Role of Diet in metabolic syndrome

Research suggests that metabolic syndrome, also known as syndrome X, marked by abdominal obesity, insulin resistance, hypertension, and hyperlipidemia is a non-communicable disease (NCD) that has become a major health hazard of the modern world. But the great news is that you can mitigate this risk or even reverse the condition by making changes to your diet and lifestyle.

What is metabolic syndrome?

Metabolic syndrome refers to a cluster of conditions that occur simultaneously, elevating your risk of heart disease, stroke and type 2 diabetes. These conditions include increased blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol or triglyceride levels.

Metabolic health on the other hand is described as having ideal levels of blood sugar, triglycerides, high-density lipoprotein (HDL) cholesterol, blood pressure, and waist circumference, without using medications. Metabolic syndrome is a cluster of conditions that occur together, increasing your risk of heart disease, stroke and type 2 diabetes. These conditions include increased blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol or triglyceride levels. (1)

Dietary Challenges in Metabolic Syndrome

Research indicates that a controlled energy dietary recommendation, together with moderate levels of physical activity, may positively change the parameters of MetS. However, there is no single dietary or exercise prescription that works for all patients. Dietary patterns such as Mediterranean-style, dietary approaches to stop hypertension (DASH), low-carbohydrate, and low-fat diets can ameliorate insulin resistance and MetS. Long-term adherence to a healthy lifestyle is key in assuring that individuals significantly reduce the risk of diabetes mellitus. [3]

Foods to steer clear of during metabolic syndrome

Overhauling your diet might sound intimidating but you don’t have to go extreme. As a first step, focussing on what unhelpful foods you can phase out helps.

Refined carbs as white flour, sugary snacks and sugar-sweetened beverages, which are low in fiber and nutrients. They cause spikes in blood sugar levels and contribute to overeating and obesity. Fructose and glucose are simple monosaccharide sugars. These are simple sugars that form the most basic units of carbohydrates. Glucose is absorbed and transported to the cells in your body to fuel your metabolism. This eventually forms water and carbon dioxide through what is known as the tricarboxylic acid cycle. In the case of excessive energy intake, another pathway is used to store it in the form of glycogen. Lastly, it is converted to fatty acids and deposited in fat tissue in the form of triglycerides. Fructose, on the other hand, gets metabolised mainly in the liver. The amount of acetyl CoA and glycerol-3-phosphate (byproducts of fructose metabolism) entering liver cells is unregulated. This can possibly give rise to unrestricted lipogenesis.. In a study funded by Yale University and the National Institutes of Health, the composition of the gut microbiome was evaluated and was found to be affected by a high intake of sucrose and fructose. (4)
Saturated fats found in foods like red meat, whole-milk dairy products and many baked goods. They can increase LDL (bad) cholesterol levels and raise the risk of heart disease.
Cured meats like hot dogs, bacon and deli meats, which have been linked to heart disease. They’re high in sodium, too, which contributes to high blood pressure.
Processed foods such as packaged items and fast food. These tend to combine the worst of the worst and often contain refined carbs, added sugars, too much salt and unhealthy saturated fats.
Artificial sweeteners: A small study found that consuming large amounts of diet drinks and artificially sweetened food may raise blood sugar levels and could increase your risk for diabetes. Avoid sweeteners such as: aspartame, sucralose & saccharin. (Read our blog on artificial sweeteners and blood sugar spikes here.)
A 2015 meta-analysis found that reducing sodium in your food can help lower blood pressure. Consuming too much sodium can raise blood pressure. Salt contains sodium, but foods that don’t taste salty can also be high in sodium. You need less than 1/4 teaspoon of salt a day. Limit added table salt and foods that have high amounts of sodium. [4]

Research suggests that overweight and obesity are affiliated with metabolic syndrome and adipose tissue dysfunction. The adipose tissue is metabolically active and an endocrine organ, whose impairment could lead to low-grade inflammation and fat depositions. The Mediterranean Diet is recommended as possible therapy for metabolic syndrome, preventing adiposopathy or “sick fat” formation (pathological adipose tissue function that may be worsened by fat accumulation (adiposity) and sedentary lifestyle in genetically inclined patients)

Foods that can prevent/ improve metabolic syndrome

Fibre rich foods

Adding more fibre to your diet can help lower your risk of heart disease and stroke. Fiber reduces low-density lipoprotein levels (LDL). LDL is known as “bad cholesterol.” Fiber can also help balance blood sugar levels. Women should eat at least 25 grams of fiber per day and men should eat at least 38 grams of fiber per day. Studies suggest that dietary fibre intake may regulate markers associated with the control of the metabolic syndrome, namely food intake (and body weight), glycemia and insulinemia, blood lipids and blood pressure. The efficacy of dietary fibre varies according to their dietary sources (fruits, legumes or cereals), but also to their specific chemical structure, instrumental in shaping their physical properties or for their fermentation capacity in the lower part of the gut. The fermentability of dietary fibre seems to play an important role in generating particular effects on satiety and glycemia through the release of gut peptides such as glucagon-like peptide-1.

