Metabolic Syndrome & Its Dietary Management; A REVIEW
Metabolic Syndrome & Its Dietary Management
DOI:
https://doi.org/10.54393/pbmj.v4i2.124Abstract
Metabolic Syndrome or MetS is a multifactorial disease consisting of obesity, hypertension, dyslipidemia, and hyperglycemia. It’s common in 25% of the general population in the Northern US and Western Europe. In Pakistan, the statistics of MetS are unknown, however, it is expected to be twice that of the US. The middle age group and the geriatrics population have the highest number of MetS cases with risk factors such as obesity, sedentary lifestyle, alcohol, inadequate, inadequate sleep, and a non-vegetarian diet. The complications of MetS include obesity, diabetes, and cardiovascular events. A Meditteranean diet rich in fruits and vegetables, whole grains, and olive oil as the source of fat is considered to be the only effective dietary management in MetS. Moreover, a high lean protein, low and complex carbohydrate and moderate unsaturated fats have also shown positive progress in MetS, especially with long-term weight reduction. Micronutrients requirements also increase in MetS. Fulfilling these increased requirements has been shown to regulate and improve the metabolism of fats and carbohydrates. Vitamin C and E, flavonoids, vitamin D, conjugated linoleic acid, omega-3 fatty acids, minerals such as magnesium and chromium, α-lipoic acid, phytoestrogens, and dietary fiber all have been studied to support the treatment of MetS along with aloe vera and other herbal products, yoga and aerobic exercises.
References
Kaur, J.J.C.r. and practice, A comprehensive review on metabolic syndrome. 2014. 2014.
https://doi.org/10.1155/2014/943162
Eckel, R.H., et al., The metabolic syndrome. 2010. 375(9710): p. 181-183.
https://doi.org/10.1016/S0140-6736(09)61794-3
Weiss, R., A.A. Bremer, and R.H.J.A.o.t.N.Y.A.o.S. Lustig, What is metabolic syndrome, and why are children getting it? 2013. 1281(1): p. 123.
https://doi.org/10.1111/nyas.12030
El-Serag, H.B., T. Tran, and J.E.J.G. Everhart, Diabetes increases the risk of chronic liver disease and hepatocellular carcinoma. 2004. 126(2): p. 460-468.
https://doi.org/10.1053/j.gastro.2003.10.065
Fiatarone, J., et al., Non‐alcoholic steatohepatitis: impaired antipyrine metabolism and hypertriglyceridaemia may be clues to its pathogenesis. 1991. 6(6): p. 585-590.
https://doi.org/10.1111/j.1440-1746.1991.tb00915.x
Ratziu, V., et al., Liver fibrosis in overweight patients. 2000. 118(6): p. 1117-1123.
https://doi.org/10.1016/S0016-5085(00)70364-7
Gholam, P.M., et al., Nonalcoholic fatty liver disease in severely obese subjects. 2007. 102(2): p. 399-408.
https://doi.org/10.1111/j.1572-0241.2006.01041.x
Mottillo, S., et al., The metabolic syndrome and cardiovascular risk: a systematic review and meta-analysis. 2010. 56(14): p. 1113-1132.
https://doi.org/10.1016/j.jacc.2010.05.034
Alberti, K.G., et al., Harmonizing the metabolic syndrome: a joint interim statement of the international diabetes federation task force on epidemiology and prevention; national heart, lung, and blood institute; American heart association; world heart federation; international atherosclerosis society; and international association for the study of obesity. 2009. 120(16): p. 1640-1645.
https://doi.org/10.1161/CIRCULATIONAHA.109.192644
Esposito, K., et al., Metabolic syndrome and risk of cancer: a systematic review and meta-analysis. 2012. 35(11): p. 2402-2411.
https://doi.org/10.2337/dc12-0336
Ali, N.S., A.K. Khuwaja, and K.J.I.j.o.f.m. Nanji, Retrospective analysis of metabolic syndrome: Prevalence and distribution in executive population in urban Pakistan. 2012. 2012.
https://doi.org/10.1155/2012/649383
Ervin, R.B., Prevalence of Metabolic Syndrome Among Adults 20 years of age and over, by sex, age, race and ethnicity, and body mass index; United States, 2003-2006. 2009.
