Friday, March 29, 2013

Why EVERYBODY Should be Talking About Metabolic Syndrome

Stories about the obesity epidemic flood the news. Practically all of us can quote the statistics: a third of adult Americans are overweight or obese; future generations are looking even more dire. And, hand in hand with obesity, the increasing pervasiveness of Type II Diabetes, a completely lifestyle-induced disease, is becoming so ubiquitous that it seems like a non-event to see someone with a glucose meter at the lunch table.

These problems seem insurmountably huge and irreversible to most of us. According to analyses of various nutritional studies, 95% of standard diets fail to produce results. Diabetes is a disease that seems to be "someone else's problem" -- until the day the doctor tells you it's now yours. How do you hope to make progress against such a tide?

Graphic courtesy of
The answer: understanding and addressing metabolic syndrome.

What? You don't know about metabolic syndrome? You've never heard of it? It affects an estimated 25% of Americans right now. That's okay. A year ago, I'd never heard of it either, and my father has had Type II Diabetes for the last 10 years.

What the heck is Metabolic Syndrome?

Put simply, metabolic syndrome is pre-diabetes. It's a set of conditions that set you up for that next step. The central condition is insulin resistance, which is the point where your muscles and other tissues can't effectively process and take up sugars from the blood anymore because insulin levels have been elevated chronically for an extended period of time.

A few quick words on insulin. It's a hormone, produced by the pancreas. Like cholesterol, it has been defamed because it is frequently mentioned in association with conditions like diabetes and Alzheimer's syndrome. But insulin isn't a bad thing at all. Like cholesterol, It has an extremely important job, to regulate energy by distributing glucose from your bloodstream to your brain, muscles, and organs. You want insulin doing its job, and doing it well. Hence, being insulin resistant is a problem for your body. It is a lifestyle-induced hormonal imbalance.

I want to break down the vicious cycle of events:

  • Any time you eat, insulin is released to handle the carbohydrate energy. But - your blood sugar is particularly spiked from high glycemic index foods (sugars, refined flour in cereals and bread, rice, potatoes, etc)

  • The liver calls for insulin to distribute the sugar from your bloodstream

  • Your muscles can't take up the sugar they need. The sugar/insulin combo sort of "bounces off" the cell walls.

  • Blood sugar remains high, so more insulin is sent out

  • Cells become more resistant to the already elevated levels of insulin, requiring more each time to overcome the barrier

  • Insulin is the body's primary signal for fat storage

  • So, while your muscles and other tissues are literally starving for energy that can't get through, your body is happily depositing all of that in fat cells instead

Throughout this cycle, your energy levels are on a roller coaster, but you can't seem to get on top of the tasks you need to accomplish. Internally, your pancreas and liver are working on overload to continually respond to the ever-increasing task of producing insulin and regulating blood sugar.

Do this long enough and - yep - you've got Type II Diabetes.

People who consume the Standard American Diet (which most do, that's why it's called standard) normally have cereal products for breakfast, sandwich items for lunch with a side of fries or chips, and pasta, potatoes, and breaded foods are dinner time staples. And that's not including the snacks, sodas, and sweets. Simple refined carbohydrates are built into virtually every bite we take. These foods spike insulin severely, over time leading to the cycle above.

I want to say it again: 25% of Americans have metabolic syndrome. Those same Americans are also struggling with weight. This is everybody's problem.

The good news about metabolic syndrome

There is actually quite a silver lining to this dire picture. First, understanding the preconditions that lead to diabetes and which are so closely linked with the weight epidemic sheds some very interesting light on both (I'll go into detail on that in a moment). Second, unlike full-blown Type II Diabetes, metabolic syndrome has been shown to be entirely reversible.

Two approaches that are regularly used successfully to reverse the insulin resistance syndrome: strength training (getting those muscles to deplete and consume all those sugars), and removing refined carbohydrates (those with the highest glycemic index/load) as much as possible from your diet. This two-pronged approach works from both ends of the cycle to restore the hormonal balance your body needs to effectively regulate insulin, fat, and weight.

Now let's take a moment to examine what metabolic syndrome reveals about obesity. Insulin is the primary signal for fat storage in the body. Fat metabolism, under normal conditions, is in a constant state of storage and release, providing your body the steady stream of slow, efficient energy it needs throughout the day. When insulin is continually released to address the blood sugar spikes from our sugary and starchy diet, the fat storage signal is increased. When we are insulin resistant and blood sugar levels remain high, the insulin redoubles its efforts. The signals increase still more and there is plenty of blood glucose that needs to be stored.

