Metabolic Syndrome and the Glycemic Index
What Bad Diet and No Exercise Will Do To You
The Big Idea Here
This page is long; and it would be an imposition upon you who have stumbled here to ask you to press on without a clear idea of what your efforts will repay you.
I think of myself as first being limited to send you a few text messages to encourage you to accept the challenge of reading this page in its entirety. This would be my attempt to do that, to convey to you the Big Idea Here in a few words:
The Standard American Diet, full as it is with high glycemic foods (foods that turn to blood sugar very rapidly after being eaten) eventually compromises muscle tissue and promotes the absorption of Calories as fat. This condition is called the Metabolic Syndrome, and it is a precursor to all sorts of degenerative conditions such as adult onset diabetes. One of the primary features is central obesity; that is, fat concentrated in the body core. A very typical scenario is an individual who, without changing diet, suddenly begins to accumulate weight and cannot seem to get rid of it. A metabolic switch has been flipped: instead of Calories going to muscle and energy, it now goes to fat cells because the muscles refuse to absorb it.
To eliminate this Metabolic Syndrome, that switch has to be flipped back. There are ways to do this.
Read on and learn more.
Metabolic Syndrome and the Glycemic Index
The broad condition of being overweight is on the rise in the developed world. The same is true of being obese. There are definitions for these terms based on Body Mass Index (BMI). There are lots of BMI calculators on the Internet. I’m going to assume you know how to find one of those and how to calculate yours. BMI is basically a measure of mass density: your mass as if it were spread over a square with your height on both sides. Sort of as if you were squooshed flat. Ick! The units are kilograms over meters squared; that is, metric units. There are some situations where the generally published rules about BMI break down. Take me for instance. I’m 6’1″ (73″ or 1.854 meters). I weigh 182 pounds (82.7 kg). That makes my BMI to be 24, which is smack in the Normal range. The Overweight category begins at a BMI>25, and I’d get there if I put on just 7 more pounds of muscle. With a little weight training, I could do that quite easily; and I have done in the past. I’d look pretty good, be very fit, and I’d score as overweight.
You can check out the chart above to get an idea of what BMI is about. If I plotted along this chart for my height and got my weight up to, say, 270 pounds, then one could certainly call me obese at a BMI of around 30. I’m not sure how I’d get that much muscle on my frame. I have seen a lot of folks around who pack that weight onto a frame my size or smaller; and their weight is not due to muscle. By the time you’ve gone north of 30, you are in some trouble.
The Metabolic Syndrome is bound up completely with this tendency to overweight. The theory behind the Metabolic Syndrome explains the root causes of the process that puts on and keeps on the fat, it tells much about the sorts of diseases that arise from condition because the Syndrome is a precursor to many degenerative conditions, and it tells how to reset the internal switch that has flipped over to shift food intake into stored fat.
This trend to overweight and obesity in the US is nothing new. The CDC has tracked the statistics behind the rise in overweight for decades now. [Click on the image for a larger version. Click off of it to come back.]
You can see from just a brief glance at that chart that something is going horribly wrong around here. The total percentage of the adult population of the US who are overweight is getting to be of extreme proportions in more ways than one.
What is this Metabolic Syndrome? Well, there are a variety of definitions out there. I’m going to pick on the one from the American Heart Association.
Waist Size Men (in inches), greater than
Waist Size Women (in inches), greater than
Triglycerides (mg/cL), greater than
Blood pressure >130/85 mm Hg
Fasting glucose (in mg/cL), greater than
HDL, men (in mg/cL), less than
HDL, women (in mg/cL), less than
Any three of the conditions shown above will satisfy the definition of Metabolic Syndrome. There are a variety of metabolic pathways associated with the underlying mechanisms of the condition. In principle, the condition begins with diet and the keystone component is high glycemic carbohydrate. So that means we have to talk about the glycemic index.
The actual definition of glycemic index is a little on the complex side.
Incremental area under the blood glucose response curve of a specific portion of a test food expressed as a percent of the response to the same amount of carbohydrate from a standard food taken by the same subject.
That’s a mouthful (pun intended). Basically what it means is that if you or I ate, say, 100 milligrams of glucose tablets, almost all of that would go straight into our blood stream as glucose. If you or I then ate 100 milligrams of any other food; e.g., carrots, chocolate cake, white rice, brown rice, whatever, then we’d generally get less total blood glucose from that meal. The ratio of the amount, as a percentage, is the glycemic index for the food.
