Diet and Metabolic Syndrome: Where Does Resistant Starch Fit In?

Abstract Metabolic syndrome is a term linking the clinical profiles of some of the world's major health problems today: obesity, heart disease, and diabetes. It is predicated on dietary patterns, and particularly on the delivery of fuel. The effects may be seen first in the development of abdominal obesity and insulin resistance leading to Type 2 diabetes mellitus and coronary heart disease. This review examines the role resistant starch might play in the prevention and management of these conditions. Beginning with a definition of resistant starch, a critical review of the scientific literature is presented. Current knowledge suggests that resistant starch in the diet may assist in the prevention and management of conditions associated with the metabolic syndrome via its potential effects on delaying the delivery of glucose as fuel with subsequent fat utilization and appetite control benefits. There is still a great deal of research to be undertaken in this area, but it is clearly warranted, given the position of starches in the global food supply and the potential impact on population health.

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Abstract P050: Glycated Hemoglobin Versus Fasting Glucose in Defining Metabolic Syndrome and Prediction of Coronary Heart Disease

Circulation ◽

10.1161/circ.127.suppl_12.ap050 ◽

2013 ◽

Vol 127 (suppl_12) ◽

Author(s):

Julie K Bower ◽

Vijay Nambi ◽

Mariana Lazo ◽

Andreea Rawlings ◽

Meredith C Foster ◽

...

Keyword(s):

Metabolic Syndrome ◽

Coronary Heart Disease ◽

Heart Disease ◽

Glycated Hemoglobin ◽

Fasting Glucose ◽

Cox Proportional Hazards ◽

Diabetes Diagnosis ◽

The Metabolic Syndrome ◽

C Statistic ◽

Definition Of

Introduction. Fasting glucose (FG) is part of the Adult Treatment Panel III (ATP III) criteria for defining the metabolic syndrome (MetS). Glycated hemoglobin (HbA1c) is a measure of 2-3 month endogenous glucose exposure and is now recommended for diabetes diagnosis and screening for high-risk individuals. The aim of this study was to evaluate if replacing FG with HbA1c to define MetS improves prediction of incident coronary heart disease (CHD) in the Atherosclerosis Risk in Communities (ARIC) cohort. Methods. We included 11,194 ARIC participants without diabetes (based on diagnosis, medication use, FG ≥126 mg/dL, or HbA1c ≥6.5%) or prevalent CHD at baseline (1990-92). Cox proportional hazards models (adjusted for age, race, and study center) were used to compare the association between MetS defined using HbA1c (5.7-6.4%) or FG (100-125 mg/dL, based on ATP III guidelines) and risk of CHD (defined by myocardial infarction or fatal CHD, event data available through 2009). Results. Study participants had a mean age at baseline of 57 years, 43% were male, and 79% were white; median follow-up time was 16 years. Thirty-four percent of the study population had both normal FG (<100 mg/dL) and HbA1c (<5.7%), 37% had elevated FG and normal HbA1c, 4% had normal FG and elevated HbA1c, and 25% had both elevated FG (100-125 mg/dL) and HbA1c (5.7-6.4%). The association of combined FG and HbA1c categories with incident CHD are shown in the Figure. The adjusted hazard ratio predicting for incident CHD from MetS status was 1.43 (95% CI: 1.25-1.63, c-statistic: 0.61) using FG in the definition of MetS and 1.69 (95% CI: 1.48-1.93, c-statistic: 0.62) in the model replacing FG with HbA1c. Conclusions. Incorporating HbA1c into the definition of the MetS may help in identifying individuals who should be targeted for aggressive CHD risk factor reduction. Additionally, HbA1c may be useful clinically and in research settings for identifying individuals with MetS in cases where FG measures are not available.

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The metabolic syndrome as a predictor of coronary heart disease and type 2 diabetes in older men

European Journal of Cardiovascular Prevention & Rehabilitation ◽

10.1097/00149831-200605001-00080 ◽

2006 ◽

Vol 13 (Supplement 1) ◽

pp. S20

Author(s):

SG Wannamethee ◽

AG Shaper ◽

L Lennon ◽

PH Whincup

Keyword(s):

Type 2 Diabetes ◽

Metabolic Syndrome ◽

Coronary Heart Disease ◽

Heart Disease ◽

Older Men ◽

The Metabolic Syndrome

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Sphingolipid Profiling: A Promising Tool for Stratifying the Metabolic Syndrome-Associated Risk

Frontiers in Cardiovascular Medicine ◽

10.3389/fcvm.2021.785124 ◽

2022 ◽

Vol 8 ◽

Author(s):

Loni Berkowitz ◽

Fernanda Cabrera-Reyes ◽

Cristian Salazar ◽

Carol D. Ryff ◽

Christopher Coe ◽

...

Keyword(s):

Metabolic Syndrome ◽

Causative Role ◽

Cardiovascular Risks ◽

Promising Tool ◽

The Metabolic Syndrome ◽

Risk Condition ◽

Disease Risks ◽

Definition Of ◽

Clinical Conditions

Metabolic syndrome (MetS) is a multicomponent risk condition that reflects the clustering of individual cardiometabolic risk factors related to abdominal obesity and insulin resistance. MetS increases the risk for cardiovascular diseases (CVD) and type 2 diabetes mellitus (T2DM). However, there still is not total clinical consensus about the definition of MetS, and its pathophysiology seems to be heterogeneous. Moreover, it remains unclear whether MetS is a single syndrome or a set of diverse clinical conditions conferring different metabolic and cardiovascular risks. Indeed, traditional biomarkers alone do not explain well such heterogeneity or the risk of associated diseases. There is thus a need to identify additional biomarkers that may contribute to a better understanding of MetS, along with more accurate prognosis of its various chronic disease risks. To fulfill this need, omics technologies may offer new insights into associations between sphingolipids and cardiometabolic diseases. Particularly, ceramides –the most widely studied sphingolipid class– have been shown to play a causative role in both T2DM and CVD. However, the involvement of simple glycosphingolipids remains controversial. This review focuses on the current understanding of MetS heterogeneity and discuss recent findings to address how sphingolipid profiling can be applied to better characterize MetS-associated risks.

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