Metabolic Syndrome-- Cancer link defined

Antoaneta Sawyer, PhD

Most scientists believe that metabolic syndrome is conglomeration of three or four diseases that together can portend a worse prognosis for certain illnesses, including number of cancers. What has not been well-defined until that moment— is the associated risk for colorectal cancer.
A national survey report presented at the 73rd Annual Scientific Meeting of the American College of Gastroenterology scientific meeting in Orlando, Florida (October, 6) concluded that patients coping with the metabolic syndrome have a 75% higher risk for developing colorectal cancer sometime in their lives (Garrow & Delegge, 2008). (Source, NH-WC"Beyond Holistic")
The authors’ purpose was to review and analyze data collected between 2000 and 2003 by the National Health Interview Survey (NHIS). Their survey was centralized on 1,200 survey participants with history of metabolic syndrome and 350 patients with a family history of colorectal cancer.
Cross-referencing disease data revealed that patients with metabolic syndrome do bear higher risk for colorectal cancer as the study showed a 75% increase. According to their opinion, this is one of the first—and certainly the largest—study to look specifically at colorectal cancer risk.
The National Survey Report read at the American College of Gastroenterology scientific meeting in Orlando, Florida concluded that there is indeed a higher (75%) risk for colorectal cancer in this population.
Similar results on the connection of metabolic syndrome, obesity and diabetes and cancer were gathered in studies of colon cancer (Cowey & Hardy, 2006) breast cancer (Goodwin et al., 2005), pancreatic cancer (Huxley et al., 2005), prostate cancer( (Hammarsten & Hogstedt, 2004), and endometrial cancer (Cust et al., 2007, T. Bjorge et al., 2010; and Lane, 2008).
In Cowey and Hardy's words, " Specifically, we examine the hypothesis that individual components of the metabolic syndrome contribute to the development of several processes, including insulin resistance, aromatase activity, adipokine production, angiogenesis, glucose utilization, and oxidative stress/DNA damage, which can work together to increase cancer risk beyond that of the individual components alone. We propose that the metabolic syndrome be considered as a high-risk state for certain types of cancer and that this relationship should be systematically explored across cancer types."
Metabolic syndrome and obesity are also associated with an increased risk for clear-cell renal carcinoma (RCC), according to results reported in the January issue of BJU International (2010; 105, 16-20). The goal of this study was to evaluate the association between body mass index (BMI) and histology of RCC in a cohort of 1640 patients with renal cortical tumors being surgically removed from January, 2000 to December, 2007. Of these tumors, 12% were benign and 88% were malignant, while 61% of the last ones were clear-cell RCCs.
The lead author William T. Lawrence, from Memorial Sloan-Kettering Cancer Center (MSKCC), New York, NY, stated, "This makes it more important than ever to identify those people who face an increased risk of developing this variant, which is on the rise in the USA." The association of BMI with RCC histological features was examined with multivariable logistic regression by the researchers. The lead researcher concluded, "The widespread use of abdominal imaging has definitely contributed to increased detection of RCC, but fails to account for it entirely." A number of studies have suggested that obesity could be a risk factor for RCC, but the exact reason is still unknown. Researchers speculated that it might be secondary to hormonal changes, decreased immune function, hypertension or diabetes in obese patients.
Obesity, defined as a BMI of equal or more than 30 kg/m2, was found in 38% of patients. BMI was associated with clear-cell renal carcinoma (RCC) histological features, after adjustment for tumor size, age, sex, American Society of Anesthesiologists (ASA) score, estimated glomerular filtration rate (GFR), hypertension, diabetes mellitus, and smoking. (Source, Wiki)
BMI was considered an independent predictor of clear-cell renal carcinoma histology in the subgroup of patients with RCC “We also looked at other health and lifestyle factors, like diabetes, hypertension and smoking. This showed that the only other factors that were independent predictors of clear-cell RCC were male gender and tumor size" concluded the author.
Finally the authors stated, "This study is useful as it provides individual predictors of the chance of developing this form of RCC cancer and obesity provides the strongest association." (Source, NH-WC "Beyond Holistic")

Prediabetes revisited

Antoaneta Sawyer, PhD


Syndrome X (Metabolic Syndrome) is a metabolic disease characterized by the presence of several of the following risk factors: glucose intolerance with hyperglycemia, hypertension, low high-density lipoprotein (HDL), elevated very low density lipoprotein (VLDL), high triglycerides, and abnormal body mass index (BMI), microalbuminuria, endothelial dysfunction, and general prothrombotic state– all at the background of chronic inflammation. (Source, Wiki and Wrong Diagnosis)
The main problem of our last century is that the syndrome is constantly escalating around the world, and especially here in U.S. It is estimated that over 22% of the adult U.S. population have the syndrome and its incidence is rapidly increasing each year. There are expectations that additional number of 12 million adults will likely develop the disease as a result of aging alone by 2022.
Metabolic syndrome is also known as a “prediabetic” phase or as a precursor to the development of type 2 diabetes. Prediabetes is recognized as the condition of having abnormal or elevated levels of glucose (sugar) in the blood. It is found in cases when blood glucose levels are elevated beyond normal but are not considered high enough to indicate true type 2 diabetes. There are 57 million people in the United States who have pre-diabetes. Recent research has shown that some long-term damage to the body, especially (Source, ADA)
Prediabetes is recognized as the condition of having abnormal or elevated levels of glucose, insulin, and triglycerides in the blood. In general, the ‘prediabetic’ phase should be defined as combination of insulin resistance, glucose intolerance, elevated insulin secretion, and inflammation - all seen as predictors of the metabolic syndrome. Even in non-diabetic subjects, people who are insulin resistant always have slightly elevated glucose levels. There are two different tests your doctor can use to determine whether you have pre-diabetes: the fasting plasma glucose test (FPG) or the oral glucose tolerance test (OGTT).
(Source, ADA and Wiki)
From multiple literature data is concluded that increased cardiovascular risk factors precede the onset of type 2 diabetes. An issue is whether it is glucose intolerance or insulin resistance that increases the cardio-vascular risk. As shown in the Framingham Heart Study (FHS) and the Insulin Resistance Atherosclerosis Study (IRAS) there is a beta-cell dysfunction (an increased insulin resistance and decreased insulin secretion) and chronic subclinical inflammation. The United Kingdom Prospective Diabetes Study (UKPDS) data suggest that the relationship between glucose concentrations, while clearly significant related to myocardial infarction (MI) is not as significant in its relationship to microvascular disease. Pyorala and co-authors also presented data from a 22-year follow-up of the Helsinki Policemen Study reported in Circulation (1998) that showed that nondiabetic men with the highest insulin resistance (IR) are at greatest risk for a major CHD event.
The "prediabetic" phase is seen by most of the researchers as an early attempt metabolic syndrome to be defined. Most adults who develop “prediabetes” have insulin resistance as its main culprit. Insulin resistance refers to the mechanism by which one develops prediabetes or metabolic syndrome. In fact they are not considered two different conditions. They are cause and effect — insulin resistance is a synonym for metabolic syndrome which is the preamble of the prediabetes state.
The recently completed Diabetes Prevention Program (DPP) study and the Wisconsin Diabetes Strategic Plan (WIDSP) 2004-2009 are showing to people with prediabetes the way how they can prevent the development of type 2 diabetes by making changes in their diet and increasing their level of physical activity. The American Diabetes Association (ADA) is offering allot of resources for people at risk for diabetes that can be used by people with prediabetes.
In conclusion, prediabetes and Type 2 diabetes are both intimately associated with insulin resistance, glucose intolerance, visceral (central) obesity, hypertension, and dyslipidemia. The metabolic syndrome describes the same constellation of abnormalities, with or without glucose intolerance. In conclusion, “prediabetes” is a term-synonym for metabolic syndrome. The prediabetic phase is found in case when blood glucose (sugar) levels are elevated beyond normal but are not considered high enough to indicate true Type 2 diabetes. (Source, Wiki and Emedicine)
Otherwise, prediabetes is diagnosed when the levels of glucose are abnormal but below the well known diabetic values: fasting values of 100-125 mg/dl, and 140-199 mg/dl (two hours after a glucose load). For true diabetes to be confirmed, the values must be 126 mg/dl (fasting levels) and 200 mg/dl (two hours after a glucose load).

