changing that spare tire (metabolic syndrome)

by Dr. Robert Keith

That spare tire around your waist may be causing you more than embarrassment and discomfort. It may be robbing you of health and possibly even life.

Scientists believe that Metabolic Syndrome, a condition associated with apple-shaped people with large fat deposits around their waistlines, is linked to a nationwide epidemic of chronic conditions such as cardiovascular disease, hypertension and diabetes. An estimated 25 percent of Americans suffer from this problem.

While scientists have known something about this disorder since the early 1900’s, they have gained a clearer picture of it within the last few years. Physical inactivity and unhealthy diets have a lot to do with Metabolic Syndrome. But scientists also believe something more is involved – an enzyme that contributes to excessive levels of hormones within the body known as glucocorticoids, which, in turn, influence body metabolism.

In laboratory studies, doctors have determined that mice with excessive levels of these enzymes became more susceptible to weight gain and developed excessive abdominal fat.

What they’ve learned about lab mice also applies to humans. Even worse, many of the markers associated with these chronic diseases such as hypertension, heart disease and diabetes tend to be present in the blood samples of people with large waistlines. These include high levels of cholesterol and triglycerides, low levels of the so-called "good" or protective HDL cholesterol and elevated blood sugar levels.

Even without blood tests, a potbelly should be considered strong evidence of Metabolic Syndrome. Granted, people with excessive abdominal fat may not suffer from all of the problems associated this condition, but there’s a strong chance they do.

So what should they do to address this condition?

For starters, if your waistline is anywhere near 40 inches (for men) or 35 inches (for women) you should consult your doctor to see if you actually suffer from any of the conditions associated with Metabolic Syndrome. Even if you are not overweight, you may still be at risk with a tummy paunch and carry excessive weight in your abdominal area. Having a least one sibling or parent who suffers from type 2 (adult-onset) diabetes is another major risk factor.

Also, women who developed gestational diabetes during pregnancy also face a higher risk.

The second and perhaps important step is to develop a strategy to reduce this abdominal fat, through healthy eating and adequate exercise.

While medication is available to treat high cholesterol, diabetes and other conditions related to Metabolic Syndrome, no pill has yet been developed to treat all of these at once. That is why healthy diets and regular exercise remain the most ideal solutions to the condition.

Even modest weight losses between 5 and 10 pounds can lower blood pressure and reduce the problems associated with diabetes, such as insulin insensitivity. But the challenge lies in adopting a strategy for lifestyle change and sticking with it.

As a general rule, you should eat more fruits and vegetables and reduce you intake of saturated fats.

Exercise, equally as important as diet, doesn’t have to be as intrusive as you may fear. Current guidelines recommend staying physically active for about 30 minutes every day. This can involve either 30 minutes of continual activity or two or three individual chunks lasting between 10 and 15 minutes each.

Yes, changing this spare tire from fat into lean muscle may pose a minor inconvenience at first, but the possible alternatives – heart disease, diabetes and hypertension – are far worse.

Dr. Robert Keith is an Alabama Cooperative Extension System nutritionist and Auburn University professor of nutrition.

Posted October 2002