High glycemic foods are items like white bread, white rice, extruded breakfast cereals, pretzels, bagels, corn flakes, and sugars. Low glycemic foods include beans, seeds, whole grains, fruits & vegetables.
Since it is a ratio or percentage, glycemic index does not say much about the total Calorie content of any given meal. For this, we turn to the definition of glycemic load. Glycemic load is just the glycemic index multiplied by the total carbohydrate content of a food in milligrams.
The rate of rise in blood sugar is not, in principle, part of the definition of glycemic index. However, in practice high glycemic index foods tend to deliver their total carbohydrate content into the blood stream very rapidly. Typically, this is because their carbohydrate content is very easy to digest and convert into glucose. A result of this correlation is that eating high glycemic meals tends to spike blood sugar levels. In contrast, low glycemic meals tend to release their total caloric content into the blood stream in a much more measured rate. The image below shows some examples of this effect.
Interestingly enough, I’ve done this graph in a way that emphasizes the difference by including two foods that deliver exactly the same glycemic load; but with one having a pattern typical of high glycemic food and the other having a pattern of a low glycemic food. That means that the low glycemic meal was actually the larger of the two in terms of total carbohydrates.
I’ve simulated the impact of the two meals on a relative scale of blood sugar. The actual normal blood sugar level is more like 90mg/100ml; but here I’ve just labelled the resting case as 0.5. The body wants to keep blood sugar in a reasonable range of this “homeostatic” value. The pancreas plays a significant role in this control response. On the one hand, it has beta cells that generate the hormone, insulin. On the other hand, it has alpha cells that generate the hormone, glucagon. The role of insulin is to remove glucose from the blood stream. The presence of insulin causes muscle and adipose tissue to absorb glucose. It also causes the liver to take up glucose and turn it into glycogen, which is a short-term storage format for the quick release of glucose into the blood.
The high glycemic meal, as depicted above, spikes the blood sugar and causes a significant rise in insulin. As you can see, this rapidly reduces the sugar level and actually causes an overshoot in the negative direction. Oddly enough, the high glycemic meal has the counter-intuitive side effect of actually lowering blood sugar levels. This causes the pancreas to release glucagon in order to push the blood sugar level back into the desired range. This is a highly problematic result, about which I’ll have more to say below.
The general roles of the pancreas and liver in maintaining a homeostatic value for blood sugar are indicated in this illustration. You can see how insulin is used to move glucose out of the blood stream and into the liver, muscle & adipose tissue, on the one hand; while glucagon is used to release glucose into the blood stream from stores of glycogen in the liver.
Back to our two meals, the low glycemic meal (with the same glycemic load) shows a more stable rise and fall of blood sugar. In particular, there is no significant overshoot as the total meal is consumed. Hence, the work of removing the incoming glucose and pushing it into body tissues is done without the need for glucagon as a counter-measure. Imagine that you have just consumed that high glycemic meal yourself. As you can see from the chart, your initial blood sugar levels were falling in a natural way. So you felt hungry and you ate this meal. As the blood sugar spike is dropped rapidly by your high production of insulin, you actually began to feel hungry again very quickly. Here is the addictive quality of snack or junk foods in action.
This body reaction, so typical of snack foods, has one of the oddest psychological affects that you could imagine. It is the flip side to the funny image of the stoner who can’t stop binging on chips and pizza and whatever. It’s been shown that appetite is tied to the body’s own production of cannabinoids, also known as endocannabinoids because they come from internal sources. The stoner has increased his appetite by driving up his density of cannabinoids by smoking them. Trust me; I’m not making this up. The quote below is from that Wikipedia article on the endocannabinoid system:
While there is need for more research, these results suggest that cannabinoid activity in the hypothalamus and nucleus accumbens is related to appetitive, food-seeking behavior.
It is really true that our bodies make the same chemicals as found in marijuana and use them as reward triggers in the central nervous system. In short, there is an addictive side to the high glycemic meal: it literally causes the on-going production of cannabinoids in the pleasure centers of the brain making the cycle of binge eating very difficult to break.