The Science of Nutrition

Antoaneta Sawyer, PhD

Proper and balanced nutrition is absolutely necessary for proper metabolic health.(Source, NYTimes) The connection between nutrition and metabolic syndrome is studied by Stephen Holt, MD. He offers another metabolic syndrome term- Syndrome X, Y, Z... In his book "Combat Syndrome X Y & Z" by Stephen Holt MD and Julian Whitaker, the authors claim the metabolic syndrome may qualify as the number- one public health problem faced by the Western societies.
In author's proper words, "Metabolic diet tailored to specific weight control targets and objectives consists of: a) Short-term accelerated weight loss with low carbohydrate approach; b) Long-term maintenance with restricted simple sugar, trans-fatty acids and saturated fats, moderate protein intake (1g/Kg) with vegetable protein inclusion, moderate salt intake. (Source, NaturalClinician)
Isaacs and Vagnini (2005) offer a complete and comprehensive nutritional path to a complete metabolic syndrome healing in their book "Overcoming Metabolic Syndrome". Karst (2006) believes that what and how much one eats may provoke the metabolic syndrome appearance (The Metabolic Syndrome Program). According to Kushi & Kushi (1993) the "Macrobiotic diet" is the correct road to final cure of most of the chronic degenerative diseases, such as cancer and metabolic syndrome including. (Source, Amazon)
The right nutritional balance is an essential approach in the prevention and healing of the metabolic syndrome in its early and advanced stages. Consuming meals that include all ingredients is known to benefit the metabolic health, and could add years to people life, according to the U.S. Department of Health. The claim is that five or more daily portions of fruits and veggies may cut risk of heart disease, cancer and other diseases. The researchers used data from eight studies in Europe, Japan and the U. S. have identified nearly 40 vitamins and minerals that the body needs for various tasks, from shoring up bones to bolstering the immune system and repairing cellular damage. Instead of delivering predictable effects at particular doses, nutrients team up in complex synergistic ways. (Source, HHS)
On October 10, 2008, Wisconsin Governor Jim Doyle announced the Wisconsin Genomics Initiative (WGI), which is a collaborative research effort among Marshfield Clinic, Medical College of Wisconsin, University of Wisconsin School of Medicine and Public Health, and University of Wisconsin-Milwaukee. Their statement is, "The vision of WGI is to be able to predict for individual patients in a clinical setting the risks of disease susceptibility and treatment response using the combined power of cutting edge genetic, phenotypic, and environmental analyzes, thereby making the promise of personalized medicine a reality" (School of Medicine and Public Health, and University of Wisconsin, Milwaukee)
The amount, type, balance, and the pharmacokinetic marker "bioavailability" of nutrients are all important in nutrition. It is well known that insulin resistance, metabolic syndrome and diabetes are all intimately related to nutrition. By selecting nutrition from all four food groups, and by choosing fresh colorful vegetables and fruits, whole grains, rich sources of protein and good (healthy) fats, while avoiding heavily processed food is the way to go. The American Diabetes Association (ADA) published officially its nutrition recommendations and interventions for diabetes that are the same as the metabolic syndrome nutrition recommendations and interventions (ADA, 2007).
"Metabolic syndrome is a phenotypic expression of the genetic code as it interacts with the whole body environment and if someone has a genetic tendency to develop the metabolic syndrome phenotype, he/she will be far more likely to develop this phenotype if overweight, doesn't exercise, consumes a diet high in simple carbohydrates, saturated fats, and doesn't add specific nutrients" believes Steven Joyal MD (Source LEMagazine,2005). The author published a completely new ‘nutriphenotypic' approach, based on the individual phenotypic metabolic characteristic to weight management and obesity. His conclusions are that the ‘phenotypic nutritional approach' enables people to choose dietary strategies and nutrients that influence powerful biochemical and genetic factors to help control the expression of their genetic code to their benefit.
A new allopathic program for metabolic syndrome treatment proposed by Harvard University is already in use by the conventional medicine. A well-balanced diet combined with lifestyle changing approach and daily physical activity to prevention and treatment of metabolic syndrome management was established. (Source, Harvard) The Dietary Guidelines for Americans (2010) are the main cornerstone of the U.S. Federal nutrition policy and nutrition education activities. (Source, USDA)
Epidemiological data showed that metabolic syndrome is increasing in the State of Wisconsin. The 2nd Annual Diabetes Symposium of Wisconsin (2009) showed that better diagnosis, management, as well as institution of preventative measures can affect these outcomes positively. (Russell A. Wilke, MD, PhD "Obesity...Exploring Management Strategies for a Growing Epidemic") The future of nutrition will be based on the science of nutrigenomics - the study of the effects of foods and food constituents on gene expression. (Source, Wiki)

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Childhood obesity pandemic

Antoaneta Sawyer, PhD

Obesity in the United States has reached epidemic proportions. The Americans are slowly but steadily expanding their waistline. As per recent statistics 33 percent of the adult population is considered obese. Almost a third of all American children are considered either overweight or obese.
Generally one is considered obese if is more than 20 percent overweight over his ideal body weight. In fact that is the most commonly used definition of obesity. According recent statistics about 200,000 Americans will have weight loss surgery this year only. Obesity accounts for nearly 300,000 deaths in the United States each year, and is associated with numerous chronic health issues.
The main cause of obesity in humans is the constantly increasing caloric intake and the rate of physical inactivity. Generally, obesity results when the person consumes more calories than he uses in his daily activity. Chronic consumption of an excessive amount of calories will result in a steady weight gain.
Obesity sets the stage for metabolic syndrome which itself increases your child chances of diabetes, heart disease, stroke, gout, Alzheimer’s disease and other chronic disturbances. While the metabolic syndrome is becoming more common in elderly (above 40 y), now children as young as 15 are being diagnosed with the syndrome leading to diabetes, stroke, heart attack, Alzheimer’s disease, macular degeneration, gout, kidney failure, eye problems or peripheral neuropathy later in life.
Constantly increasing rates of metabolic syndrome are influencing type 2 diabetes cases. The World Health Organization (WHO, 1998) estimations are that by 2025, the number of people with diabetes will reach 300 million—a staggering 122% increase in less than 30 years. Prevalence of obesity among children and adolescents: United States, Trends 1963–1965 Through 2007–2008 is reported by CDC. According to the Centers for Disease Control and Prevention (CDC) between 1990 and 1998, obesity fueled a 33 percent jump in adult diabetes and 70 percent for those between the ages of 30 to 39.
Childhood obesity pandemic rates represent one of the WI top health priorities. Since 1960, the number of children who are obese has doubled in the United States. The U.S. government estimates that some six million children are now overweight enough to endanger their health. According to the National Center for Health Statistics (NCFHS), 14 percent of the children between the ages of six and 11 are overweight (1988 to 1994)- a six percent increase over the 1976 to 1980 period. The percentage of teenagers who are overweight increase by six percent (1976 to 1980) to 11 percent (1988 to 1994). (Source, Univ Iowa)
There is a new project funded by the Wisconsin Partnership Program with a team led by Aaron Carrel, MD (medical director of the UW Health Pediatric Fitness Clinic) aimed to address childhood obesity rates among Latino children in Milwaukee. The purpose of the project is to examine how different factors will affect health, nutrition and lifestyle of these children. The program is focused on helping the child, and the whole family, to create and maintain healthy eating behaviors. It will be introduced in Milwaukee- (Bruce-Guadalupe School). Individual nutritional choices and fitness programs will be documented by technology. (Source, UWSMPH)

The new obesity hypothesis

Antoaneta Sawyer, PhD

The bacteria in our bowel, also known as residents (normal inhabitants) are between 10- 100 trillion. In order the human body to be healthy, they must function in a constant equilibrium, being intimately connected with immunity and metabolism. The gut bacteria are not just passive microorganisms, they provide us with many benefits but on times they may compromise our health. In a new study was proved that they may not only influence our metabolism but to determine how much calories we absorb from food. They may be the new hypothetical reason behind metabolic syndrome and obesity.

