Posts Tagged ‘Metabolic Syndrome’
For quite a while some experts believed that a little extra body fat would not necessarily trigger health problems like metabolic syndrome, a cluster of diseases that often accompanies weight gain. There was even talk of an “obesity paradox,” meaning that some people could derive certain benefits from being obese. But all that may just be fantasy, according to a recent study from Canada.
“Obese persons are at increased risk for adverse long-term outcomes even in the absence of metabolic abnormalities, suggesting that there is no healthy pattern of increased weight,” wrote Dr. Caroline K. Kramer of Mount Sinai Hospital’s Lunenfeld-Tanenbaum Research Institute in Toronto and lead author of the study report.
Whether being overweight is immediately harmful depends on a number of factors, including a person’s genes, activity level, hormonal functions, and the source of calories, said Dr. David L. Katz, founder and director of the Yale University Prevention Research Center, to HealthDay. Fat accumulation, especially when it affects inner organs like the liver, can do serious damage even at low levels, he warned.
The notion that fat and fit are not necessarily exclusive of one another stems in part from studies that found overweight but physically active people to be healthier than normal-weight folks who never exercised.
Also, judging someone’s health status based on body-mass index (BMI) alone has been widely criticized as an inaccurate measure in terms of overall health. Instead, most healthcare providers now prefer waist circumference as an indicator for weight-related health issues.
According to guidelines published by the National Institutes of Health (NIH), overweight people can be considered healthy if their waist size does not exceed 40 inches for men, or 35 inches for women, and if they don’t have high blood pressure, high blood sugar, or high cholesterol.
However, when it comes to obesity (BMI of 30 and above), almost all studies agree that even being relatively fit cannot offset the health risks.
The issue is not so much the extra weight itself but what is called “metabolic health.” For any person – obese, overweight, or normal-weight – to be metabolically healthy, his or her blood pressure must be less than 130/85 mmHg, triglycerides under 150 mg/dL, fasting blood sugar equal to or lower than 100 mg/dL, and HDL (“good”) cholesterol above 40 mg/dL in men and 50 mg/dL in women.
But what about the so-called “obesity paradox,” a finding that overweight and moderately obese patients who suffer from chronic conditions like diabetes or heart disease sometimes outlive their normal-weight counterparts with the same disease? There may be a number of explanations for this, including genetic differences and access to treatment options. Either way, the fact remains that both weight management and fitness are important factors for good health, as is dietary quality.
Timi Gustafson R.D. is a registered dietitian, newspaper columnist, blogger and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog and at amazon.com. For more articles on nutrition, health and lifestyle, visit her blog, “Food and Health with Timi Gustafson R.D.” (www.timigustafson.com).
When Michelle Obama announced “Let’s Move,” her signature initiative to combat childhood obesity, she emphasized that major diet and lifestyle changes were not required in her view to turn this growing health crisis around. “Small changes add up,” she said. “We don’t need to totally evaporate our way of being as we know it today.” In other words, if we just cut a few calories here and there and exercise a bit more, things will be fine before long. A comforting thought.
But that may be wishful thinking, according to Mark Hyman, MD, chairman of the Institute for Functional Medicine and medical director of the UltraWellness Center in Lenox, Massachusetts, and author of several bestselling health books, including his latest, titled “The Blood Sugar Solution.” The way he sees it, we are in the middle of an explosive epidemic of obesity and type 2 diabetes that will touch almost everyone in one way or another. He does not hesitate to call it “the modern plague.”
Obesity, insulin resistance, metabolic syndrome, pre-diabetes, type 2 diabetes, heart disease, dementia and cancer are ultimately all rooted in one and the same problem: Our dismal diet- and lifestyle choices. Diagnosing and treating these diseases separately as if they were not interconnected misses the whole picture. Instead, Dr. Hyman proposes using a more comprehensive term to describe the continuum of which all these health problems are part of: “Diabesity.”
Diabesity can range from slight weight problems and mild insulin resistance to morbid obesity and severe diabetes. Because the disease is not well understood as a continuum, millions of those affected by it remain undiagnosed and untreated. As a consequence, more people all over the world die now from chronic illnesses than from infectious diseases. The real tragedy is that the causes are almost always environmental and lifestyle-related, which would make them perfectly preventable or curable through public education and enough political will to implement the necessary changes.
“This is a lifestyle and environmental disease and won’t be cured by medications,” Dr. Hyman writes. “Billions and billions have been wasted trying to find the ‘drug cure,’ while the solution lies right under our nose. Shouldn’t the main question we ask be why is this happening? Instead of what new drug can we find to treat it?”
Since most of our modern-day ailments are primarily caused by poor diet choices, chronic stress and sedentary lifestyles, as well as toxins and allergens in the environment, we must address these problems from the ground up (literally). Instead of looking for quick fixes through medication and surgical procedures, we can make many important corrections by ourselves and without delay by using the right ingredients that make us healthy again, including whole, fresh food, vitamins and minerals, water, fresh air, exercise, stress reduction, etc. “When we take out the bad stuff and put in the good stuff, the body knows what to do and creates health and disease goes away,” writes Dr. Hyman. Care for the environment is part of that, too. Here, he strongly agrees with Sir Albert Howard, who is by many considered the founder of the organic agriculture movement, when he wrote in his landmark book, “The Soil and Health,” that we must “treat the whole problem of health in soil, plant, animal and man as one great subject.”
Finding our way back to wholesome nutrition is one of the greatest challenges we face today. “In America, we eat more than we ever have, yet we are nutritionally depleted,” writes Dr. Hyman. The epidemic of diabesity and other chronic illnesses is paralleled by an epidemic of nutritional deficiencies. Most of us don’t eat enough the kind of food that protects us from diseases and too much of the kind that makes us sick.
“Food literally speaks to our genes,” he writes in a chapter titled “Nutrigenomics.” “The information your body receives from the foods you eat turns your genes on and off.” Whole-foods and plant-based diets have been shown in clinical studies to be able to turn off cancer-causing genes or turn on cancer-protective genes. No medication can do this. “What you put on your fork is the most powerful medicine you can take to correct the root causes of chronic disease and diabesity,” he writes.
“The Blood Sugar Solution” is a highly informative but, thankfully, also a very accessible book for both professionals and the laypersons. Some readers may find Dr. Hyman’s positions to be somewhat radical, if not utopian, especially where he seeks to offer hands-on solutions. Admittedly, he writes with passion and a sense of urgency – and rightly so. The obesity crisis keeps growing unabatedly worldwide and the time for “small steps” may have passed. Something has to change on a fundamental level. Unfortunately, that makes it so much less likely that we will see significant successes in the near future, if ever.
Timi Gustafson R.D. is a clinical dietitian and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog, “Food and Health with Timi Gustafson R.D.” (http://www.timigustafson.com), and at amazon.com. You can follow Timi on Twitter and on Facebook.