Metabolic Syndrome

Condition:

Metabolic syndrome, hyperlipidaemia Hypercholesterolaemia, pre-diabetes , the metabolic syndrome and obesity 

Definition:

There are two types of physical long term health problems. 

Firstly there are some long term health problems that are clearly diseases, a disease being   something that you either have or don’t have with some test that allows the doctor to either diagnose that you have the diseases or rule out the disease completely. Examples of this type of long term problem are rheumatoid arthritis or cancer or Parkinson’s disease. 

Secondly there is another type of long term problem, sometimes called a long term condition,  which is some altered state in your body which is not so much a disease in its own right and is better regarded as a risk factor. A person is judged to have the condition if some variable, their blood, the cholesterol level or some other lipid level or their height of their blood sugar level for example, is above a certain threshold, determined by national or international committees. The person is usually told they ‘have’ a condition like they would be told they ‘have’ cancer but they should in fact be told they have a risk factor which is at a level that they should consider taking action to reduce their level of risk. 

Cause for scope and prevention:  

These conditions are confusingly similar to one another, each having been developed by a group of doctors and researchers each of which believes their particular creation is the most important. There is no sharp distinction between them and the average doctor or patient just has to make sense of this fact. They all indicate a higher risk for cardiovascular disease.

The basic cause is usually said to be ‘lifestyle’ but they can also be considered to be environmental, and this is often a more effective means of motivating the person to take action. The best advocate is of this approach Daniel Lieberman, which he describes very clearly in his book The Story of the Human Body. He has been discovering biological mechanisms that link inactivity, a feature of life that has been with us for not much more than fifty years, to the increase in our modern epidemics. The link between inflammation and the development of amyloid one of the key proteins involved in the development of Alzheimer’s disease is also the focus of research. Thousands of years of evolution have meant that people who are more active have survived better so we are all genetically ‘programmed’ for an active lifestyle but in the last fifty years the car and the computer and the desk job, and a super abundance of high calorie food has meant that we live in a dangerous environment with genes selected for an environment requiring constant activity with very little food. He calls these diseases Mismatch Diseases.

It is worth noting that Daniel Lieberman’s new book is titled Exercise; why something we never evolved to do is healthy and rewarding – as he says we have a paleolithic body in a post paleolithic world.

Some people do have high levels of cholesterol although they are thin and active because they suffer from a genetic condition called Familial Hypercholesterolaemia.

Diagnosis:

The diagnosis is based on laboratory tests usually of cholesterol and blood glucose or haemoglobin A1C, a more sophisticated measure of glucose.

Standard medical therapy:

Prescription of statins and advice on diet and weight reduction.

Benefits of exercise therapy:  

Physical activity is of vital importance together with advice on diet and the NHS website is very clear 

• eat a balanced calorie-controlled diet as recommended by a GP or weight loss management health professional (such as a dietitian)
• join a local weight loss group
• take up activities such as fast walking, jogging, swimming or tennis for 150 to 300 minutes (2.5 to 5 hours) a week
• eat slowly and avoid situations where you know you could be tempted to overeat

For rapid weight loss significant reductions in calorie intake is necessary but to keep to the reduced weight physical activity is of vital importance.