Immunity and Metabolic Syndrome

The Metabolic Syndrome and the Immune System

The metabolic syndrome is not a disease alone but is a cluster of related disorders that include:

  • Excess fat around the waist (>40 inches or more (men)and >35 inches or more for women).
  • Blood pressure of 130 /85 mmHg or higher, or being on blood pressure medication
  • Triglycerides above 150 mg/dl
  • Fasting blood glucose greater than 100 mg/dl, or being on glucose-lowering medications
  • High density lipoprotein (HDL) less than 40 mg/dl for men or less than 50 mg/dl for women.

A person can be considered to have metabolic syndrome if they have at least three of these conditions.

An important function of the immune system is to provide healthy, short-term (acute) inflammation that is normal in most situations. This is necessary for the immune function to battle injuries made from disease-causing bacteria, and viruses (antigens). What results is redness, swelling, heat, sometimes fever, and pain.

However, one of the unhealthiest conditions is paradoxically chronic inflammation that ultimately can result in complications, and even a greater risk of death. The greater overreaction of immune system components is often referred to a “cytokine storm”. Cytokines are small proteins that are used to convey information. I call them “messengers”. They play a crucial role in the development of diseases and how your cells are able to respond. In a sense, cytokines are the language of your immune system.

Chronic inflammation can come from the accumulation of belly fat as well as low levels of HDL cholesterol, which normally can have anti-inflammatory properties. (Scott Butsch, MD, Director of Obesity Medicine at the Bariatric and Metabolic Institute at Cleveland Clinic.)

“Those with metabolic syndrome typically have low levels of HDL and thus, have less of its beneficial properties to fight infection”, says Dr. Butsch. This can also occur with aging, poor diet, and other unhealthy practices.

How Does Obesity affect the Immune System?

“One of the many reasons obesity is such an unhealthy thing is that fat tissue produces loads of inflammatory cytokines. So even on a good day, an obese person has a lot of inflammatory biomarkers (signals) in their system. When infected by the coronavirus, for example, their starting point is already worse, they are already more inflamed than they should be. In any case, the coronavirus pandemic was a stark reminder of why your immune system is so incredibly important and why we should all benefit from understanding it better.” (Immune: A Journey into the Mysterious System that Keeps you Alive. Philipp Dettner. 2021).

According to Dr. Butsch, “obesity impairs the response of immune cells that “remember past viruses so you can attack that virus effectively the second time you may encounter it. This is why obesity is linked to an increased failure of vaccines”

How Can You Improve Immunity with Metabolic Syndrome?

“Losing weight is the key to improve your metabolic syndrome biomarkers as well as your immune system responses. When you lose some extra weight, your fat cells shrink and cause an improvement in systemic chronic inflammation,” Dr. Butsch says. Increasing your physical activity may also help. In this case, this is one time that eating less and moving more is primary to decreased inflammation, metabolic syndrome biomarkers and its complications from infectious diseases.

Weight Loss: The Good News

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The Metabolic syndrome may not be a household phrase, but it should be. It’s been estimated that more than 30% of the U.S. population may have this disorder. It is defined as a cluster of symptoms that include excess fat around the waist, high blood sugar, high blood pressure, low levels of HDL and high triglyceride (blood fat levels). Diagnosis involves having at least three of these conditions.

The good news is that even a small weight loss (at least 10% of your current weight) may have a positive effect on your health.

Going Vegan?

Lose weight and live longer on a vegetarian diet.? From the Harvard Medical School Health Guides

There is a lot of attention being paid to switching to a plant-based diet. There are many published articles and recipes on plant-based diets to achieve a lower body index, lower blood pressure, and reduced risks for heart disease, diabetes, type 2, cancer, and longevity. Plenty of attention is being paid to the health benefits of those centenarians living in the Blue Zones, particularly ones that live in a plant-based environment as well as those with a more modified vegetarian approach. I suggest you search for more posts on these excellent topics on the “Blue Zones” on this blog or check at your local library.

If you’re thinking of going vegetarian but worried about making such a big change, there are several ways to try to see if you can manage a diet with less animal protein.

Here are some options:

  • A flexitarian diet – meat is limited as a condiment and not considered the main attraction. Use vegetables, appetizers instead.
  • Semi vegetarian diet (no red meat)
  • Pescatarian – avoid meat and poultry but eat fish and seafood.
  • Lacto -ovo -vegetarian – skip all meat, fish, and poultry but include dairy and eggs in your diet.

If you’re trying to lose weight -go heavy on fruits, vegetables, and whole grains but limit foods high in saturated fats (ice cream, whole milk, and cheese.) An important aspect of losing weight is often not what you eat – but how much you eat to keep daily calories in check. After all, vegan foods have calories, too. And some are not as healthy as they could be.

