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Syndrome X / Metabolic Syndrome

Gerald Reaven, Terry Kirsten Strom, Barry Fox

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SYNDROME X, THE SILENT KILLER

If you have Syndrome X - and 60-75 million Americans do - that "good" diet can be deadly. If you have the syndrome, carefully dieting to lower your total cholesterol or LDL cholesterol won't solve the problem. In fact, conscientiously doing so may make a heart attack even more likely.

The Number-One Predictor of Heart Disease

Syndrome X, also known as the "insulin resistance syndrome," may be the surest route to a heart attack. It is as powerful a predictor of coronary heart disease as elevated cholesterol or LDL "bad" cholesterol, if not more so.

WHAT IS SYNDROME X?

This deadly heart ailment begins in the bloodstream, shortly after we eat. That's not a startling idea, for we know that eating fatty or cholesterol-laden foods can be bad for our hearts. However, the Syndrome X culprit isn't red meat or butter, it's carbohydrates. Yet these carbohydrates are reluctant, inadvertent offenders.

Before entering the body proper, our food is broken down into various constituent parts in the intestine. One of these is glucose (blood sugar) from carbohydrates. Upon entering our cells, some of the glucose is put right to work providing the energy that cells need to perform their various tasks. The rest is stored in certain cells for later use. But the glucose doesn't simply flow into the storage cells. Instead, it must be guided in by insulin, a protein secreted by the pancreas.

Insulin acts like a shepherd, herding its precious flock into the cellular "corrals." Unfortunately, in many of us, glucose behaves like a group of errant sheep, stubbornly refusing to go where the shepherd directs. When that happens, the pancreas pumps out more and more insulin. That's the biochemical equivalent of sending out more and more "shepherds" to get the "sheep" into the "corrals."

Imagine hundreds of shepherds chasing thousands of sheep across a pristine field covered with thick, beautiful green grass. Those hundreds of feet and thousands of hoofs will quickly tear up the field, ripping out or flattening down clumps of grass. Soon, the field that once looked so green and lush will be trampled and scarred, brown and dirty.

Something similar happens inside your body when glucose refuses to move into the storage cells at insulin's command. The interior linings of your arteries, like the grassy field, are "ripped" and "trampled" as the body attempts to overcome this problem.

Eventually, the insulin "shepherds" corral the glucose, and order is restored in the body. But all is not well, for the "field" (the lining of your coronary arteries) is damaged, and there's other damage, as well. This damage sets the stage for heart disease.

We don't know exactly how many hearts have been attacked by Syndrome X, although it may be responsible for as many as 50 percent of all heart attacks - or even more. Unfortunately, very few people are aware of Syndrome X, know whether or not they have it or are doing anything about it. And their doctors aren't telling them.

It's Not Always Necessary, Yet It's Vital

Not all cells need insulin in order to absorb blood sugar. Brain cells, for example, do so without the help of the hormone. It's as if evolution realized that getting fuel (glucose) into brain cells was too important a task to depend on the presence of insulin at the right time, in the right amounts. Kidney and red blood cells also "grab" the glucose they need without insulin's assistance. On the other hand, muscle and fat (adipose) cells depend on insulin's aid, and that's where the problems with insulin resistance arise.

Excess insulin in the bloodstream prompts the damage associated with Syndrome X, but the insulin is only trying to do its job. The underlying problem is insulin resistance. About 25 to 30 percent of Americans are resistant to their own insulin - their "shepherds" are simply not strong enough to properly herd glucose. This means that greater amounts of insulin are required to get the job done. Unfortunately, excess insulin is the first in a series of events which triggers the damage to arteries that may precipitate a heart attack.

Insulin resistance is at the heart of Syndrome X. That's why simply lowering total cholesterol or LDL "bad" cholesterol won't solve the problem. And that's why the low-fat, high-carbohydrate diet so highly recommended by most physicians and health organizations is so dangerous for those with the disorder. Remember, carbohydrates become glucose, and glucose must be herded into certain cells. That requires insulin. More carbohydrate equals more glucose equals more insulin: that's the formula for disaster for those with this "unknown" syndrome.

Up until about ten years ago, insulin resistance was recognized as a malady which, if not compensated for, could lead to type 2 diabetes. Thanks to thirty years' worth of research into Syndrome X, we now know that even if you never develop diabetes, you can still suffer other ill effects from insulin resistance and high insulin levels: you may suffer from a constellation of changes that greatly increases your risk of coronary heart disease. In short, if you are insulin resistant, you are in real trouble.

