Melissa Diane Smith - Syndrome X

An abbreviated version of this article was published in Delicious Living!, January 2001

In her mid 20s, Mary found her weight ---and waist size -- creeping up a little every year. Today, at age 37, she has a serious case of "middle-age spread."

Mary's husband, Ed, who is 40, has a pot belly that's been getting steadily bigger, and he has just been diagnosed with high blood pressure.

Mary's mother, Nancy, 62, has had high blood triglyceride levels and an unhealthy cholesterol profile for years and has just been diagnosed with "pre-diabetic" blood sugar levels. Mary, Ed and Nancy don't realize it, but they all have the same underlying health problem: Syndrome X.

Mary, Ed and Nancy aren't alone: an estimated two-thirds of all Americans have Syndrome X. This mysterious-sounding term may be unfamiliar, but Syndrome X refers to a cluster of conditions many Americans are very familiar with: abdominal obesity (a "spare tire" around the middle); high blood pressure; high blood triglycerides; and high blood cholesterol levels. These heart disease risk factors tend to occur together -- that's why they're called a "syndrome" -- but even if you have just one of the conditions combined with insulin resistance (a pre-diabetic condition that can cause any of the others), you have Syndrome X.

As my co-authors and I explain in our book Syndrome X: The Complete Nutritional Program to Prevent and Reverse Insulin Resistance (John Wiley & Sons, 2000), Syndrome X develops over time primarily from a diet high in refined carbohydrates, such as sweets, breads, and flour- and sugar-based snack foods. These foods trigger a rapid increase in blood sugar levels and the body responds by raising levels of insulin, the hormone that moves blood sugar into cells. The more refined carbohydrates consumed, the more the body pumps out insulin to deal with all the extra blood sugar. Eventually, insulin resistance develops: the body's cells become overwhelmed by so much insulin and actually become sluggish in response to it. High insulin promotes fat storage, raises blood pressure and worsens blood fat profiles, leading to the development of Syndrome X.

The most serious condition resulting from insulin resistance is type II diabetes. Syndrome X, therefore, can really be considered "pre-diabetes." Not only does Syndrome X set the stage for type II diabetes and heart disease, it may also increase the risk of Alzheimer's disease and some types of cancer. What's more, Syndrome X generates high levels of cell -- damaging free radicals and ages people faster than they should.

The scale of Syndrome X as a public health problem sinks in when you consider that 55 percent of Americans are overweight, 50 million have elevated cholesterol levels, and 50 million have high blood pressure.

Middle-aged baby boomers are the most likely candidates to get Syndrome X. But the condition can affect teenagers and children, too. Consider that 25 percent of children and adolescents are now obese, and more and more of them are being diagnosed with type II diabetes (which is often called adult-onset diabetes because it rarely used to develop in children).

Early warning signs that can tell you you're on the fast track to developing Syndrome X are: extra weight around the middle; frequent cravings for sweets, breads and other carbohydrates; and tiredness or sleepiness after meals. If you don't yet have Syndrome X, you are at serious risk of developing it if you eat a diet high in refined carbohydrates.

The Anti-X Diet
Here's the good news about Syndrome X: the condition is a nutritional disease; it develops primarily from eating the wrong foods. That means Syndrome X can be prevented and reversed with a change in diet along with a good supplement regimen of helpful nutrients.

The Anti-X diet that I developed combats insulin resistance and Syndrome X from all nutritional fronts. In the area of carbohydrates, rule #1 is to avoid the main dietary culprit behind the condition, refined carbohydrates. This includes some of the most common foods in the American diet: bread, pasta, bagels, and sweets of all sorts -- basically, all foods made with sugar, other concentrated sweeteners, white flour and white rice. Although it may seem strange to avoid foods that are so entrenched in the American culture, eating a lot of these foods is exactly what has caused Syndrome X to be such a common health problem. Consider that women who eat large amounts of refined carbohydrates have double the risk of developing type II diabetes as those who eat less refined foods (Journal of the American Medical Association, 1997, vol. 277).

Although refined carbohydrates are the worst for blood sugar control, too many natural carbohydrate-dense foods, such as whole grains, corn and potatoes, also quickly raise blood sugar to high levels and, therefore, contribute to the development of Syndrome X. These foods can be included in small amounts in a balanced diet if you're just trying to prevent Syndrome X. However, if you already have Syndrome X, you should avoid these and other carbohydrate-dense foods (such as fruits and legumes) until your weight, blood pressure and blood fats normalize.

