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Metabolic Syndrome: How 55 Million Americans Can Overcome It


By Scott Isaacs, M.D. and Fred Vagnini, M.D


Perhaps you have heard of metabolic syndrome. Or, maybe you’re like millions of others who have never heard of it.  Certainly, it has not been a condition that grabs headlines like diseases such as cancer or coronary heart disease.  But still, it’s a serious health condition. Without lifestyle changes and treatment, it increases your risk of  an early death from a heart attack or stroke.

How prevalent is metabolic syndrome? It estimated that 55 million Americans have metabolic syndrome.  That’s 27 percent of the population.  Fortunately, metabolic syndrome is receiving more and more recognition as a serious medical condition, and more health professionals are diagnosing it.

What Is Metabolic Syndrome?

First, the term metabolism refers to the chemical and physical changes that take place within the body and enable its continued growth and functioning. A syndrome is a cluster of symptoms that characterize a specific disease or condition. However, metabolic syndrome is not actually a disease in the usual sense of the word, rather it is a cluster of disorders. So, it would be technically inaccurate to refer to metabolic syndrome as having symptoms.  Accordingly, to define it, we must look at the disorders or components that make up the syndrome.

You may have heard metabolic syndrome also being referred to by other names. It was called Syndrome X during the years that the medical community didn’t fully understand the condition and the complex relationship between the disorders.  It has also been referred to as insulin resistance syndrome since insulin resistance is a core factor in the development of the condition.

Criteria for Metabolic Syndrome

There is some disagreement in the medical community over what constitutes metabolic syndrome; however medical experts have established a criteria of disorders, which one must meet to be considered as having metabolic syndrome. Anyone with three or more of the abnormalities listed in the criteria is considered as having the syndrome.

  • High Fasting Blood Glucose.  This means blood sugar, or glucose, levels are high when tested after fasting, but are not high enough to be classified as diabetes. High glucose levels are often a sign of insulin resistance, the body’s inability to use insulin efficiently.
  • Abdominal obesity. The fat around the belly, or “central obesity,” is a key risk factor.
  • Low HDL cholesterol.  The high-density lipoprotein cholesterol, or HDL, is commonly known as the “good” cholesterol.
  • High triglycerides. Triglycerides are a form of fat the body uses for energy. The medical term for high triglycerides is hypertriglyceridemia.
  • High blood pressure.  High blood pressure occurs when the force of blood flowing through the artery walls is too high.  High blood pressure is also referred to as hypertension.
  • This definition, or criteria, for metabolic syndrome is the most commonly accepted one in medical circles. It was developed by the National Cholesterol Education Program of the National Heart, Lung, and Blood Institute.

The late anthropologist Margaret Mead once said, “It’s easier to change a man’s religion than his diet.” Most of us who have ever tried to lose weight understand the truth of that statement. Millions of Americans struggle to lose weight. If you look at the best-seller lists, you’ll find diet books at the top of the charts. Each one promises something new and easy, whether it be a low-carbohydrate or low-fat diet or one that comes from a celebrity’s kitchen or even the Bible. Yet, all too often we find we cannot sustain the latest fad diet. Often, we lose weight but gain it back.

History suggests to us that the fad diets don’t work well over the long term.  The best approach is finding a food plan that you can live with. Weight loss and balanced nutrition are important keys to preventing or reversing metabolic syndrome.

Finding the Right Food Plan

There is not one specific diet for overcoming metabolic syndrome. There is no “magic pill.” You have heard it before, but the words are still true. In order to lose weight, you need to burn more calories than you take in. The key to weight loss is developing a healthful diet plan, along with a physical activity regimen, and following it consistently.

Choose a food plan that works for you. Many weight loss experts say never choose a food plan that you could not live with the rest of your life. In other words, choose a balanced, nutritious diet over a fad diet that delivers quick results in the short term, but fails you over time.  Then once you choose a good plan, stick to it. Stringing together days of healthful eating will deliver weight loss. You will find that every ounce of energy you put into losing weight is worth it. The benefits of losing weight are many.