In the U.S. Standard diet (SAD) our meals and snacks are taking on gargantuan proportions. “The food industry decided they had to make portions larger to stay competitive and people got used to larger sizes very quickly. Today, normal sizes seem skimpy,” says Marion Nestle, PhD, MPH, Professor of Nutrition and Food Studies at New York University.

When eating out, the transition to a plant-based diet is easier than than you might think. Fill your plate with vegetables – cooked, raw, or in a salad. Check out the sides that are offered. Then gradually introduce all vegetarian meals once or twice a week and if you like, increase it until you are as “vegan” as you want to be. Try a few meals from a local vegan restaurant, then try a few on your own. You may be surprised. Bon Appetit!!


INTERMITTENT FASTING?

“The weight-loss idea is quite appealing: Limit your eating to a period of six to eight hours each day, during which you can have whatever you want.” However, is it effective for weight loss?

“Almost every type of diet out there works for some people,” he said. “But the take-home supported by this new research is that when subjected to a properly designed and conducted study — scientific investigation — it is not any more helpful than simply reducing daily calorie intake for weight loss and health factors.”

Nevertheless, intermittent fasting may act as a positive tool for some people to practice the act of mindful eating. (SJF).

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CHOOSING A PLANT-BASED DIET?

Michael Pollan started it – “Eat food, not too much, mostly plants”. In Defense of Food: An Eater’s Manifesto and The Omnivore’s Dilemma.

Many people are taking more of an interest in plant-based diets. People are switching for various reasons – weight control, sustainability, the environment in general, health reasons, media hype. Food companies load their products fortified with grams and grams of protein in order to “make up” for an alleged protein deficit – however, there are plenty of non-meat sources of protein found in plant foods. Most Americans get enough protein. “Protein is not the key for weight loss and animal protein is not the healthiest food we can eat. Carbs are not the enemy – they are a source of energy, and are staples in the diets of the longest-living people in the world.” Garth Davis, M.D. Proteinaholic: How Our Obsession with Meat is Killing Us and What We Can Do About It. 2015


High amounts of protein are not needed by most consumers unless there is a medical reason. The adult RDA or Daily Value is about 50 grams for most adults. That amount can be found in only 3-4 ounces of most meats – or a portion about the size of a deck of cards.

People have tried a number of diets – Paleo and Keto are of the low carb genre resulting in high protein and high fat diets. Since then, weight gain has taken over with an obesity rate higher than ever along with its companion- diabetes type 2.

Michael Pollan refers to the American diet as ‘the “American paradox” – the more we worry about nutrition, the less healthy we seem to become”.

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Is Your Liver Fat?

Most people have never heard of NAFLD, a.k.a. non-alcoholic fatty liver disease, HOWEVER, nearly one in four adults in the U.S. has NAFLD. NAFLD is more common in obesity and diabetes type 2.

In the long term, NAFLD can cause fibrosis (scarring) of the liver that eventually can cause impairment of normal liver function. Advanced scarring can lead to cirrhosis, an irreversible condition that can lead to liver failure. The only long-term treatment is a liver transplant. No drugs are currently approved to treat it.

The emphasis should then be on prevention with the usual recommendations: Eat less processed foods, lose a little weight if necessary, and more exercise comes to mind – healthier lifestyles in general, e.g. less alcohol.

Normally most of the blood draining from the GI tract (gut) travels directly to the liver before entering general circulation. This exposes the liver to toxins that may cause oxidative stress and chronic inflammation.

There are new clinical trials on subjects diagnosed with NAFLD to investigate the influence of probiotics on the microbiome residing in the GI tract. These findings suggest that the probiotic – prebiotic blends can stop the progression of liver disease, liver damage and liver inflammation when compared to a placebo. Interesting???

Richard Moore. Life Extension: The Science of a Healthier Life, May, 2022.

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The Gut Microbiome

Body Image Acceptance: Health at Every Size

The obesity epidemic rages on with no end in sight. Unfortunately, as we focus more on weight control and body size, more people are affected by being the victims of fat shaming. Even health professionals are often guilty by not addressing the weight problem with their patients – patients become ashamed due to the lack of help they experience from their physicians or the professionals themselves may be victims of the epidemic. They may be crying out for help for weight loss advice and interpret the silence as a shameful topic. This can result in more cases of body dissatisfaction, more dieting attempts like yo-yo dieting and/or avoidance of reporting eating disorder symptoms such as bulimia and anorexia.

There is an alternative approach – Health at Every Size (HAES). This concept focuses more on healthy weights rather than how much a person weighs. A study in 2011 called the Succeed Foundation conducted a Body Image Survey that aimed to improve body image and prevent eating disorders. The survey revealed the following:

  • “30 percent of women say would trade at least one year of their life to achieve their ideal weight and shape.
  • 46% of the women say have been ridiculed or bullied because of their appearance.”

