When Will We Change Course for Metabolic Syndrome?

March 14, 2006 at 4:54 pm Leave a comment

The current approach to treating Metabolic Syndrome – a constellation of metabolic maladies in concert together – dyslipidemia (low HDL, high triglycerides, and/or high LDL), obesity, high blood sugars, high insulin levels, high blood pressure – is basically “isolation” treatment. That is, each feature is treated on its own rather as a single problem, rather than a more comprehesive approach that recognizes the reality that these features are not occuring in isolation, but are red flags to a systemic issue of metabolism dysfunction.

For example, if you have high blood pressure, obesity and dyslipidemia, the approach is often a statin to tackle the cholesterol problem, a blood pressure medication to bring BP under control and recommendation to lose weight.

This, in my opinion, is only placing a band-aid on the problem and not taking the critical step necessary to reverse the metabolic dysfunction at the root of the problems.

Will medication lower the cholesterol? Perhaps – but it isn’t addressing why the cholesterol is rising or forcing a change to actively resolve the cause and may have side effects that cause another problem.

Will medication lower the blood pressure? Perhaps – but it isn’t addressing the cause of the elevation, only managing the problem and may have side effects that cause another problem.

Will losing weight make a difference? Perhaps – but even that too isn’t addressing the underlying cause of the obesity in the first place. With the failure rate as high as it is, without establishing a long-term eating pattern to not only lose weight, but keep it off, is only a short-term fix.

The same holds true for the two items I didn’t include in my example – blood sugars can be “controlled” with medication and/or insulin injections, but these do not fix the metabolic disturbance – these act only as a band-aid and do not improve the metabolic function of the body.

With the recent findings, presented at the 55th Annual Meeting of the American College of Cardiology (ACC), that since 1998 there has been a 50% rise in the incidence of Metabolic Syndrome, we must begin to demand accountability and establish standards of care that require improvement in whole body metabolism, not just management of the syndrome.

We’ve got a lot of band-aids out there, but still have an alarming surge in the rates of Metabolic Syndrome. We’re doing something wrong here and instead of wringing our hands and continuing down the path to nowhere, it’s time to step back and re-evaluate the evidence that clearly shows marked improvement in those with Metabolic Syndrome when they are placed on a low-carb diet.

While such a diet is politically incorrect, there is no denying the strong support in the data from numerous trials that found significant improvements in all features of Metabolic Syndrome when the dietary approach was low in carbohydrate (60g net or less carbohydrate a day). Not only does the diet appear to effectively reverse the features of Metabolic Syndrome, it also reduces or eliminates the need for many of the medications used to manage the features of the disorder.

So, why does the medical establishment continue to dismiss the findings and continue with medical management and less effective dietary intervention? At this point in time, I can only reach one conclusion – profitability. A patient is simply not as profitable to a medical practice, pharmaceutical company or other corporate interests if they are able to reverse their metabolic disorder by implementing a controversial, yet scientifically supported, dietary approach.

Do I think those making recommendations are consciously thwarting the dissemination of this critical evidence?

Honestly, probably not – I think it’s more likely from years of deeply rooted dogma driving the decision making process more than a purposeful attempt to keep people sick. But, at this point in time, with the alarming rates continuing to rise even further, we seriously need to step back from our assumptions and stick with the evidence and not our consensus driven dogma that simply does not have a foundation in the evidence.

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