Metabolic Syndrome – The Biggest Killer of Humans

METABOLIC SYNDROME

What the heck is that now?   Oh—-just one of the biggest causes of heart attack and stroke s’all.

TALK WITH YOUR DOCTOR if you have metabolic syndrome.

There are 5 criteria–you need THREE out of the five.

The criteria are:  you need to know your ‘cholesterol numbers’ folks to do this assessment.

GET INVOLVED – KNOW YOUR NUMBERS!

  1. waist over 40 inches for men, 35 inches (89cm) in a woman   Asian/ Latinos 35 for men, 32 for women
  2. blood pressure over 130 on top OR over 85 on bottom(or on blood pressure meds)
  3. triglycerides over 150 mg/dl (1.7mmol/L)—The number when NOT on cholesterol meds by the way.
  4. HDL (good cholesterol) under 50 mg/dl in a woman (1.2 mmol/L)
  5. fasting sugar over 100 mg /dl (5.6 mmol/L)-or on meds for sugar issues.-or any history of failing sugar tests–such as diabetes in pregnancy.

You need THREE!  and you don’t have to be overweight to have this! Why Worry? This is what it can lead to:

  • Twice the risk of flat out diabetes
  • Five times increased risk of heart attack and stroke
  • Sleep apnea
  • Fertility problems
  • cancers
  • Acid reflux
  • Erectile dysfunction
  • PCOS  (polycystic ovaries) (See Post)
  • Fatty liver
  • EARLY DEATH!

The other things not mentioned when talking about this condition are depression, alcohol and drug use, poor self-image, back pain , joint pain, shortness of breath……..It is like a snowball rolling down a mountain!

What Can You Do?

LIFESTYLE CHANGE IS BETTER THAN ANY MEDICATION–studies show this–it’s not just my opinion.   SOUTH BEACH AND MEDITERRANEAN DIET show better outcomes over 3 years than other diets.   CALORIE DEFICIT is needed–we are consuming more calories now than 50 years ago.

I no longer believe that all calories are created equal.  I believe that that 100 grams of butter does not cause the same body response as 100 grams of table sugar.

I will try to explain.

There are three basic food groups:

CARBOHYDRATES        PROTEINS       FATS

Carbohydrates–ESPECIALLY processed carbohydrates are broken down into sugar.  The sugar causes your body to respond with INSULIN.  The job of insulin is to LOWER your blood sugar.  It does this by making you pee more, so you lose sugar in your urine, AND it stores sugar in your liver and other cells –and INSULIN MAKES FAT CELLS.   The more you eat–especially carbohydrates–the more insulin you make, and if your calories are above what you need, you will start to make fat.

When your insulin is UP–your body cannot burn off the fat.  So—if you are trying to starve yourself, and you are obese–you will start to lose weight, but then you stop–your body just won’t go and get the fat and get rid of it!   If you eat–as many of us do–breakfast, morning snack, lunch, afternoon snack  supper, evening snack–then you are constantly making your pancreas  churn out insulin to keep your sugars under control.

After years of EAT  SUGAR INSULIN EAT SUGAR INSULIN EAT SUGAR INSULIN…..we eventually become INSULIN RESISTANT.    Same with antibiotics–when we use then all the time  then they don’t work!   Now–our sugars go up, and you are labeled a TYPE 2 DIABETIC.

The difference between Type 1 Diabetic and Type 2 is that

Type 1 has NO INSULIN and HIGH SUGAR

Type 2 has HIGH INSULiN and HIGH SUGAR

This picture is of a girl before being started on insulin—-a life saving drug for TYPE 1 diabetics.  This was back when insulin was first discovered.   Her high sugars before were certainly not making her fat.  Insulin saves her life but—see the weight gain?

I strongly urge you to listen to Dr. Jason Fung–here is a link to one of his videos—all his information is on YOUTUBE—free.  His books can be obtained at library–FREE  and to follow his plan—FREE

I understand that you need to reduce calories–but I was stuck at a plateau for 16 months despite a 500-1000 calorie a day deficit most days—and i was working out at the gym 3-6 hours a day—POUND class CycleFIT,  ZUMBA, WEIGHT LIFTING 4 days a week–I can leg press 620pounds!  BOOT CAMP,  WATER BOOTCAMP, SWIMMING an hour 5 days a week–heck I even trained enough to run a 21K!!!   Weighing my food!   NO WEIGHT LOSS!!!  Both me, and my trainer were stymied.

My trainer had me send pictures of everything I put in my mouth–and even though I may have had a chocolate bar a week I counted that 250 calories in, and STILL had a deficit!   I LIVED at the Y when I wasn’t working.   The answering machine on my phone (I am on call for the hospital pretty well all the time), says that if I don’t answer and they need me, they can call the Y–I’m typically there!

