19 January 2014

Metabolic Syndrome

Great summary from the book Fat Chance (Robert H. Lustig) about the development of Metabolic Syndrome (in bold):

1. Metabolic Syndrome starts as your body accumulates energy, storing it in the liver and in visceral fat tissue. This makes the liver insulin resistant, which starts metabolic dysfunction – a detrimental cascade of effects that damages every organ in the body.

2. Liver insulin resistance causes the liver to transport energy improperly. The pancreas responds by increasing insulin release to make the liver do it’s job. This drives insulin levels even higher (hyperinsulinemia), which causes further energy deposition into subcutaneous fat tissue and causes the persistent weight gain that drives obesity.

My comment
The cluster of conditions associated with Metabolic Syndrome:
  • abdominal obesity (visceral fat)
  • high blood pressure
  • high glucose levels in the bloodstream
  • high triglycerides
  • low HDL level
Normally, when we eat carbohydrates, the pancreas secretes insulin to stimulate the cells to take up glucose from the bloodstream. The cells will burn the glucose, giving us the necessary energy. The liver also stores glucose (in the form of glycogen), this is necessary when glucose level goes down, we don't have time to eat and we need energy, for example when we see a lion and need to run, or when our boss is yelling at us and we need to yell back.

Under normal circumstances when insulin is high (a sign of high glucose level), the liver does not release it’s glucose stores. But, when the liver becomes insulin resistant (a result of a constantly high-carbohydrate diet, therefore, chronically high insulin levels), the liver does not see insulin and secretes glucose even in the presence of insulin. This high glucose level, in turn, will prompt the pancreas to produce even more insulin, setting the path for obesity and diabetes.

3. The liver tries to export the excess fat as triglycerides, to be stored in the subcutaneous fat tissue. The blood lipids rise to drive dyslipidemia [abnormal amount of lipids (e.g. cholesterol and/or fat) in the blood], one of the risk factors for heart disease.

My comment
The liver produces fat as a result of a high carbohydrate and especially sugar (fructose) diet. Alcohol consumption is also contributing to fatty liver. If you haven't seen it, here's the video explaining sugar metabolism: Sugar: The Bitter Truth.

4. The high insulin acts on blood vessels, causing the smooth muscle cells that surround each blood vessel to grow more rapidly than normal. This process tightens the artery walls and promotes high blood pressure.

(See my earlier post: Path to Diabetes)

5. The combination of insulin resistance, lipid problems, and high blood pressure wreaks havoc throughout the body. This promotes cardiovascular disease, which can result in heart attack or stroke.

6. The fat in the liver causes inflammation, which drives further insulin resistance. Eventually the liver can scar, which results in nonalcoholic fatty liver disease. This can later progress to cirrhosis.

7. Insulin resistance and hyperinsulinemia in women can drive the ovary to make extra testosterone and reduce estrogen, resulting in polycystic ovary syndrome, hirsutism (excess bogy hair), and infertility. 

(See my earlier post: Fertility Problems)

8. As the liver insulin resistance gets worse and the body fat grows, the pancreas has to make more insulin. Eventually the pancreatic beta-cells fail, precipitating type 2 diabetes.

9. Insulin is one of the hormones that cause cells to divide. Hyperinsulinemia is associated with the development and growth of various forms of cancer. 

(See my earlier posts: Cancer, and Sugar and Cancer)

10. There is evidence, although by no means proven, that insulin resistance in the brain leads to dementia.

(See my earlier post: Alzheimer - Also Related to Sugar Consumption)

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