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Metabolic health has come into the forefront of the collective medical mind in the last decade. The growing attention makes sense, given growing prevalence of both the prediabetic condition and concerns around fat metabolism and heart disease.
In 2010, 79 million Americans over the age of 20 could be considered prediabetic; by 2012, that number had risen to 86 million.(1) Further, about half of all American adults have at least one of three risk factors for heart disease, which causes one in every four deaths in the United States each year.(2)
These facts have led many patients to a personal diagnosis in the form of metabolic syndrome, which is not a disease, but instead a combination of risk factors. According to the American Heart Association, over one-third of Americans have metabolic syndrome (MetS).(3)
As patient awareness for this condition grows, it is the practitioner’s duty to understand the syndrome’s causes and to help patients develop health protocols to address each one.

Metabolic Syndrome: Defined

While there is some debate about the actual parameters necessary for a MetS diagnosis, the five factors which the National Institutes of Health includes in its guidelines are:
• Large waist circumference
• High triglyceride level
• Reduced HDL cholesterol
• Increased blood pressure
• Elevated fasting blood sugar(4)
What causes these risk factors to emerge? We know that behavior can affect some of what leads to MetS, but some precursors are less amendable, like genetic predisposition and age.
Causes of MetS include insulin resistance, hormonal imbalance, sedentary lifestyle, obesity and poor diet.(5)
When we consider diet, we see a behavioral modification that could preclude the emergence of MetS. Consider the impact of sugary drinks. In one analysis of 11 independent studies, combined findings showed that people who consume one to two sugary drinks per day demonstrate a 26% higher risk of developing type 2 diabetes, and a 20% higher risk of developing MetS than did people who drank a maximum of one sugary drink per month.(6)
Diet is not the only way to address the potential for metabolic syndrome. There are three big pieces to the puzzle of energy balance: glucose metabolism, inflammation and lipid metabolism.

Glucose Metabolism

Impaired glucose tolerance contributes to high fasting blood sugar, a MetS risk factor. Insulin resistance is part of this process. Both are associated with the development of type 2 diabetes, a complication of MetS. It’s important to note that type 2 diabetes also affects other MetS risk factors. It correlates with lowered HDL cholesterol, and through diabetic dyslipidemia, has been shown to raise LDL and triglycerides.(7)
Studies show links between insulin resistance, diabetic dyslipidemia, and atherosclerosis and blood vessel disease.(8)This knowledge tells us that maintaining normal glucose metabolism is a must when addressing the development of MetS.

Inflammation

While researchers on unclear on the exact link between inflammation and metabolic syndrome, it is known that an inflammatory condition accompanies MetS.(9)
Obesity and inflammation have also been linked in recent medical literature, as have insulin resistance and inflammation.(10) So we see that two potential causes of MetS have a relationship to inflammation.

Lipid Metabolism

Perhaps the most obvious of relationships to MetS lies with lipid metabolism, as dyslipidemia represents three of five MetS risk factors.
A type of dyslipidemia, hyperlipidemia, can be related to the endocrine system and hormonal diseases like diabetes.(11)
Considering the MetS complications of cardiovascular disease and type 2 diabetes, we see some important connections. In mice models, researchers have found that hypoglycemia on its own did not stimulate proliferation of macrophages in atherosclerosis lesions, but when in concert with hyperlipidemia, that stimulation could occur through a pathway that involves oxidation of LDL, dependent on glucose metabolism.(12) As we see, the energy balance of the body is delicate, each piece of the equation dependent on or the cause of the next.

