Unmasking syndrome

Unmasking syndrome – Syndrome X

Terry Kristen Strom

Is your low-fat diet killing you? It could if you have Syndrome X, according to Gerald Reaven, M.D., professor of medicine at Stanford University School of Medicine. Although Dr. Reaven first described this lethal cluster of major risk factors for heart attack in 1988, most people have never heard in 1988, most people have never heard of Syndrome X. Based on more than 35 years of research, we now know that nearly I out of every 3 Americans is at risk for Syndrome X.

But there’s hope, says Dr. Reaven You can reverse the ravages Syndrome X can inflict on your arteries.

What is Syndrome X?

Syndrome X also known as the insulin resistance syndrome and the Reaven Syndrome may be the surest route to a heart attack. It can occur if you’re born with insulin that is inefficient at shutting glucose into cells. The resulting high insulin levels left over in the bloodstream trigger all but one of the major risk factors responsible for the vast majority of all heart attacks. The other risk factor is LDL (bat) cholesterol, which is not part of Syndrome X.

When something goes wrong Insulin is a natural protein hormone secreted by specialized beta cells in the pancreas. Insulin acts as a “sugar cop that regulates the flow of energy throughout the body, signaling blood sugar to enter cells where it’s used for immediate energy or stored for later use. Since we need energy even when we sleep, insulin must always be present in the bloodstream to escort blood sugar through the cell doors and into appointed body cells.

Before entering the cells, our food is broken down into various elements in the intestine. One of these elements is glucose, or blood sugar, from carbohydrates. Sugar doesn’t simply flow into the cells, however; it must be “shepherded” in by insulin. Nearly 30 percent of all Americans are resistant to their own insulin – their shepherds simply aren’t strong enough to properly herd the sugar into the cells, so they require greater amounts of insulin to do the job.

After every meal, the pancreas begins to furiously secrete insulin. The longer the cell doors remain shut before a flood of insulin forces them open, the higher the sugar level will rise in the bloodstream, and the more the pancreas will secrete insulin to drive the sugar into the cells to get the level back to normal. It may take two or three times as much insulin as normal to strong-arm the glucose into the cells. That extra insulin “batters down” the cell doors, allowing sugar to enter the cells and act as fuel for the energy factories inside. However, people with Syndrome X may eventually lose the ability to secrete large loads of insulin. Every individual is born with a finite number of insulin-secreting beta cells, and that supply can be used up over a lifetime, particularly if these cells work overtime. As the beta cells dwindle, type 2 diabetes mellitus can develop.

Risk factors

Although science hasn’t mapped out the genes responsible for triggering Syndrome X, it’s most likely that abnormalities in several genes are involved. Ethnicity also plays a role, with people of non-European origin being at somewhat greater risk. That doesn’t mean that people of European descent don’t get Syndrome X; they do. Family history also factors into the equation, with the odds of developing Syndrome X increasing with the number of relatives who have had diseases related to insulin resistance, such as heart attack, hypertension and type 2 diabetes. Obesity can also lead to insulin resistance and make Syndrome X worse.

There are no outward symptoms, such as a rash, sore throat or fever. People who haven’t been tested aren’t likely to know they have Syndrome X until they land in the emergency room with a heart attack. It pays to get tested early, even in childhood–adolescents can and do develop Syndrome X. Anyone over 40 years of age should be tested. Tests for Syndrome X include measurements of triglycerides and HDL cholesterol levels, a glucose tolerance test, and a blood pressure check. Regardless of your age, it’s never too late to be tested, because it’s never too late to reverse Syndrome X.

Treating Syndrome X

If you have Syndrome X, you can take steps that will reduce your insulin resistance. Weight loss and regular physical activity can both be effective. Diet is also part of the treatment; the right diet has a powerful impact on maintaining healthy insulin and triglyceride levels.

Weight loss

If you’re overweight, losing weight will make you more insulin sensitive and diminish the need for your pancreas to secrete the extra insulin that leads to the risk factors for heart disease.

Some recent news headlines have indicated that insulin can make you fat, According to Dr. Reaven, this is a fallacy: “Actual clinical studies show that insulin and insulin resistance don’t make you fat. It’s a myth with little or no sup porting scientific evidence,” Reaven adds, “A calorie is a calorie is a calorie.” Insulin escorts blood sugar made from food into cells for energy. Cells can’t determine whether the sugar originally came from a candy bar, steak or broccoli: all calories pack the same bundle of energy. The more calories you eat above the number of calories you expend, the more weight you will gain. However, certain foods contain more calories than others do. For example, one donut has more calories than one cup of string beans, and an ounce of potato has more than an ounce of watermelon.

There’s one more thing to consider.

Being overweight doesn’t cause insulin resistance; its origin is genetic. But obesity can make Syndrome X worse.

Metabolism, genes and weight loss

You’ve probably seen news reports that say specific genes are responsible for obesity and a wealth of other ailments. But in all these articles, way down at the bottom, you read that the genes in question play only a small role. Studies show that genetic controls over weight gain and loss are minimal and are likely to account for no more than a 4 percent difference in energy efficiency. Eating one slice of bread less a day would counteract any average individual’s genetic tendency to gain weight. How much you eat appears to be a much more powerful modulator of weight gain and loss than differences in your metabolism.

Diet composition also doesn’t play that strong a role in weight loss. “When it comes to weight loss, low-fat diets don’t make you lose, and high-carbohydrate diets don’t make you gain if your calorie intake stays the same as before,” says Dr. Reaven. “Good fat, such as olive oil, isn’t the dieter’s enemy either. One calorie of fat packs as much energy and weight gain potential as one calorie of protein or carbohydrate. Any diet, as long as you consume fewer calories than you use, will help you lose weight.”