Instead of refined carbohydrates or carbohydrate-dense foods, emphasize non-starchy vegetables, such as salad greens, spinach, broccoli, green beans and asparagus. Non-starchy vegetables protect against Syndrome X because they cause minimal rises in blood sugar and insulin levels and are rich in nutrients and fiber.

The types of fats you eat can also make a big difference in warding off Syndrome X. Be sure to avoid trans-fats, found in fried foods, most margarines and foods that contain partially hydrogenated oils, and make an oil change: get rid of all oils in your house except for heart-healthy olive oil. Also, eat coldwater fish at least a couple times a week. Research shows that eating a diet that emphasizes monounsaturated fats (such as olive oil) and omega-3 fats (in coldwater fish) is very effective medicine against Syndrome X. After one year, people eating a diet relatively high in these fats became more sensitive to insulin and less insulin resistant; had reductions in blood pressure, fasting glucose, and triglyceride; and had increases in "good" HDL cholesterol (Diabetologia, 1996, vol. 39, suppl. 1). If you don't like fish, other ways to increase your omega-3 intake are to eat omega-3-enriched eggs, dark green vegetables and flaxseeds or flaxseed oil -- or to take omega-3 supplements.

Protein is important because it stimulates the production of glucagon, a hormone that opposes insulin and allows the body to burn stored body fat. Eating small amounts of protein throughout the day helps prevent the urge to overeat carbohydrates. Good sources include fish, eggs, poultry and game meats.

Many people have been led to believe that protein-rich diets promote heart disease -- a primary consequence of Syndrome X -- because of the saturated fats meats contain, but recent research strongly contradicts this idea: A 14-year-old study of more than 80,000 women by researchers at Harvard Medical School discovered that women with the highest protein intakes were 26 percent less likely to develop heart disease than those who ate the least protein (American Journal of Clinical Nutrition, 1999;70:221-227).

Vegetarian sources of protein, such as beans, aren't good protein choices for those with Syndrome X because they raise blood sugar and insulin levels significantly higher than meat (American Journal of Clinical Nutrition, 1997, vol. 66). If you prefer not to eat meat, though, you can follow a vegetarian version of the Anti-X Diet by emphasizing eggs, high-protein dairy foods such as cottage cheese, and tofu. Be sure to supplement with Anti-X nutrients that you might be missing with this type of diet, such as zinc (found in the highest amounts in poultry and red meats) and omega-3 fatty acids (found in coldwater fish).

Anti-X Supplements
Nutrient supplements fine-tune the effects of the Anti-X diet to prevent and correct Syndrome X. While you should work with a nutrition professional to personalize the supplement program that's best for you, pay attention to a several supplements that are standouts for protecting against this condition.

First, there are the antioxidants, alpha-lipoic acid, natural vitamin E and vitamin C. These nutrients scavenge cell-damaging free radicals, which are at higher levels in individuals with Syndrome X. They also help normalize blood sugar and insulin function or improve insulin sensitivity (Diabetes und Stoffwechsel, 1996, vol. 5, Suppl 3; American Journal of Clinical Nutrition, 1993, vol. 57; American Journal of Clinical Nutrition; 1994, vol. 60).

The three most important Anti-X minerals are chromium, zinc, and magnesium. All three play critical roles in maintaining proper insulin function; deficiencies of these minerals, which are common in this country, disturb normal insulin function and increase the risk of Syndrome X and type II diabetes. Supplementation, however, can prevent or even reverse Syndrome X. Chromium is so effective at reversing insulin resistance, for example, that one 1997 study found that 1,000 mcg of chromium picolinate daily completely corrected type II diabetes in patients (Diabetes, 1997, vol. 46).

The herb standout for Syndrome X is milk thistle (Silybum marianum). The herb and its active ingredient, silymarin, have long been known to improve liver function and the liver plays an important role in maintaining normal blood sugar levels. In the largest human study of silymarin in the treatment of type II diabetes, those taking silymarin experienced a significant drop in their blood sugar levels, but did not experience bouts of low blood sugar. The patients' fasting insulin levels decreased by an average of 40 percent -- indicating a significant reduction in insulin resistance (Journal of Hepatology, 1997, vol. 26).