Did you know that diabetics often report a ravenous, insatiable hunger? Think about it. The cells themselves are starving in a sea of energy just out of reach.

The flip side of this metabolic cycle is when, through activity or stress, you need to consume energy at an increased rate for a time. Adrenaline, sex hormones, and growth hormone are the primary signals to call for additional energy. But this call only goes out from the liver when your blood sugar has reached a low threshold. If you're continually supplying your body with that "cheap energy", the liver will delay the need to call for that all-important fat energy to fuel the body.

Let's recap

Even though there is heated debate on the most effective methods and means for weight loss in the medical community, strangely, the processes described above are accepted as gospel. The line of thinking is hard to miss, though. Most Americans eat a certain way. Those eating habits irrefutably result in a strain on the pancreas and liver to handle all the sugar. The body has a limited tolerance for this kind of abuse. Insulin signals fat storage. Metabolic syndrome is insulin regulation run amok. 25% of Americans have metabolic syndrome and almost all of them are overweight or obese.

It's reversible. We know how to treat it. Nutrition and rigorous exercise (particularly strength training) are the key. Strength training also releases adrenaline, sex hormones, and growth hormone, the fat releasing signals. So why aren't we talking about it and what are we waiting for?

Spread the word. Learn about how different nutrients affect and fuel your body. Make your health an immediate priority. Have a glucose test to check for insulin resistance. And get into a strength program. And join us here often for more information and to share your success with us and others.


  1. I noticed that you called Type II Diabetes "completely lifestyle induced." This is false:

    There are many genetic and other non-modifiable risk factors. I think it may be more accurate to say that often the *primary* inductive factor appears to be poor nutrition and no exercise leading to obesity/insulin resistance/metabolic syndrome, but this is not true for all, and I suspect in virtually no case is poor nutrition and no exercise *solely* responsible. Diabetes is an extremely complex, multifactorial polygenic disorder with many subtypes that can't be just summed up as "insulin resistance, yo."

    Insulin resistance, by the way, is also considerably more complicated that just "too much sugar does it."

    Also, I'm somewhat confused by your suggestion that the liver is in charge of signaling for secretion of adrenaline, GH, and sex hormones. I'm not aware of any physiologic basis for that, most coordination of those hormones is CNS-based to my knowledge. The liver does participate in GH effects by producing IGF-1, though.

    All that said, I do think the general advice you give here regarding lifestyle modifications to fight insulin resistance is good. It's pretty much all you can do, given that the other factors are "non-modifiable", and we should all be doing it for lots of other reasons anyway, diabetes or no. I personally think that maintaining or attaining normal weight is probably more important for fighting insulin resistance than reducing "refined" carbs, but we agree on exercise 100%.

    1. Thanks for the read and the comments. I will confess to taking a simplified approach to a complex subject. I try to walk an appropriate line of accuracy and simplicity for readers to take as a baseline and then continue learning for themselves.
      You are absolutely right that there are underlying factors that ultimately contribute to full blown Type II. If there weren't even more people would develop it. Why some can tolerate a life of carbohydrate abuse without developing full Type II and others are more susceptible it not clearly established, but it's also not much of a surprise. Everybody has varying tolerances for stimuli. However, absent the lifestyle risk behaviors, I believe most medical professionals would support the assertion that people, even those particularly susceptible, would not develop the disease.
      I didn't mean to give the impression that the liver secreted growth and sex hormones. This is of course not true. I will refine the sentence structure.
      Again, thanks. Come back and comment often. It's the dialog that really reveals the best of what we can accomplish together.

    2. While type II diabetes can be genetic, genetics is not a guarantee that you will get diabetes just because you have the genes for it. Epigenetics has a very big role in one actually turning a gene on and coming down with the phenotype "diabetic." What turns the gene on is a multi-faceted response but even as a genetic state, just as the switch can be turned on, so it can be turned off (or at least put into remission) for life.

      Thus, while I agree that it is a bit over simplified, I think the purpose it met since not everyone is a scientist knowing everything and many people prefer the simplification. In an article like this, the simpler the better to reach broader audience.

      You did a great job Michael trying to reduce the complexity to kitchen talk language.

    3. Angela - thanks for the comments. It's a tough balance to strike. We actually did dig into genetics and epigenetic factors in another article:
      Would love to hear your comments on that too.

  2. Is it really only 25% With the obesity rates what they are and obesity and metabolic syndrome being linked, isn't it more like 60+%

    1. The article is a little out of date now, and these statics are tough to nail down because so much of it is undiagnosed. It's way too much. It's epidemic. And it's costing us our health, our wealth, and our ability to enjoy life.


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