scholarly journals Dietary management of the metabolic syndrome – one size fits all?

2013 ◽  
Vol 72 (3) ◽  
pp. 310-316 ◽  
Author(s):  
Catherine M. Champagne ◽  
George A. Bray

Diagnosis of metabolic syndrome includes a set of laboratory and physical findings, including central adiposity, elevated TAG, reduced HDL-cholesterol, hypertension and elevated fasting glucose or insulin resistance. While definitions have varied slightly, from a practical point of view, identifying dietary and lifestyle factors, including low levels of physical activity, are important in designing a diet and exercise programme that can help individuals with the metabolic syndrome to reduce the associated detrimental health consequences. Specific features of the metabolic syndrome require intervention, whether dietary or otherwise, to move towards normal ranges. It is important to remember that no one size or treatment fits all. While central obesity is perceived as the hallmark of the metabolic syndrome, other features need to be treated independently if they do not respond to lifestyle change. The future may hold treatments for the metabolic syndrome that involve modulation of inflammation.

2005 ◽  
Vol 64 (3) ◽  
pp. 349-357 ◽  
Author(s):  
D. I. Shaw ◽  
W. L. Hall ◽  
C. M. Williams

Obesity and overweight are linked with a cluster of metabolic and vascular disorders that have been termed the metabolic syndrome. Although there is not yet a universally-accepted set of diagnostic criteria, most expert groups agree that the syndrome is characterised by impaired insulin sensitivity and hyperglycaemia, dyslipidaemia (elevated blood triacyglycerols with depressed HDL-cholesterol), abdominal obesity and hypertension. Based on existing published criteria estimates suggest that the syndrome affects a substantial percentage of the middle-aged and elderly populations of most European countries (10–20%) and confers increased risk of type 2 diabetes (2–8.8-fold) and CVD (1.5–6-fold), as well as having a marked effect on morbidity. Although the pathophysiology is incompletely understood, insulin resistance and abdominal obesity are central to subsequent abnormalities in circulating glucose and lipoproteins, and vascular function that lead to type 2 diabetes, atherosclerosis and CVD. The link between metabolic syndrome, type 2 diabetes and CVD, as well as inability to reverse the present rising rates of obesity, will lead to economically-unsustainable costs of health care in the next 10–20 years. Preventative strategies for metabolic syndrome are required to slow rates of progression and to reduce dependence on costly medical management. A notable development is recent evidence that shows that diet and exercise are more effective than drug treatment in preventing the development of type-2 diabetes in high-risk individuals. The LIPGENE project will investigate dietary fat quality as a strategy for the prevention of metabolic syndrome and identify food chain approaches that can support consumer attempts to alter their dietary patterns.


2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 5159-5159
Author(s):  
J. P. Nobes ◽  
S. E. Langley ◽  
R. W. Laing

5159 Background: The association between androgen deprivation therapy (ADT) for prostate cancer and metabolic syndrome has been reported, with insulin resistance as the key to its development. This is the first study to investigate the effect of metformin and lifestyle changes on the development of ADT-related metabolic syndrome. Methods: Forty men with any stage of prostate cancer, due to receive ADT with a GnRH agonist, were recruited to a prospective randomised pilot study. The control arm comprised 20 patients receiving ADT alone. Men in the intervention arm (n=20) received ADT with 6 months of metformin, a low glycaemic index diet and a regular aerobic exercise programme. All patients were investigated pre-treatment and at 6 months for the metabolic syndrome, insulin resistance, and related biochemical and physical parameters. Results: After 6 months a significant reduction in metabolic syndrome cases (NCEP ATP III definition) was seen in the intervention arm (p=0.042), with an equal number seen in the control arm as at baseline. There was an increase in HDL cholesterol in both arms, which reached greater significance in the intervention arm (p=0.008) than the controls (p=0.015). The table shows an improvement in abdominal girth, weight, body mass index, and systolic blood pressure in the intervention arm, when measured as a % change over 6 months. Biochemical markers of insulin resistance did not significantly differ between each group. Conclusions: ADT is widely used in prostate cancer, but metabolic complications may be responsible for an increased cardiovascular mortality. The preventative role of metformin and lifestyle changes has been evaluated in this study, showing potential beneficial effects. However, the anticipated increased incidence of insulin resistance and metabolic syndrome has not been demonstrated in men receiving ADT alone, which may be due to small study size. Further studies will ascertain whether overall survival can ultimately be improved by this approach. [Table: see text] No significant financial relationships to disclose.