Kaur, J., Assessment and Screening of the Risk Factors in Metabolic Syndrome. 2014. 2(3): p. 140-152.
https://doi.org/10.3390/medsci2030140
Ogbera, A.O., Prevalence and gender distribution of the metabolic syndrome. Diabetology & Metabolic Syndrome, 2010. 2(1): p. 1.
https://doi.org/10.1186/1758-5996-2-1
Ogbera, A.O.J.D. and M. Syndrome, Prevalence and gender distribution of the metabolic syndrome. 2010. 2(1): p. 1-5.
https://doi.org/10.1186/1758-5996-2-1
Weiss, R., A.A. Bremer, and R.H. Lustig, What is metabolic syndrome, and why are children getting it? Annals of the New York Academy of Sciences, 2013. 1281(1): p. 123-140.
https://doi.org/10.1111/nyas.12030
Antonini-Canterin, F., et al., Association Between Carotid Atherosclerosis and Metabolic Syndrome: Results From the ISMIR Study. 2010. 61(5): p. 443-448.
https://doi.org/10.1177/0003319709360523
Momiyama, Y., et al., Inflammation, Atherosclerosis and Coronary Artery Disease. 2014. 8s3: p. CMC.S39423.
https://doi.org/10.4137/CMC.S39423
Novo, S., et al., Preclinical atherosclerosis and metabolic syndrome increase cardio- and cerebrovascular events rate: a 20-year follow up. Cardiovascular Diabetology, 2013. 12(1): p. 155.
https://doi.org/10.1186/1475-2840-12-155
Mottillo, S., et al., The Metabolic Syndrome and Cardiovascular Risk. 2010. 56(14): p. 1113-1132.
https://doi.org/10.1016/j.jacc.2010.05.034
Martínez-González, M.A., et al., Benefits of the Mediterranean Diet: Insights From the PREDIMED Study. Progress in Cardiovascular Diseases, 2015. 58(1): p. 50-60.
https://doi.org/10.1016/j.pcad.2015.04.003
Ros, E., Olive oil and CVD: accruing evidence of a protective effect. British Journal of Nutrition, 2012. 108(11): p. 1931-1933.
https://doi.org/10.1017/S0007114512003844
Braun, S., K. Bitton-Worms, and D. LeRoith, The link between the metabolic syndrome and cancer. International journal of biological sciences, 2011. 7(7): p. 1003-1015.
https://doi.org/10.7150/ijbs.7.1003
Kastorini, C.-M., et al., The Effect of Mediterranean Diet on Metabolic Syndrome and its Components. 2011. 57(11): p. 1299-1313.
https://doi.org/10.1016/j.jacc.2010.09.073
Radulian, G., et al., Metabolic effects of low glycaemic index diets. Nutrition Journal, 2009. 8(1): p. 5.
https://doi.org/10.1186/1475-2891-8-5
Abete, I., et al., Obesity and the metabolic syndrome: role of different dietary macronutrient distribution patterns and specific nutritional components on weight loss and maintenance. 2010. 68(4): p. 214-231.
https://doi.org/10.1111/j.1753-4887.2010.00280.x
Pirozzo, S.L., et al., Advice on low‐fat diets for obesity. 2002(2).
https://doi.org/10.1002/14651858.CD003640
Sacks, F.M., et al., Comparison of weight-loss diets with different compositions of fat, protein, and carbohydrates. 2009. 360(9): p. 859-873.
https://doi.org/10.1056/NEJMoa0804748
Petersen, M., et al., Randomized, multi-center trial of two hypo-energetic diets in obese subjects: high-versus low-fat content. 2006. 30(3): p. 552-560.