Benefits of Losing Weight

If you have lost weight in the past or have spoken to others who have, you understand how weight loss can bring improved health, more energy, and a greater sense of well-being. The Endocrine Society, an international organization of endocrinologists, has researched the benefits of weight loss and report the following:

  • Weight loss reduces insulin resistance; reduces risk of developing type 2 diabetes.
  • Losing just 5 to 15 percent of total body weight can lower chances for heart disease or stroke, because weight loss improves blood pressure, cholesterol levels, triglycerides, and decreases inflammation in the body.
  • A weight loss of 10 to 15 pounds reduces the development of osteoarthritis of the knee, a degeneration of the cartilage cushion between bones in the knee.
  • Loss of 5 to 10 percent of total body weight can raise HDL.
  • For every two pounds lost, LDL decreases by 1 percent.

How We Became Fat

Thousands of years ago, food was scarce. There were no supermarket shelves bursting with foodstuffs.  Our ancestors were known as hunters and gatherers. If they found nuts and berries or killed some wild game, they ate. If they did not, they went hungry. In looking for food, they stayed on their toes, literally and figuratively. If they could find food only on the high branches of a tree, they climbed.  If they had to chase an animal to eat, they ran. Likewise, if an animal decided that they were the prey, they ran some more. Exercise wasn’t an option. It was necessary for survival.
Because food was not readily available, their bodies adapted—they became “programmed” to easily convert glucose to fat easily and store it. This was a valuable resource—when food wasn’t available, the body could tap into its reserves.

Now, zoom ahead to a couple hundred years ago. A number of innovations came along in rapid succession. The automobile, which led to the rise of the suburbs, shopping malls, changed the way we lived. We no longer needed to walk several miles a day. Now we drove. Factories produced finely milled grain. Refrigeration allowed the shipment of perishable foods across the world.  As time went on, we produced more and more food products.

Today, food is big business. It is attractive, relatively inexpensive, and inescapable.  Dozens of times daily, we are exposed to enticing commercials on television, radio, newspapers, and on the Internet. We Americans spend nearly $1 trillion on food each year, according to the U.S. Department of Agriculture. We are spending more and eating more.

Clearly, our culture has advanced, but our bodies are still like those of our ancestors who had to hunt for food. So, when we eat more than we need, we simply store the extra calories as fat. Looking back at the evolution of our eating patterns, it seems almost predictable that we would become a nation that is overweight.

Tips for Succeeding at Weight Loss

Set Realistic Goals
Don’t rush yourself. A weight loss of one or two pounds a week means you are succeeding.  It may not seem like much if you are eager to shed pounds, but the lost pounds add up. Think of it this way: If you lose 1 pound a week, by the end of the year you’ll have dropped 50 pounds. That’s an enormous amount of weight.
Remember that crash diets usually result in just that…a crash. Starving yourself, cutting your caloric intake to the minimum, usually results in “falling off the wagon.” Many nutrition experts say adopt at food plan that you can live with for the rest of your life.

Determine How Many Calories You Need
How much weight do you have to lose? Then, begin with the amount of calories each day you take to maintain your present weight.

  • Inactive people require 10-11 calories per pound. If you’re a 150-pound woman and inactive, that means if your diet contains 1500 calories per day, you will maintain your weight.
  • Mildly active people, those who exercise rarely but are usually on their feet, burn about 13 calories per pound. That works out to 1,950 calories a day for a 150-pound woman.
  • Active people, who do at least three 30-60-minute workouts per week, burn 15 calories per pound daily. That’s 2,250 calories daily for a 150-pound woman.

If you’re obese, you likely weigh a bit more than 150 pounds. So another formula to figure in is this: 3,500 calories equals 1 pound of body fat. If you can cut 250 calories a day—the equivalent of a chocolate bar—you can lose one-half pound a week. Ideally, you should cut 500-1,000 calories a day, which can help you drop 1-2 pounds a week.

Balance Your Food Groups
For those with metabolic syndrome, an optimum diet would be made up of about 25 percent protein, 45 percent low carbohydrate, and 30 percent fat, but exact percentages aren’t critical. The fat should be primarily unsaturated, which is the more healthful kind of fat for your body

Choose the Right Carbohydrates
Many processed carbohydrates contain finely milled grain. By milling out wheat bran and wheat germ, these products have been stripped of many minerals, vitamins, fiber, proteins.  The white flour in these products is rapidly converted to sugar and causes a spike in blood sugar levels. Choose “complex carbohydrates,” like vegetables, fruits and whole grains that will be metabolized more slowly.