Until now the science shows data that every person has 160 different kinds of gut bacteria, which belong to two main families: the family of Bacteroidetes and the family of Firmicutes. These bacteria are found not only in humans and in animals, but they are also isolated from water and soil samples. Normally they are beneficial but when they overpopulate- they may cause a disease. (Source, Wiki)

“On the whole, our gut bacteria are beneficial as they prevent disease-causing bacteria from taking hold in our body simply by filling up all the available space. And they help us digest foods, such as some starches that we cannot break down ourselves, producing vitamins and energy sources we can use,” states Ruth Ley, a microbial ecologist at Cornell University in Ithaca, N.Y.(Source, Los AngelesTimes)

A comparative study done by the same team (2005) at the Washington University School of Medicine in St. Louis, studied the gut bacteria in mice, and compared lean mice with genetically obese ones. The genetically obese mice had a mutation in the hormone leptin, which normally controls appetite and metabolism. Similarly to mice, the two main gut inhabitants in humans were Bacteroidetes and Firmicutes. The researchers were surprised to find out that obese and lean mice had different proportions of each. In particular, fat mice tended to have more Firmicutes, and fewer Bacteroidetes, just the opposite to lean mice who had more Bacteroidetes than Firmicutes.

In a separate study, the same team worked with sterile (bacteria-free) mice that have no gut bacteria. Generally, these mice eat a lot, but do never get fat, presumably because they don't have Firmicutes bacteria to absorb all the calories from the food. For their surprise, when the researchers implanted the same bacteria from fat mice to their sterile counterparts, the recipients mice gained weight. This result, reported in Nature (2006), directly suggests that intestinal bacteria are directly connected with obesity and weight gain.

In another study also published in Nature (2006), the team tried to compare the results in mice with people, and studied the proportion of Firmicutes and Bacteroidetes in 12 people. They examined the bacteria in obese people in one year of follow up diet program. Before the diet started, the subjects had more Firmicutes and fewer Bacteroidetes, but as the diet progressed, the Bacteroidetes went up, while the Firmicutes numbers went down. Despite the conclusions in 12 people are far from being statistically significant, the question behind the new obesity hypothesis is still open for a future research.

Generally, babies are born “bacteria-free” (sterile), but start collecting bacteria from their mothers and their family. It is obvious that there is also an inheritance from family members. If the gut-obesity theory proved correct, that would suggest obesity risk could be over passed with correct diet, selected foods and drinks which regulate the kind of bacteria that are not beneficial.

A study found that ‘a "high-fat, high-sugar" diet changes the composition of bacteria in the gut, making it easier to gain weight and harder to lose it. ’According to the study published in the new Journal of Translational Medicine, ‘the changeover can happen in as little as 24 hours." Researchers led by Andrew Gewirtz at Emory University found that bacteria in human gut may play an important role in whether the body will use fat for energy or will store fat for future occasion. " If a person has changes in their gut bacteria — and that could be due to anything, to diet, to illness or antibiotic use and if that person has kids, then they can transfer those gut bacteria and maybe transfer the problem," Gewirtz stated. (Source, Time)

Otherwise, Firmicutes are seen as bacteria that absorb maximum calories from food by fighting for each available calorie from food and drinks, while signaling the body to either to store fat, slowing down metabolism. In fact the more Firmicutes one individual has the more obese he (she) is.

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Mediterranean diet prescription for healthy living

Antoaneta Sawyer, PhD


Mediterranean diet is built on high-quality food with basic ingredients that include fresh fruits and vegetables, whole grains, nuts and seeds, legumes, seafood, yogurt, olive oil, and small amount of wine. This diet has the reputation for being a "true model of preventive eating" for patients with chronic degenerative disease and is known to contribute for better quality of life. (Source, AHA and NH-WC "Beyond Holistic)
The Mediterranean-style diet which is mainly a "low-carb" diet is quite more effective than low-fat- low-calorie diet for prediabetics and aged people with a cognitive decline. It is also rich in olive oil, nuts, and fish, but low in red meat, dairy products and alcohol. Whole food should be seasonal, fresh, strictly portioned, appropriately cooked, and organically grown. (Source, Wiki)
"This diet emphasizes organic vegetables, fruits, fish, olive oil, lower meat consumption, and moderate wine and non-refined grain intake," concludes lead author Tangney (Rush University Medical Center in Chicago), in a news release from the American Society for Nutrition (ASN). In a completely new and ongoing prospective study called the Chicago Health and Aging Project (CHAP, 2010), a team led by Tangney, have found that adherence to the Mediterranean diet may reduce the risk of cognitive decline with older age. (Source, Rush Univ)
A traditional nut-enriched Mediterranean Diet helps reverse metabolic syndrome, and appears to be useful for managing metabolic abnormalities in older adults, as well as provides substantial protection against diabetes, heart disease and stroke. (Source, MedPage Today) One of the first major studies on the Mediterranean diet use as preventive nutritional strategy in metabolic syndrome was performed in 2004 by a team of Italian scientists. Researchers randomized 180 men and women with metabolic syndrome to compare the effect of two diets-- "Mediterranean diet" and the so called "prudent diet." The nutrient ratio composition of both diets was identical consisting in 50%-60% carbohydrates, 15% protein, and <30%>It was concluded that after 2 years on both diets, metabolic syndrome patients on Mediterranean diet lost more weight, had lower plasma C- reactive protein (CRP) and interleukin 6 (IL-6) levels (a guarantee of reduced inflammation), and less insulin resistance, comparatively to the control group. Their total cholesterol and triglycerides fell, while the good cholesterol (HDL) rose significantly comparatively to the participants on the prudent diet. The main and maybe most important feature from the whole study was the endothelial function improvement in the Mediterranean diet group, while it remained unchanged in the control group. That was the first proof ever in the scientific literature (JAMA) that a Mediterranean diet works in people with obesity and metabolic syndrome, including people with diabetes and cardiovascular diseases. (Esposito et al., 2004) (Source, Wiki and PubMed)
The Mediterranean-style diet is more effective than a typical "low-fat" and "calorie-restricted" diet in case of metabolic syndrome prevention. According to a new study released last Monday, not only did the Mediterranean diet lead to a greater weight loss, but it also resulted in better glucose tolerance, and improved some of the serious metabolic effects (cardiovascular risk factors). The study, presented at the Experimental Biology 2010 meeting in Anaheim California experimented with testing the diet of 4,000 adults aged 65 and older. Final conclusions from the above study were that, "Adults over age 65 should look to include more olive oil, legumes, fiber, nuts, and seeds in their diet in order to improve their recall times and other cognitive skills, such as identifying symbols and numbers." Tangney, lead author of the above study, added to the above equation the necessity of a daily physical activity as an important part of maintaining cognitive skills. (Source, ASIP)
Authors (Cloutier & Adamson, 2004) claim that the Mediterranean diet is more than just a diet- it is a lifestyle. They believe that by finding fulfillment in exercise, the outdoors lifestyle, and relationships-- all fundamental part of the Mediterranean life style--would help prevent anyone falling back into unhealthy habits. The authors found that a compound in olive oil named "oleocanthal" (whose pungency induces a stinging sensation in the throat) m?y help reduce inflammation, and may prevent conditions like he?rt disease, metabolic syndrome, Type 2 diabetes, arthritis, Alzheimer's disease, autoimmune disease, and certain cancers. (Source, NH-WC "Beyond Holistic and ElementsForHealth)
Needes separately concludes that in order to lessen gout and kidney damage, protein levels had to be kept low and should not be above 15- 20% of the total diet calories (Needes, 2002). Based on the results of a 20 year mega-nutritional study two authors scientifically illustrated that a "plant-based- oil-free diet" can not only prevent and stop the progression of heart disease but it can also reverse its effects (Caldwell & Esselstyne Jr, 2008). Mediterranean diet is connected with less risk of mild cognitive impairment, according to another report (Scarmeas, 2009). (Source, NH-WC Beyond Holistic")
Another Italian team or researchers (Sofi, Cesari, Abbate, Gensini & Casini, 2008) assessed and analyzed 12 international studies, which collectively included more than 1.5 million participants whose dietary habits and health were tracked for follow-up periods ranging from three to 18 years. A score based on the strict adherence to the Mediterranean diet could be used as an effective preventive tool for reducing the risk of premature death in general population. It was examined the concept of using a numerical score to estimate how much people stick to the diet, known in the literature as an "adherence score." The researchers found that people who stayed strictly on the Mediterranean diet had significant improvements in their health, including a 9% drop in overall mortality, a 9% drop in mortality from cardiovascular disease, a 13% reduction in incidence of Parkinson and Alzheimer's disease, and a 6% reduction in cancer. (Source, BMJ)
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The DASH diet

