**EP414: Modern (Metabolic) Syndrome**
**Dr. Auric Bishop:** Welcome, my name's Dr. Auric Bishop. I'm a cardiologist, an author, and a keynote speaker. I'm the CEO of the Healthy Heart Network. I'm all about trying to help people live as well as possible for as long as possible. Heart disease is huge in Australia. Every 20 minutes, someone suffers a heart attack. Most of these could probably have been avoided if only we knew what to do. This podcast is all about helping you understand blood pressure, weight, and cholesterol for better health. If you enjoy this podcast, I would be honored for a five-star review. You can share it with your family and friends. It may well save someone you love.
**Warwick:** G'day, it's Warwick here, and I hope you're well. Thank you for joining me. Thank you for joining my podcast and videocast station. Today, I'm going to talk about reversing the metabolic syndrome. But it could, I guess, just as easily be called reversing the modern syndrome because it really seems to be a scourge of modern times.
Well, I'm going to talk about what the metabolic syndrome is, what sort of tends to be driving it, how you might be able to reverse it, and then we'll call it a day. Sometime in my next few podcasts, I'm going to be talking about saunas. If you're interested in saunas—that's how we say it in Australia—if you're from Northern Europe, you would call them saunas, a different way of saying it. I'm also going to be talking about a number of really important cardiovascular risk predictors that are often not tested. So, you may not be interested in reversing the metabolic syndrome, but you might tune in for those other two podcasts, which could well be in the future or may have just been released. Either way, you might like them, so I thought I'd let you know about them.
So, let's talk about the metabolic syndrome. What is it? Well, is it a disease? I guess a disease, strictly speaking, is defined as something that gives rise to a symptom or a loss of function. To a large degree, the metabolic syndrome isn't necessarily a disease itself, but it is a warning system. It really is a sign that there could well be significant problems ahead. The metabolic syndrome is a number of things that all come together and drive or are closely linked with significant increased risk of heart disease, stroke, type 2 diabetes, renal disease, and really importantly, dementia.
Well, that sucks, doesn't it? I mean, these are really common conditions. These are the sort of chronic diseases of our modern society. But really, more specifically, what is metabolic syndrome—or should I call it, as I said, modern syndrome? Well, the definition revolves around having a number of criteria or characteristics. It's said that you have to have three of the following five:
1. Elevated waist circumference. That's that sort of beer drinker's belly sticking out in front of you. It's the weight that is directly related to you putting the holes in your belt out, not in.
2. High triglycerides.
3. Often seen with high triglycerides: low good cholesterol or low HDL cholesterol.
4. High blood pressure.
5. Elevated fasting blood sugar.
But here's the deal. Because this is something that is long-term, it doesn't make any sense or any point if you have any of those factors to actually be waiting until you've got full-blown metabolic syndrome to do something about it. So hopefully, you're listening, thinking, "Oh, I'm going to avoid actually getting the diagnosis in the first place," and that would be super sensible.
Really, at the heart of it all is a thing called insulin resistance. This is where your cells—pretty well all the cells in the body—stop responding properly to insulin. Insulin is a storage hormone. Insulin is what's released when we eat, particularly carbohydrate-based foods; to a lesser degree, protein-based foods and fats don't move the needle at all. So, insulin's initial role was really around the storage of energy. We need to look back to our evolutionary past to understand that when we were on the African plains millions of years ago, rich energy from food in the form of carbohydrate would have been seasonal and infrequent.
So, our body had a mechanism for converting that energy, that sugar, into fat, and it did it through a hormone called insulin. But we've still got that hormone, and these days, exposure to carbohydrate is nowhere near as infrequent or limited as it was millions of years ago, and there, my friends, is the rub. As we find ourselves confronted with more and more carbohydrate in our diets, we store this excess calories as fat. That increase in fat starts to reduce the way the body is able to respond to insulin.
As we fail to respond to that insulin, we seem to have more and more consequences of raised insulin levels and increasing fat. We start to store fat around our organs; we call that visceral fat. We start to get higher levels of blood sugar because those carbohydrates in the bloodstream are not being absorbed by the cells within the body. Higher triglycerides are a sign of energy moving through the body looking for somewhere to be stored. Inflammation, which seems to be linked to visceral fat tissue or fat around organs and insulin levels, and we get problems with the cells in the pancreas called the beta cells that produce insulin.
