Do you have the metabolic syndrome and what you can do about it.
NHS Choices defines metabolic syndrome as a medical term for a combination of diabetes, high blood pressure and obesity. Metabolic syndrome is a hot topic in diabetes right now with CCG’s trying to reduce glucose levels, blood pressure and cholesterol in patients. The idea being, long term consequences can be reduced if we can lower these markers early.
Lifestyle modification can vastly improve or even reverse metabolic syndrome. It can be a very frustrating condition. Patients have direct control over many outcomes with metabolic syndrome based on their lifestyle. Yet if they do not make the necessary lifestyle changes to improve the syndrome, it will likely worsen over time.
Technically this can exist in any form of diabetes but is more commonly seen with type 2’s. Type 1’s can’t do a great deal about the glucose levels from a lifestyle perspective. They can improve glucose control, blood pressure and weight however. Therefore, metabolic syndrome is a condition we should all be aware of. Diabetes or no diabetes.
I recently did a blog all about obesity which you can find here. The article explains the level of obesity we now see in the UK. It highlights the burden to healthcare costing us approximately £16 billion in 2007 and predications indicate this figure will rise to £50 billion by 2050. A huge financial burden. Even the NHS who’s annual budget is £124.7 billion per year will notice that.
Therefore, any condition which is obesity driven, the first line treatment is to lose weight. How you achieve this is based on what works best for you but there are some general rules that work well.
What you can about it
1. Be consistent. Whatever changes you make, stick with them. All too often I see patients who quit their lifestyle change because it’s taking too long or they undo all their good work with blow outs. A good rule of thumb is to stick to your lifestyle changes 80-90% of the time allowing for 10-20% of relaxed discipline.
2. Healthy eating. Choose plenty of vegetables, fruits, beans, pulses, lentil and beans. These should dominate most of your meals with healthy protein sources like eggs, fish, lean meats and nuts and small amounts of starchy carbohydrate.
3. Get active. Inactivity reduces the margin of error you have with your diet. In other words, it’s much easier to overeat if you are inactive. Inactivity also makes you less fit. Being fit is a crucial element in reducing the risk and onset of disease.
4. Be realistic. It’s good to set long term goals. However, I see too many patients focused on losing 5 stone before they’ve even lost 5lbs. Set long term goals but focus short term. This keeps you motivated and focused.
5. Stay the course. If you continually start and stop diets you will never progress. Instead you will likely swing between weight loss and weight gain. Choose a lifestyle change and stick with it. If the focus is on health it doesn’t matter how long it takes for the weight to come off.
High glucose levels over the long term can directly effect blood pressure and cholesterol. High glucose levels injure the blood vessels responsible for transporting blood around the body. When injury occurs here plaque starts to form.
Therefore, if you suffer with metabolic syndrome and suffer with high glucose levels on top of this, you are really increasing your risk of problems.
If you are type 2, all the above points help to reduce glucose levels. That’s the beauty of type 2, the dietary advice is very similar to that of weight management.
If type 1, your management is going to be more about matching your insulin correctly to your carbohydrate intake. People achieve this using carbohydrate counting principles. If this is done correctly your glucose levels should mostly be within target.
Increased blood pressure is due to a narrowing of the blood vessels due to build up of plaque. This plaque is caused by increased fat, increased bad cholesterol, smoking, poor dietary behaviour and inactivity.
As a result, blood has less space to flow through the vessels causing an increase in pressure. As the vessels become more narrow pressure builds. This can lead to hardening of the vessels, circulatory problems, damage to the kidneys, damage to the eyes, stroke, heart attack and even death.
Medication can address this. Usually this involves thinning the blood or making you excrete more fluid, which reduces the volume of blood. Other medications help relax the blood vessels giving the blood more space to flow. None of these solutions cure the actual reason for the problem.
Over a lifetime everyone will see a certain amount of plaque forming regardless of their lifestyle. Some people develop high blood pressure regardless of healthy living. However, if considered alongside metabolic syndrome the cause is almost certainly lifestyle related.
All the changes outlined above will help reduce blood pressure. However, there are some more changes you can make to help this.
What you can about it
1. If you smoke, quit. Smoking with metabolic syndrome or even just diabetes, is like throwing a hand grenade onto the situation.
2. Aim to eat oily fish or a good source of fat i.e. olive/rapeseed oil, nuts, seeds, avocado and olives twice per week.
Monounsaturated fat found in oils, avocado and some nuts lower bad cholesterol whilst maintaining good cholesterol.
Polyunsaturated fats which contain our essential fatty acids omega 3 and omega 6 are also great for improving cardiovascular health.
These are your good fats. They help to reduce inflammation in the blood vessels.
3. Get active. Being active helps to reduce blood pressure. Only go to tolerance and build up slowly. Speak with your GP before commencing any new exercise regime.
4. Eat more soluble fibre. Soluble fibre can be absorbed into the body and acts like a sponge. It mops up lots of plaque and cholesterol and therefore can help improve blood pressure and cardiovascular disease.
Soluble fibre is found in fruit, vegetables, beans, pulses, lentils and oats. One portion of these is considered 80g/4 tbsp or 2 small fruits, 1 medium fruit or one decent slice of a large fruit.
Guidelines recommend aiming for a minimum of 5 a day of fruit and vegetables. This gives you all the fibre you need in a day. High fibre intakes help to improve health outcomes long term. This is likely because they are nutritious and replace higher calorie alternatives in the diet.
Most people reading this will not be at the point of developing metabolic syndrome. Remember, it is not like other chronic diseases because you have the power to make a considerable difference to your health. Glucose levels, blood pressure and weight are all modifiable risk factors.
Chances are if you are reading this you already have difficulty controlling your glucose levels. This already puts you on your way towards developing metabolic syndrome. This isn’t saying you will definitely develop it but why take the risk. There is no time like the present when it comes to changing your lifestyle.
Support and education are important but consistency and will power are arguably the most important factors.
Choose a lifestyle behaviour that works for you and stick to it. I wish you good luck!