Let’s get physical

Being physically active every day can help overcome the damaging effects of Syndrome X. Thirty minutes of heart-thumping aerobic activity is ideal and will yield significant results in reversing the disorder and increasing insulin sensitivity. However, if you’ve been inactive and 30 minutes daily seems overwhelming, start slowly and increase your activity level gradually. Any increase in activity increases insulin sensitivity and helps reduce your risk of heart attack.

A proper diet

The proper diet won’t cure Syndrome X–its effects are not as powerful as weight loss or physical activity. But it can reduce the manifestations of all the risk factors. The Syndrome X Diet is based on more than 35 years of clinical research at Stanford University and other prestigious institutions. It is the only diet shown to be effective in maintaining healthy insulin and triglyceride levels.

The American Diabetes Association, in response to the clinical studies, has already modified its guidelines to meet the Syndrome X challenge and its connection to diabetes by advising Americans to eat 10-20 percent of total calories in protein, with the remaining 80-90 percent of calories split between fat (primarily monounsaturated) and carbohydrate.

The American Heart Association is considering doing the same. Its present dietary recommendations aim at lowering LDL (bad) cholesterol, but this won’t reverse insulin resistance. The low-fat, high-carbohydrate diet touted by most health organizations and physicians is dangerous for people with this disorder. Carbohydrates become blood sugar, and sugar must be herded into certain cells. That requires insulin. More carbohydrate translates to more blood sugar and more insulin–a perfect formula for heart attack.

The 15/40/45 percent solution

The diet solution for Syndrome X lies in decreasing saturated fat and replacing it with unsaturated good fat–not with protein or carbohydrate.

In clinical trials, the only diet shown to be effective against corn bating Syndrome X and all other major risk factors for coronary heart disease is Dr. Reaven’s 15 percent protein, 40 percent fat (mostly monounsaturated) and 45 percent carbohydrate. This diet was found to reverse Syndrome X and high insulin levels and lower LDL cholesterol, protecting the heart as much as possible from the factors that contribute to heart attack.

“Studies show,” says Dr. Reaven, “that although protein and carbohydrates stimulate insulin secretion, fat doesn’t. The rule of 15/40/45 provided the optimum ratio and still provided complete and balanced nutrition for everyone. Diets with higher carb and protein contcnt make Syndrome X worse. We need to eat a fair amount of good unsaturated fat every day and can tolerate a small portion of saturated fat.”

Popular diets

While popular diets, such as The Zone or the Atkins Diet, can help you lose weight, they can be dangerous to your heart health, each for different reasons. The Atkins diet is loaded with artery-clogging saturated fat that increases LDL cholesterol levels. The Zone diet is not the best diet for people who have Syndrome X because it replaces insulin-stimulating carbohydrate with insulin-stimulating protein. Studies show that protein might stimulate insulin less than carbohydrate, but insulin levels do climb in response to eating protein.

Terry Kristen Strom is the co-author of Syndrome X: Overcoming The Silent Killer That Can Give You A Heart Attack, with Gerald Reaven, M.D., and Barry Fox, Ph.D.

Risk Factors for Coronary Heart Disease

* High insulin levels

* Impaired glucose tolerance

* Elevated triglycerides (bad blood fats)

* Low HDL (good) cholesterol

* Slow triglyceride clearance

* Smaller, denser LDL cholesterol particles

* Increased ability to form blood clots

* Reduced ability to dissolve blood clots

* Elevated blood pressure

A Syndrome

X Menu Plan — 1,800 calories —


* 1/2 cup cooked oatmeal with cinnamon, topped with 2 teaspoons sliced almonds

* 1/3 cup lowfat milk

*1/2 grapefruit

* 1 slice whole wheat toast with 2 teaspoons safflower margarine

* 1 slice Canadian bacon


* Toasted sesame sandwich: 2 tablespoons peanut butter 1/4 teaspoon sesame seeds, 1 tablespoon honey, and 1/3 cup seedless green grapes cut in halves between 2 small slices toasted whole wheat, rye or white bread

* 1 cup salad greens with 4 tomato wedges, cucumber slices 3 tablespoons small cooked shrimp, and 2 teaspoons vinaigrette

* 1 Nabisco [R] gingersnap


* 2 1/2 ounces roasted turkey breast without the skin

* 1/4 cup cranberry sauce

* 3/4 cup mashed potatoes with 2 teaspoons safflower margarine

* 1/4 baked yam with 2 teaspoons safflower margarine

* 1/2 cup fresh peas with 1 teaspoon safflower margarine

* 1/8 of a pumpkin pie

Planning to Protect Your Heart

Follow these six simple steps to protect your heart from coronary heart disease caused by Syndrome X.

1. Diagnosis

Ask your doctor for an evaluation of your HDL cholesterol and triglyceride levels and get the simple blood test for detecting Syndrome X.

2. Weight check

If you’re overweight, even shedding 15 pounds will improve Syndrome X.

3. Syndrome X Diet

A 15/40/45 diet helps your body maintain healthy insulin and triglyceride levels and provides complete nutrition.

4. Daily physical activity

Regular exercise can keep you fit and increase your good HDL cholesterol.

5. Healthy lifestyle habits

Cigarette smoking increases your likelihood of developing Syndrome X; if you smoke, stop.

6. Re-check

Go back to your doctor a few months after initiating your lifestyle changes. Ask about medical intervention if your new habits are not enough to reverse Syndrome X.

COPYRIGHT 2001 Measurement & Data Corporation

COPYRIGHT 2001 Gale Group