https://doi.org/10.1038/sj.ijo.0803186
Due, A., et al., Comparison of the effects on insulin resistance and glucose tolerance of 6-mo high-monounsaturated-fat, low-fat, and control diets. 2008. 87(4): p. 855-862.
https://doi.org/10.1093/ajcn/87.4.855
Lejeune, M.P., et al., Ghrelin and glucagon-like peptide 1 concentrations, 24-h satiety, and energy and substrate metabolism during a high-protein diet and measured in a respiration chamber. 2006. 83(1): p. 89-94.
https://doi.org/10.1093/ajcn/83.1.89
Psota, T. and D. Layman, A Moderate-Protein Diet Produces Sustained Weight Loss and Long-Term Changes in Body Composition and Blood Lipid.
Krauss, R.M., et al., AHA Dietary Guidelines: revision 2000: A statement for healthcare professionals from the Nutrition Committee of the American Heart Association. 2000. 102(18): p. 2284-2299.
https://doi.org/10.1161/01.CIR.102.18.2284
Layman, D.K.J.J.o.t.A.C.o.N., Protein quantity and quality at levels above the RDA improves adult weight loss. 2004. 23(sup6): p. 631S-636S.
https://doi.org/10.1080/07315724.2004.10719435
Pencharz, P.B. and R.O.J.A.r.o.n. Ball, Different approaches to define individual amino acid requirements. 2003. 23(1): p. 101-116.
https://doi.org/10.1146/annurev.nutr.23.011702.073247
Wolfe, R.R.J.T.A.j.o.c.n., The underappreciated role of muscle in health and disease. 2006. 84(3): p. 475-482.
https://doi.org/10.1093/ajcn/84.3.475
Pascual, R.W., et al., Diet Quality and Micronutrient Intake among Long-Term Weight Loss Maintainers. Nutrients, 2019. 11(12).
https://doi.org/10.3390/nu11123046
Astrup, A. and S.J.I.j.o.o. Bügel, Overfed but undernourished: recognizing nutritional inadequacies/deficiencies in patients with overweight or obesity. 2019. 43(2): p. 219-232.
https://doi.org/10.1038/s41366-018-0143-9
Agarwal, S., et al., Comparison of prevalence of inadequate nutrient intake based on body weight status of adults in the United States: an analysis of NHANES 2001-2008. 2015. 34(2): p. 126-134.
https://doi.org/10.1080/07315724.2014.901196
Via, M.J.I.S.R.N., The malnutrition of obesity: micronutrient deficiencies that promote diabetes. 2012. 2012.
https://doi.org/10.5402/2012/103472
Steele, E.M., et al., The share of ultra-processed foods and the overall nutritional quality of diets in the US: evidence from a nationally representative cross-sectional study. 2017. 15(1): p. 1-11.
https://doi.org/10.1186/s12963-017-0119-3
Marriott, B.P., et al., Intake of added sugars and selected nutrients in the United States, National Health and Nutrition Examination Survey (NHANES) 2003-2006. 2010. 50(3): p. 228-258.
https://doi.org/10.1080/10408391003626223
Kaidar-Person, O., et al., Nutritional deficiencies in morbidly obese patients: a new form of malnutrition? 2008. 18(7): p. 870-876.
https://doi.org/10.1007/s11695-007-9349-y
García, O.P., K.Z. Long, and J.L.J.N.r. Rosado, Impact of micronutrient deficiencies on obesity. 2009. 67(10): p. 559-572.
https://doi.org/10.1111/j.1753-4887.2009.00228.x
Goncalves, A. and M.-J. Amiot, Fat-soluble micronutrients and metabolic syndrome. Current opinion in clinical nutrition and metabolic care, 2017. 20(6): p. 492-497.
https://doi.org/10.1097/MCO.0000000000000412
Khosravi-Boroujeni, H., F. Ahmed, and N. Sarrafzadegan, Is the Association between Vitamin D and Metabolic Syndrome Independent of Other Micronutrients? 2015. 85(5-6): p. 245-260.
