The Metabolic Syndrome – A Wakeup Call to Change Your Habits

The Metabolic Syndrome (aka Syndrome X) is a group of risk factors that increase the chance of developing heart disease and diabetes. According to the American Heart Association/National Heart Lung and Blood Institute you have the metabolic syndrome if you have at least 3 of the following conditions.

• You are a man with a waist greater than 40 inches or a woman with a waist greater than 35 inches.
• Your triglyceride level is 150 mg/dl or greater.
• Your HDL cholesterol (the good cholesterol) is less than 40 mg/dl for men and less than 50 mg/dl for women.
• Your blood pressure is greater than 130/80 mm Hg or currently taking high blood pressure medication.
• Your blood sugar is greater than 100 mg/dl or you are currently taking medications to lower your blood sugar.

Knowing if you fit the definition of having the metabolic syndrome is important because people in this group are up to twice as likely to develop heart disease and up to 5 times more likely to develop diabetes. In fact, the more of the above characteristics you have the greater the risks. Health professionals use the metabolic syndrome as a tool to asses health risk but it does not replace cardiovascular risk assessment.

The Metabolic Syndrome is quite common affecting approximately 23% of Americans. It is more common in older people than the young. The prevalence ranges from about 6% in those aged 20 to 29 to about 43% in those aged 60 to 69.

There are two risk factors associated with the metabolic syndrome. These are obesity and insulin resistance. This is not to say that all people with the metabolic syndrome have these risk factors. They just indicate an increased risk of developing the metabolic syndrome.

The dramatic rise in obesity in recent years is thought to be a key factor in the increase in the metabolic syndrome also seen. Fat cells secrete many different chemicals into the circulation. The end results include decreased insulin sensitivity, increased cholesterol production and increased inflammation. The kind of fat deep inside the abdominal cavity is more responsible for these negative effects than fat in the rest of the body. This is why a larger waist measurement is important.

Insulin is responsible for helping glucose enter cells. Insulin resistance describes a state when the cells do not respond to normal levels of insulin and glucose levels increase. The pancreas responds by making more insulin. Eventually the pancreas fails to make enough insulin to force glucose into the cells and the body now has increased glucose levels and increased insulin levels. The increased insulin levels result in increased triglycerides, It also interferes with how your kidneys work so blood pressure increases.

Management of the metabolic syndrome involves reducing the risks for cardiovascular disease and type 2 diabetes. The best way to decrease these risks is through lifestyle modifications. An individual is encouraged to lose weight, increase activity and eat a healthy diet. If a person has high blood pressure, high blood sugar and/or high cholesterol, appropriate drug therapy should be used under the supervision of a physician.

A mediterranean style diet has been shown to be effective in reducing the number of people with the metabolic syndrome. This type of diet can also help you to lose weight and keep high blood pressure under control. Combine this with an exercise program getting 30 to 60 minutes a day of moderate intensity exercise every day for best results.

Excellent resources for more information.

http://www.nhlbi.nih.gov/health/dci/Diseases/ms/ms_whatis.html

http://www.mayoclinic.com/health/metabolic%20syndrome/DS00522
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A Good Nights Sleep Essential in Fighting Off a Cold

There are a large number of things your body does when you sleep. Sleep is more than simply rest for the mind and body. In fact, according to the National Sleep Foundation, when you are asleep your blood supply to muscle increases, tissue growth and repair occurs, energy is restored, hormones are released essential for growth and development. Sleep helps contribute to a healthy immune system, balances our appetite by regulating hormones responsible for hunger and feeling full.

According to the National Institutes of Health research shows that the average healthy person will sleep 8 to 8.5 hours a night when allowed to sleep unrestricted. Some may need more and some less sleep in order to feel rested. In 1910 most people slept 9 hours a night. In a 2008 survey by the National Sleep Foundation the average time people spent sleeping was only 6 hours and 40 minutes.

In the January 12, 2009 issue of the Archives of Internal Medicine there is an article studying sleep patterns and susceptibility to the common cold. The theory was sleep quality is an important predictor of immunity and as a result the ability to resist getting a cold.

The researchers used 153 healthy volunteers. These men and women recorded their sleep patterns and how rested they felt over 14 days. After this initial period, the participants were quarantined and given nose drops with a cold producing virus (rhinovirus). They were then monitored for the development of a cold.