What happens when this cycle of high glycemic meal after high glycemic meal continues for decades? The short answer is insulin resistance. Recall that the impact of insulin in the blood stream is to open portals in muscle, adipose & liver tissues to allow for the absorption of glucose. In muscle tissue, glucose is used to create energy. In adipose cells, it is used to store energy as fat. In liver tissue, it is used to produce glycogen. In this overall scheme of things, only the muscles are net consumers of physical energy; adipose and liver tissues are store-houses.
Suppose one is predominantly a sedentary animal and yet is hooked on a binge cycle of high glycemic foods. Clearly, one is consuming more Calories than one is using to produce energy; and that imbalance is going to start one putting on weight. But there is another result. Your muscles will gradually become more resistant to the insulin level in your blood stream; that is, it will require a higher level of insulin in order to open up your muscles’ portals that allow the passage of glucose into the cell.
Now we have ourselves a vicious cycle in the making. Our high glycemic diet is causing us to crave more and more of the same bad food. It is rewarding us with cannabinoids in our pleasure centers. We are becoming more addicted to those snack foods and junk foods and fast foods every day. We do not exercise, so after decades of this pattern, our muscles require higher and higher doses of insulin in the blood stream to get them to absorb glucose. The excess, the increasing excess, of glucose flows straight into our adipose cells.
By this stage, we are seeing the identifying marks of Metabolic Syndrome. Our waist lines are growing. Our blood work is increasingly bad. Our doctor is warning us to start dropping weight.
The Failure of Exercise and Diet at this Stage
Perhaps we honestly try to exercise and diet. But every exercise and diet plan turns into failure. If this is you, or if you know someone like this, do not be down-hearted. It is almost guaranteed that diet and exercise programs will fail unless they take into account two critical aspects of the Metabolic Syndrome condition. The first is that one’s muscles have become insulin resistant. That means that they cannot properly absorb the glucose that they need in order to produce energy: they are weak and will fatigue quickly. The second is that years, if not decades, of behavioral patterns have rewarded you for starting your day with a high glycemic meal. Bagels, cereals, pastries, toast & jam, coffee with sugar, and et cetera. These meals spike your blood sugar, get those cannabinoids flowing in your brain; and you’re off to the races once again. We all love this stuff for breakfast. Too bad that it’s doing us in.
What is needed is a reset. We need to flip the switch in our muscle tissue. I’ve said it before and here I’m going to say it again: a Calorie is not a Calorie. In a typical healthy teenager, muscle absorbs 80% of Calorie intake and uses it to produce energy. As any individual continues on the path of a high glycemic diet, as their muscle tissue becomes insulin resistant and begins to atrophy, that ratio decreases. If 80% of the Calories in could go to muscle performance at one time, once Metabolic Syndrome has set in, a smaller and smaller proportion of total Calories can make to the muscles. That excess will still go to adipose tissue.
This reset requires two actions: (1) eat only low glycemic foods with enough protein and healthy fat; and (2) begin a practical and sustainable program of moderate exercise five to six days a week. On the first point, there are companies that provide precisely the kind of meal replacements that someone experiencing Metabolic Syndrome needs to “kick the habit”; that is, to quell the pleasure pathways that reward the high glycemic cycle. On the second point, a 50-year-old person who hasn’t exercised seriously since they were in middle school ought not just run down to the gym and turn up the treadmill to “Top Gun”. Walking is a great exercise. Get out and walk. Walk around the block to begin with. The main thing is, do as much or as little as you can; but do it five or six days a week. Do it consistently.
These are the two secrets and there are no other secrets. Well, OK, I missed one secret: proper micro-nutrition. Get the right micro-nutrition is secret three. So these are the three secrets and there are no other secrets. Really. Right macro-nutrition. Right exercise. Right micro-nutrition.
It takes about 10 days to two weeks to achieve that reset in most people. Two weeks of a steady diet of only low glycemic foods, sustainable exercise for five to six days a week and proper micro-nutrition. That doesn’t mean losing 50 pounds and looking like a Hollywood action star. That means flipping the internal metabolic switch back to normal and starting to get the muscle tissue in the direction of absorbing and using, instead of rejecting, blood sugar.
Then you have to keep it up. It is not a question of being on a diet for a few weeks or a month. No. Eat the same healthy food that you would for the rest of your life. Do a moderate amount of exercise five to six days a week for the rest of your life. Find proper micro-nutrition for the rest of your life. Rinse. Repeat.
Give me a Shout
This can be a hard one. I know. I’m here to help.
Contact me with questions about how to reset your metabolic switch.