“ HAES approach briefly states: 

  • Accepting and respecting the natural diversity of body sizes and shapes.
  • Eating in a flexible manner that values pleasure and honors internal cues of hunger and satiety.
  • Finding the joy in moving one’s body and becoming more physically active.
  • Reference: https://haescommunity.com/pledge/

Citation

Evelyn Tribole, M.S.,R.D, Elyse Resch, M.S., F.A.D.A., C.E.D.R.D.

Intuitive Eating: A Revolutionary Program That Works.

Low Carb Diets: A Brief History

“Conventional scientific opinion says that eating too many calories without doing enough exercise to burn them off again causes weight gain. But this prevailing energy balance model faces a fresh challenge from the carbohydrate-insulin model (CIM) following the publication of a new article in The American Journal of Clinical Nutrition.

The CIM argues that it is the quality of the food a person eats — rather than the quantity — that determines whether a person will gain weight and eventually develop obesity. Consuming large quantities of processed and starchy carbohydrates in particular sustains a cascade of hormonal and metabolic changes that result in the storage of excess energy as fat.

Crucially, the CIM says that the urge to eat too many calories is a result of accumulating excess fat in the body, not its cause. This directly opposes the energy balance model.

So which model is correct? The answer has huge implications for the diets of billions of people, as well as the prospects of overcoming the obesity pandemic.

This week, Medical News Today spoke with several experts from both camps about the merits and shortcomings of each model. There is one thing that both models agree on: the sugars and refined grains that make up 42% of the calories in the U.S. diet should be drastically reduced.

To learn more about both models and the debate that rages around them, jump to “Obesity and weight loss: Why overall calorie intake may not be so important.”


Tim Snaith
Newsletter Editor, Medical News Today

What Does “Fattening” Mean?

Sally Feltner MS, PhDDiet and Health, The American Plate November 15, 2019 1 Minute

Spaghetti, Noodles, Tomatoes, Pasta

A term used for decades to describe foods that would make one gain weight was the expression of  “fattening”.

Moderate avoidance (though not totally responsible) of these foods became the conventional wisdom to help avoid weight gain and became a dieter’s mantra.  In fact, food history indicates that body-weight was relatively stable until about the late 1990’s in the United States. At that time, dietary advice had shifted to low-fat diets with the added disadvantage of food companies at the time replacing fat in their food products with more carbohydrate-containing foods.

Keep in mind- basic biochemistry tells us that all carbohydrates (except for dietary fiber) are eventually converted to glucose in the body to be used for energy.  We are further reminded that some carbs are referred to as “starchy” (bad) and others as “non starchy” (good ).

The following article further elucidates the term of what are now commonly referred to as “white foods” and refers to their state of processing – refined or unrefined and how they may participate in our current obesity epidemic.

CLICK HERE.

Weight Gain and Inflammation

“Researchers have found a possible explanation for why being overweight is harmful. This new knowledge may provide new drugs for heart attack, stroke, cancer and chronic intestinal inflammation.”

Weight control programs based on lifestyle changes that focus on behavioral strategies for caloric intake and increasing physical activity have been demonstrated to be successful.

CLICK HERE.

Diet and Lifestyle in Diabetes Control

Notes: Sally Feltner, M.S., Ph.D.

Diabetes blood sugar control is getting worse for U.S. adults. By Bobbie Berman, June 14, 2021 .

The study was published in The New England Journal of Medicine, Fang, Michael, Ph.D., et al. Trends in Diabetes Treatment and Control in U.S. Adults. 2021; 384; 2219-2228, 

After scanning the original article in NEJM for any mention of the role of diet in the control of glycemic parameters, I found none.

In the article above by Mr. Berman, there is only a mention of diet in the following manner:

“A person with diabetes can still eat the foods that they enjoy, just less frequently or in smaller portions.

Follow the advice of a doctor or dietitian, eat a varied meal plan that includes foods from all groups, and stick to the recommended amounts.

Some people with diabetes should eat at the same time each day, while others have a little more flexibility when it comes to the timings of meals. Portion size is also very important in people with diabetes. Speak to a dietitian about the best way to manage this.”

Finally, someone gave it at least an after thought. I had a close relative with diabetes type 2 who when asked if he had ever seen a certified diabetic educator (CDE, often a dietitian,) or spoken about diet with his physician. He always said “No”. 

Perhaps if doctors were more educated about the effects of diet on diabetes control, patients would be more compliant with these recommendations. I am not a certified diabetic educator, but am retired as a registered dietitian. I strongly recommend that if you are diabetic, consult with your primary care physician and try to see someone with the proper credentials about diabetes care. (Sally Feltner)

Take a look at the following article on a study done to compare lifestyle factors vs. metformin ( a common compound taken by diabetic patients for glucose control) Spoiler Alert: LIFESTYLE FACTORS WIN OUT OVER METFORMIN and prevention is the key.

CLICK HERE.