Antoaneta Sawyer, PhD

Another "metabolic syndrome friendly" diet is the Dietary Approaches to Stop Hypertension diet also known as the " DASH diet." This is maybe one of the most rigorously researched diets than anyone else in the scientific literature. (Source, DASH diet) The influence of a diet on blood pressure monitoring results is studied by Djousse et al., 2006 ( Source, AHA)
The National Heart, Lung, and Blood Institute (NHLBI) started in a joint venture manner a huge multi-centered, well randomized, outpatient version of a study across the US nation, involving Harvard School of Public Health, Johns Hopkins University, Duke University, Kaiser Permanente Center for Health Research, and Pennington Biomedical Research Center (1993- 1997). As a result of this research the diet (DASH) approach was officially recommended by the NHLBI, as part of the National Institutes of Health (NIH) to control blood pressure and to help maintaining stable weight. (Source, Wiki)
One of the main and most specific DASH diet features is to limit the intake of sodium in the general diet. The diet is proven to help lower hypertension (elevated blood pressure) what name it- Dietary Approaches to Stop Hypertension (DASH). The diet is proven to reduce systolic blood pressure by 11mm Hg and diastolic blood pressure by 6 mm HG in hypertensive patients and systolic blood pressure by 6 mm Hg and diastolic blood pressure by 3 mm Hg in patients with normal blood pressure. (Source, Wiki and EHow)
DASH diet was also found to reduce and stabilize blood glucose and to reduce blood lipids, what makes her good and reliable choice of a diet in case of metabolic syndrome and obesity. The emphasis is on good eating habits, by encouraging the consumption of nuts, whole grains, fish, poultry, fruits and vegetables, while lowering the consumption of red meats, sweets, and sugary foods and beverages. Generally, the diet is focused on the replacement of "junk food" and highly processed food pattern (a typical western diet) with home cooked healthy alternatives. So this is in fact another option for someone who is overweight or obese and has metabolic syndrome.
DASH diet is highly abundant in lean protein, fruits and vegetables, whole grains and low-fat dairy option. It is also rich in potassium, magnesium, and calcium, as well as protein and fiber. DASH diet consists of lean protein, 8-10 fruits and vegetables, low-fat dairy, whole grains, and about 25 percent of the total daily calories come from good fats, like olive and canola oil. In general the diet recommends nine servings of fruits and vegetables per day, two to three servings of low-fat dairy and protein, and five to six servings of whole grains.
Actually, DASH diet is a good prototype-example of a low GI diet and also one of the best diets for prediabetes, obesity with hypertension and metabolic syndrome as it has been tested and proven to significantly lower blood pressure and lipid levels, and to improve glucose intolerance. It can be compared also with the Mediterranean diet as it requires 8-10 fruits, vegetables and fiber in the diet. (Source, ADA)
What can compare DASH to the Low GI diet is that all the fruits and vegetables must be with low glycemic index. It is high in fruits and vegetables and whole grains - plus, it recommends a certain amount of low-fat dairy and lean protein pretty much alike the Mediterranean diet. You may learn more about the DASH diet specifics by reading the NIH guidebook (2009) termed "Your Guide to lowering your Blood Pressure with DASH." The manual offers healthy food alternatives and their nutritional value, as well as meal plans and exact proportions of macronutrients.
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The ‘Fat Resistance’ diet

Antoaneta Sawyer, PhD

Dr. Leo Galland, wrote his book ‘The Fat Resistance Diet: Unlock the Secret of the Hormone Leptin to: Eliminate Cravings, Supercharge Your Metabolism, Fight Inflammation, Lose Weight & Reprogram Your Body to Stay Thin' ( 2006), based on the concept that hormones such as leptin, insulin, ghrelin, glucagon and adiponectin control appetite and closely monitor body fat levels.
The diet is built with the idea of possible biochemical and metabolic changes, following a recovery from the effects of 'bad eating' habits. (Source, Amazon; Fatresistancediet) As an internist, the author recognizes that obesity, metabolic syndrome and type 2 diabetes are modern pandemics of our American society. While separating myths from facts, Galland is completely sure that 'leptin resistance' is the phenomena that drives obesity and metabolic syndrome up. The critical relationship between inflammation, incorrect diet habits, and obesity is well explained in the initial chapters of the book. (Source, Answers)
According to the author, when the body lipids elevate, that causes chronic but steady proinflammatory background, which subsequently alters the whole body biochemistry and creates hormonal imbalances. The book is built on healthy eating guidelines, so you can reverse your metabolic problem by designing your proper menu. The Wall Street Journal termed it: "The new thing in dieting." (Source, Random House)
By offering a variety of more than 100 different recipes, the author is introducing the reader to his version of an "anti-metabolic syndrome" diet plan to the road of success in combating ‘leptin resistance' timely and steadily with the help of hormone-balancing and anti-inflammatory nutrients.
As most of the well known diets, the Galland's diet is built on three-phase (stage) approach:
Stage 1. Consisting in a radical and quick weight loss
Stage 2. Directed to a moderate but steady weight loss
Stage 3. Geared to a long term "lifestyle" maintenance
Galland claimed that it is possible for dieters to achieve their ideal weight by inhibiting inflammation and to restore body biochemistry in terms to reduce cravings, and to increase metabolism and fat burning. In addition, his nutritional approach is based on detoxification and the addition of several super foods, what has been associated with weight loss and significant decline in cholesterol levels and blood pressure- all recognized as metabolic syndrome effects. (Source, Wiki)
The author's purpose is to transform the human body into a "fat-fighting" lean machine with the help of correct nutrition. The foundation of the "Fat resistance diet" is based on the abundant intake of fresh fruits and vegetables rich in antioxidants and phytonutrients such as carotenoids and flavonoids that have proven their anti-inflammatory effect. The author's idea is simple, but reasonable: eat plenty of veggies, fruits, and lean meats (fish and chicken), never overeat, maintain an active lifestyle, and get your daily exercise.
Foods high in carotenoids include carrots, spinach, tomatoes, broccoli, grean leafy vegetables, pumpkins and papaya, already recognized as powerful natural anti-inflammatory key weapons. The diet also emphasizes an increased intake of foods that are high in good fats, such as the omega 3 fatty acids found in fish, walnuts, and flax seeds.
Despite there is no any guarantee that the ‘Fat Resistance’ Diet will work exactly in your individual metabolic syndrome case, as there is no ‘one-size-fits-all’ diet out there on the American market, you can still educate yourself on several rules for healthy and preventive nutrition.
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Role of Probiotics and Prebiotics in the modern diet

Antoaneta Sawyer, PhD

Recent USDA statistics show that since 1970, the average daily caloric intake in the U.S. has increased by nearly 25 percent. Researchers at the Cornell University examined 52 paintings of the well known 15th century painting created by Leonardo da Vinci the “ Last Supper” and digitally compared the size of food and plate for a period of time of 1000 years with the most modern one.