Author(s):  
Noora Wael Rasheed ◽  
Ooroba Jameel Taresh

       Some studies indicated a relationship between increased serum levels of osteoprotegerin with arterial calcification and as a result, it leads to the risk of cardiovascular disease. In our study group we selected patients with osteoporosis, with similar age and body mass index for the assessment of the relationship between cardiovascular disease and osteoprotegerin serum level. We took into account the analysis of correlation and association between the presence of distinct patterns of atherosclerosis and associated diseases like high blood pressure,  diabetes mellitus, low HDL cholesterol, increased LDL cholesterol, increased triglycerides and was the case of presence of any type of dyslipidemia, in case of pre-existent treatment. Objective of study was the assessment of osteoprotegerin value as predictive marker for cardiovascular and metabolic risk in osteoporotic patients. Our results showed significant correlations of parathyroid hormone, osteocalcin and biochemical markers of bone with glucose metabolism and lipid were found in our research, maintaining crosstalk between calcium and biochemical markers of bone and cardiovascular risk. The serum level of Osteoprotegerin has been shown to have a large predictive value for the metabolic syndrome as a cardiovascular risk standard in patients with osteoporosis. The osteoprotegerin serum levels were increased in the patients with metabolic syndrome as a protective response facing the atherosclerotic lesions.


2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Mercedes Sotos-Prieto ◽  
Rosario Ortolá ◽  
Miguel Ruiz-Canela ◽  
Esther Garcia-Esquinas ◽  
David Martínez-Gómez ◽  
...  

Abstract Background Evidence is limited about the joint health effects of the Mediterranean lifestyle on cardiometabolic health and mortality. The aim of this study was to evaluate the association of the Mediterranean lifestyle with the frequency of the metabolic syndrome (MS) and the risk of all-cause and cardiovascular mortality in Spain. Methods Data were taken from ENRICA study, a prospective cohort of 11,090 individuals aged 18+ years, representative of the population of Spain, who were free of cardiovascular disease (CVD) and diabetes at 2008–2010 and were followed-up to 2017. The Mediterranean lifestyle was assessed at baseline with the 27-item MEDLIFE index (with higher score representing better adherence). Results Compared to participants in the lowest quartile of MEDLIFE, those in the highest quartile had a multivariable-adjusted odds ratio 0.73 (95% confidence interval (CI) 0.5, 0.93) for MS, 0.63. (0.51, 0.80) for abdominal obesity, and 0.76 (0.63, 0.90) for low HDL-cholesterol. Similarly, a higher MELDIFE score was associated with lower HOMA-IR and highly-sensitivity C-reactive protein (P-trend < 0.001). During a mean follow-up of 8.7 years, 330 total deaths (74 CVD deaths) were ascertained. When comparing those in highest vs. lowest quartile of MEDLIFE, the multivariable-adjusted hazard ratio (95% CI) was 0.58 (0.37, 0.90) for total mortality and 0.33 (0.11, 1.02) for cardiovascular mortality. Conclusions The Mediterranean lifestyle was associated with lower frequency of MS and reduced all-cause mortality in Spain. Future studies should determine if this also applies to other Mediterranean countries, and also improve cardiovascular health outside the Mediterranean basin.


2012 ◽  
Vol 94 (6) ◽  
pp. 331-337 ◽  
Author(s):  
MARYAM ZARKESH ◽  
MARYAM SADAT DANESHPOUR ◽  
BITA FAAM ◽  
MOHAMMAD SADEGH FALLAH ◽  
NIMA HOSSEINZADEH ◽  
...  

SummaryGrowing evidence suggests that metabolic syndrome (MetS) has both genetic and environmental bases. We estimated the heritability of the MetS and its components in the families from the Tehran Lipid and Glucose Study (TLGS). We investigated 904 nuclear families in TLGS with two biological parents and at least one offspring (1565 parents and 2448 children), aged 3–90 years, for whom MetS information was available and had at least two members of family with MetS. Variance component methods were used to estimate age and sex adjusted heritability of metabolic syndrome score (MSS) and MetS components using SOLAR software. The heritability of waist circumference (WC), HDL-cholesterol (HDL-C), triglycerides (TGs), fasting blood sugar (FBS), systolic blood pressure (SBP) and diastolic blood pressure (DBP) as continuous traits after adjusting for age and gender were 27, 46, 36, 29, 25, 26 and 15%, respectively, and MSS had a heritability of 15%. When MetS components were analysed as discrete traits, the estimates of age and gender adjusted heritability for MetS, abdominal obesity, low HDL-C, high TG, high FBS and high blood pressure (BP) were 22, 40, 34, 38 and 23%, respectively (P < 0·05). Three factors were extracted from the six continuous traits of the MetS including factor I (BP), factor II (lipids) and factor III (obesity and FBS). Heritability estimation for these three factors were 7, 13 (P < 0·05) and 2%, respectively. The highest heritability was for HDL-C and TG. The results strongly encourage efforts to identify the underlying susceptibility genes.


