The End of Metabolic Syndrome?
American waistlines continue to grow and doctors are struggling to deal with the issues those extra pounds bring. To describe patients who have several risk factors combined, doctors came up with a diagnosis they call Metabolic Syndrome (MetS).
You may have also heard it called Syndrome X, Reaven's syndrome or CHAOS in Australia. There are several different "official" ways to determine if someone has MetS, but most agree you must have the following general conditions.
- Waist to hip ratio or Body Mass Index of obese.
- Raised blood pressure at or above 140/90.
- Elevated fasting blood glucose or previously diagnosed type 2 diabetes.
- Raised triglycerides and lower HDL or "good" cholesterol.
In 2009 the National Health Statistics Reports found that 34% of the adult population over 20 years old have MetS. People who are diagnosed with MetS have a higher risk of heart disease, stroke and type 2 diabetes than the general population.
There's just one problem with the diagnosis. It's not helping treat people and it's not telling doctors anything new. Bear with me for a minute while I explain.
When something is classified as a "syndrome," it's typically three things.
- The combination of several clinical signs,
- patient-reported symptoms and
- specific characteristics that occur together.
Just seeing a couple of things can tip off a doctor to be on the lookout for others. Examples include Down syndrome or Parkinsonian syndrome.
Put all the characteristics of a syndrome together and it's supposed to be greater than the sum of each clinical issue. The problem with MetS is that patients who've been diagnosed with it don't have any greater health risks than what each individual problem would cause alone.
In a study published in the Archives of Internal Medicine (March, 2010) researchers decided to go through seven clinical trials that followed the plaque progression in the hearts of 3,500 people. Nearly 60% of the participants in the studies were diagnosed with MetS.
After, "adjusting for its individual components" the researchers found that "MetS was no longer an independent predictor." In other words, the research subjects who were diagnosed with MetS got just as sick, no quicker or slower than one would expect from each of their individual risk factors.
To make matters worse, for over 30 years doctors have been looking into outside things that might be "causing" MetS such as stress, endocrine disorders or genetics. My response to that is, are they kidding? Doctors don't know why Americans are getting fatter?
The answer's simple. Americans are eating more and moving less. That's making us fatter which in turn is destroying our health. Instead of calling it a syndrome and looking for miracle cures in a pill or clinical treatment, what doctors should be doing is finding ways to treat the root problem.
Develop ways to give people clear nutritional advice. Put a score on the front of every box rating the food from 0 to 100. The higher the score, the higher the nutritional value. Don't compare the same types of foods, compare everything against a master list. You can't claim to be the most nutritious breakfast bar. You have to compare your breakfast bar or cracker box against a cup of blueberries or a green pepper.
Offer subsidies to promote whole vegetables and take away incentives from producing less nutritious foods. Each year the United States gives about 20 billion dollars in farm subsidies, with more than 90% going to five crops; wheat, corn, soybeans, rice and cotton. Take that $20 billion and provide subsidies for the production of vegetables. The cost of high fructose corn syrup will go up and the price of broccoli and cauliflower will go down.
Put physical education back into every school and make it important as English, science or math. Give tax deductions for businesses that encourage employees who walk or bike to work.
Let's dump this mysterious affliction called "Metabolic Syndrome" and start dealing with the real issues behind our expanding national waistline.
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