Their report, published in The International Journal of Obesity (April, 2010), showed that the plate, as well as the entrée size enlarged by about two-thirds over the millennium while bread size increased by nearly 25 percent. (Wansink, B & Wansink, C.S.)
The World Health Organization (WHO) estimations are that by 2015, there will be more than 1.5 billion overweight consumers, with an incurring health cost beyond $117 billion per year in the US alone. (NH-WC "Beyond Holistic) Thus, the need of future research in the science of metabolomics for obesity control is strongly substantiated. (Source, Wiki, and PMV)
The new science of metabolomics is constantly discovering new mechanisms to control morbid obesity as part of the metabolic syndrome. Recently it was found a new connection between obesity as part of the metabolic syndrome disorder related to the use of probiotics and prebiotics, as regulators of the gut microflora (Source, Wiki)
Results from recent research suggested that there is a significant decrease in body mass index (BMI), linked to a modulation of gut peptides and appetite modulation that have been observed upon long term treatment of overweight and obese patients with probiotics and prebiotics. The study published in the Curr Opin Clin Nutr Metab Care (2005). also noted that the concept may be also applicable to humans, “Moreover, the metabolomic analysis will allow to select the potential new microbial targets related to obesity and related disorders in the future” (Delzenne & Cani, 2005).
Gut microorganisms, also termed “microbiota” are the trillions of bacteria that normally reside in the human GI tract, and affect nutrient absorption, energy and immunity regulation. Margaret Furtado MS, RD, LDN claims in her article"Probiotics, prebiotics, gut microbiota, and obesity" that ingestion of probiotics and their synbiotic use with prebiotics is highly recommended as preventative approach to the road of health and well-being (Source, BariatricTimes)
The rule that early gut microbiota composition can guide weight development throughout early childhood was established. Ingestion of probiotics is recommended as preventative approach to maintaining the balance of the intestinal microflora and thereby enhancing health and well-being (Furtado, 2009). The role of the gut microflora in affecting the caloric intake control and satiety is gradually being unraveled” are the statements of Prof. Glenn Gibson (University of Reading).
New science breakthrough study published in Nature (Ley, Turnbaugh, Klein & Gordon, 2006) reported that microbial gut flora is different between obese and lean people and that obese people are losing weight when probiotics are added. Two main divisions of beneficial bacteria—Bacteroides and Firmicutes—are recognized as normal residents in the gut, and the equilibrium between the two species is very important in determining an individual’s chance for obesity. This breakthrough is based on the finding that the obese people microflora reverted back to the one of the lean people, suggesting that obesity may have a microbial pathogenesis component.
Thus, the obesity phenomena is induced not so much by overeating, but as to the different metabolic activities of already modified gut flora facilitating the extraction of calories from ingested dietary substances that is storing calories in the adipose tissue for later use. It is obvious that there is an elevated rate of food ingestion in obese patients. Therefore, the attempt to modulate the equilibrium or gut microflora may have a role in the future prevention and treatment of obesity.
Probiotics are nonpathogenic live microorganisms that are believed to confer health benefits to the host when ingested (WHO). (Source, USProbiotics.com) As Gibson (2010) stated “The role of the gut microflora in affecting calorie control and satiety is gradually being unraveled.” The author’s conclusion is that prebiotics may beneficially modify bacterial populations in the guts and aid weight management, with “promising effects also shown in humans.” Larsen, Vogensen, Van den Berg & Anderson proved that "Gut microflora in human adults with type 2 diabetes differs from non-diabetic adults” (2010)
Prebiotics are non-digestible oligosaccharides believed to act as “fertilizers” of the colonic microflora, enhancing growth of beneficial residential organisms (e.g. Bifidobacterium, and Lactobacillus) (Reuter, 2001). Despite known as “non-digestible” the prebiotics are between the food fibers or ingredients that have a beneficial effect through their selective metabolism in the intestinal tract” (Gibson et al., 2004). Prebiotics are believed to offer health benefits on the host, explained with the activation or modulation of lipid metabolism most likely via the process of fermentation. (Source, NutritionNews)
The combination of prebiotics and probiotics, known as "synbiotic", is believed to show enhanced health benefits acting as a “functional food.” (Source, Invista.com) Recent studies reviewed the synergistic role of prebiotics and probiotics on obesity and suggested that individuals with obesity may have differing amounts of particular microflora (e.g. Firmicutes). (Source, Wiki) The combination of probiotics and prebiotics has been proposed to be used in food due to its health-enhancing, and anti-obesity properties to modify the gut flora to its beneficial ratio.
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The Glycemic Index diet

Antoaneta Sawyer, PhD

Maintaining normal blood sugar levels is considered factor number one for metabolic syndrome prevention. Conversely, maintaining chronic elevated levels of blood sugar is a guarantee to develop not only diabetes, but abdominal obesity, dyslipidemia and high blood pressure (all abnormalities of the metabolic syndrome cluster). (Source, AHA)
The Glycemic Index (GI) and Glycemic Load (GL) are relatively new concepts that relate to how quickly sugar in the food is absorbed into the blood stream from the gastrointestinal (GI) tract. You maybe know that, not all carbohydrates are created the same. If you consume low GI foods, your blood sugar will stay stable, so you will feel more energetic and happy, but if you consume high GI foods, you blood sugar will fluctuate, resulting in frequent hunger, mood shifts and general fatigue.
The main difference between carbohydrates is in their rate of absorption. There are two main groups of carbohydrates- (complex and simple)- that show different rate of a break down and absorption. For example white bread behaves quite differently than a vegetable (e.g. broccoli or carrots) as per its rate of absorption or break down rate. Basically all simple carbohydrates are absorbed rather quickly. High glycemic foods (e.g. white bread, instant rise, pretzels, cakes and crackers) are absorbed very quickly, while low glycemic foods (some vegetables and fruits, oatmeal, popcorn and nuts) are absorbed less quickly. (Source, About and Weightlossforall)
The glycemic index (GI) is a scale from 1 to 100 that determines how quickly food causes a spike in blood sugar levels. Otherwise, the GI concept is a numerical system of measuring how much of a blood sugar rise a carbohydrate triggers. Thus, the higher the number, the greater the blood sugar rises. For example, food ranking lower in the scale (less than 55) will cause a slower spike, while food with a high GI score (above 70) will cause an immediate spike. There are also foods with intermediate GI score (between 56 and 69). The glycemic index is an interesting, despite deceptive concept especially in diabetics. (Source, Wiki)
The glycemic load (GL) concept is a ranking system for carbohydrate content in food portions based on their glycemic index and the portion size. Some low GI foods are oats, carrots, barley and they are digested more slowly providing gradual and steady supply of blood sugar that is often referred as “slow carbs.” (Source, Wiki)
Both terms (GI and GL) are relevant to the dietary guidelines for counteracting metabolic syndrome.

Foods rich in simple sugars can be expected to cause a rapid rise in blood glucose which causes insulin secretion from the pancreas. They were termed by Axelrod and Levine (1982) as “high glycemic foods.” High GI foods are determined to a degree by the altered rates of transfer of glucose to its site of maximal absorption in the small bowel, which is a function of the rate of gastric emptying. By avoiding high glycemic foods and choosing low glycemic index foods will help you feel satisfied and more energetic. (Source, EHow)
Hence, slower glucose supply is critical for prevention and treatment of obesity and metabolic syndrome. According to Giampapa et al. (2004) carbohydrates must constitute 45% of the daily food intake in metabolic syndrome but they must be complex carbohydrates only.
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The power of sugar in our diet