2021 ◽  
Vol 15 (7) ◽  
pp. 1494-1496
Author(s):  
M. Imran Ashraf ◽  
Shazana Rana ◽  
M. Salee Makhtar ◽  
Adnan Afzal ◽  
Bushra Suhail ◽  
...  

Background: Metabolic syndrome is a disorder which is categorized by the presence of various features like hypertension, obesity, insulin resistance and dyslipidemia. One of the basic features of this syndrome is hypertension that may lead to increased incidence of cardiovascular incidents. Aim: To determine the gender based comparison of metabolic syndrome among the hypertensive patients who reported in the outpatient department. Study Time: The present study was conducted from January 2019 to June 2019 over a period of six months. Methods: Known hypertensive patients aged between 20 to 50 years who fulfilled the selection criteria were included in this study. After informed written consent, the physical examination and required laboratory investigation were done. The data was entered and analysed by using SPSS version 23 Mean±standard deviation was recorded for the quantitative variables while frequency was utilized for the qualitative variable. The p-value of ≤0.05 was taken as significant. Results: A total of 85 known patients of hypertension were included in the study comprising (70.12%) males and (35.40%) females. They were evaluated for the metabolic syndrome using the Adult Treatment Panel III- A (ATP –III A) criteria. Their blood pressure was recorded and fasting blood sample were taken to determine the levels of serum glucose, HDL-cholesterol and triglyceride. Conclusion: Metabolic syndrome is more prevalent in the hypertensive patients Keywords: Metabolic syndrome, Hypertension, Dyslipidemia


2004 ◽  
Vol 89 (1) ◽  
pp. 108-113 ◽  
Author(s):  
Martha L. Cruz ◽  
Marc J. Weigensberg ◽  
Terry T.-K. Huang ◽  
Geoff Ball ◽  
Gabriel Q. Shaibi ◽  
...  

The prevalence of the metabolic syndrome is highest among Hispanic adults. However, studies exploring the metabolic syndrome in overweight Hispanic youth are lacking. Subjects were 126 overweight children (8–13 yr of age) with a family history for type 2 diabetes. The metabolic syndrome was defined as having at least three of the following: abdominal obesity, low high-density lipoprotein (HDL) cholesterol, hypertriglyceridemia, hypertension, and/or impaired glucose tolerance. Insulin sensitivity was determined by the frequently sampled iv glucose tolerance test and minimal modeling. The prevalence of abdominal obesity, low HDL cholesterol, hypertriglyceridemia, systolic and diastolic hypertension, and impaired glucose tolerance was 62, 67, 26, 22, 4, and 27%, respectively. The presence of zero, one, two, or three or more features of the metabolic syndrome was 9, 22, 38, and 30%, respectively. After controlling for body composition, insulin sensitivity was positively related to HDL cholesterol (P &lt; 0.01) and negatively related to triglycerides (P &lt; 0.001) and systolic (P &lt; 0.01) and diastolic blood pressure (P &lt; 0.05). Insulin sensitivity significantly decreased (P &lt; 0.001) as the number of features of the metabolic syndrome increased. In conclusion, overweight Hispanic youth with a family history for type 2 diabetes are at increased risk for cardiovascular disease and type 2 diabetes, and this appears to be due to decreased insulin sensitivity. Improving insulin resistance may be crucial for the prevention of chronic disease in this at-risk population.


2011 ◽  
Vol 152 (32) ◽  
pp. 1265-1271 ◽  
Author(s):  
György Jermendy ◽  
Levente Littvay ◽  
Rita Steinbach ◽  
Ádám Jermendy ◽  
Ádám Tárnoki ◽  
...  

