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The Skinny on the Metabolic Syndrome Cutting the Fat

The overweight and obesity epidemic has fueled a dramatic rise in the prevalence of something doctors call the "Metabolic Syndrome"--the combination of abdominal obesity, diabetes, high blood pressure and a particularly malignant form of high LDL ("bad") cholesterol. Recently published statistics suggest that almost one half of adult Americans are overweight and one in four are obese. This new syndrome is a lethal risk factor for heart attacks and strokes. The eleven year study by Kuopio found that middle-aged men with metabolic syndrome were about three times more likely to die of coronary artery disease than unaffected individuals, and twice the risk of stroke.

This combination of risk factors is also vitally important for women, and several investigations have evaluated their effects on women's health. The Framingham Heart Study found that diabetic women weighted more and hid higher blood pressure than non-diabetic women. In addition, their LDL (so-called "good" cholesterol) levels were lower than those of non-diabetic women. A Finnish study of newly diagnosed diabetic women determined likewise that they were more obese and had lower good cholesterol levels than non-diabetic women. Sixty percent of them were also taking medication for high blood pressure.

The common denominator for this syndrome is abdominal obesity. The Framingham Study found that as weight rises and falls, so too do blood pressure and blood sugar levels. Obesity leads to diabetes, and low good cholesterol.

Dr. William Castelli, director of the study, ahs described this characteristic pattern of obesity: "When you put the 'spare tire on at the waist, you produce a different kind of LDL, much more atherogenic (causing atherosclerosis). You raise your blood pressure and increase your lipids (fats)." It is estimated that obese individuals develop diabetes at more than twice the rate of others. Why are such seemingly different problems such as obesity, high blood pressure, diabetes and high cholesterol grouped together? Because they are very much interrelated and there are similar or identical methods to prevent and/or control them. What to do? The best approach to achieving and maintaining a healthy weight has four basic components.

None of them involves being on a diet: 1. Understand and modify your relationship with food. This will enable you to be in control, rather than being under the control of compulsive or rigid and unrealistic goals.

According to author Dr. Janet Greeson, who has managed not to regain the 150 pounds she lost more than 18 years ago, "Diets are not really treating the person, and so if you focus on food as the problem, you are not successful. The problem is the feelings a person associates with food." 2. Enjoy what you eat by becoming a conscious eater.

This will help you select healthy and satisfying food, including some of your favorites, rather than limit you to rigid calorie-cutting and self-deprivation. Experiment. Become a student of your own behavior. 3. Exercise regularly. Physical activity is a powerful weapon in weight control for several reasons.

It burns calories, it contributes to positive feelings and thus reduces the stresses and emotions that cause overeating, and it restores a consciousness of the body, which overweight people tend to lose. Exercise allows you to reclaim yourself physically and thereby strengthens you motivation to achieve and maintain healthy weight. 4. Create a support system. This can come from family, friends and/or a support group. Joining a structured weight loss program like Weight Watchers can be invaluable.

Such a program provides you with a caring environment and people who both understand and share your struggle with overeating. They help you to become more honest about your eating habits and when you feel you may be slipping, they are there to help. Remember: We are more than what we eat, but what we eat can help us to become less and therefore more of what we want to be.

Richard Helfant, MD is a Harvard-trained cardiologist. Courageous Confrontations, Dr. Helfant's latest work, is about how life-threatening illnesses transformed patients' outlooks on life, often resulting in significant weight loss.

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