Here are two phrases you might not be familiar with: insulin resistance and metabolic syndrome. But you should be, as either one, or both, can have serious implications for your health.
Insulin resistance is just as it sounds: a condition whereby your body’s cells resist the ability to properly process insulin, thereby resulting in your muscles, body fat and liver being unable to efficiently use the glucose from your blood for energy. When this happens, your pancreas steps in to produce more insulin, eventually causing increased blood sugar levels, and potential problems such as type 2 diabetes, high blood pressure and high cholesterol (or low “good” cholesterol).
Some experts use the terms insulin resistance and metabolic syndrome interchangeably and that’s probably because they’re intricately linked. Other experts say that metabolic syndrome is the more commonly used term nowadays rather than insulin resistance syndrome. (In today’s blog, we’ll use a little of both terms.)
Metabolic syndrome is a cluster of conditions including high blood sugar, rising blood pressure, abnormal cholesterol or triglyceride levels—conditions that are the three big factors that can lead to increased risk of heart disease, stroke and type 2 diabetes.
One tell-tale sign of metabolic syndrome is excess body fat around your waist and abdominal area—sometimes called central obesity—defining your body as apple-shaped. There are others, mainly related to high blood sugar levels, that are also symptomatic of diabetes, including frequent urination, increased thirst, fatigue, and sometimes blurred vision.
The signs of insulin resistance are unsurprisingly similar because the two problems are intertwined. This piece references some numbers as follows as signals that you may be insulin resistant:
- A thick waist, more than 40 inches around in men and 35 inches or more in women;
- a fasting glucose level over 100 mg/dL;
- blood pressure results consistently over 130/80 or higher;
- a fasting triglyceride level above 150 mg/dL;
- an HDL (“good”) cholesterol level less than 40 mg/dL in men and 50 mg/dL in women;
- skin tags; and,
- acanthosis nigricans, which are patches of dark, velvety skin.
Insulin resistance can be temporary or chronic and you don’t have to have diabetes to have insulin resistance. However, people with prediabetes or type 2 diabetes generally are insulin resistant and those who have type 1 diabetes can also be insulin resistant. And remember, left unaddressed, insulin resistance syndrome is likely to lead to prediabetes and then type 2 diabetes, itself.
What May Cause Insulin Resistance Syndrome/Metabolic Syndrome?
There are several factors associated with these conditions, some of which you may have some control over, while others may be more difficult to compensate for. Both genetic factors and environmental factors (e.g., diet, exercise, lifestyle, etc.) can contribute to developing insulin resistance and/or metabolic syndrome.
6 Potential Causes for Developing Metabolic Syndrome:
- Genetic Factors—With regard to the pathophysiology (defined as the functional changes that accompany a particular syndrome or disease) of obesity, some experts estimate that genetics play a role in 40-80% of obesity. Further, genetic factors in insulin resistance and type 2 diabetes, also play a role in those diseases. Therefore, it is thought that genetics also may be connected to development of metabolic syndrome.
- Obesity—This study found that a body mass index (BMI) greater than 25 increases your risk of metabolic syndrome, as does having a pear shape rather than an apple shape. We mentioned the latter fact earlier, but it bears repeating. If you carry extra weight around your waist and abdomen (sometimes called “central obesity” but in familiar circles you probably refer to it as “belly fat”) your risk for developing metabolic syndrome increases.
- Progressive Weight Gain—The same study found that metabolic syndrome is present in only about 5% of those people with normal body weight, while for those deemed overweight and obese, metabolic syndrome was found in 22% and 60% of those subjects, respectively. Further, the study found that those adults who continue to gain 5 or more pounds per year as they age raised their risk of developing metabolic syndrome by up to 45%.
- Physical Inactivity and Sedentary Lifestyle—If you’re not moving, you’re not doing yourself any favors when it comes to metabolic syndrome. This study claims that both observational and interventional studies suggest an important role for physical activity and higher fitness in mitigating metabolic syndrome. According to this article, organizations such as the American Heart Association advise that you need 150 minutes per week of moderate-to-vigorous-intensity cardio exercise. Even if it’s brisk walking in 10-minute (or more) increments throughout the day.
- Unhealthy Diet—You know we could write about this one all day long. This article makes it simple: start by phasing out “unhelpful” foods, such as refined carbs and sugary snacks and beverages; saturated fats in red meat, some baked goods, and some milk dairy products; cured meat; and processed and fast foods. Then bring in the “good” stuff: veggies, fruits, whole grains, and the “good” fats like omega-3s. Research and real-life support that losing even a little bit of weight can lower blood pressure and help with insulin resistance. Here’s another supportive post.
- Smoking—add metabolic syndrome to the long list of damaging health problems for which smoking may contribute.
What Other Factors Increase Risk for Developing Metabolic Syndrome?
