Metabolic Malady by Dato Dr. Rajen M

Research has shown that a cluster of symptoms that signals a body’s metabolism has malfunctioned, is triggered by a diet rich in sugar and fat, and eating such food frequently and at odd hours.

Syndrome X and You
It kills and you could have it. Your co-worker or neighbor could be dying from it. Maybe, your mum and dad died because of it. If you were old enough, your children could be afflicted. Don’t worry. It is not some new virus that you can “catch” and “pass on”. The name - Syndrome X was coined by Gerry Reaven of Stanford University in the late 1980s. It sounds threatening, and with good reason. Syndrome X is a hidden but life-threatening cluster of bodily metabolism that is likely to hasten the end of anyone who has it. It’s alarmingly common. One in 5 of us has it and we are more prone as we age. It is non communicable. That means that we bring it on ourselves, by the way we eat. “We’re suffering from chronic food intoxication,” says Werner Waldhausl, editor of the journa Diabetologia.

Symptom Cluster
In well-fed parts of the world, a third of the adult population may have succumbed already, and there will be plenty more in the coming years. Most of them won’t know that there’s a problem yet - the early stages go unnoticed. All the same, the symptoms are all there: high blood pressure, raised levels of tell-tale fats called triglycerides found in the blood, and insulin resistance - an acquired resistance to the body’s vital glucose-handling hormone. Diabetes and heart disease are lying in wait for anyone with this group of symptoms collectively known as Syndrome X. “The syndrome is a major cause of coronary heart disease,” Reaven says, though nobody can yet be more precise than that. So what causes it? The usua suspects are three:

  • Fatness
  • Laziness sloth
  • Bad genes

But there are some good news from the latest studies of the biochemistry of Syndrome X. What we eat and how we eat it can make a difference. One key insight is that the liver holds the secret to Syndrome X. Manipulating the behavior of this organ could keep at bay the twin perils of heart disease and diabetes. Another is that sugar could be as bad for your heart as saturated fat. "We've long known that diets high in saturated fats are bad news," says Victor Zammit, Head of Cell Biochemistry at the Hannah Research Institute in Ayr, Scotland. But we don't have to eat saturated fats to find our bodies awash with these dangerous molecules. As our liver deals with the products of digestion, it can flood the bloodstream with deadly saturated fats that are already within the body. Anything that encourages the liver to do this could be just as bad as ingesting saturated fat itself.

Wrong Eating
Evidence is emerging also that our "grazing" pattern of eating could partly explain why Syndrome X is on the increase. Zammit believes that eating too frequently could be one of the triggers that turns your liver into a relentless fat-secreting machine. Each time we eat, insulin is released into the bloodstream. This vital hormone, secreted by special cells in the pancreas, encourages our tissues - particularly our muscles - to gobble up the glucose surging through the bloodstream after a meal.

This is good, but glucose hanging about in the blood is dangerous stuff. It can stick to proteins and destroy their ability to do their job. Blindness, kidney damage and amputations may result. But insulin has another vital role. After a meal, it stops the liver from releasing any fat, a potential metabolic fuel, into the blood. Why after a meal? It turns out that just like glucose, these fats are dangerous if they hang about in the blood for too long. They are released as triglycerides, carried within molecular escorts known as very low density lipoproteins, or VLDLs. But in the blood they become altered biochemically in a way that makes them more likely to stick to artery walls. And of course once the arteries become narrowed by such fatty plaques, a heart attack may not be far away. These fats are particularly undesirable in the bloodstream just after a meal because the enzymes that can safely remove them from circulation are busy dealing with fat from the food you've just eaten.

Rat Theory?
Zammit and his colleagues have only recently discovered how this process can go wrong - in rats at least. He believes that the road to Syndrome X begins with frequent high-energy snacks, exposing the liver to insulin for long periods without a decent break. In studies of laboratory rats, the researchers found that when insulin is present for long periods, it flicks a metabolic switch in the liver that prevents it from inhibiting triglyceride secretion. Instead, perversely, insulin stimulates the liver to release even more triglycerides, carried within heart disease promoting VLDLs (see Diagram). Zammit believes that the same process is likely to happen in people. What happens to the sugar in our diet? It is a vicious cycle. In turn, the excess triglycerides make muscle cells insulinresistant, interfering with the signalling pathway that normally allows them to soak up glucose from the blood. As a result, more insulin needs to be secreted, and full-blown Syndrome X is fast approaching. Eventually our adipose cells - bombarded with extra calories to store in the form of triglycerides and glucose - succumb to insulin resistance too. In a final twist, the overloaded fat cells flood the blood with fatty acids which in turn start killing the insulinsecreting pancreatic cells. Insulin levels plummet, glucose accumulates in the blood even between meals - and a diagnosis of Type 2 Diabetes is made. If the patient fails to change their diet and lose weight, the destruction of insulin-secreting cells continues apace. Eventually, daily injections of insulin are needed just to keep the patient alive. It's a frightening scenario, but we can do something about it. For a start, we can exercise to use as many of our muscles as possible, and to help them use up the extra fatty fuel. New research by physiologists at the University of Loughborough, Christina Koutsari and Adrianne Hardman, reveals that a moderate amount of daily exercise might even prevent the dramatic rise in blood triglyceride levels that happens when healthy volunteers are switched to a high-sugar diet. We have to watch what we eat. Especially when eating or drinking certain things can increase fat secretion by the liver and have just as detrimental an effect as ingesting saturated fat itself. Drink too much alcohol, for instance - more than the equivalent of a glass or two of wine a day - and you stimulate your liver to churn out the very fats that promote heart disease. The big surprise is that sugary foods could be just as damaging as fats and alcohol. "Foods high in fructose - and that includes ordinary sugar, sucrose, which is half fructose - may be just as bad as saturated fats," says Zammit. Both sorts of food are royal roads to Syndrome X. Over the past decade or so, various studies have suggested that the body treats fructose in a markedly different way from the simple sugar glucose. What's worrying is that fructose is selectively shunted towards the liver, and the formation of fats. For a start, it is metabolised in the liver to provide one of the building blocks of triglycerides. But a fructose-rich diet also directly stimulates the liver to secrete those dangerous triglycerides, just as bombarding the liver with insulin does. "Fructose could be mimicking what I think frequent insulin secretion does," Zammit explains. In the short term it could promote insulin resistance in muscle – the first step to Syndrome X - and in the long term it could promote heart disease.


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