The Metabolic Toolbox

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About Us
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What Is Metabolic Syndrome (MetS)

WANTED DEAD or ALIVE: Metabolic Syndrome aka MetS

Known as The Silent Killer

Known aliases: Syndrome X, insulin resistance syndrome, dysmetabolic syndrome, the deadly quartet, or the obesity dyslipidemia syndrome

This sneaky killer affects nearly 1 out of 3 adults (Moore et al. 2017, Noubiap et al. 2022).

Why is this disorder a killer?

MetS increases your risk of having a heart attack or stroke; developing type 2 diabetes (T2D); becoming depressed; gaining weight; having cancer; losing your eyesight; developing dementia; flaring up asthma and more. Luckily, MetS can be prevented. The development of this disease is highly dependant on lifestyle including diet and exercise.

What is MetS anyway?

MetS is an interrelated cluster of metabolic abnormalities that includes whole-body inflammation, impaired carbohydrate metabolism, dysfunctional lipid metabolism, abdominal obesity, increased risk of blood clotting, mitochondria alterations, and elevated blood pressure (Huang 2009, Cheng and Almeida 2014, Mendrick et al. 2018).

When I talk about MetS, I often use the modern broader definition of MetS that I discussed above, not the older more narrow definition of MetS. Old school MetS is only diagnosed if you exhibit multiple risk factors including but not limited to abdominal obesity, high blood pressure (BP), high fasting plasma glucose, elevated serum triglycerides and low high-density cholesterol (HDL) concentrations. New school MetS includes more metabolic abnormalities.

MetS increases the risk of type 2 diabetes mellitus (T2DM), stroke, gout, cardiovascular disease, kidney disease, and non-alcoholic fatty liver disease (NAFLD) (Mendrick et al. 2018). New school

MetS is linked to other devastating disorders including cancer, depression and autoimmune diseases (Braun et al. 2011, Zhang et al. 2021, Gheshlagh et al. 2016). As overall obesity increases, the percentage of people with metabolic abnormalities also increases.

Tami K (32 year old woman): "I was diagnosed with metabolic syndrome, high blood pressure, pre-diabetes, high cholesterol and fatty liver disease all at once! All my tests were normal at my last doctors visit six months ago.

I have been gaining weight for the last three years. About a year ago my BMI reached 30 for the first time. Right now BMI is 34. I've been totally stressed this year and I was trying to relax. Now I feel completely overwhelmed and like I've been slapped.

Since my dad and grandmother have all of these conditions I'm so worried that genetics is fighting against me and I won't be able to get healthy or lose weight."

What we do at the Metabolic Toolbox

The Metabolic Toolbox discusses the development and pathology of MetS, how nutrition and diet can accelerate or reverse the course of MetS, and how current MetS research supports using specific diets to prevent and treat patients for MetS. Health professions can use these guidelines to develop sound, scientifically based MetS prevention and treatment plans.

David Teniers the Younger - The Village Doctor c1678 oil on canvas.

David Teniers the Younger, Public domain, via Wikimedia Commons

Kick MetS's butt with diet and lifestyle changes

What is your risk of MetS? If you are a member of certain groups you will be more susceptible to MetS and may have to make more stringent diet and lifestyle adjustments. This is due to your genetics. I know it is not fair but it is better to be informed.

Native Americans and any indigenous/tribal people are most susceptible to metabolic disorders. If your recent ancestors lived a traditional life as hunting, gathering roots and berries, raising livestock, or practicing horticulture you have less genetic resistance against dietary assault by processed and fast foods (and alcohol).

Man holds a large Chinook salmon (Oncorhynchus tshawytscha) at the Entiat National Fish Hatchery in Washington 2021 USFWS.

USFWS, Public domain, via Wikimedia Commons

Other groups that may be more susceptible to MetS include: South Asian people, Black women, Mexican and Hispanic people, postmenopausal women, smokers and former smokers, people who work night or rotating shifts, people with mental health problems, and people with obesity of any age (including kids). If you are in any of these groups you need to be more careful with diet and exercise.

If your recent European ancestors lived in crowded filthy cities; brewed and drank tons of beer to avoid polluted water; and ate sugar and processed grains; you likely have some resistance to developing MetS. Natural selection weeded out some of the most susceptible individuals a few centuries ago. As result the population is somewhat protected. You can easily blow past this advantage, however, by making McDonalds your favorite eating spot, not being active and/or developing obesity.

You can prevent and reverse MetS

MetS is preventable in most cases. The development and pathology of MetS is heavily influenced by lifestyle including diet and exercise. Current research suggests that diet and exercise intervention(s) can prevent, reverse the severity of symptoms or even cure MetS (Yamaoka and Tango 2012).

Specific dietary guidelines for MetS have not been established yet, but research suggests that some approaches are much better than others. The main therapeutic strategy for the treatment and management of metabolic syndrome are lifestyle modifications, especially diet. For more on using science to guide a healthy diet see diets to reduce inflammation.

What causes MetS?

Fat Cells Gone Bad: The villain origin story of MetS

In this tale, fat cells go bad due to excess energy, become giant dysfunctional mutants, and start spewing out inflammatory chemicals. Inflammatory chemicals, known as CYTOKINES, recruit white blood cells and turn them bad as well.

