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Spokane, Washington  Est. May 19, 1883
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The metabolic syndrome weighs in

The Spokesman-Review

So there we were, my husband and I, sitting in the Oakland airport about 6 o’clock on a Sunday afternoon, waiting for the plane to Spokane. The Oakland Raiders had just played a home game. We knew that because we saw the faithful streaming out of the Oakland Coliseum on our way to the airport. Jeffry leaned over and whispered, “Are you noticing all those ‘tanks’ walking around in Raiders’ T-shirts?”

Indeed, I don’t think I’ve ever seen so many men looking like they were approaching their ninth month of pregnancy. Gargantuan bellies spilled over beltlines — some might call them beer bellies. The doctor calls the condition “central obesity” and sees a walking epidemic of upcoming ill health.

She sees someone who, more likely than not, has a condition called the metabolic syndrome. She sees a ticking time bomb.

The definition of the metabolic syndrome varied according to which group was doing the defining, and this made it difficult to assess the prevalence of the problem and to compare treatment strategies across different studies.

So in April of this year, the International Diabetes Federation issued a global consensus definition of the syndrome. It includes central obesity plus two or more of the following: high blood triglycerides, low HDL (good cholesterol) levels, elevated blood pressure, and prediabetes (fasting blood sugar is high, but not high enough to be called diabetes).

These components represent some of the most dangerous heart attack risk factors. And people with the metabolic syndrome have a fivefold greater risk than those without of developing Type 2 diabetes (if they don’t already have it.)

Central obesity, the predominant physical trait in those Raiders fans, translates to a waist size of 31.5 inches for Caucasian women and 37 inches for Caucasian men. We’ve known for some time that fat that collects around the middle behaves differently than fat elsewhere in the body. It is more “atherogenic,” leading to those abnormal blood lipid levels that clog our arteries, setting the stage for a heart attack.

And now we know that it is not just the plaque caused by the lipids, but inflammation of the plaque and the tendency of our blood to clot around that inflamed plaque that sets the heart attack in motion. Somehow, those centrally located fat cells are responsible for all of it.

Insulin resistance is often seen as a central component of the metabolic syndrome. Insulin controls how our body uses carbohydrates, fats and proteins.

Folks with insulin resistance require a lot higher levels of insulin to keep their blood sugar in check, and eventually, the pancreas, the maker of insulin, can’t keep up. That’s type 2 diabetes.

Metabolic syndrome – that cluster of excess weight, high insulin levels, high blood pressure and abnormal lipid levels – is a case of the whole being greater than the sum of its parts.

Any one of these conditions is a risk factor for diabetes, heart attacks and stroke. Put them together and the risks for life-threatening illnesses are boosted dramatically.

Although genetic factors most certainly play a role in the development of the metabolic syndrome, our sedentary American lifestyle is the key factor that has led to an epidemic: According to the Mayo Clinic, one in four American adults and 40 percent of adults over 40 have the metabolic syndrome.

A lot of them were walking around the Oakland airport, sporting the T-shirt with the one-eyed pirate.

The good news about metabolic syndrome is that we have control over it. And the control is as close as the TV clicker.

Turn the football game OFF, and instead of watching the athletes, become one.

Start exercising at least 30 minutes a day. Start eating that sensible diet you know you’re supposed to eat.

Make an appointment with your doctor and get your blood pressure, fasting blood sugar and lipid levels checked.

And while you’re at it, ditch the cigarettes. Who needs another invitation for that heart attack?

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