- Age—About one in three American adults have metabolic syndrome and the risk increases with age. This study using data from over 6,000 participants (men and women) in the Third National Health and Nutrition Examination Survey (NHANES III) found metabolic syndrome to be present in 26% of those ages 65 and under and in 55% of older adults beyond 65.
- Gender—It’s not always a simple “more women than men” have metabolic syndrome. As the authors in this study explain, the contribution of several metabolic components to the metabolic syndrome is different in men and women. For example, in their study involving 500 subjects ages 30+, metabolic syndrome was present in 29% and 23% of women’s and men’s sample, respectively. More interestingly though is how the genders breakdown when it comes to the different components of metabolic syndrome. For example, in the women, elevated BMI, low HDL cholesterol, increased waist circumference and hyperglycemia were significantly larger contributors to the metabolic syndrome while in men these were hypertension and elevated triglycerides.
- Ethnicity/Race—It’s unclear why, but here in the U.S., Hispanics are at the greatest risk of developing metabolic syndrome. Some articles have indicated that African Americans and Native Americans are also more likely to develop this condition; however, that data is not consistent. This study, for example, says that the “prevalence of metabolic syndrome is highest in Hispanics and lowest in African-Americans…” with whites in between the two. (The article notes that the term “whites” doesn’t describe an ethnic group.) Interestingly, the study points out that despite more than 80% of the world’s population being of non-European descent, the overwhelming majority of research on metabolic syndrome is in predominantly European-derived populations, leaving a critical knowledge gap when it comes to cardiometabolic risk and how it may differ along racial/ethnic lines.
- Family History—If you have a family history of type 2 diabetes, your risk is increased for metabolic syndrome.
- Other Diseases/Conditions—When it rains it pours, as the saying goes, and in this case, if you’ve had any of the following conditions, your likelihood of developing metabolic syndrome is higher than if you haven’t had:
- Sleep apnea
- Non-alcoholic fatty liver disease
- Polycystic ovary syndrome (PCOS)
- Gestational diabetes
Here’s one more little tidbit: those with underlying metabolic conditions are more vulnerable than healthy individuals when it comes to epidemic diseases, like COVID-19. According to this scientific report, up to half of those who die from COVID-19 have metabolic and vascular disease.
What Can You Do to Prevent or Manage Metabolic Syndrome?
First, keep in mind that metabolic syndrome is a multi-factorial condition. As such, preventing and treating it is complex; however, the good news is that it can be reversed by taking actionable steps to improve your diet, increase physical activity, lose weight—all important tactics to decrease blood pressure, correct your cholesterol numbers, and improve insulin resistance.
You’ll want to work closely with your doctor on this one as on-going testing will be helpful, actually necessary, in determining whether you’re heading in the right direction. Your doctor will measure your waistline, note your BMI, check your blood pressure and order bloodwork to determine your blood glucose, cholesterol and triglyceride levels. In addition, if you have some of the other conditions discussed above that increase the risk for metabolic syndrome—e.g., sleep apnea, type 2 diabetes, non-alcoholic fatty liver disease—you’ll want to be on top of managing those too, with your doctor’s help.
An Interesting Aside About Future Tests
Please allow us, here at OmegaQuant, a little bragging rights and a bit of good news. Recently, we announced that OmegaQuant has been awarded a small business innovation research (SBIR) grant to develop a dried blood spot test identifying fatty acid patterns that predict metabolic syndrome and type 2 diabetes as early screening tools.
This is of high significance as it would advance a method for predicting impending (versus already established) metabolic syndrome and type 2 diabetes.
According to OmegaQuant’s Chief Operating Officer, Kristina Harris Jackson, PhD, RD, who is the principal investigator for the grant, “Metabolic diseases, such as metabolic syndrome and type 2 diabetes affect a significant portion of the population, with substantial impact on health, quality of life and financial security of these individuals.”
She added that there is “a need for accessible and inexpensive early predictive biomarkers of metabolic syndrome and/or type 2 diabetes to facilitate the early identification of high-risk individuals, providing the time necessary to make meaningful lifestyle changes to slow or prevent disease progression.”
Emerging evidence suggests that fatty acid profiles may serve as an early signal of impending hyperglycemia up to five years before type 2 diabetes develops regardless of whether insulin sensitivity, insulin secretion, and glycemic status are known.
OmegaQuant will partner on this project with the Fatty Acid Research Institute (FARI) which will provide fatty acid expertise, biostatistical support and data access by leveraging existing prospective cohort data.
Bottom Line: Metabolic syndrome and insulin resistance can potentially be prevented, mitigated, even reversed and/or improved through paying attention to your health with regular doctor consultations, proper tests to know your numbers, medical and nutritional supplement interventions as advised, and making healthy lifestyle improvements to keep your numbers in check.