Antoaneta Sawyer, PhD

The overconsumption of sugar can be compared with one of the most frequent addictions seen later in life. Simple sugar is what our cells painfully crave to be used as fuel for energy supply. Some of this sugar is stored in the liver as glycogen for future use, while the excess of it is stored as fat, in order to be used in periods of starvation and famine.
The Western medicine claims that turning to sugar is similar to material rewarding or spiritual nurturing, while the Traditional Eastern (Chinese and Ayurvedic) medicine compaires the craving for sugar, as a craving for mother love, material security and spiritual comfort or the so called "Yin energy". Nowadays, many nutritional authorities believe that chronic overconsumption of sugar is building the road to the most modern chronic degenerative diseases of the last century- obesity, metabolic syndrome, diabetes, Alzheimer's disease and even cancer. Nancy Appleton PhD numbered the 146 reasons why sugar is ruining your health and wrote her books "Lick the sugar habit" and "Lick the sugar habit sugar counter."(Source, Rheumatic)
Sugar especially in case if consumed in excess can compromise your immunity or your ability to fight illness in a long run. In a number of studies it was found a positive correlation between daily consumption of sugar and several cancers- colon, pancreas, prostate, kidney, ovary and brain.(Source, NH-WC "Beyond Holistic") As dietitian Edith Hogan claims many people consume 450 calories a day through sugary drinks. (Source, USAToday)
Despite of the heated debate between the lobby of modern nutritionists and the one of sugar industry, the U.S. Government now refers to minimal elevations of glucose, known as "prediabetes"- the stage of impaired fasting glucose. Thus, anyone at high risk, with a sibling or parent with diabetes, excess weight, and abdominal obesity is advised to be tested annually for fasting glucose. Glucose levels below the threshold for diabetes- 126 mg/dl- used to be admitted as normal in past. Nowadays, even a level of 100-125 mg/dl can raise a significant risk of developing metabolic syndrome, type 2 diabetes, heart attack, stroke, Alzheimer, and certain cancers. (Source, ADA and Wiki)
The American Heart Association (AHA) recently made a scientific statement published in Circulation (2006, June 15) saying that "Hyperglycemia and the often-associated insulin resistance are related to numerous cardiovascular complications, including CHD, stroke, cardiomyopathy, peripheral vascular disease, and heart failure (p.85) and it recommended that a) women consume no more than 100 calories a day, or about 6½ teaspoons, from added sugars; b) men, no more than 150 calories, or about 9½ teaspoons. You should know that the above recommended amount includes table sugar, brown sugar, HFCS, honey, molasses, brown rice syrup, agave syrup and other caloric sweeteners.
What most of the metabolic syndrome patients fail to recognize is the rapid preliminary "aging" effect of sugar. The bottom line is that blood sugar frequent spikes known as "hypoglycemia," can make anyone excessively hungry, and prematurely older than his generation. The explanation behind this statement is that when excess blood sugar reacts with proteins in the blood, advanced glycosylation end- products (AGEs) are formed what is leading to rapid reaction of glycation. As a dangerous process, reaction of glycation impairs biomolecular, cellular, organ and tissue functions leading not only to premature aging but also to rapid degenerative decline. Hence, a good blood sugar control is considered of a paramount importance for longevity and anti-aging as well as for metabolic syndrome prevention. (Source, Wiki)
Metabolic syndrome dietary recommendations are generally not different than those for managing type 2 diabetes. The carbohydrate intake should include whole grains, fibers, fruits, vegetables and low-fat milk. The total amount of carbohydrate consumed, rather than the type or source of the carbohydrate, determines the glycemic effect-sucrose does not increase glycemia any more than isocaloric amount of starch. Although very high carbohydrate diets may exacerbate existing levels of dyslipidemia, it has not been proven that substituting unsaturated fats in place of some carbohydrates will improve the lipid profile. Saturated fats should be also reduced as stated by ADA in the article Dietary Approaches to Prevent the Metabolic Syndrome" (Diabetes Care) and an active lifestyle with daily exercise should be followed as per the Journal of Physical Education, Recreation and Dance (JOPERD, 2006).

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Depression can trigger abdominal obesity

Antoaneta Sawyer, PhD

With the latest economic downturn- the exponential growth of depression and anxiety, intensity, duration, and frequency of worry are leading to serious impairment of our normal physical and psychological functioning. (Source, MedicineNet and Wiki)
Anxiety is often, despite not always, accompanied by mild (distimia) to moderate depression with number of physical symptoms including headache, muscle tension, elevated blood pressure, gastrointestinal problems, fatigue, mood shifts, insomnia, and irritability. It is believed to affect about an estimated 19 million adult Americans (15% of the U.S. adults), and is converting in more common than any other mental health disorder.
Many conditions (symptoms, syndromes and diseases) are direct result and consequence of a brain chemicals (neurotransmitters) imbalance. Inadequate or imbalanced neurotransmitter levels can result in distorted signals between the brain cells known as "neurones." Latest research has shown that lowered levels of the brain hormone- serotonin and increased levels of the adrenal hormone- cortisol could be responsible for anxiety and depression, obesity, chronic insomnia, addiction to food, addictions in general, obsessive compulsive disorders, etc. (NH-WC Beyond Holistic) Multiple literature data proved the probability that neurotransmitters' imbalance can trigger chronic muscle/ joint pain, obsessive/ compulsive behaviors, attention deficit disorder (ADD), irritable bowel syndrome (IBS), migraines, hypertension, fibromyalgia and many others. (Source, Wiki)
A new study published in the American Journal of Public Health (June 9, 2010) and performed in the University of Alabama at Birmingham (UAB) showed conclusive data that depression could play a role in abdominal obesity- one of the major metabolic syndrome markers. The researchers compared data from the coronary artery risk development in young adults study (CARDIA)- a 20-year mega-longitudinal study of more than 5,115 men and women aged between 18-30. The main task of this study was to prove the “cause-effect” connection and to testify whether the body mass index (BMI) and waist circumference measurements were associated with increases in depression and vice versa. Their findings were that over a period of 15 years, all the subjects put on some pounds, but the group selected as “depressed” individuals gained even faster. (Source, UAB.edu)
The study strongly confirmed that depression may trigger abdominal obesity, but did not find any confirmation data on the question if overweight people are more depressed than their lean counterparts. "Those who started out reporting high levels of depression gained weight at a faster rate than others in the study, but starting out overweight did not lead to changes in depression" claimed UAB Assistant Professor of Sociology Belinda Needham, Ph.D She stated that since cortisol, is already known as the hormone of stress, depression and abdominal obesity, can be speculated that elevated levels might explain why depressed people tend to gain more belly fat than the rest of the group. Finally, the author concluded, "Our study is important because if you are interested in controlling obesity, and ultimately eliminating the risk of obesity-related diseases, then it makes sense to treat people’s depression. It's another reason to take depression seriously and not to think about it just in terms of mental health, but to also think about the physical consequences of mental health problems."

