Metabolic Syndrome & Nutrition Intervention

Written By Rachel Moore

Overview

Metabolic Syndrome is made up of several disorders that increase an individual’s risk for developing cardiovascular disease, obesity, Type 2 Diabetes, and more. The metabolic disorders that make up Metabolic Syndrome (MetS) include: central obesity, insulin resistance, high blood pressure, and dyslipidemia (or high cholesterol levels). It is estimated that 24% of men and 22% of women in America experience MetS. Genetic, lifestyle, and environmental factors all play a role in the development of this condition. Insulin resistance, chronic inflammation, and changes in adipose (or fat) tissue are thought to be some of the main contributors to MetS. Insulin resistance occurs when glucose regulation is impaired; with abnormal responses to glucose, increased fat deposition, increased inflammation, and changes in hormones can occur. It is this cascade of events that can lead to poor absorption of nutrients, slow metabolism of food, increased sensations of hunger, decreased sensations of fullness, and more. These changes in insulin sensitivity in the body then contribute to stress and even damage elsewhere in the body, increasing risk for diabetes, high blood pressure, and heart disease. Overeating, high caloric intake of simple carbohydrates and saturated or trans fats, is a contributing factor that can cause impaired glucose control over time, and increase adipose tissue. An increase in adipose (fat) tissue can alter hormones and even neurotransmitters in the brain, further impacting metabolic function. A sedentary lifestyle, combined with many of these factors, ultimately contributes to the development of Metabolic Syndrome, which is diagnosed by a medical professional.

Food Plan & Therapeutic Foods

A high-quality Plant-Based diet is one that has been shown to positively impact insulin resistance, obesity, blood pressure, and cholesterol, all markers of Metabolic Syndrome. A Plant-Based diet includes plant sources of nutrients, focusing on legumes, whole grains, fruits, vegetables, seeds, and nuts, with minimal to no inclusion of processed foods. Consumption of a plant-based diet without added sugar, refined grains or oils, was associated with a 4% lower risk of developing Metabolic Syndrome after one year. While animal or dairy products may be included in a balanced Plant-Based diet, it is important to recognize that a strict vegan or vegetarian diet may not be beneficial for all individuals with MetS. Overall, high intake of vegetables and fruits is associated with increased insulin sensitivity, increased glucose regulation, decreased systemic inflammation, reduced systolic and diastolic blood pressure, increased HDL cholesterol, reduced waist circumference, and reduced visceral adiposity. For example, after 6 weeks of consuming strawberries, cranberries, and blueberries (approximately 330mg worth of polyphenols), insulin sensitivity was improved in obese, non-diabetic insulin resistant adults. Consuming two, uncooked Roma tomatoes daily for four weeks improved lipid profiles, increasing HDL cholesterol by upwards of 5mg/dL.3 Non- starchy vegetables, a variety of fruits, legumes, nuts, and seeds provide powerful phytonutrients. High fiber, antioxidant and polyphenol rich foods can greatly reduce the risk of developing Metabolic Syndrome and can help manage the condition for those who already experience it. Atherosclerosis and Type 2 Diabetes are two complications of MetS that can develop. A balanced, plant-based diet has been shown to aid in those conditions as well. Negative aspects of a plant-based diet include its restrictiveness and the potential for developing nutrient deficiencies. Consulting a health professional to customize the diet to promote adherence is one way to overcome both the restrictiveness and potential nutrient deficiencies of the plant-based diet.

Dietary Supplements

There are many supplements found to aid in the prevention or management of Metabolic Syndrome. One supplement that can be helpful in managing MetS is Omega-3 fatty acids. This nutrient is commonly found in fatty fish and certain types of nuts and seeds. Usually, the supplements contain a combination of DHA and EPA, two types of omega-3 fatty acids. Supplementation of 2g/day for six weeks significantly reduced triglyceride levels, total cholesterol, blood pressure, inflammatory markers (such as CRP, TNF-alpha, and IL-6/1), and increased HDL cholesterol. While there is some debate about dose and length of supplementation, it is important to always consult a health professional before taking omega-3 supplements. Doses above 5g/day may have negative health impacts, such as impaired immune function or increased heart disease risk. Omega-3 supplements may interact with anticoagulant drugs, like Warfarin. Ginger is another helpful supplement when it comes to Metabolic Syndrome. Supplementing with 2g of ginger powder daily for 12 weeks was shown to improve triglyceride levels and insulin sensitivity in individuals with MetS. Other markers like weight, waist circumference, cholesterol levels, and blood pressure may also be improved with ginger, though more studies need to be done. Ginger is generally regarded as safe and has little to no adverse effects.