Those with less than 7 hours of sleep were almost 3 times more likely to develop a cold than those who slept more than 8 hours. Also, those who slept most poorly were over 5 times more likely to develop a cold than those who slept best. These findings were not related to a persons health practices, demographics, body mass or socioeconomic status.

The researchers concluded when people don’t sleep enough or don’t sleep well in the weeks before being exposed to a cold virus, they are more likely to catch it. They have a lower resistance to illness.

As a result of this research it is important to make sleep a top priority, especially during cold season. Time invested in adequate and efficient sleep will likely pay you back in better health, fewer colds and greater productivity.

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Are You Getting Enough Vitamin D?

Vitamin D is commonly known as the sunshine vitamin because our skin makes vitamin D in response to exposure to the sun. It was originally thought that the only problems associated with a vitamin D deficiency were a development of rickets, a softening of the bones with potential deformation in children, and osteomalacia, a softening of the bones in adults.

Today it is known that most tissues and cells of the body contain a receptor for vitamin D indicating this essential nutrient plays an important role in overall health. In fact research is starting to find vitamin D may play an important role in decreasing the risk of some cancers, autoimmune diseases, cardiovascular diseases and infectious diseases.

Measuring serum levels of 25-hydroxyvitamin D (25-OH-D) are considered the best indicator of vitamin D deficiency but the exact cutoff levels have not been determined. A vitamin D level less than 11 ng/ml (1 ng/ml = 2.5 nmol/ml) is associated with rickets. A level less than 10 to 20 ng/ml is considered to be a deficiency and inadequate for bone and overall health. A level of 21 to 30 ng/ml in considered to be a relative insufficiency and level above 30 ng/ml is considered to be sufficient for good health.

It is estimated that over 1 billion people worldwide and over half the US population has inadequate vitamin D levels (less than 30 ng/ml). Vitamin D levels below 30 ng/ml are associated with an increased risk of bone fractures, several cancers, multiple sclerosis, and type 1 diabetes. The Institute of Medicine has established adequate daily intakes of vitamin D for children and adults, but these guidelines reflect the amount of vitamin D needed to prevent rickets and osteomalacia. Also, these guidelines have not been updated to reflect the abundance of research supporting supplementation at higher doses.

The New England Journal of Medicine published an excellent review of vitamin D deficiency. The article is not free online but most public libraries should have a copy. http://nejm.highwire.org/cgi/content/extract/357/3/266

The National Institutes of Health has a good overview of vitamin D but they still have the old intake guidelines. http://ods.od.nih.gov/factsheets/vitamind.asp

An important issue was raised in the American Journal of Clinical Nutrition in March 2007. The author states the press has been effectively reporting the prevalence of vitamin D deficiency as research has come out. The problem comes when the media has been referencing the outdated guidelines as the correct way to supplement vitamin D intake. In fact the suggested 400 IU dose from the outdated guidelines will only raise vitamin D levels by 2.8 to 4.8 ng/ml. The author states a dose of 1700 IU per day would be needed to raise blood levels enough. This is about 4 times the dose. http://www.ajcn.org/cgi/content/full/85/3/649

The Linus Pauling Institute at Oregon State University has a great review of the literature and has published their own set of guidelines for Vitamin D intake. They say generally healthy adults should take in 2000 IU of vitamin D daily. http://lpi.oregonstate.edu/infocenter/vitamins/vitaminD/

A group of 18 scientists at the University of California have joined together to support a total daily intake of 2000 IU of vitamin D. They want the government to re-examine its recommendations and build awareness of the deficiency problem. http://newsroom.ucr.edu/cgi-bin/display.cgi?id=1968

What about Toxicity?

The National Institutes of Health (NIH) has published tolerable upper limits for vitamin D intake of 1000 IU a day for the first year of life and 2000 IU a day for everyone else. At the same time the NIH reports many scientists challenge this upper limit due to newer evidence stating doses as high as 10 000 IU per day are reportedly safe. Because of this, the NIH upper limits may be overly conservative.

Vitamin D toxicity can cause nausea, vomiting, poor appetite, constipation, weakness and weight loss. It can also raise calcium levels causing confusion and heart rhythm abnormalities. Also, the combination of vitamin D and calcium intake can increase the chance of kidney stones. A serum level of greater than 200 ng/ml is considered to be toxic.

