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“Metabolic syndrome” may be a new term for you. It’s a collection of clinical features that are associated with increased future risk of type 2 diabetes and atherosclerotic complications such as heart attack and stroke. One in six Americans has metabolic syndrome. Diagnosis requires at least three of the following five conditions:
- high blood pressure (130/85 or higher, or using a high blood pressure medication)
- low HDL cholesterol: under 40 mg/dl (1.03 mmol/l) in a man, under 50 mg/dl (1.28 mmol/l) in a women (or either sex taking a cholesterol-lowering drug)
- triglycerides over 150 mg/dl (1.70 mmol/l) (or taking a cholesterol-lowering drug)
- abdominal fat: waist circumference 40 inches (102 cm) or greater in a man, 35 inches (89 cm) or greater in a woman
- fasting blood glucose over 100 mg/dl (5.55 mmol/l)
One approach to improving the numbers is a low-carb, high-fat (LCHF) diet. Here’s a journal article abstract from JCI Insight:
BACKGROUND. Metabolic syndrome (MetS) is highly correlated with obesity and cardiovascular risk, but the importance of dietary carbohydrate independent of weight loss in MetS treatment remains controversial. Here, we test the theory that dietary carbohydrate intolerance (i.e., the inability to process carbohydrate in a healthy manner) rather than obesity per se is a fundamental feature of MetS.
METHODS. Individuals who were obese with a diagnosis of MetS were fed three 4-week weight-maintenance diets that were low, moderate, and high in carbohydrate. Protein was constant and fat was exchanged isocalorically for carbohydrate across all diets.
RESULTS. Despite maintaining body mass, low-carbohydrate (LC) intake enhanced fat oxidation and was more effective in reversing MetS, especially high triglycerides, low HDL-C, and the small LDL subclass phenotype. Carbohydrate restriction also improved abnormal fatty acid composition, an emerging MetS feature. Despite containing 2.5 times more saturated fat than the high-carbohydrate diet, an LC diet decreased plasma total saturated fat and palmitoleate and increased arachidonate.
CONCLUSION. Consistent with the perspective that MetS is a pathologic state that manifests as dietary carbohydrate intolerance, these results show that compared with eucaloric high-carbohydrate intake, LC/high-fat diets benefit MetS independent of whole-body or fat mass.
TRIAL REGISTRATION. ClinicalTrials.gov Identifier: NCT02918422.
FUNDING. Dairy Management Inc. and the Dutch Dairy Association.
Steve Parker, M.D.
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