WHO IS LIKELY TO DEVELOP SYNDROME X?

Syndrome X is not an exotic disease visited on a few genetically unlucky people. Between 60 and 75 million of us are insulin resistant. A small percent of those millions, perhaps 5 to 10 percent, will develop Type 2 diabetes because their pancreases simply can't produce enough insulin to overcome the insulin resistance. The pancreases of the remaining people will furiously secrete insulin until the resistance is overcome, thus setting the stage for heart disease.

Although we haven't yet mapped out all the genes responsible for triggering Syndrome X, we do know that there must be abnormalities in several genes before the disease can manifest itself. We also know that ethnicity plays a role, with people of non-European origin being at a much greater risk.

Family history also factors into the equation, with your odds of developing Syndrome X increasing substantially if you have a family history of diseases related to insulin resistance, such as heart attack, hypertension and type 2 diabetes. Lifestyle factors are apparently as important as the genetic: improper diet, obesity, lack of physical activity and cigarette smoking worsen Syndrome X. The fact that our behaviour plays a role in the syndrome is good and bad news. We can't alter our genetic heritage, but we can change our diets and daily habits.

The Difference Between Syndrome X and Diabetes

Problems with insulin are at the heart of both Syndrome X and type 2 diabetes.

If you have type 2 diabetes, your insulin isn't working well; it's not as effective as it should be. When sugar (glucose) from food enters your bloodstream, your pancreas does its best to secrete enough insulin to overcome the insulin resistance and escort that glucose into certain body cells. If the pancreas cannot keep up the effort, the amount of sugar in your blood will continue to rise until there's so much, it begins entering the cells by sheer force. When this happens, you have type 2 diabetes. All that excess glucose in your bloodstream causes damage that can lead to blindness, kidney failure and other problems.

Something similar happens with Syndrome X: the insulin pumped out by your pancreas isn't able to guide glucose into designated cells properly. But - and this is the key difference - with Syndrome X your pancreas shifts into high gear, spewing out more and more insulin until all the glucose has been safely tucked into the cells.

The difference between Syndrome X and type 2 diabetes is that people with the former can continue pumping out the large amounts of insulin needed to use glucose normally, while those with type 2 diabetes cannot. Being able to produce enough insulin to overcome insulin resistance keeps your blood sugar from going too high, so you don't suffer from type 2 diabetes and its many ills. That's the good news.

Unfortunately, you're left with very high levels of insulin in your bloodstream, concentrations that lead to the many risk factors for Syndrome X and heart disease. And, to make matters worse, the ability of your pancreas to manufacture insulin may weaken over time, adding type 2 diabetes to your list of ailments.

THE NEWEST, MOST IMPORTANT RISK FACTOR

Thanks to decades' worth of painstaking study and observation, physicians have compiled a list of the risk factors for heart disease. That list usually looks likes this:

Elevated LDL "bad" cholesterol
Low HDL "good" cholesterol
Obesity
Elevated blood pressure
Diabetes mellitus
Cigarette smoking
Lack of physical activity

The more of these risk factors you have, the greater your odds of suffering a heart attack.

This standard list of heart disease risk factors is a good start, but it's missing a vital ingredient. The list is inadequate for those with Syndrome X because it does not address insulin resistance or compensatory hyper-insulinemia (excess insulin) and their consequences.

The complete list of heart disease risk factors for people with Syndrome X looks like this:

Syndrome X risk factors
Impaired glucose tolerance
High insulin levels (hyper-insulinemia)
Elevated triglycerides (blood fats)
Low HDL "good" cholesterol
Slow clearance of fat from the blood (exaggerated postprandial lipemia)
Smaller, more dense LDL "bad" cholesterol particles
Increased propensity of the blood to form clots
Decreased ability to dissolve blood clots
Elevated blood pressure
Lifestyle factors that worsen Syndrome X
Obesity
Lack of physical activity
The wrong diet
Cigarette smoking

The additional independent risk factor:

Higher than normal LDL cholesterol

Notice the differences. The Syndrome X heart disease risk factor list includes the rate at which fat clears from the blood, not just the amount of fat in the blood. It also considers the formation and clearance of blood clots, and the physical characteristics of LDL cholesterol (not just the amount).