The Glycation Connection

When glycation occurs in the body, rogue molecules called advanced glycation endproducts (AGEs) are formed. They’re an important part of the MetS conversation because they can disrupt metabolic pathways.
In addition, high levels of AGEs can mean depletion of nitric oxide. That can cause vascular damage, which could be a contributing factor to a patient’s declining heart health.(13)
High levels AGEs also contribute to neuropathy, retinal disease and kidney failure, three well-known complications of diabetes.(14)
Many researchers suspect that glucose, via glycation and the resulting production of AGEs, is the primary damaging molecule to the aging body.(15)

Nutrient Support for Metabolic Health*

Both diet and exercise are important to maintaining metabolic health. Supplemental nutrition can also help, through providing support for each aspect of energy balance.*
For example, curcumin may offer healthy inflammatory support through a mechanism of PPAR-gamma activation.(16)
Carnosine offers support for the degradation of glycated proteins and a healthy life cycle of the cell. Berberine has been shown to support normal blood glucose metabolism and glucose uptake, as well as normal insulin sensitivity.(17)
Trans-resveratrol supports glucose balance, but also inflammation. Its principal mode of action with regard to inflammation is support for normal activation of the enzyme Sirtuin 1, which deacylates the peroxisome proliferator called PGC-1 alpha, thereby reducing the gene expression of inflammatory mediators.
With a supplement program that include nutrients to support healthy inflammatory response, free radical fighting, insulin sensitivity, glucose balance and fat metabolism, those concerned about metabolic syndrome can head off the risk factors at the pass.


References:
1. Statistics About Diabetes: American Diabetes Association®. (n.d.). Retrieved from http://www.diabetes.org/diabetes-basics/statistics/
2. CDC – DHDSP – Heart Disease Facts. (n.d.). Retrieved from http://www.cdc.gov/heartdisease/facts.htm
3. Metabolic Syndrome. (n.d.). Retrieved from http://www.heart.org/HEARTORG/Conditions/More/MetabolicSyndrome/Metabolic-Syndrome_UCM_002080_SubHomePage.jsp/
4. How Is Metabolic Syndrome Diagnosed? – NHLBI, NIH. (n.d.). Retrieved from http://www.nhlbi.nih.gov/health/health-topics/topics/ms/diagnosis
5. What Causes Metabolic Syndrome? – NHLBI, NIH. (n.d.). Retrieved from http://www.nhlbi.nih.gov/health/health-topics/topics/ms/causes
6. Sugary Drinks Link To Diabetes And Metabolic Syndrome Risk Is Clear And Compelling Medical News Today. (n.d.). Retrieved from http://www.medicalnewstoday.com/articles/206066.php
7. Cholesterol Abnormalities & Diabetes. (n.d.). Retrieved from http://www.heart.org/HEARTORG/Conditions/Diabetes/WhyDiabetesMatters/Cholesterol-Abnormalities-Diabetes_UCM_313868_Article.jsp
8. Cholesterol Abnormalities & Diabetes. (n.d.). Retrieved from http://www.heart.org/HEARTORG/Conditions/Diabetes/WhyDiabetesMatters/Cholesterol-Abnormalities-Diabetes_UCM_313868_Article.jsp
9. Monteiro, R., & Azevedo, I. (2010). Chronic Inflammation in Obesity and the Metabolic Syndrome. Mediators of Inflammation, 2010, 289645. doi:10.1155/2010/289645
10. Monteiro, R., & Azevedo, I. (2010). Chronic Inflammation in Obesity and the Metabolic Syndrome. Mediators of Inflammation, 2010, 289645. doi:10.1155/2010/289645
11. Dyslipidemia Symptoms and Treatment | Hormone Health Network. (n.d.). Retrieved from http://www.hormone.org/diseases-and-conditions/heart-health-and-metabolism/dyslipidemia
12. Hyperlipidemia in Concert With Hyperglycemia Stimulates the Proliferation of Macrophages in Atherosclerotic Lesions. (n.d.). Retrieved from http://diabetes.diabetesjournals.org/content/53/12/3217.full
13. Advanced glycation end-products induce vascular dysfunction via res… – PubMed – NCBI. (n.d.). Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/20186099
14. Glucose, glycation and aging. – PubMed – NCBI. (n.d.). Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/15609100
15. Glucose, glycation and aging. – PubMed – NCBI. (n.d.). Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/15609100
16. Mechanism of the Anti-inflammatory Effect of Curcumin: PPAR-gamma A… – PubMed – NCBI. (n.d.). Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/18274631?dopt=Abstract
17. Berberine modulates insulin signaling transduction in insulin-resis… – PubMed – NCBI. (n.d.). Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/20036710


*These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.