I certainly don’t have the answers–but the idea of insulin driving obesity makes SENSE to me.   I have looked at the studies that Dr, Fung quotes–and he’s right — the studies do not show that low fat diets work at all!   He is also encourages Time Restricted Eating.  This means you pick a 6 or 8 hour window during which time you can eat—SENSIBLY–and then you DON’T EAT for 16-18 hours.  16:8  or 18:6

During the NO EAT time you have to stay well hydrated with non sweetened, no calorie (NO ARTIFICIAL SWEETENERS) liquids—tea, black coffee, water, beef broth or other broths.

So I started doing TIME RESTRICTED EATING, and reduced carbohydrates to vegetables and fruit sources–NO BREAD, NO CEREAL, NO RICE, NO PASTA, NO COOKIES,  NO POTATOES—and I calculated my calories –there are APPS for that– to lose half a pound a week (more livable/doable plan)–I actually had to INCREASE my calories—that’s how much i was working out!   I actually don’t go to the gym as much–it was just too much–now I do 1-3 hours 5 days a week—more manageable.

BOOM!

After 16 months–I lost 16 pounds in one month–and now 26 in last 3 months–and I am 2 pounds away(as i write this) from NORMAL BMI.   I don’t feel perpetually hungry–hunger—I need to study more on GHRELIN and LEPTIN!!   Your HUNGER will go up, and this is likely a big factor to make you regain the weight after losing—-your body is determined to get you back up to your high body weight.  For YEARS, this abnormality of hunger continues after people lose weight.

Yes– I have to watch my binge eating(chocolate)–but I am good 28 out of 31 days a month–and when I “fall off the wagon” I get my butt down to the gym, and do some extra time–and get back with the program.   You CAN’T give up!!!

I eat from 12 noon until 8 pm most days–I have gone up to 42 hours with not eating–I actually wasn’t hungry once I reduced my carb intake.  I try to listen to my body–that’s a work in progress!  If I am not hungry at “lunch time”, I simply DON’T EAT!

I still eat all the calories I am allowed a day—but I try to extend the NOT EATING time.  The idea is that you will use up all the carbohydrates in your body and now YOUR INSULIN LEVEL WILL DROP.   Now that your insulin level has dropped YOUR BODY CAN GO AND GET ENERGY FROM YOUR FAT!   It is recommended that before you eat your first meal, that you do some exercise–a walk, a swim–anything!   Your body will need FUEL for that exercise–and it HAS to go and get it somewhere–and now insulin is not stopping you from accessing your fat as a source of fuel/

I keep myself well hydrated with lots of water and herbal teas.   If I wake up, and i am hungry i will drink some tea–usually that will be all I need for hunger to pass.  If I do that and the hunger is now becoming stronger–then even if it is not NOON, I will eat a little something—but NOT A CARBOHYDRATE—I may have a small piece of cheese–or 10 almonds, or a small tin of tuna—I am trying to make sure I do not make my insulin go up. This happens maybe a couple of times a month–usually if I have been up all night at work.

I WILL eat carbs at noon, or at supper –I like fruit in my plain yogurt–and vegetables have carbs in them–but they are not PROCESSED—like cereal is–or cookies etc.   Potatoes have carbs too–but TOO many for me–I had to stop eating them–  because I ate too many!!!   I MAY have one a month now!

Do I eat cookies—Yes—on Thursday night I meet with my knitting group–I don’t eat cookies every week–but if someone has made some squares—I will have one—or two.   I go swimming in the morning on Thursdays, and walk as much as I can at work–KNOWING that ‘knitting cookies’ will happen— so I better burn off some calories BEFORE I go!

HEART ATTACKS

The number of people having heart attacks has dropped by 50% between 1980 and 2000, and dropped another 33% between 2000 and 2010. * Half of this drop is because drugs are being used to treat high cholesterol, and the other half drop is due to treatment of high blood pressure, diabetes, and quitting smoking.

WANT TO KNOW YOUR 10 YEAR RISK OF HAVING A HEART ATTACK?

CLICK HERE TO SEE YOUR RISK OF HEART ATTACK–you need to know your ‘cholesterol’ numbers

Should you be on blood pressure meds?

Newest guidelines get a lot more people off blood pressure meds, but many people with hypertension are not being treated.

GET THIS!  Your risk of heart attack goes up when your systolic (top number)  blood pressure hits 118!!!    118 folks!  That’s when the uptick in risk starts to happen!

What can you do?

If you are overweight–try AGAIN to lose weight–I know–I hated the constant reminder–but it’s the raw truth—the weight is going to hurt you!  It really does come down to DO IT OR DIE!   There are support groups out there in most communities–because so many of us struggle every day with weight, and trying to eat the right foods.  IT IS HARD TO LOSE WEIGHT—and it will be a life long battle to maintain any loss.   People in support groups do better than those doing it alone!

