Metabolic Syndrome


By Philip S. Chua, MD, FACS, FPCS

The epidemic of childhood obesity, which obviously parallels the incidence among adults, have contributed to the explosion of metabolic syndrome, the most common cause of major illnesses our society faces today. The word “metabolic” refers to the biochemical processes and physiology governing the body’s normal functions to achieve homeostasis (balanced, healthy state).

What is Metabolic Syndrome?

Metabolic Syndrome is also called Insulin resistance Syndrome or Syndrome X. This is a cluster of medical risk factors — high blood pressure, high fasting blood sugar and cholesterol/triglyceride levels, and excess body fat around the waist — that increase the likelihood of heart attacks, stroke, and type 2 diabetes. This syndrome, which is usually without symptoms, except for an expanding waistline, might someday overtake smoking as a leading cause of cardiovascular diseases and deaths.

How common is metabolic syndrome?

Metabolic syndrome is very common in the United States. About 35 percent of all adults and 50 percent of those aged 60 and over have this syndrome. The “seeds” for this condition are planted while the fetus is in the womb and continue during childhood, where the children’s DNA are gradually damaged by unhealthy diet, habits, and behavior of the mother and the children themselves, starting from the crib. Children drinking soft drinks, diet or regular, cola or uncola, are 40 percent more prone to develop metabolic syndrome, starting with weight gain and then childhood obesity, later, hypertension (high blood pressure), arthritis, heart attack, stroke, Alzheimer’s, and even cancer. Soft drinks are also toxic to adults as well, with 40 percent risk also, according to the US National Institute of Health.

What are the metabolic risk factors?

Excess body weight, obesity, lack of exercise, smoking, alcohol excess are all risk factors for developing metabolic syndrome, besides damages in the genes. With metabolic syndrome, there is also increased insulin resistance, where the hormone called insulin produced by our pancreas is having difficulty getting into the cells to perform its normal job in sugar metabolism. As a result the blood glucose (sugar) is not metabolized and absorbed by the cells properly (to provide us energy) and its level goes up (high blood sugar and A1C levels), resulting in type 2 diabetes.

Excessive caloric intake (overeating, especially rice and other non-vegetable carbohydrates) and lack or absence of exercise, leading to overweight condition or obesity, are the main factors that contribute to the development of metabolic syndrome. While heredity is a factor, it is outweighed by lifestyle, behavior and habits. Filipinos have 11.3 percent incidence of diabetes compared to Chinese, 4.4 percent, because of rice consumption and other carbohydrates (including bread, ice cream, sweets, etc). Chinese eat smaller amount of rice and they also eat a lot of vegetables, tofu, and nuts daily. Many of them are vegetarians. Low carbs is healthier.

What mechanism is in play here?
For each individual, there is a normal homeostatic morphology and physiology. Our genes determined our general and specific makeup. We have normal ranges in our system’s blood chemistries and bodily needs that keep us healthy and fit. When we fall short or exceed our individual normal requirements (calories, physical exercise, rest, etc.), or consume toxic food, drinks, drugs, or expose ourselves to harmful chemicals or radiation, our health suffers, and we develop illnesses. After birth, it is our lifestyle (from the womb, the crib, and into adulthood) that determines our health and longevity, more significantly than our genes in most cases.

Are chubby kids healthy?
Absolutely NOT! While growing up, I remember society’s concept that a chubby child is a healthy child. Medically, it could not be farther from the scientific truth. Even today, television shows feature chubby kids as actors, which sends a bad signal to the viewers. Children who are overweight, who are not guided and disciplined to portion their caloric intake, especially from rice, and other carbohydrates (bread, sweets), will become obese adults and face all the disease consequences of obesity, including cancer. Obesity is a significant risk factor in the development of cancer. The earlier the appropriate dieting starts, the better for the child’s health and longevity as an adult.

Are snorers prone to this syndrome?
Those who snore and do not get a restful sleep should undergo a Sleep Study. If the test shows they have Obstructive Sleep Apnea (OSA), which could sometimes cause prolonged breath-holding and cardiac arrest, they could benefit from the use of a CPAP (Continuous Positive Airway Pressure) machine every time they go to sleep. OSA increases the risk for metabolic syndrome and the cluster of disease listed above, including cancer.

How do we prevent metabolic syndrome?
As with any illnesses, prevention is the key. In my book, Let’s Stop “Killing” Our Children (, I have highlighted the fundamental principle that disease prevention must be a proactive and pre-emptive strategy starting from the cellular level (in the womb and in the crib) to protect the child’s DNA from any damages that will lead to diseases. Maternal lifestyle, habits, and health during pregnancy are essential in shielding the DNA of the fetus from toxic substances in its time in the womb and in the crib after delivery. The protection includes dieting for the baby staring from the crib and onward to teen-years and adulthood. By protecting the DNA, these children (future adults) will not have to be saddled with the illnesses most of us have today, heredity considered, as I have alluded to earlier.

What is the treatment?

Greater awareness of the metabolic syndrome and its health consequences is the key and a major part of the management of this serious condition. Since this is a cluster of diseases, the treatment is tailored to the individual’s presenting illness(es), like high blood pressure, diabetes, thyroid problem, heart disease, stroke, Alzheimer’s, etc. The single most essential one is lifestyle changes to a healthier one: proper weight maintenance by caloric control (especially rice, bread, and other carbohydrates restriction), daily physical exercise, abstinence from tobacco, minimal alcohol use, if any, stress management by having adequate restful sleep, relaxation, regular vacation, and regular medical-dental check-up. While this will be a life-long endeavor, the reward is great and worth all the effort — much less illnesses, better health, and longevity.
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