Integrative Approach to Metabolic Syndrome Management

Antoaneta Sawyer, PhD

Metabolic Syndrome is well known as a cluster or constellation of several common disorders, including high blood pressure, glucose intolerance, abdominal obesity, hyperinsulinemia, and abnormal cholesterol levels that make anyone susceptible to the risk of Type 2 diabetes, heart disease and stroke.
Each of these disorders is by itself a risk factor for many other degenerative diseases such as: gout, kidney failure, Alzheimer’s disease, and in combination, all of the above dramatically boost the metabolic syndrome patient;s chances of developing potentially life- threatening illnesses. (Source, AHA)
Worldwide, over 250 million people suffer from the disease and the estimations for 2025 are depicted at a total of 380 million patients. As per Feinstein and Eden (2008) an additional 12 million adults will likely develop the disease as a result of aging alone by 2022. (Source, NH-WC Beyond Holistic) Widely known as "The Nutrition Reporter" Jack Challem (2007) claims, “Two- thirds of the Americans are now overweight or obese (including four out of five men), and upward of 100 million Americans are prediabetic - with 1 million Americans now being diagnosed with full-blown diabetes each year. Between, 60 -75 million of us are insulin resistant and 5-10 percent of those millions will develop Type 2 diabetes.
Managing metabolic syndrome is to address all of the available risk factors rather than each one individually, and separately (Holt & Whitaker, 2002). The authors state, "Obesity must be addressed with rapid and immediate weight loss, high blood pressure must be reduced, high cholesterol must be diminished and blunting of surges in blood glucose must be accomplished. " Nowadays many authors relate the syndrome X predominantly with an increasing rate of morbid obesity in the Western industrialized world. (Source. Amazon)
As per latest AHA recommendations for managing metabolic syndrome- the primary goal of the metabolic syndrome management program is to reduce the risk for cardiovascular disease and Type 2 diabetes. Thus, the “first-line” therapy approach should be oriented to reduce the major risk factors for heart disease: to stop smoking, to reduce LDL cholesterol (its VLDL fraction), blood pressure and glucose levels to the recommended levels.
For managing both- long and short term risk consequences, lifestyle therapies must constitute the primary intervention management plan. These lifestyle interventions include: (a) Weight loss to achieve a desirable weight (BMI less than, 25 kg/m2); (b) Increased physical activity, with a goal of at least 30 minutes of moderate-intensity activity on most days of the week; (c) Healthy eating habits that include reduced intake of saturated fat, simple carbohydrates, saturated fat and cholesterol. (Source, AHA)
Darwin Deen, MD (2004) claims that “low fat- high-carbohydrate diets” have been criticized because they may raise triglycerides and lower HDL-cholesterol levels in some patients, leading to aggravation of dyslipidemia in metabolic syndrome. The metabolic syndrome diet should remind to a typical Mediterranean-style diet. Deen states, "For sedentary patients with elevated triglycerides, who are obese and insulin resistant-- a lower carbohydrate diet that limits sodas, juice drinks, and refined grains (such as sweetened cereals, baked goods, and desserts) is advisable." (Source, AAFP)
Incorporating activity into most, if not all days of the week, is a prerequisite for longevity and a graceful aging. Regular exercise helps prevent cardiovascular disease, elevated blood pressure, diabetes, obesity (all part of the metabolic syndrome cluster). The American Academy of Family Physicians (AAFP, 2007) recommends an exercise routine of 30 minutes of physical activity, at least four to six days per week — a combination of aerobic, strength, and flexibility training. (Source, AAFP)
Thus, among the first steps in addressing metabolic syndrome are:
1. Lifestyle changes, with specific avoidance of substance abuse, including smoking cessation, reduced caffeine and simple sugar intake.
2. Behavior modification, including changing eating patterns and extinguishing adverse lifestyle choices.
3. Exercise matched to the level of aerobic fitness (with professional training advice).
4. Diet, reduced in simple sugars, salt, and saturated fat with controlled protein intake and more liberal in healthy fats (e.g., fish oil, olive oil and monosaturated fats).
Stephen Holt, MD (2003) considers rapid dietary and lifestyle modification as fundamental in the rapid improvement of metabolic syndrome. Syndrome X dietary recommendations are generally not different than those for managing diabetes. Excessive dietary intake of refined sugar, lack of exercise, poorly defined genetic tendencies and adverse lifestyle variably contribute to the cause of metabolic syndrome.
All of the above suggestions are consistent with dietary attempts to restrict the carbohydrate intake, and may explain the “quick-fix” (or short-term) success of some low carbohydrate diets for weight control. “Current pharmaceutical and dietary approaches in metabolic syndrome management show multiple disadvantages, restrictions and limitations,” believe Holt and Whitaker (2002). It had been proposed and then reiterated by the same authors that focused pharmaceutical treatments on the components of metabolic syndrome are not likely to provide better outcome than integrated management strategies.
Despite conventional treatments (cholesterol-lowering drugs, blood pressure lowering medications, anti-obesity drugs and surgery) have their specific role when risks within metabolic syndrome are already present, they should form the “back-up” strategy plan for management, while in contrast, diet approaches, active lifestyle modification, exercise, nutritional, and nutraceutical interventions may provide versatile, flexible and powerful “first-line” management option. According to the same authors the idea of holistic strategies opens the door for the so called "integrative approach" with dietary supplements. (Source, Dr Weil)
“Effective prevention and treatment of metabolic syndrome should involve a multifaceted approach to impact all cardinal components of the disorder,” believe the authors. It had been suggested that focused treatments on obesity, hypercholesterolemia, and hypertension (the individual components of the syndrome) were unlikely to provide better outcome than are integrated management strategies. (Holt et al., 2003).
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Curtesy to Youtube and to Dr Oz "The Healthiest Diets"

Detoxification and Weight Loss Connection

Antoaneta Sawyer, PhD

We as humans, tend to follow the tendency to make poor diet choices and to overeat, despite being well informed that our ‘bad food’ choices may soon ricochet in a “bad health’ status. There are known over 85,000 chemicals, officially licensed for use in North America, most of which are scientifically proven and demonstrated carcinogens, poisons, contaminates or hormonal disrupters (xenoestrogens).

Some of them are fluoride, bis-phenol, clothing dyes, chlorine, mercury, dioxin, chlorine, sulfite, nitrites, nitrates, phthalates, pesticides, herbicides, fungicides, insecticides food additives, poisons and contaminates. Drugs, sugar and alcohol are also toxins. Over the time they can build up – a process called “ bio-accumulation.” (Source, Wiki)

Detox, or detoxification, is the process of holistic (natural) or conventional (medicinal) removal of toxic and potentially harmful substances from the human body (sugar, toxins, alcohol, drugs, metabolites). Although the process of detoxification is primarily thought of as a treatment for alcohol and opiates, the term detox is also used in reference to nutrition, diets, herbal detox, and many other methods of removing toxins from the body for general health achievement. The mechanism behind a “full body detox” can refer to the period of withdrawal during which an organism returns to homeostasis after long-term use of an addictive substance. (Source, Fullbodydetox and Wiki)

There are countless of products, articles and books on the market that are step by step detox plans to support physiological detoxification by increasing elimination, cleansing the colon, enhancing circulation, lymph cleansing, eliminating foods from the diet that are allergenic, while providing nutrients to support the liver, known as the main organ involved in the detoxification process.

Majority of the diet detox programs are one to two-four week plans to support detoxification by increasing elimination from the body, cleansing the colon, enhancing circulation to clear toxic substances, eliminating foods from the diet that require detoxification or are allergenic, and providing nutrients to support and protect the liver, the majaor organ involved in detoxification. (Source, Dietdetoxsecrets)

There is a difference between the conventional and alternative medicine detoxification procedures. The holistic (alternative) detox approach is based on latest scientific research, empirical case studies, self-tests and inquires. Holistic medicine is constantly focused on the numerous benefits of choosing a raw diet, fasting, juicing with fresh fruits and vegetables rather than cooked meals. (Source, Wiki)

Many alternative practitioners promote various types of detoxification such as detox diets, detox foot pads, oil pulling, botanical detox, body cleansing, Gerson therapy (diet), electromagnetic treatment (such as the Aqua Detox treatment), raw diet, water fasting, metabolic therapy, etc. but the conventional doctors argue that there is little scientific evidence that detox diets have any health benefits.

Certain detox writers believe that the body accumulates toxins that must be removed, especially after periods of over-eating or the consumption of non-nutritious and processed foods. Nearly all detox diets advocate increased water consumption, at least eight glasses a day.

An example for a detox diet is described in the book 21 Pounds in 21 Days: The Martha's Vineyard Diet Detox. The book offers three different detox programs, one of which is the rapid 21-day "Master Fast," in which 21-pounds are lose in 21 days. The book is based on detox through stress reduction, fasting, exercise, lifestyle changes and the use of antioxidants, vitamins, and enzymes designed to nourish the body during the process of detoxification. Also included in the book are recipes, juices, formulas, etc. (Source, Mydietdetox)

Another detox diet book is The Fast Track Detox Diet: Boost metabolism, get rid of fattening toxins, jump-start weight loss and keep the pounds off for good by Ann Louise Gittleman. Combining the theory with practice, the writer incorporates the method into one day of fasting plan. The author’s opinion is that the weight loss approach- is absolutely necessary to the road of health, longevity and graceful aging. (Source, Everydiet)

The New Detox Diet –The Complete Guide to Lifelong Vitality with Recipes, Menus, and Detox Plans by Elson Haas is another practical guide to detoxification that uses common ingredients and helps you feel stronger and healthier. The author explains the difference between transitional and general detoxification diets, detox throughout supplements, juices and fasting, and offers recipes that can be incorporated for a long life detox dieting. (Source, Elsonhaas)

A good example of a natural raw food diet book the 12 Steps to Raw Foods: How to End Your Dependency on Cooked Food by Victoria Boutenko. The author believes that raw food diet is necessary to the road to absolute energy and health, throughout optimal nutrition. After years of research, Boutenko found that the only group that matches by all essential macro nutrients and micro nutrients to a complete and optimal nutrition is the family of green foods. (Source, Amazon)

Generally the medical community is skeptical to detox diets. Conventional medicine believes that there is no scientific evidence for toxic bioaccumulation, as the liver and kidneys automatically detoxify and excrete the toxins, including its proper body metabolic byproducts.Under the conventional medical theory if toxins are too rapidly eliminated the process of elimination can damage the body and cause disease. The conventional medicine detox approach can be achieved by using antidotes versus toxins, as well as techniques as kidney dialysis or chelation therapy. A UK-based charitable trust “Sense about Science”, determined that most commercial “detox’ products can be considered a "waste" of money. (Source, Wiki and Senseaboutscience)
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A review of the new 2010 dietary guidelines for Americans