Get some help with smoking!   Most people need more than one thing to help them quit.  You CAN use meds (Champix, Chantix) AND a patch AND an inhaler!   You can use more than one 21 mg patch–if you are a three pack a day you may need THREE patches!    If you are pregnant, you can use the patches, gum, inhalers–but the drugs are not approved—yet….all this is safer for baby than lighting that cigarette!

If you need that first cigarette within 30 minutes after you get up–you likely need the inhaler–the quick hit!

I have people who never used the meds say they get nightmares just by quitting smoking–so I don’t know if Chantix etc got the rap for that–but that is the one thing that seems to stop  people using it.   To look after this, the company came out with a 16 hour patch–you take it off to go to bed.

You can still smoke while on the patch!!!   YES!!! YOU CAN!!!    The idea is that you won’t light up as much!

Anyway–that’s enough on that…

‘Doc, you’ve cured me of my white coat syndrome. Unfortunately, I’m afraid of clowns.’

Blood pressure–OK OK  you say you have “white coat hypertension”–thing is that this leads to under-treatment—we can’t just blow off your blood pressure as nothing–you need to take it for several days-at different times–and be honest about the numbers—fudging the numbers to avoid meds only hurts YOU!

35-55% of those with “white -coat  hypertension” actually get hypertension vs less than 10% of those with normal blood pressure

 

 

With the new guidelines, we now don’t treat with meds unless the top number is 150 or more, and the goal of treatment if to keep at 150 or below.

When you reach point of needing meds, you can discuss this with your doctor.  Unless I get requests, I am not going into all the blood pressure meds.

CHOLESTEROL  

OK–so first off–know your numbers–take a picture of your lab report with that new fangled camera phone in your purse!

There are FOUR groups of people who are helped by going on medication to treat high cholesterol:

First off  — use the calculator to see what your risk of having a heart attack is!

CLICK HERE TO ASSESS YOUR RISK OF HEART ATTACK OR STROKE IN NEXT 10 YEARS

THE FOUR GROUPS HELPED ARE:

  1.    those who have HAD a stroke or heart attack–to try and prevent another
  2.    people with family history that shows a genetic problem that causes  heart attack and strokes
  3.   40-75 years of age AND diabetic
  4.   40-75 years old and your risk by the new risk calculator is 7.5% or more

OTHER THINGS YOU CAN DO…

If you are put on a STATIN drug for your cholesterol, you need to discuss the use of aspirin with your doctor.  The studies say you should be on it–but MAKE SURE IT’S OK FOR YOU

You CAN eat eggs, shellfish, and food with cholesterol.

There is NO evidence that eating saturated fats will hurt you–so enjoy your butter!   Just learn how to make almond bread instead of using your regular bread—the high carbohydrates is a problem–we eat TOO MANY carbs.

I am NOT saying to do “keto”–so carb restricted that most of us will go mad–but let;s face it–we DON’T need a roll with every meal, or a sandwich every day, or cereal for breakfast–eat some bacon and eggs!)–and a serving of rice is HALF A CUP (TWQ TABLESPOONS!!)   IT IS NOT TWO CUPS OF RICE.    Eat out less often–PLAN your meals, and get them ready at home—eat home cooked as much as you can—usually you will get half the calories.

OUR CURRENT FOOD GUIDELINE is still promoting bread and people think “whoe wheat ” or “multigrain bread” is GOOD for them—–NOT!!   We eat too much bread and cereal–and you also need to look for hidden sugars.    4.2  grams of sugar is i tsp of white sugar.   Vanilla yogurt has about 5 teaspoons of sugar in 3/4 cup of yogurt—READ THE LABEL!!   Sugar is in psalmist everything–especially processed foods!

Learn to read food labels—oh –another post.

 

 

You can use the salt shaker—but avoid salty snacks and processed soups etc—they are REALLY high in salt—we don’t want our food tasteless–but don’t need a salt lick either!

From 2016 Controversies in Women’s Health, presented by the Division of General Internal Medicine, Department of Medicine, University of California, San Francisco Robert B. Baron, MD, MS, Professor of Medicine, Associate Dean for Graduate and Continuing Medical Education, University of California, San Francisco, School of Medicine

*From 2016 Controversies in Women’s Health, presented by the Division of General Internal Medicine, Department of Medicine, University of California, San Francisco Robert B. Baron, MD, MS, Professor of Medicine, Associate Dean for Graduate and Continuing Medical Education, University of California, San Francisco, School of Medicine

Well–that’s a lot of information!   Ask questions in the comments–I will add to this if new information changes anything.

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