https://doi.org/10.1024/0300-9831/a000277
Panchal, S.K., S. Wanyonyi, and L. Brown, Selenium, Vanadium, and Chromium as Micronutrients to Improve Metabolic Syndrome. Current Hypertension Reports, 2017. 19(3): p. 10.
https://doi.org/10.1007/s11906-017-0701-x
Desai, M., J. Jellyman, and M.J.I.j.o.o. Ross, Epigenomics, gestational programming and risk of metabolic syndrome. 2015. 39(4): p. 633-641.
https://doi.org/10.1038/ijo.2015.13
Tarrade, A., et al., Placental contribution to nutritional programming of health and diseases: epigenetics and sexual dimorphism. 2015. 218(1): p. 50-58.
https://doi.org/10.1242/jeb.110320
Brenseke, B., et al., Current thoughts on maternal nutrition and fetal programming of the metabolic syndrome. 2013. 2013.
https://doi.org/10.1155/2013/368461
Knip, M., H.K.J.E.N. Åkerblom, and i.L.C.N. Opportunities, Early nutrition and later diabetes risk. 2005: p. 142-150.
https://doi.org/10.1007/1-4020-3535-7_21
DeBoer, M.D., et al., Early childhood growth failure and the developmental origins of adult disease: do enteric infections and malnutrition increase risk for the metabolic syndrome? 2012. 70(11): p. 642-653.
https://doi.org/10.1111/j.1753-4887.2012.00543.x
Alvisi, P., et al., Recommendations on complementary feeding for healthy, full-term infants. 2015. 41(1): p. 1-9.
https://doi.org/10.1186/s13052-015-0143-5
Yin, J., et al., Traditional Chinese medicine in treatment of metabolic syndrome. 2008. 8(2): p. 99-111.
https://doi.org/10.2174/187153008784534330
Hollander, J.M. and J.I.J.J.o.t.A.D.A. Mechanick, Complementary and alternative medicine and the management of the metabolic syndrome. 2008. 108(3): p. 495-509.
https://doi.org/10.1016/j.jada.2007.12.007
Sui, Y., et al., A systematic review on use of Chinese medicine and acupuncture for treatment of obesity. 2012. 13(5): p. 409-430.
https://doi.org/10.1111/j.1467-789X.2011.00979.x
Jang, S., et al., Herbal medicines for treating metabolic syndrome: a systematic review of randomized controlled trials. 2016. 2016.
https://doi.org/10.1155/2016/5936402
Yeh, G.Y., et al., Systematic review of herbs and dietary supplements for glycemic control in diabetes. 2003. 26(4): p. 1277-1294.
https://doi.org/10.2337/diacare.26.4.1277
Sahebkar, A., et al., Nigella sativa (black seed) effects on plasma lipid concentrations in humans: A systematic review and meta-analysis of randomized placebo-controlled trials. 2016. 106: p. 37-50.
https://doi.org/10.1016/j.phrs.2016.02.008
Tiwari, P., B. Mishra, and N.S.J.B.r.i. Sangwan, Phytochemical and pharmacological properties of Gymnema sylvestre: an important medicinal plant. 2014. 2014.
https://doi.org/10.1155/2014/830285
Davì, G., F. Santilli, and C. Patrono, Nutraceuticals in Diabetes and Metabolic Syndrome. 2010. 28(4): p. 216-226.
https://doi.org/10.1111/j.1755-5922.2010.00179.x
Franzini, L., et al., Dietary antioxidants and glucose metabolism. 2008. 11(4): p. 471-476.
https://doi.org/10.1097/MCO.0b013e328303be79
Riccioni, G., et al., Antioxidant vitamin supplementation in cardiovascular diseases. 2007. 37(1): p. 89-95.