Suggested fibrous foods include:

Certain fresh and frozen fruit such as apples, berries in small portions
Some types of dried fruit such as prunes in small portions
fresh and frozen vegetables
oats
barley
dried beans
lentils
brown rice
quinoa
couscous
bran
whole-grain bread and pasta
cinnamon powder [5]

Potassium

Potassium-rich foods help balance blood pressure. This heart-healthy mineral helps counter the effects of sodium, which raises blood pressure. A study suggests an inverse relationship of abdominal obesity and fasting hyperglycemia with potassium intake. Add these high-potassium foods to your diet:

bananas
dates
orange
grapefruit
cantaloupe
collard greens
edamame beans
black beans
lentils
mushrooms
potato with skin
tomatoes
oat bran
Yogurt [6]

Omega 3 Fatty Acids

Omega-3 fatty acids help raise HDL cholesterol levels. They also help keep your heart and blood vessels healthy. A study observed that people who ate diets rich in monounsaturated fat or low-fat, high complex carbs and omega-3 fatty acids had lower triglycerides than their counterparts who were on other two diets. These healthy fats can be found in some fish and other foods, such as:

flax seeds
chia seeds
pumpkin seeds
olive oil
pine nuts
walnuts
almonds
navy beans
avocados
salmon
sardines
tuna
mackerel
Trout [7]

The right mix of foods keeps your insulin and blood sugar in check. When you have insulin resistance (when cells in your muscles, fat, and liver don’t respond efficiently to insulin), that balance gets out of whack. It’s harder for your body to burn foods for energy. And when too much sugar builds up in your bloodstream, you may be on the path to type 2 prediabetes or diabetes. You don’t need special foods for the insulin-resistance diet. In a nutshell, you’ll eat less unhealthy fat, sugar, meats, and processed starches, and more vegetables, fruits, whole grains, fish, and lean poultry.

Certain lifestyle changes can also go a long way in preventing/reversing Metabolic Syndrome.

Adopt healthy habits. A crash diet won’t help you. This is about changing your approach to food. Go slowly and build new habits that can become permanent. Some studies have discovered that up to 55% of women experience weight variation due to fad diets. Weight fluctuations can also cause high visceral fat (fat around internal organs) accumulation that can put people at risk of heart diseases, irrespective of weight. (Read our blog on the long-term effect of fad diets here.)

Make it work for you. You may enjoy different foods than what others like to eat. A diet needs to fit your taste buds and your lifestyle for you to stick with it. Most people need support along the way, so a good dietitian can be a big ally.

Don’t skip meals. You might think missing a meal means fewer calories and more weight loss. That just makes your insulin and blood sugar levels swing up and down. And that can lead to more belly fat, which makes your body more likely to resist insulin.

Focus on calories and quality. The debate over the best mix of carbs, proteins, and fats has no clear answers. Your best bet is to watch your total calories and to really make them count. So skip the white rice and go whole grain instead. According to WHO, energy intake (calories) should be in balance with energy expenditure. To avoid unhealthy weight gain, total fat should not exceed 30% of total energy intake. Intake of saturated fats should be less than 10% of total energy intake, and intake of trans-fats less than 1% of total energy intake, with a shift in fat consumption away from saturated fats and trans-fats to unsaturated fats and towards the goal of eliminating industrially-produced trans-fats. Limiting intake of free sugars to less than 10% of total energy intake is part of a healthy diet. A further reduction to less than 5% of total energy intake is suggested for additional health benefits. Keeping salt intake to less than 5 g per day (equivalent to sodium intake of less than 2 g per day) helps to prevent hypertension, and reduces the risk of heart disease and stroke in the adult population. (7.1)

Based on short-term nitrogen balance studies, the Recommended Dietary Allowance of protein for a healthy adult with minimal physical activity is currently 0.8 g protein per kg body weight (BW) per day.

Mix it up. There’s no magic food that’ll fix everything, so vary what you eat. When you have a choice, choose the food with more vitamins, minerals, and fiber.

Smaller portions and turning half your plate into a melange of colours by choosing red, orange, and dark-green vegetables is one of the ways of eating healthy. Studies suggest that there is substantial evidence surrounding the effects of portion size on energy intake. Offering large portions of high-energy-dense (HED) foods increases overall intake in children and adults. This is the enduring portion size effect (PSE).

(Read our blog on learning to eat in the era of diets here.) [8]

Conclusion

Metabolic syndrome (MetS) is a group of conditions that increase the risk of diabetes, heart disease, and stroke. According to the NCEP ATP III definition, metabolic syndrome is present if three or more of the following five criteria are met: waist circumference over 40 inches (men) or 35 inches (women), blood pressure over 130/85 mmHg, fasting triglyceride (TG) level over 150 mg/dl, fasting high-density lipoprotein (HDL) cholesterol level less than 40 mg/dl (men) or 50 mg/dl (women) and fasting blood sugar over 100 mg/dl. Metabolic health is defined as having less than 2 metabolic abnormalities among the components of metabolic syndrome besides waist circumference criteria and insulin resistance. The term “Metabolic Fitness”, just like physical fitness describes where an individual is at the spectrum of metabolic health, how efficient are the body’s cells in creating and expending energy. Improving and maintaining metabolic fitness happens through conscious and continuous efforts. Studies have concluded that the Western dietary patterns consisting of high processed foods and meat, refined grains and fried foods have resulted in developing metabolic syndrome. The role of diet is to decrease the components of developing MetS by including fresh fruits and vegetables for fiber, anti inflammatory and antioxidant properties, nuts, healthy fats and oils for omega-3 fatty acids, whole grains and legumes for complex carbohydrates, lean meat, eggs, fish for protein and avoiding refined grains, full-fat dairy, trans-fats, sugar and junk foods.

Disclaimer: The contents of this article are for general information and educational purposes only. It neither provides any medical advice nor intends to substitute professional medical opinion on the treatment, diagnosis, prevention or alleviation of any disease, disorder or disability. Always consult with your doctor or qualified healthcare professional about your health condition and/or concerns and before undertaking a new health care regimen including making any dietary or lifestyle changes.

References

Role of Diet in metabolic syndrome

What is metabolic syndrome?

Dietary Challenges in Metabolic Syndrome

Foods to steer clear of during metabolic syndrome

Foods to steer clear of during metabolic syndrome