Both genetic and environmental factors play role in the pathogenesis of the metabolic syndrome. The magnitude of genetic and environmental influences on the components of metabolic syndrome may vary in different populations. Aims: The present study was aimed to determine the effects of genetic and environmental factors on risk factors characteristic for the metabolic syndrome. Methods: A total of 101 (63 monozygotic and 38 dizygotic) adult twin pairs (n = 202; mean age: 43.3±15.8 years) were investigated. Medical history was recorded and physical examination was carried out for each subject. Fasting venous blood samples were used for measuring laboratory parameters. The presented estimates include the heritability structural equation (A-C-E) model results. In Model-1, all presented parameters are age- and gender- corrected. In Model-2, parameters were corrected for age, gender, body mass index and waist circumference. Results: Heritability in waist circumference (as well as in other anthropometric parameters such as weight and height) was high (Model-1: 71.0–88.1%). Similarly, genetic factors had the highest proportion of total phenotypic variance in systolic and diastolic blood pressure (Model-2: 57.1% and 57.7%, respectively). Based on the results of Model-2, unique environmental factors dominate alterations in serum triglycerides values (55.9%) while shared environmental factors proved to be substantial in alterations of HDL-cholesterol and fasting blood glucose values (58.1% and 57.1%, respectively). Comparing the results of Model-1 and Model-2, the difference in A-C-E model varied from 0.0% to 17.1%, indicating that only a minor proportion of genetic and environmental influences can be explained by the effects of anthropometric parameters. Conclusions: Among adult Hungarian healthy people, genetic factors have substantial influence on waist circumference and blood pressure values while environmental factors dominate alterations in serum triglycerides, HDL-cholesterol and fasting blood glucose values. The different heritability of individual risk factors challenges the original unifying concept of the metabolic syndrome. The results may be useful for establishing and implementing primary cardiovascular prevention both at individual and population levels. Orv. Hetil., 2011, 152, 1265–1271.


2018 ◽  
Vol 59 (13) ◽  
pp. 2028-2039 ◽  
Author(s):  
Peri H. Fenwick ◽  
Khursheed Jeejeebhoy ◽  
Rupinder Dhaliwal ◽  
Dawna Royall ◽  
Paula Brauer ◽  
...  

Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Catherine J Vladutiu ◽  
Anna Maria Siega-Riz ◽  
Alison M Stuebe ◽  
Daniela Sotres-Alvarez ◽  
Andy Ni ◽  
...  

Background: Physiologic adaptations occurring across successive pregnancies may increase the risk of adverse cardiovascular health outcomes in later life. Previous studies have found an association between higher parity and the metabolic syndrome (MetS). However, no studies have examined this association in a Hispanic/Latina population. Hispanic women have a higher prevalence of the MetS and higher birth rates than non-Hispanic women. Hypothesis: We assessed the hypothesis that higher parity is associated with the prevalence of components of the MetS in a cohort of Hispanic/Latina women. Methods: There were 9,482 Hispanic/Latina women of diverse backgrounds, aged 18-74 years, who participated in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) from 2008-2011. Components of the MetS were defined according to the AHA/NHLBI criteria and included abdominal obesity (waist circumference ≥88cm), elevated triglycerides (≥150 mg/dL), low HDL cholesterol (<50mg/dL), high blood pressure (systolic ≥130mmHg or diastolic ≥85mmHg or on medication), and elevated fasting glucose (≥100mg/dL or on medication). Logistic regression models were used to estimate odds ratios for the association between parity and components of the MetS, adjusting for sociodemographic, behavioral, and reproductive characteristics, and accounting for the complex survey design and sampling weights. Results: At HCHS/SOL baseline, women reported none (19.2%), one (18.9%), two (25.3%), three (19.7%), four (9.3%), and five or more (7.6%) prior live births. Compared to women with only one live birth, women with four live births had the highest odds of abdominal obesity (OR=2.5, 95% CI 1.8, 3.3) and those with five or more live births had the highest odds of low HDL cholesterol (OR=1.5, 95% CI 1.2, 1.9), elevated glucose (OR=1.8, 95% CI 1.3, 2.3), elevated triglycerides (OR=1.4, 95% CI 1.01, 1.8), and high blood pressure (OR=1.5, 95% CI 1.1, 2.0), after adjusting for age, Hispanic background, education, marital status, income, nativity, smoking, physical activity, menopause status, oral contraceptive use, hormone replacement therapy, and field center. Further adjustment for body mass index attenuated these associations for all MetS components, including abdominal obesity (OR=1.5, 95% CI 1.1, 2.2), low HDL cholesterol (OR=1.3, 95% CI 1.03, 1.7), and elevated glucose (OR=1.6, 95% CI 1.2, 2.1), but the associations for triglycerides and blood pressure were no longer statistically significant. Conclusion: Higher parity is associated with the prevalence of selected components of the MetS among U.S. Hispanic/Latina women. High parity among Latinas with a high prevalence of abdominal obesity suggests a context of high risk for metabolic dysregulation. A better characterization of the links between pregnancy, adiposity, and body fat distribution is needed.


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