Nonprescription approaches to metabolic syndrome
Weight loss can lead to improved insulin sensitivity.
The potential benefits of fiber in metabolic syndrome relate to two proposed mechanisms. Insoluble fibers absorb and retain water in the gastrointestinal tract, leading to a feeling of satiety and potential weight loss.
Monounsaturated fats have been shown to decrease LDL and increase HDL cholesterol, as well as decrease serum triglycerides. They are found in almonds, cashews, hazelnuts, macadamia nuts, peanuts, and pistachios, as well as avocados, canola oil, sesame oil, grapeseed oil, and high-oleic safflower oil.
Polyunsaturated fatty acids
Omega-3 (fish oils, flaxseed) and omega-6 (vegetable oils) are the main dietary polyunsaturated fatty acids. Omega-3 fatty acids are considered to reduce inflammation, whereas omega-6 fatty acids tend to increase inflammation. This is one of the theorized benefits of the Mediterranean diet, promoting "a healthier balance" in the ratio of omega-3 fatty acids to omega-6 fatty acids (Table 2).
TABLE 2. Simple approaches that may be beneficial for metabolic syndrome
|Weight loss||Target BMI of 19–25|
|Exercise||Aerobic and weight/resistance training|
|Limit sugar and simple carbohydrates||Substitute with vegetables, beans, and low glycemic fruits such as berries|
|Emphasize monounsaturated fats||Olive, avocado, and canola oils, and nuts such as|
|Increase fiber||Particularly helpful: eggplant, oat products, and supplements containing psyllium (Metamucil, Konsyl, and others)|
|Omega-3 fatty acids||Most effective: fatty fish two or three times weekly; salmon, anchovies, sardines, or fish oil supplements (Nordic Naturals Omega-3, New Chapter Wholemega, and many others)|
The prevalence of metabolic syndrome and the toll that it is exacting on the health of our patients warrants all clinicians to not accept the status quo and to find the best way to help our patients make meaningful progress in reducing the prevalence and impact of this common problem.
Thomas Duncan, MD, is in private practice in North Carolina.
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