Develop Good Eating Habits
Part of eating right is developing good eating habits. That doesn’t just mean eating the right foods; it means adhering to a schedule and listening to your body. Eat at set times. Eat when you are truly hungry. Don’t let your body be overcome by cravings. Eat a breakfast, lunch, and dinner at the same time each day, and have a healthful snack at about the same time each day as well.
Choose healthful foods. Do you fill your snack times with cookies? Try fruit instead. Do you fill up on bread before a meal? Have a salad. If you’re in a fast-food restaurant, order a healthful side dish instead of fries; drink water instead of soft drinks or fruit juices.

Control Portion Sizes
In this era of “supersizing,” it is easy to overlook the importance of controlling the size of our food servings. Don’t have a measuring cup handy?  Use the “thumb and fist” method for measuring. Here’s an easy guide to judging portion size.

  • Thumb tip: 1 teaspoon, as in a serving of mayonnaise or margarine.
  • Thumb: 1 oz., as in a piece of cheese.
  • Handful: 1 or 2 oz. of snack food, as in a handful of nuts.
  • Palm: 3 oz., as in a cooked serving of meat.
  • Fist: 1 cup of cereal flakes

Control of portion sizes works in both directions.  Most people who diet do not eat enough vegetables and fruits.  You should work on increasing the portion sizes of vegetables and fruits.  When it comes to weight loss, vegetables and fruits should be consumed to excess.  The more you eat, the more weight you will lose.  Why?  Because these miracle foods are high in nutrients, fiber and water and low in calories.  They help you feel full and satisfied with out adding extra calories.  The best way to be successful losing weight is to keep yourself full of these healthy foods, so you have less room to eat higher calorie foods.

For a personalized food pyramid plan, visit the Web at:

Keep a Food Diary
People who keep a daily diary of what they eat, lose more weight.  A diary is an effective way to become aware of what you’re eating and how much you’re eating. Often, when we are operating out of poor, established, eating habits, we may take in far more extra calories a day than we realize.
Write down everything you eat and the approximate size of the serving. Note the times you had a meal or a snack. You can keep track of the calories, too, but if you’re eating the right amounts of healthful foods it shouldn’t be necessary, at least not after the initial few days when you’ve established your setup. After a week, look over your notes. Are you eating good foods? Are you varying your diet so it doesn’t get boring? Are you “slipping”?  If so, don’t berate yourself.  Pick yourself up and return to your plan.

Sample Weight Loss Diet

  • Egg-white omelet with vegetables; 1 cup fat-free yogurt; several servings of fresh fruit or
  • 1 cup fat-free cottage cheese; several servings of fresh fruit or
  • Two eggs; 2 slices of turkey bacon, soy sausage or serving of fish/chicken; several servings of fresh fruit


  • ½ sandwich with 2 oz. Fat-free lunch meat; several servings of vegetables and fruits or
  • Several servings of low-fat vegetable soup or
  • 1 large salad with hard boiled egg whites, chicken or turkey and low fat dressing or
  • 3-5 oz. of fish, chicken or turkey with several servings of vegetables and fruits


  • 1 large salad with fat-free dressing; several servings of vegetables and fruits and
  • 3-5 oz. Fish, chicken or turkey or
  • 3-5 oz. Lean red meat (once a week)

Snacks (3 times a day)

  • fruits
  • vegetables
  • ½ serving (2-4 oz.) tuna or chicken or
  • 2 slices soy cheese or low-fat cheese or
  • ¾ cup unsweetened breakfast cereal; ½ cup skim milk;
  • 5 whole grain crackers

Plan before You Shop
Don’t go into a supermarket unprepared. Make a shopping list with appropriate food choices and stick to it. You don’t want to fall victim to impulse buying. Products in supermarkets are strategically arranged to maximize customer purchases. You’ll notice certain products at eye level while others are place on lower shelves, and not as easy to notice. Buy exactly what you need and nothing more. You’ll find that not only is this good for your diet, it’s also good for your pocketbook.

