Diacentrum – helping people with diabetes

In the beginning of the 1970s, Professor Gerald M. Reaven from Stanford University, California, defined a group of symptoms that predispose its bearers to a greater risk of the so called developed economies diseases. These symptoms were: increased blood insulin levels, increased cholesterol and triacylglycerol values, increased uric acid values, hypertension and obesity. It was revealed that these symptoms are the result of complex processes based on a greater volume of body fat tissue - and especially its accumulation in the abdomen.

 

Why is the Metabolic Syndrome dangerous?

It is important to state that Metabolic Syndrome, over the course of decades, eventually leads to a number of pathological changes in the body ending in Type 2 Diabetes and accelerated atherosclerosis which often leads to myocardial  infarction or stroke. How significantly Metabolic Syndrome and the associated Diabetes Mellitus   endangers the lives of  affected patients can be illustrated by the fact that 75% of Type 2 diabetics die of one of  its manifestations i.e. of myocardial infarction or stroke. It is also worth mentioning that while within the general population males are put at a significantly higher risk of  myocardial infarction (3x), in Type 2 Diabetes patients this risk is almost equal in both males and females, even slightly higher  in females.

 

What are the origins of the Metabolic Syndrome?

Metabolic Syndrome results from a change in the ratio of  energy output (physical activity) and energy intake (food). In other words, the cause is overeating. The difference in the ratio of intake to output can be in the beginning quite negligible and people usually do not notice it. They may become aware only when their weight increases. Younger people usually do not pay much attention to a few kilograms of extraweight, since they know that they can manage to slim down comparatively easily. With increasing age, however, it becomes obvious that losing weight is not so easy, and their weight contiues to increase.

It is very easy to get out of  energy balance. For example, chocolate is considered to be a treat and is, therefore, mostly consumed after actual energetic requirements are met. It is necessary to bear in mind that 100 g of plain  milk chocolate contains around 500 kcal. Consequently, if we eat 50 g of chocolate a day (nothing  unusual in our patients) the energy intake is 250 kcal. The bigger part of these kcalories changes to fat deposits. So, 30 days of eating 50 g of chocolate brings about 7,500 kcal which represents 833 g of fat (1kg of fat = 9,000 kcal), so 10 kg of newly acquired fat per year. If we manage to cut this surplus caloric intake by 75%(208 g a month), it still means an annual weight increase of 2.5 kg, which is 25 kilos of new fat tissue over 10 years.

 

Where does the Metabolic Syndrome come from and why isn‘t everybody affected?

Around 30% of the population is at risk of  Metabolic Syndrome. It is not easy to reply when asked why this number is relatively high. One of the most interesting theories concerning origins of Metabolic Syndrome is the theory of the so-called thrifty-gene. This is the label given to a hypothetical gene that enables an organism to intake far more energy than is needed. Consequently, the energy accumulates in the form of fat reserve. Historically, people equipped with this hypothetical gene were more resistent to famine, and, compared to the rest of the population, had a greater chance of survival. So their number in the population has been relatively high. In the times of comparative plenty, however, the ability to accumulate fat turns against them as it leads to the development of  Metabolic Syndrome with all its negative consequences mentioned above.

Particularly characteristic in this respect is a group of  Pima Indians from North America. This tribe, which lived on fishing and farming, was forced to abandon their traditional way of life due dam construction in their territory at the turn of the 20th century. Instead they live on cash subsidies provided by the US government. At present, more 70% of Pima Indians are diagnosed with Type 2 Diabetes, so with Metabolic Syndrome as well. This incidence is higher than in any other ethnic group. Looking at the illustrations bellow, it is obvious that a number of population groups have been subject to similar changes.

 

 

These are the five characteristic symptoms of the metabolic syndrome:

 

In a simplified form Metabolic Syndrome consists of a set of overweight-related illnesses, especially in patients with observed increased fat accumulation in the abdomen (see the type „apple“ in the previous chapter). These illnesses do not occur at the same time but over a number of years, mostly as a concrete patient keeps putting on the weight.

Metabolic Syndrome often begins at a comparatively young age where there is a slight increase in some laboratory values (such as cholesterol, triacylglycerols, uric acid, glucose…) If the person continues to add weight over time, Metabolic Syndrome manifests in a number of the so-called civilization diseases. These are namely hypertension, Type 2 Diabetes and coronary heart disease mostly presenting themselves around the beginning of the fifth decade in life.

Metabolic Syndrome is a significant health risk.

Recent medical research provides evidence of certain genetic predispositions to the Metabolic Syndrome development in approximately 30% of  the Czech population,  thus putting this group at high risk of developing the associated diseases. Therefore, members of this group should make their struggle with weight a top priority. It is most important for them to understand how important their endeavour to prevent overweight is.

Who is in danger of the Metabolic Syndrome?

If you asked your doctor whether you personally suffer from Metabolic Syndrome, he would answer only after a detailed physical examination and blood analysis. You can roughly answer the question to yourself.

The reliable factors for estimating your risk of Metabolic Syndrome are:

1. height vs. weight (body mass index BMI)
2. waistline measurement

 

1. The BMI index was introduced to simplify the classification of increased body weight. It is calculated using the equation below.

 

BMI = weight (kg)/height (m)²

 

For example, if your weight is 80 kg and  your height is 175 cm or 1.75 m, your BMI is 26.14.

80/1.75 x 1.75

80/3.06 = 26.14

 

Within the definition of BMI, people with a BMI greater than 30 are considered obese.

 

1. Waistline measurement has become a very important parameter for revealing the degree of risk for Metabolic Syndrome in people who are overweight and obese. It takes into account that especially abdominal fat is more harmful.

 

Waistline-related Metabolic Syndrome risk

 

 

Should your BMI be higher than overweight or if your waistline measurement meets the above criteria, you are among the group at significant risk of  developing Metabolic Syndrome. See your doctor to confirm or deny your suspicion.

 

 

How to fight Metabolic Syndrome?

Advice is easy, action is difficult. Reversing the ratio of  energy intake to output is the obvious way to reduce your risk of Metabolic Syndrome. By increasing your physical activity and decreasing your food consumption.  And the risk of the metabolic syndrome development with all its complications will be significantly lower.