The Bottom Line

Most people should probably increase vitamin D intake. The Linus Pauling Institute recommendation of 2000 IU per day is probably safe. It falls right at the NIH upper limit of safety which are considered to be very conservative. Vitamin D is available in many pharmacies in doses of 400 IU and 1000 IU. Vitamin D is also found in fortified milk and other foods. It also occurs naturally in fatty fish and egg yolk. If your diet includes a lot of these foods, consider supplementing with 400 to 1000 IU of vitamin D. Otherwise you may consider supplementing with 1000 to 2000 IU daily of vitamin D. Check with your doctor, especially if you have kidney disease, hyperparathyroidism, sarcoidosis, tuberculosis or lymphoma. These conditions may cause an excessive increase in calcium levels in response to vitamin D.

When selecting a product, chose one that states it contains vitamin D3. This is the active form more easily utilized by the body.

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Popping the Airborne Bubble

Airborne was originally developed by a second grade school teacher. The product began flying off the shelf after being featured on Oprah. Since its introduction people have been using it to fight colds, prevent colds and boost their immune system. The problem here is there is currently no scientific evidence Airborne is effective for any of these uses. Furthermore, the company has previously used deceptive advertising to convince people this product was effective for colds. As a result this product has achieved $100 million per year in sales.

The first sign that Airborne is a gimmick is the statement on the package “ Created by a school teacher”. How is it possible a school teacher can develop a product to treat a cold when millions of doctors, scientist, university research centers and pharmaceutical manufacturers have been unsuccessful. If it were possible to create a product that did effectively treat or prevent a cold, the sales would be much higher than Airborne’s because the medical community would stand behind it.

A close look at the package reveals more evidence. The original package (it was recently redesigned) stated “take at first sign of a cold symptom or before entering crowded environments”. This statement has since been removed from the updated package. Now the package states “Helps support your immune system”. The company has backed away from claiming effectiveness in treating a cold. If they had proof it helps prevent a cold, they would not remove this original statement in favor of a claim that is more vague. Also, claiming to support your immune system does not mean it will help fight a cold.

Reviewing the ingredients reveals a bunch of vitamins, minerals and herbs. None of these has been proven to reduce the frequency, duration or severity of a cold. The two ingredients with the best track record are Vitamin C and Echinacea. Both of these have some studies showing a benefit in cold treatment but there are numerous studies showing no benefit. I once attended a lecture which cited a study showing increased immune system activity after taking echinacea but this did not translate to improved outcomes. Boosting the immune system did not treat the cold in this study. The national library of medicine website has a great information page for Vitamin C (http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-vitaminc.html) and one for Echinacea(http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-echinacea.html).

Further evidence against Airborne is the study they once referenced on both the old package and on the website. The study was done by GNG Pharmaceutical Services which according to ABC news was started up just to do the Airborne study. You can read the ABC news article here. http://abcnews.go.com/GMA/OnCall/story?id=1664514&page=1

One more thing. The original formula contained 5000 IU of Vitamin A with the instructions to take every 3 hours. The upper safe limit of Vitamin A is 10 000 IU daily. This original formula could have resulted in up to 40 000 IU daily of Vitamin A which is 4 times the safe limit. Vitamin A overdose can be serious resulting in hair loss, liver problems, muscle pain and much more. They have since decreased the Vitamin A content to 2000 IU per dose with instruction not to exceed 3 doses per day. This company obviously had not done enough research to provide a safe product. This information could have been discovered in a few minutes at the local library but they marketed a potentially toxic product.

It is difficult to believe they have done enough research to prove effectiveness if they failed to provide for safety in the original product. Also, they provide no evidence they have studied the new formula for effectiveness. Even if the old formula had been effective, new research needs to be done to prove the new one is as effective as the previous one.

Finally, the makers of Airborne has settled a $ 23 million class action lawsuit due to deceptive advertising. Read the story here. http://abcnews.go.com/Health/ColdFlu/Story?id=4380374&page=1

Here are a couple more places for more in depth information.

http://whohastimeforthis.blogspot.com/2006/04/created-by-school-teacher.html

and

http://purplekangaroopuzzle.blogspot.com/2006/01/airborne-cold-remedy-helpful-dangerous.html

Conclusion

If you want to fight a cold you need to keep your immune system strong. Here are proven ways to keep your immune system healthy.

• Get your sleep. (7 to 8 hours a night)
• Exercise
• Eat healthy including lots of fruits and vegetables
• Drink plenty of water

There is no magic bullet in preventing a cold. If you take something like Airborne and do not get a cold it is most likely because you were not going to get it anyway. There are millions of people who did not get a cold today.

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