So, I've alluded to carbohydrate and carbohydrate exposure being central to this, but of course, it's compounded. If you're not exercising, you're not burning calories, then consumption of excess calories is problematic. So, a sedentary lifestyle is a big deal. Lack of exercise is a big deal. Sleep deprivation is a really big deal. Chronic stress feeds into this, and of course, as we like to, we can look to our parents for genetic predisposition, which can drive that condition.
That was incredibly obvious for me in later years. I grew up with a very good friend whose family genes lent towards insulin resistance from a relatively early age, whereas my genes did not. When we stood side by side, we were the best of mates, but physiologically, we were quite different. I didn't tend to put on weight easily; I tended to have the metabolic profile for someone who was a long-distance athlete, and that's sort of what I did through my life. My best friend tended to put on weight easily in his later life, but in his younger life, he was a power athlete—quite a different metabolic profile altogether.
So, never forget the importance of your parents in setting the stage for how your body may well function.
What can you do to reverse insulin resistance if you think you've got it or if it actually has been demonstrated? Well, probably the first and easiest thing is to cut your carbohydrates. If you're curious about how to do that, on my website, I've got a weight loss course. So, if you go to Dr. Warwick Bishop, go to the website or go to the Healthy Heart Network, either of those webpages, go to the resources, check on resources, which has a drop-down box, and look for the weight loss course. You can find my weight loss course there. It's about 20 bucks, 25 bucks. It's got lots of videos, lots of downloads, lots of hints and tips, and it's really all about reducing carbohydrates.
The most important thing you can do is reduce processed carbs and start to focus on whole foods. Think Mediterranean diet, actually, and maybe even measure your carbohydrates for a while and go low carb. I cover a lot of that in that course if you are interested.
Once you've attended to your diet, it's time to move your body. It's time to exercise and actually burn some of those calories. It doesn't matter what you do; you just have to do it. You could walk, you could pogo stick, you could do strength training, you can swim, cycle, ride a horse, ride a motorbike. It doesn't really matter. As long as you're being physically active, use your body. If you like going to the gym, go to the gym; if you don't like going to the gym, then don't, because you won't sustain it. Please find something that you really enjoy that you can sustain and continue doing.
Remember to manage your stress. That chronic stress will drive things like cortisol, and that will be detrimental to the way your body functions. It puts your body into the wrong state for health and wellness; it gets the body releasing sugar into the bloodstream and driving change that would be problematic in the long term.
If you're carrying too much weight, do check out my weight loss course because only five to ten percent of body weight loss can have a massive difference on where you sit with regard to insulin resistance. And remember, you're not just thinking about the fat that's around your tummy; what you're really wanting to move is the fat that's gripping and strangling your organs silently that you're not even aware of.
The single best indicator if you're getting it right is if your belt is coming in, not going out. So, if you can bring your belt in a notch or two or three, or if you really, really need it beyond that, then you are kicking goals. You're doing the right thing. I often ask my patients, "Have you lost any weight, or do you think you...?" You know, after I've got them to embrace a reduced carbohydrate diet, I ask, "Do you think you've dropped any kilos?" They go, "Oh, I don't know, doc, I don't know, I haven't checked, I haven't weighed." And of course, what I point out to them is I don't need you to weigh. What I really need you to do is tell me what's happened to your belt. So that is your honesty strap.
So, what can we say about, well, the modern-day syndrome or the metabolic syndrome? It's something to be aware of. It's not a disease of your own. It is something that is multifactorial, and you can address different aspects of it. But it turns out that addressing each of the aspects has such a lot of overlay that eating well, reducing carbs, exercising, sleeping well, and reducing stress will help all aspects. You need to try and implement these changes in a way that's sustainable, because if it's not sustainable, it won't make a difference.
I hope that helps. I hope if you are on that slippery slide towards metabolic issues that you start to embrace some change and make a real difference. I am going to be talking about saunas in some of the next episodes—not sure which one yet. I'm also going to talk about some of the most underrated tools in your health. Stay tuned. Keep that subscription or keep following me if you wouldn't mind.
If you have enjoyed this podcast, please share it. If you've got something nice to say about it, please write a review. I'd love that. If you've got something not so nice to say about it, we can keep that between us. For now, I am going to wish you the very best. I do hope you live as well as possible for as long as possible. Take care and bye for now.
Did you know that coronary artery disease kills one in four people? So, most of us are likely to carry some risk or know someone who does. If you're interested in finding out more about how to evaluate that risk, check out www.virtualheartcheck.com.au. It'll give you information about risk and what else can be done to be even more precise.