Dining Out
Going out for meals is more popular than ever in our fast-paced society, but if you’re trying to lose weight, it can be a challenge. Though government regulations now require many restaurants to post the nutrition information of their menu items, this food value information is not always available. Here are a few things to keep in mind when dining out:

  • If the restaurant has a Web site, look it over for nutritional information before you go.
  • At the restaurant, eat a salad (with fat-free dressing) before your meal. The greens are full of nutrients and fiber, and the dish will limit your intake of the entrée.
    Have a side order of steamed vegetables in addition to your regular meal.  The vegetables will help you fill up and eat less of the other food.
  • Avoid appetizers. They’re often high in calories and fat. True, that’s not always the case, but you won’t miss the dish – and you’ll save a few dollars.
  • Order sauces, butter and dressings on the side.
  • If having pasta, have tomato-based sauces. Tomatoes are rich in antioxidants – and not rich in the artery-clogging substances that are found in cream-based sauces.
  • Don’t eat any bread if possible. Those slices will fill you up with calories in no time. If you’re at breakfast, eat whole wheat bread or toast with no butter.
  • Drink water, diet soda or unsweetened tea. Avoid beer, alcohol and soft drinks.
  • Have a fruit cup for dessert.
  • Substitute veggies for potatoes or fries. Potatoes are a high-starch item; French fries combine that starch with hot vegetable oil, which shoots the carb and fat counts off the scale.

Cooking at Home
At home, you have total control over your meal. Here are a few ideas to make those meals even better:

  • Cut all liquid calories except skim milk. (Diet soda and other diet beverages, which have less than ten calories per servings are OK.)
  • Eat fruits and – especially – vegetables whenever you can; eat first before a main meal to calm your appetite.  Remember, when it comes to fruits and vegetables, “more is better!”
  • Balance your meals and snacks. Include a small amount of low-fat protein with each meal and snack whenever you can.
  • Add spices to your dishes. Just because they’re good for you doesn’t mean they have to be bland.
  • Cut visible fat on meats and chicken.

Do a Self Inventory
After the first few weeks, take an inventory of your weight loss plan. How do you feel? Thanks to improved nutrition, you are probably feeling better in addition to having lost weight. Are you sleeping better? Do you have more energy? If so, give yourself a pat on the back.

Recommended Foods

Chicken and poultry: it’s high in protein and B vitamins. Chicken and turkey are good choices. Avoid the skin, which is full of fat.

Beef and pork: these meats are high in protein, B vitamins, and stearic acid, a saturated fatty acid, which does not raise cholesterol. Choose lean cuts—the less fat, the better

Fish: choose cold-water fish such as halibut and salmon, which are high in protein and Omega-3 fats.

Beans: they are high in fiber and full of protein. kidney beans and soy beans a good choices. Soy beans come in many forms, from soy milk to tofu.

Olive and canola oil: these are monounsaturated fats and contain Omega-3 fats. They are still fats, however, so watch portion sizes.

Nuts: contain monounsaturated fats, minerals, fiber, and Omega-3 fats. Almonds and walnuts are good choices. Although healthy, nuts are also very high in calories and you should only have very small portions of nuts.  Peanut butter, which is extremely high in calories and fat should be avoided altogether.

Fruits and vegetables: If there is a so called “miracle food” for weight loss this is it.  Fruits and vegetables are high in nutrients and fiber and help you feel full.  Fresh fruits and vegetables are best but frozen and canned can also be good.  Avoid dried fruits and fruit juices.

Whole grains: grains, including flax. are excellent sources of fiber, Vitamin E, and minerals. Avoid processed, finely milled grains when possible.  True whole grain products are “crunchier” and will be digested more slowly.

Dairy: milk and other dairy products contain calcium, good for bones and for lowering lood pressure; they contain vitamins A and D. Choose low-fat or fat-free varieties; use cheese in limited amounts.

Fats:  The so-called “good fats” include monounsaturated fats, which remain liquid at very low temperatures. They’re generally found in oils such as olive oil, peanut oil, and canola oil.

Polyunsaturated fats: Remain liquid at room temperature. They’re found in oils such as corn oil, safflower oil and soybean oil. They’re also found in fish and fish oil. Avoid foods high in trans fats and saturated fats.

Green tea: this beverage contains antioxidants, compounds that protect against cell damage inflicted by molecules called oxygen-free radicals, which are a major cause of disease and aging. Green tea is also believed to lowers LDL and triglycerides. Some experts believe that green tea also has an appetite suppressing effect.

Red wine: has been proven to lower cholesterol; however, use in moderation—alcohol is high in calories and can raise triglycerides and blood sugar levels.