Just how important are the Syndrome X risk factors?

Several studies have shown that a low HDL cholesterol, a central feature of Syndrome X, is at least as powerful, if not more so, in increasing risk of heart attack as is high LDL cholesterol. Studies have shown that every separate component of Syndrome X is an individually significant heart attack risk factor. That means that the more components of Syndrome X you have, the greater the heart attack risk. The most reputable research studies reflect this profound fact. For example, the Quebec Cardiovascular Study found that for each 30 percent elevation in insulin levels, there was a 70 percent increase in risk of heart disease over a five-year period. The risk increased with each added component of Syndrome X.

THERE IS A SOLUTION to Syndrome X

The best way to prevent Syndrome X is to choose your parents carefully. After all, if you have a family history of heart attack, you run a greater risk of having one yourself. But since the wonders of modern biology have yet to give us the option of choosing our parents, we must find a more practical solution.

There are numerous heart attack prevention programs and diets. But none of them gives you the complete and effective approach that attacks all risk factors simultaneously, for none deals with Syndrome X and insulin resistance. In fact, much of their dietary advice makes the syndrome decidedly worse.

The solution to Syndrome X is based on rigorous scientific research. It is safe, effective and very easy to follow. The dietary changes require only slight adaptations for most people, who are delighted to learn that the Syndrome X Diet™ allows significantly more fat than the standard "heart healthy" diet. This means that your health-enhancing diet actually tastes good! Since it's nutritionally balanced, all family members can share the same food, even if they don't have the disorder. The non-dietary facets of the program are equally practical and easy to do.

Syndrome X is a complicated disorder, making it impossible to devise a magical "one size fits all" cure. Nonetheless, it's relatively easy to identify your practical needs and the ideal solution. Your particular strategy will be based on your laboratory results.

Which strategy you adopt depends on how many aspects of Syndrome X you have, and how severe they are. It's possible to have developed all aspects of Syndrome X, or only one or two. Some people surfer from all the manifestations at severe levels, some develop one or two at a slight level and others land somewhere in between. The more Syndrome X risk factors you have, and the more severe they are, the greater your risk of having a heart attack. But even if you are only standing on the precipice of Syndrome X, adopting and maintaining a preventive program now will greatly enhance your heart health for the rest of your life.

Having a safe and effective plan for yourself has psychological as well as physical benefits. Imagine waking up each morning feeling as if you were going to live a long and productive life. You take a brisk half-hour walk feeling as if you can tackle anything that comes your way. You eat a healthy breakfast that satisfies you until lunch. At work you focus easily as you knock off tasks one by one. At night you float off to sleep, as sure as anyone can be that your good fortune will continue. Why so confident? Because you've been tested for Syndrome X and you know you have it. But you are following the prevention program and have the problem well under control. You are on your way to preventing the damage to your coronary arteries caused by the syndrome. Things have never looked better.

This scenario is quite realistic. There's no magic to it. Anyone can undergo the simple diagnostic tests for the syndrome, and anyone can get treatment. If you know what to look for, Syndrome X can be easily identified and effectively treated.

Note: This is an extract of 6 pages from a total of almost 300 pages of Gerald Reavens SYNDROME X, THE SILENT KILLER I have literally hundreds of books but this one one of my favourites resulting in an amazing turnaround in my health and lifestyle.

Syndrome X Resources

An Interview with Gerald Reaven Syndrome X Syndrome X : The Risks of Insulin Resistance. Gerald Reaven, M.D., Professor Emeritus (Active) of Medicine at Stanford University.

Insulin Resistance

What is Insulin?
What is insulin resistance?
Why is insulin resistance in the news?
What is Syndrome X?
Who has insulin resistance?
What are the symptoms of insulin resistance?
What causes insulin resistance?
Do all people with insulin resistance develop diabetes?
What is the best diet for people with insulin resistance?

Dr Lam on Syndrome X

How do you develop Syndrome X
SYNDROME X as explained by Dr Reaven
Pathology of Syndrome X
Manifestation of Syndrome X
Laboratory Values
Syndrome X in a Nutshell
Cardiac Syndrome X
Causes of Syndrome X
Syndrome X and Type 2 Diabetes
Syndrome X and Coronary Heart Disease
Syndrome X and Aging
Conventional Treatment of Syndrome X
Natural Treatment of Syndrome X