bodies and wash out toxins. Oprah has a golden goblet from which she quaffs her water; another idea comes from Ellza Belleza, an esthetician at the Gerard Bollei Salon in the Galleria of Manhattan’s Trump Tower: “I don’t like the taste of water, so I squeeze in a little piece of lemon, cantaloupe or watermelon. When I drink the flavored water, my whole body feels different.”

Asparagus – Asparagus is great when you’re waterlogged, suggests Bollei makeup artist Janet Paolucci. “Asparagus is a wonderful diuretic if your face is too puffy. Steam it a little and also drink the water in the bottom of the pot,” she said.

Japanese Green Tea – Japanese green tea is good for the skin as an afternoon pick-me-up, according to Paolucci. “When you’re fatigued, your skin doesn’t have that glow. You want to get rid of all the toxins in your body and I find that green tea works wonderfully,” Paolucci said.

Berries – Dr. Nora Maya Kachaturoff, a dermatologist in private practice in Grosse Pointe Farms, Mich., said, “If I had to pick one food to recommend, I’d say gorge yourself on fruit, especially fresh berries. My personal favorite is a mixture of fresh berries and yogurt, which is natural, low fat, low cal and delicious. When fresh berries aren’t available, frozen ones count, as most fruit is frozen within 12 hours of being picked and retains its natural elements.”

Apples – Belleza points out that apples supply amino acids, which are the building blocks of protein and are vital components for skin, hair, muscle tissue and other vital organs. Unprocessed apple cider confers similar benefits, but not processed applesauce or juice.

Pineapple – Pineapple has digestive properties and nutrients that are good for the skin, says Jane Cannan, an esthetician at the Linh Phan Salon in Bryn Mawr, Penn. “Pineapple has a cleansing effect on the digestive system and that helps with sensitivities and allergies in the skin,” Cannan said. “Papaya has similar properties.”

Salmon, Fresh Fish and Poultry – Dr. Nicholas Perricone, a dermatologist at the Yale School of Medicine in New Haven, Conn., and author of the recently published “The Wrinkle Cure,” recommends salmon, fresh fish and poultry. “Eating high-quality protein will make your skin glow and give you healthier hair,” he said.

Enzymes – Enzymes are the concern of Bill Wolfe, a naturopathic medical doctor and a doctor of dental surgery in Albuquerque, N.M. Wolfe calls enzymes “the missing link in our daily skin care regimes,” and recommends going to a health food store and finding a combination of the enzymes amylase, cellulase, lactase, lipase and protease. “Any good produce will have all those in different quantities,” Wolfe said. “Enzyme therapy is a way of taking care of the skin from the inside out. Processed foods, stress, environmental insults, disease and aging deplete our enzyme supply, and if we don’t supplement or replace our enzymes, serious health problems can occur. We’ve always been told that beauty is only skin deep; however now, with all the research on enzyme therapy, we know that beauty is truly from within.”

Co-Enzyme Q10 – Paolucci endorses Q10, a co-enzyme in pill form. She recommends that people start with the lowest dose, once a day. “Q10 is a vitamin-like substance that ignites energy production of the skin cell. “You should have more of a glow in your face, and more vitality in your skin,” Paolucci said.

Fish Oils – Belleza emphasizes the importance to skin care of getting vitamins A to E through natural sources rather than pills. She suggests a spoonful of fish liver oil daily for vitamin A. “You can get it from sweet potatoes, papaya and dark leafy green vegetables, but I don’t always have time to eat them and fish liver oil is great for [vitamin] A, which is the protective vitamin necessary for maintaining skin beauty,” Belleza said. She recommends cod liver oil for vitamin D, which is essential for calcium absorption and is also found in salmon, tuna, eggs and fortified milk.