X spells ill-health

  • Health
  • Sunday, 31 Aug 2003

Even if your cholesterol levels are normal, you may still be a victim of Syndrome X and at risk of heart disease. 

Syndrome X describes a collection of problems that increase the risk of heart attacks in individuals. 

Besides obesity, the criteria that mark Syndrome X are high triglyceride levels (>150mg/dL), low HDL-cholesterol levels, high blood pressure (>130/85 mm Hg) and high fasting glucose blood levels. However, total cholesterol levels may be normal. 

Dr Gerald Reavan was the first to associate increased risk of heart attacks with the syndrome, describing it as Syndrome X. The scientific community refers to it as insulin resistance syndrome, the plurimetabolic syndrome and the World Health Organisation (WHO) choose to call it the metabolic syndrome. 

Syndrome X is when a person’s tissues are resistant to the body’s naturally-produced insulin. Insulin is a hormone that enables our body to utilise sugar from the food we eat for energy. Our insulin-sensitive body cells have insulin receptor sites that will bind to insulin in the bloodstream. Once these receptor sites are bound to insulin, the sugar in the form of glucose will be able to enter muscle or fat cells. In doing so, insulin maintains our blood sugar level and prevents high sugar concentrations to sit in our blood. 

Too high a sugar level will result in excessive thirst, frequent urination and, if left untreated, can lead to diabetes, and, subsequently, eye disorders, heart disease, high blood pressure, kidney damage and death.  

In Syndrome X, insulin-sensitive tissue does not respond as it should and the body starts by producing even more insulin to overcome this resistance. Eventually, the ability to secrete huge amount of insulin will wane as the insulin-secreting beta calls are seriously overworked. As the number of these beta cells dwindles, Type II diabetes mellitus ultimately develops. 

Constant high insulin levels in the blood can trigger the risk factors for heart disease such as hypertension, glucose intolerance, high triglycerides and low HDL cholesterol concentrations. 

The causes of Syndrome X are believed to be genetically-linked and affects those with a family history of Type II diabetes, high blood pressure and heart attack. But before all the blame is placed on your family genes, it seems that poor diet and an unhealthy lifestyle are also contributing factors. The Western diet of highly refined carbohydrates, fast foods, fizzy drinks, saturated fat, combined with low physical activity, has resulted in an obesity epidemic. Being overweight and obese can also lead to insulin resistance and increases the seriousness of Syndrome X. 

The most frightening thing about this syndrome is that there are no symptoms to warn you of it and the your first indication that you may suffer from it is a heart attack. Hence the importance of regular medical check-ups, especially once you hit 40, including a full cholesterol test that measures triglycerides, HDL cholesterol and LDL cholesterol, plus blood pressure checks and glucose tolerance tests.  

It is currently estimated that one in four American adults have this condition and, for most of these patients, the root causes are improper nutrition and inadequate physical activity. 

Shed the pounds 

If you're overweight, taking steps to lose the extra pounds will make your body more insulin-sensitive and reduce the need for beta cells to secrete the extra insulin. Shaking off access weight calls for a modification of diet in terms of calorie intake and composition. Dr Gerald Reaven believes an optimal diet should compose of 45% of calories from carbohydrates, 40% fat, and 15% protein. 

The carbohydrates should be derived from high fibre and unprocessed food like wholegrains, bran, vegetables, fruits, seeds, nuts, legumes and lentils. Fat content should be made up of healthy fats such as olive oil, and the omega-3 and 6 fatty acids. Good sources of omega-3 are fish, soybeans, flaxseeds, egg yolk, and seed and nut oils. Omega-6 fatty acids are available from most vegetables, seeds and nut oils. Opt for complete proteins without the saturated fat. This means lean meat, skinless chicken, fish and legumes. 

Work that body

There is no doubt that anyone and everyone benefits from regular physical activity as it improves circulation, strengthens heart and body muscles, increases flexibility and results in more efficient elimination of waste products. 

Regular exercise, for at least an hour each day, has been shown to help weight-loss and decrease hunger pangs. Apart from reaping the reward of weight-loss, exercise elevates the good HDL cholesterol and also decreases insulin resistance. 

Help with nutritional supplements 

Anti-free radical nutrients In Syndrome X, LDL cholesterol is elevated and hence it is important to prevent it from being oxidised by free radicals. Oxidised LDL wreaks havoc by narrowing and hardening blood vessels, a process called atherosclerosis that leads to heart disease and strokes. Antioxidants such as vitamin A, C, E, zinc and selenium are potent free radical scavengers and hence should be incorporated into ones daily diet. 

The fat transporter 

An elevated triglyceride level is another factor in Syndrome X. L-carnitine fumarate, an amino acid, plays an important role in transporting fatty acids into cells for burning as energy for the brain, heart and muscles. It has been observed that a deficiency of carnitine contributes to high levels of triglycerides and cholesterol. 

Long chain polyunsaturated fatty acids 

The cell membrane comprises of long chain polyunsaturated fatty acids (LCPs) that act as a guard to ensure that only suitable nutrients are permitted to enter. It also plays a vital role in communication between cells such as the insulin receptors to insulin. If the integrity of the cell membrane is compromised, it allows harmful substances in, as well as the loss of sensitivity to insulin. By supplementing with LCPs, it ensures the health of cell membranes. Different varieties of LCPs are available from fish oil and evening primrose oil. 

Improve your liver function 

The liver is intricately involved in the chemical breakdown of carbohydrates, fat and proteins in our diet for energy, and as a store for vitamins and minerals. It synthesises and excretes a yellowish liquid, called bile, to help break down fat for easy digestion, absorption and elimination, and ensures that our blood sugar levels do not shoot through the roof. 

As the liver is involved in the metabolism of food and the removal of waste materials, it is important to ensure that this organ is functioning optimally. 

Herbs like milk thistle and dandelion protect and enhance liver function. Milk thistle has been shown to effect faster removal of LDL-cholesterol by the liver and to increase HDL levels in the liver’s cholesterol content. 


1. Blackburn G.L., Bevis L.C. The Obesity Epidemic: Prevention and Treatment of the Metabolic Syndrome. http://www.medscape.com/viewarticle/441282 

2. Cabot S. Can’t lose weight? You could have Syndrome X. Griffin Press (2001) 

3. B. Isomaa et al. Cardiovascular Morbidity and Mortality Associated With the Metabolic Syndrome. Diabetes Care [24(4): 683-689, April 2001] 

This article Is courtesy of Biolife. For more Information e-mail starhealth@thestar.com.my. The information is intended for educational purposes only. It is not provided in order to diagnose, prescribe or treat any disease, illness or injured condition of the body. Those individuals suffering from diseases, illness or injury should consult their physicians. 

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