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The Metabolic Syndrome
John D Zelem, MD

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Do you find yourself having trouble losing weight even with exercise and, for all intents and purposes, watching what you eat? I suspect that you have been told to eat a low fat, high carbohydrate diet and you have done that. So why is there still a problem? You probably have thought of every possible reason for your lack of success. You may have thought that your thyroid gland is not working properly or your metabolism has slowed down: probably not. Possibly your hormone levels are off or maybe you need to step up your exercise program, or maybe you need one of these more dramatic diets to go on: not likely. That sounded like me and how I was thinking.

Normal Energy Production And Storage You may or may not have been aware of something called "The Metabolic Syndrome." What is it, you may ask? Allow me to give you a little background of basic information before I define this syndrome.

Our bodies need fuel for energy just like any machine. Sugar is that source. We need to get down to the cellular level where this energy production actually occurs. Glucose is the sugar utilized by the cell for the production of energy in the furnaces of our cells, which are called mitochondria. The entry of glucose into the cells is facilitated by the hormone insulin, which is produced in the pancreas. This hormone also will drive glucose into muscle and the liver for storage in a more complex form called glycogen. This will be used as a source of energy at other times such as periods of starvation and exercise. Any amounts over and above normal usage for immediate energy and storage in liver and muscle are sent to fat cells for greater storage of energy sources.

There is an opposing hormone, glucagon, which is also produced in the pancreas and is responsible for releasing fat for energy when stimulated by the intake of protein. The intake of carbohydrates and excessive levels of insulin suppress it. Normally these hormones work in conjunction with each other maintaining a balanced situation of energy substrates utilization and storage. Situations such as dieting, starvation, exercise and the Metabolic Syndrome will alter this balance.

Glycemic Index Whenever we ingest sugar or carbohydrates our bodies react with a rise in the blood sugar inducing the secretion of insulin to get the sugar into our cells and produce energy and store the excess in muscle, the liver, and eventually, fat. The Glycemic Index is a measurement of the rate of the rise of blood sugar following the ingestion of a particular test food relative to that of a standard food such as glucose. The measurement for glucose is 100. This index will quantitate the rate of secretion of insulin. Under 55 is generally considered to be a low-glycemic food and over 70 is high-glycemic.

Low GI = 55 or less Medium GI = 56 - 69 High GI = 70 or more

Our diet today is mainly composed of over-processed carbohydrates in the form of our modern-day flour. This flour is the result of removing all of its complex components, leaving us with a pure, super-fine white powder that, when ingested, causes our blood sugar to rise rapidly to higher than normal levels. This leads to an exaggerated insulin response. This rapid rise in insulin will cause blood sugar levels to drop precipitously to relatively low levels, lower than normal, causing drowsiness, and fatigue. The subsequent rebound also results in a desire to eat again to restore blood sugar levels. Long term this becomes an uncontrollable craving for carbohydrates. This roller coaster effect occurring over and over, leads to carbohydrate addiction, carbohydrate craving, nighttime eating, insulin resistance, and the beginning of the Metabolic Syndrome. These high insulin levels also shut off the glucagon response and leave no way that fat can be utilized as a source of energy. This is when weight gain occurs and weight loss becomes almost impossible.

Eventually, this syndrome will cause inflammation and narrowing