Chen, H., et al., High-dose oral vitamin C partially replenishes vitamin C levels in patients with Type 2 diabetes and low vitamin C levels but does not improve endothelial dysfunction or insulin resistance. 2006. 290(1): p. H137-H145.
https://doi.org/10.1152/ajpheart.00768.2005
Davì, G., et al., Lipid peroxidation in diabetes mellitus. 2005. 7(1-2): p. 256-268.
https://doi.org/10.1089/ars.2005.7.256
Sesso, H.D., et al., Vitamins E and C in the prevention of cardiovascular disease in men: the Physicians' Health Study II randomized controlled trial. 2008. 300(18): p. 2123-2133.
https://doi.org/10.1001/jama.2008.600
Patrignani, P., et al., Effects of vitamin E supplementation on F2-isoprostane and thromboxane biosynthesis in healthy cigarette smokers. 2000. 102(5): p. 539-545.
https://doi.org/10.1161/01.CIR.102.5.539
Kris-Etherton, P.M., et al., Antioxidant vitamin supplements and cardiovascular disease. 2004. 110(5): p. 637-641.
https://doi.org/10.1161/01.CIR.0000137822.39831.F1
Vivekananthan, D.P., et al., Use of antioxidant vitamins for the prevention of cardiovascular disease: meta-analysis of randomised trials. 2003. 361(9374): p. 2017-2023.
https://doi.org/10.1016/S0140-6736(03)13637-9
Eidelman, R.S., et al., Randomized trials of vitamin E in the treatment and prevention of cardiovascular disease. 2004. 164(14): p. 1552-1556.
https://doi.org/10.1001/archinte.164.14.1552
Miller III, E.R., et al., Meta-analysis: high-dosage vitamin E supplementation may increase all-cause mortality. 2005. 142(1): p. 37-46.
https://doi.org/10.7326/0003-4819-142-1-200501040-00110
Bjelakovic, G., et al., Mortality in randomized trials of antioxidant supplements for primary and secondary prevention: systematic review and meta-analysis. 2007. 297(8): p. 842-857.
https://doi.org/10.1001/jama.297.8.842
House, A.A., et al., Effect of B-vitamin therapy on progression of diabetic nephropathy: a randomized controlled trial. 2010. 303(16): p. 1603-1609.
https://doi.org/10.1001/jama.2010.490
Sanyal, A.J., et al., Pioglitazone, vitamin E, or placebo for nonalcoholic steatohepatitis. 2010. 362(18): p. 1675-1685.
https://doi.org/10.1056/NEJMoa0907929
Palomer, X., et al., Role of vitamin D in the pathogenesis of type 2 diabetes mellitus. 2008. 10(3): p. 185-197.
https://doi.org/10.1111/j.1463-1326.2007.00710.x
Danescu, L.G., S. Levy, and J.J.E. Levy, Vitamin D and diabetes mellitus. 2009. 35(1): p. 11-17.
https://doi.org/10.1007/s12020-008-9115-5
Diabetologia, E.S.S.G.J., Vitamin D supplement in early childhood and risk for Type I (insulin-dependent) diabetes mellitus. 1999. 42: p. 51-54.
https://doi.org/10.1007/s001250051112
McCarty, M.F.J.M.h., Nutraceutical resources for diabetes prevention-an update. 2005. 64(1): p. 151-158.
https://doi.org/10.1016/j.mehy.2004.03.036
Hartweg, J., et al., Meta-analysis of the effects of n-3 polyunsaturated fatty acids on lipoproteins and other emerging lipid cardiovascular risk markers in patients with type 2 diabetes. 2007. 50(8): p. 1593-1602.
https://doi.org/10.1007/s00125-007-0695-z
Fedor, D., D.S.J.C.O.i.C.N. Kelley, and M. Care, Prevention of insulin resistance by n-3 polyunsaturated fatty acids. 2009. 12(2): p. 138-146.
https://doi.org/10.1097/MCO.0b013e3283218299
Beecher, G.R.J.T.J.o.n., Overview of dietary flavonoids: nomenclature, occurrence and intake. 2003. 133(10): p. 3248S-3254S.