MetS is a metabolic disorder caused by a cascading series of events that includes adipose tissue dysfunction, systemic inflammation and oxidative stress (Kahn et al. 2019). Adipose dysfunction can be triggered by lifestyle and diet. Far from being a simple static storage area for excess calories, adipose tissue is a highly active endocrine organ which helps regulates energy and glucose homeostasis (Chouchani and Kajimura 2019).

Malfunctioning adipose tissue triggered by excess energy intake is a significant cause of systemic low-grade inflammation, also known as metainflammation (Wellen and Hotamisligil 2003, Chouchani and Kajimura 2019). Dysfunctional adipose tissue provokes the diverse pathophysiology associated with metabolic disorders including insulin resistance (IR), obesity, lipid dysfunctions, and impaired glucose and insulin homeostasis (Sun et al. 2011, Chouchani and Kajimura 2019, Chait and den Hartigh 2020).

Do you want to read more about Mutant Fat Cells? Of course you do. Click here for the full story!

Corn silk by Susan Fluegel

*Names and some minor identifying details in all stories in this website are changed to protect people's privacy

I'm not your doctor so this is not medical information. I'm just a person who would like to see you happy and healthy. If you have any questions or concerns about starting an exercise regiment, diet program, or supplements please consult a professional.

References:

Braun S, Bitton-Worms K, LeRoith D. The link between the metabolic syndrome and cancer. Int J Biol Sci. 2011;7(7):1003-15. doi: 10.7150/ijbs.7.1003. Full article.

Chait A, den Hartigh LJ. Adipose Tissue Distribution, Inflammation and Its Metabolic Consequences, Including Diabetes and Cardiovascular Disease. Front Cardiovasc Med. 2020 Feb 25;7:22. doi: 10.3389/fcvm.2020.00022. Full article.

Cheng Z, Almeida FA. Mitochondrial alteration in type 2 diabetes and obesity: an epigenetic link. Cell Cycle. 2014;13(6):890-7. doi: 10.4161/cc.28189. Epub 2014 Feb 12. Full article.

Chouchani ET, Kajimura S. Metabolic adaptation and maladaptation in adipose tissue. Nat Metab. 2019 Feb;1(2):189-200. doi: 10.1038/s42255-018-0021-8. Full article.

Ghanei Gheshlagh R, Parizad N, Sayehmiri K. The Relationship Between Depression and Metabolic Syndrome: Systematic Review and Meta-Analysis Study. Iran Red Crescent Med J. 2016 May 15;18(6):e26523. doi: 10.5812/ircmj.26523. Full article.

Huang PL. A comprehensive definition for metabolic syndrome. Dis Model Mech. 2009 May-Jun;2(5-6):231-7. doi: 10.1242/dmm.001180. Full article.

Kahn CR, Wang G, Lee KY. Altered adipose tissue and adipocyte function in the pathogenesis of metabolic syndrome. J Clin Invest. 2019 Oct 1;129(10):3990-4000. doi: 10.1172/JCI129187. Full article.

Noubiap JJ, Nansseu JR, Lontchi-Yimagou E, Nkeck JR, Nyaga UF, Ngouo AT, Tounouga DN, Tianyi FL, Foka AJ, Ndoadoumgue AL, Bigna JJ. Geographic distribution of metabolic syndrome and its components in the general adult population: A meta-analysis of global data from 28 million individuals. Diabetes Res Clin Pract. 2022 Jun;188:109924. doi: 10.1016/j.diabres.2022.109924. Summary.

Mendrick DL, Diehl AM, Topor LS, Dietert RR, Will Y, La Merrill MA, Bouret S, Varma V, Hastings KL, Schug TT, Emeigh Hart SG, Burleson FG. Metabolic Syndrome and Associated Diseases: From the Bench to the Clinic. Toxicol Sci. 2018 Mar 1;162(1):36-42. doi: 10.1093/toxsci/kfx233. Full article.

Moore JX, Chaudhary N, Akinyemiju T. Metabolic Syndrome Prevalence by Race/Ethnicity and Sex in the United States, National Health and Nutrition Examination Survey, 1988-2012. Prev Chronic Dis. 2017 Mar 16;14:E24. doi: 10.5888/pcd14.160287. Full article.

Sun K, Kusminski CM, Scherer PE. Adipose tissue remodeling and obesity. J Clin Invest. 2011 Jun;121(6):2094-101. doi: 10.1172/JCI45887. Full article.

Wellen KE, Hotamisligil GS. Obesity-induced inflammatory changes in adipose tissue. J Clin Invest. 2003 Dec;112(12):1785-8. doi: 10.1172/JCI20514. Full article.

Yamaoka K, Tango T. Effects of lifestyle modification on metabolic syndrome: a systematic review and meta-analysis. BMC Med. 2012 Nov 14;10:138. doi: 10.1186/1741-7015-10-138. Full article.

Zhang M, Chen J, Yin Z, Wang L, Peng L. The association between depression and metabolic syndrome and its components: a bidirectional two-sample Mendelian randomization study. Transl Psychiatry. 2021 Dec 13;11(1):633. doi: 10.1038/s41398-021-01759-z. Full article.