Self-Management

Self-management skills can improve health outcomes for individuals with Metabolic Syndrome. Exercise, adequate sleep, and meal timing can help manage MetS. Engaging in 150 minutes of aerobic or resistance exercise weekly is effective at managing every aspect of MetS. Impaired sleep patterns have been shown to worsen metabolic control; following a sleep hygiene routine and getting 8-9 hours nightly has been shown to improve MetS symptoms. Lastly, meal timing and frequency can impact MetS. Late night eating is associated with worsening symptoms and higher risk for developing complications of MetS. Eating 6 small meals throughout the day, finishing before 6pm was shown to reduce the development of obesity and improve blood sugar control.

The Importance of a Healthcare Team

Collaborating with other healthcare professionals can be beneficial when trying to prevent or manage Metabolic Syndrome. Finding a provider that is trained in Biofeedback therapy can help relieve symptoms and risks associated with MetS. Biofeedback therapy can be done in many settings with providers from various backgrounds, though many tend to be Psychologists. This technique uses sensors that measure specific bodily functions. With training, an individual learns different techniques to help modulate these functions. Studies show that after 6 months of biofeedback, individuals had decreased waist circumference, BMI, blood pressure, triglycerides, total cholesterol, LDL cholesterol, and lower fasting plasma glucose.

Conclusion

Metabolic Syndrome is a complex condition involving several metabolic disorders. Development of MetS is multifaceted and can increase an individual's risk of developing serious health conditions such as Type 2 Diabetes and other cardiovascular diseases. Prevention and management is possible through various methods including diet and lifestyle modifications.

References:

  1. Swarup S, Ahmed I, Grigorova Y, et al. Metabolic Syndrome. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan. Updated 2024 Mar. Accessed October 10, 2024. Available from: https://www.ncbi.nlm.nih.gov/sites/books/NBK459248/

  2. Fahed G, Aoun L, Bou Zerdan M, Allam S, Bou Zerdan M, Bouferraa Y, Assi HI. Metabolic Syndrome: Updates on pathophysiology and management in 2021. International Journal of Molecular Sciences. 2022; 23(2):786. https://doi.org/10.3390/ijms23020786

  3. Peña-Jorquera H, Cid-Jofré V, Landaeta-Díaz L, Petermann-Rocha F, Martorell M, Zbinden-Foncea H, Ferrari G, Jorquera-Aguilera C, Cristi-Montero C. Plant-based nutrition: Exploring health benefits for atherosclerosis, chronic diseases, and Metabolic Syndrome—A comprehensive review. Nutrients. 2023; 15(14):3244. https://doi.org/10.3390/nu15143244

  4. Wang Y, Wang Y, Shehzad Q, et al. Does omega-3 PUFAs supplementation improve metabolic syndrome and related cardiovascular diseases? A systematic review and meta-analysis of randomized controlled trials. Crit Rev Food Sci Nutr. 2024;64(26):9455-9482. doi:10.1080/10408398.2023.2212817

  5. Omega-3 Health Fact Sheet. Office of Dietary Supplements. Accessed October 11, 2024. https://ods.od.nih.gov/factsheets/Omega3FattyAcids- HealthProfessional/#h39

  6. Rahimlou M, Yari Z, Rayyani E, et al. Effects of ginger supplementation on anthropometric, glycemic and metabolic parameters in subjects with metabolic syndrome: A randomized, double-blind, placebo-controlled study. J Diabetes Metab Disord. 2019;18(1):119-125. Published 2019 Mar 22. doi:10.1007/s40200-019-00397-z

  7. Liang M, Pan Y, Zhong T, Zeng Y, Cheng ASK. Effects of aerobic, resistance, and combined exercise on metabolic syndrome parameters and cardiovascular risk factors: a systematic review and network meta-analysis. Rev Cardiovasc Med. 2021;22(4):1523-1533. doi:10.31083/j.rcm2204156

  8. Chasens ER, Imes CC, Kariuki JK, et al. Sleep and Metabolic Syndrome. Nurs Clin North Am. 2021;56(2):203-217. doi:10.1016/j.cnur.2020.10.012

  9. Alkhulaifi F, Darkoh C. Meal timing, meal frequency and Metabolic Syndrome. Nutrients. 2022;14(9):1719. Published 2022 Apr 21. doi:10.3390/nu14091719

  10. Mitchell, J.C., Paulson, J., Cannarozzi, M. et al. Maladaptive cardiac autonomic control during a stress reactivity assessment among primary care patients with Metabolic Syndrome. Appl Psychophysiology and Biofeedback 42, 97–105 (2017). https://doi.org/10.1007/s10484-017-9355-3

Rachel Moore
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