https://doi.org/10.1093/jn/133.10.3248S
Jiang, F. and G.J.J.C.v.p. Dusting, Natural phenolic compounds as cardiovascular therapeutics: potential role of their antiinflammatory effects. 2003. 1(2): p. 135-156.
https://doi.org/10.2174/1570161033476736
Di Castelnuovo, A., et al., Meta-analysis of wine and beer consumption in relation to vascular risk. 2002. 105(24): p. 2836-2844.
https://doi.org/10.1161/01.CIR.0000018653.19696.01
Di Castelnuovo, A., et al., Alcohol dosing and total mortality in men and women: an updated meta-analysis of 34 prospective studies. 2006. 166(22): p. 2437-2445.
https://doi.org/10.1001/archinte.166.22.2437
Hertog, M.G., et al., Flavonoid intake and long-term risk of coronary heart disease and cancer in the seven countries study. 1995. 155(4): p. 381-386.
https://doi.org/10.1001/archinte.155.4.381
Knekt, P., et al., Flavonoid intake and risk of chronic diseases. 2002. 76(3): p. 560-568.
https://doi.org/10.1093/ajcn/76.3.560
Mukamal, K.J., et al., Tea consumption and mortality after acute myocardial infarction. 2002. 105(21): p. 2476-2481.
https://doi.org/10.1161/01.CIR.0000017201.88994.F7
Lau, F.C., et al., Nutrigenomic basis of beneficial effects of chromium (III) on obesity and diabetes. 2008. 317(1): p. 1-10.
https://doi.org/10.1007/s11010-008-9744-2
Singh, U. and I.J.N.r. Jialal, Retracted: alpha-lipoic acid supplementation and diabetes. 2008. 66(11): p. 646-657.
https://doi.org/10.1111/j.1753-4887.2008.00118.x
Bartlett, H.E., F.J.O. Eperjesi, and p. optics, Nutritional supplementation for type 2 diabetes: a systematic review. 2008. 28(6): p. 503-523.
https://doi.org/10.1111/j.1475-1313.2008.00595.x
Ziegler, D., et al., α-Lipoic acid in the treatment of diabetic polyneuropathy in Germany: current evidence from clinical trials. 1999. 107(07): p. 421-430.
https://doi.org/10.1055/s-0029-1212132
Cederroth, C.R., S.J.M. Nef, and c. endocrinology, Soy, phytoestrogens and metabolism: A review. 2009. 304(1-2): p. 30-42.
https://doi.org/10.1016/j.mce.2009.02.027
Papathanasopoulos, A. and M.J.G. Camilleri, Dietary fiber supplements: effects in obesity and metabolic syndrome and relationship to gastrointestinal functions. 2010. 138(1): p. 65-72. e2.
https://doi.org/10.1053/j.gastro.2009.11.045
McMurray, R.G. and L. Bo Andersen, The Influence of Exercise on Metabolic Syndrome in Youth: A Review. 2010. 4(2): p. 176-186.
https://doi.org/10.1177/1559827609351234
Dieli-Conwright, C.M., et al., Effects of Aerobic and Resistance Exercise on Metabolic Syndrome, Sarcopenic Obesity, and Circulating Biomarkers in Overweight or Obese Survivors of Breast Cancer: A Randomized Controlled Trial. Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2018. 36(9): p. 875-883.
https://doi.org/10.1200/JCO.2017.75.7526
Touati, S., et al., Exercise reverses metabolic syndrome in high-fat diet-induced obese rats. Medicine and science in sports and exercise, 2011. 43(3): p. 398-407.
https://doi.org/10.1249/MSS.0b013e3181eeb12d
Cramer, H., et al., Yoga for metabolic syndrome: A systematic review and meta-analysis. European Journal of Preventive Cardiology, 2020. 23(18): p. 1982-1993.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2021 Pakistan BioMedical Journal
This work is licensed under a Creative Commons Attribution 4.0 International License.
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments editor@pakistanbmj.com