Foods to Avoid

Fatty Meats: these meats are usually mass-produced and heavily processed; many red meats often contain high amounts of in fat.

Fruit juices and dried fruits: these are often high is sugar and are high in calories. Fresh or frozen fruit is better.

Soft drinks and energy drinks: avoid the full-sugar drinks. They will spike blood sugar and are full of empty calories.

Beer and alcohol: these products are high in calories.

Processed carbohydrates:  these foods include white bread, mashed potatoes, white rice, pasta and most snack foods.

Salt:  when you ingest salt, the body draws more water into the cells to dilute it. More fluid in the blood means the heart has to work harder and blood pressure may increase on the walls of you blood vessels.

Fats: The “bad fats” include saturated fats are solid or almost solid at room temperature. They are found in animal fats, whole-milk products, coconut oils and palm oils. Saturated fats are generally bad for you. They raise LDL cholesterol and triglycerides. Trans fats are even worse than saturated fats. Trans fats are produced when food manufacturers infuse hydrogen gas into oil converting it to a solid state in order to extend the shelf life of food products. This process is called hydrogenation. Examples of products containing trans fats are margarine, shortening, snack foods, commercial baked goods, and commercially fried foods such as French fries. Avoid all trans fats. They raise LDL and triglyceride levels and lower HDL.

The Glycemic Index 

If you have insulin resistance, the glycemic index is a valuable tool in learning to avoid spikes in blood sugar levels.  The index was created in 1981 by Dr. David Jenkins and Dr. Thomas M.S. Wolever. The two doctors noted that not all carbohydrate foods break down the same way, meaning that not all foods release glucose into the bloodstream at the same rate.

Foods with a higher glycemic index dump sugars into the blood stream, producing an insulin spike. Foods with a lower index break down slowly and release glucose gradually into the bloodstream, keeping sugar levels more stable so that insulin does not spike. The higher the glycemic index, the greater the glucose and insulin response.

Understandably, individuals with metabolic syndrome benefit from eating foods with a lower glycemic index.  Pure glucose is set at a value of 100 which happens to be the same as white bread. It is recommended that you choose foods with a low glycemic index as often as possible. 

Although important, the glycemic index does not tell the whole story about the impact of glucose in the bloodstream. In 1997, Harvard University researchers introduced the concept of the glycemic load, which takes into account the volume and fiber in a food item.  Foods with higher fiber do not quickly flood the bloodstream with glucose. Why not? When fiber is ingested, it makes you feel full—it makes the stomach swell. This fiber slows gastric emptying, keeping the food in the stomach longer. As a result, blood sugar levels are lower and insulin does not spike.

Here’s an example. Cantaloupe may have a high glycemic index (64) but a low glycemic load (4); it contains sugar, but the fiber allows the sugars to be released more slowly.  Foods that have a glycemic load of 10 are good are considered better carbohydrates for people with metabolic syndrome.    

The glycemic load is obtained by dividing the glycemic index value by 100, then multiplying that sum by the number of grams of carbohydrate in the serving. The lower the glycemic load, the better for people with insulin resistance.

Glycemic Index Classifications

Low Glycemic Index:  below 55
Moderate Glycemic Index:  56-69
High Glycemic Index:  above 70

Glycemic Load Classifications

Low glycemic load: below 10 
Intermediate glycemic load: 11-20
High glycemic load:  over 20

Find Support

Losing weight is one of things that is often difficult to do all alone.  Give yourself the benefit of support. That means emotional support and educational support. You will find emotional support especially helpful if your emotions are one of the reasons you overeat.

ducational support means learning about good nutrition and ways to avoid the disease risks that come with metabolic syndrome.

Weight loss programs, such as Weight Watchers can be invaluable in urging you on. Also, working with a dietitian can be most helpful; a dietitian can be supportive, help you stay accountable to yourself, and help you continually shape your diet when you feel like you’re getting into a rut. Remember, the goal isn’t only to lose weight, it’s to build a better, healthier life.


Excerpted from Overcoming Metabolic Syndrome by Scott Isaacs, M.D. and Fred Vagnini, M.D. Copyright © 2006 by Scott Isaacs, M.D. and Fred Vagnini, M.D. All rights reserved. Reprinted with permission from Addicus Books. $14.95. Available in local bookstores or call 800-352-2873 or click here.

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