Antoaneta Sawyer, PhD

On June 15, 2010, the USDA’s Nutrition Evidence Library (NEL) specializing in conducting systematic reviews to inform the US public on the changes in Federal nutrition policy and programs announced the preliminary release of the Report of the Dietary Guidelines Advisory Committee on the Dietary Guidelines for Americans, 2010.
Generally, the dietary guidelines are the foundation of the My Pyramid Food Guidance System, formerly known as the Food Pyramid. (Source, Cnpp.Usda) The dietary guidelines are based on what the USDA's experts have determined to be the "best scientific knowledge" on food, diet and nutrition, including requirements for physical activity, and lifestyle changes, related to what individuals aged 2 years and older. These guidelines are under review every five years and provide the foundation of the latest federal government general (food and nutrition) policy based on latest research, labeling, and food promotion rules. (Source, Cnpp.Usda)

During the 70’s, the USDA’s nutrition recommendations were based on high animal protein and eggs. The increasing rate of heart attacks, diabetes and strokes during that time requested drastic changes of the food pyramid towards the high carbohydrate- low fat diet corner. Thus, the next USDA guidelines included higher carbs, lower fat and lean protein. For the first time since 1980, the dietary guidelines for Americans emphasized more on exercise for weight loss and less on cardiovascular and other modern diseases risk.
Despite of the drastic changes in nutrition and active lifestyle recommendations, the Americans are still facing today a pandemic rate of metabolic syndrome and obesity, while the heart disease and cancer are leading the list of modern mortality statistics. The main problem in 70-80's years guidelines was that there were not exact specifications of what kind of carbs exactly were recommended (e.g. breads, pastas, drinks, oats and cereals, or just vegetables and fruits).
The 2005 y guidelines were based on the rapidly increasing rate of obesity in the U.S. The Health and Human Services Secretary Tommy Thompson stated, “Two-thirds of the Americans are still overweight or obese, and more than 50 percent of us Americans do not get the recommended amount of physical activity, so the new guidelines emphasize physical activity and calorie control more than ever before.” Thus, the 2005 guidelines specific recommendations, included eating whole grains, reducing fat intake to less than 30% of the total intake, eating whole (home prepared) foods as opposed to overly processed foods. In addition they added a daily exercise routine at least 30- 60 minutes of moderate exercise on a daily basis. It was underlined that those who need to lose weight should exercise between 60 and 90 minutes each day.

The new 2010 Advisory Committee report observations are the following: "The single most significant adverse health trend among US children in the past 40 years has been the dramatic increase in overweight and obesity. Since the early 1970s, the prevalence of overweight and obesite people has approximately doubled among children ages 2 to 11 years, and tripled among adolescents’ ages 12 to 19 years. Not only is obesity associated with adverse health effects during childhood, but evidence documents increased risk of future chronic disease in adult life. “
While kindly acknowledging the lack of progress, the Advisory Committee is advising Americans to consume ‘nutrient-dense’ foods with a follow up note ‘but again not too much of them.’ In their proper words, “Currently, Americans consume less than 20 percent of the recommended intake for whole grains, less than 60 percent for vegetables, less than 50 percent for fruits, and less than 60 percent for milk and milk products. Inadequate intakes of nutrient-dense foods from these basic food groups place individuals at risk for lower than recommended levels of specific nutrients, namely vitamin D, calcium, potassium, and dietary fiber. “
The new guidelines can be shortly summarized with the following statements:
a) Eating a healthy balance of nutritious (nutrient dense) foods continues as a central point in the dietary guidelines, but balancing nutrients is not enough for health.
b) There is an emphasis on increased availability of fresh produce for consumers.

c) To be placed a stronger emphasis on calorie control and physical activity. The amount of total calories also should be considered.
d) Reduction of salt intake by 40%. The new guidelines lower the recommended maximum daily intake of salt from 2,300 milligrams to 1,500 milligrams.

e) General reduction of solid fats and added sugar (sugary foods and drinks).

f) To give preference on plant (vegetables and fruits) based diet.

g) To be selected low fat, high on fiber, dairy and whole grains based diet.

h) Another emphasis is on the improvement in nutrition based on cooking skills and home cooked healthy foods and on creating new nutrition programs and physical education in schools. (Source, Cnpp.usda.gov)
Despite vit. D, iron, calcium, omega-3 fatty acids, potassium, dietary fiber and folic acid are positively included in the guidelines for Total American diet, the general use of dietary formulas and other supplements among healthy Americans is completely dismissed. Here is the final executive summary statement to your attention: “A daily multivitamin/mineral supplement does not offer health benefits to healthy Americans.”
Generally, the use of supplements is oriented to selected demographic groups of the population: “Women of reproductive capacity should consume foods rich in folate and iron, and older individuals should consume fortified foods rich in vitamin B12 or B12 supplements, if needs cannot be met through whole foods. Nutritious breakfast consumption and in some cases nutrient-dense snacking may assist in meeting nutrient recommendations, especially in certain subgroups.”
Their final statement is the following: “The food industry will need to act to help Americans achieve these goals.” “Every aspect of the industry, from research and development to production and retail, needs to contribute healthful food solutions to reduce the intake of SoFAS [solid fats and added sugar], certain refined grain products, and sodium. Sound health and wellness policies at the local, state, and national level also can help facilitate these changes.”

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Father's Day health discussion

Antoaneta Sawyer, PhD

Nowadays, there are many men who are complaining of the so called “androgen (testosterone) deficiency” syndrome, characterized by several symptoms like: anxiety, low energy, low libido, frequent fatigue, mood shifts, erectile dysfunction, osteoporosis, sleep disturbance, morning tiredness, frequent anger and depression. The association between androgens and sexual function is proven 30 years ago.
The main function of the prostate is to secrete and store a clear fluid with slightly alkaline PH 7.29 that constitutes 10-30% of the volume of the semen. The rest of the seminal fluid is produced by two seminal vesicles. To work properly, the prostate needs androgens (male hormones), which are responsible for the male primary and secondary characteristics. The main male androgen hormone- testosterone is produced by the testicles and in very small amounts by the adrenals. The hormone regulator of the prostate gland is the metabolite of testosterone known as “dehydrotestosterone”. As in aging men the production of testosterone is generally reduces, they have not enough production of its metabolite either.
Generally, androgen deficiency in males above 40 must be confirmed by at least two morning samples taken on different mornings. The phenomena “androgen deficiency” is confirmed by testosterone less than 8 mmol/ L, or 8-15 mmol/ Litter with elevated LH greater than 1.5 times the upper limit of the normal reference eugonadal range for young men. The conventional medicine defines androgen deficiency as available when men show lower than normal amounts of testosterone or in older men is a synonym of the so called “male menopause.” Erectile impotence (ED), known as the main symptom behind the phenomena is proven related to metabolic syndrome (hypertonia, cardiovascular diseases) or as a side effect of its therapy.
Despite it can be diagnosed with a simple blood test, there are also many cases showing it as an uncommon cause of men with ED. Malcolm Carruthers, MD, an UK based physician published several popular books on the diagnosis and treatment of testosterone deficiency, “Male Menopause” “Maximizing Manhood” and “The Testosterone Revolution”, “ADAM : Androgen Deficiency in the Adult Male.”
Adrenal (testosterone) deficiency is a frequent syndrome in elderly due to the following factors:
1. Prostate operation (radical and partial).
2. Latent (subtle) form of adrenal deficiency.
3. Undiagnosed form of adrenal deficiency.
4. Missing health care coverage.
5. Low socioeconomic status.
According to an U.S. study, published May 26, 2008 in the journal Archives of Internal Medicine many men with low testosterone levels do not receive any treatment, due to their low socioeconomic status and missing health care coverage: a/ low socioeconomic status b/ missing health care coverage.
http://www.wrongdiagnosis.com/medical/dehydrotestosterone.htm
The conventional medicine offers several options for hormonal replacement therapy (HRT), able to restore testosterone levels back to the normal range. Testosterone can be administered as: gel, capsules, patches, injections, implants. The best way to find out which option is the best for you is to consult with your primary physician. The holistic medicine offers botanicals and nutritional formulas proven to help in this disorder like: Pygeum africanum, Saw palmetto, Tribulus terrestris, Rhodiola (Rhodiola rosea), Stinging nettle (Urtica dioica), Vitamin E, Selenium, Pumpkin Seed Oil, Horny Goat, Zinc and Lycopene.

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