With this guest contribution from Heike Erner on metabolic syndrome in the context of obesity, we continue our mini-series on important health and nutrition topics in our online magazine. Metabolic syndrome, also known as the "deadly quartet," is associated with a significantly increased risk of resulting cardiovascular diseases.
Heike Erner has been a naturopath and holistic nutritionist since 2009, as well as holding a degree in business administration with a focus on personnel management and coaching. For the past 8 years, she has been focusing on nutritional counseling, health coaching, and micronutrient therapy. In addition, she advises and researches for companies in the nutrition sector regarding new and interesting findings in the fields of naturopathy and nutritional medicine.
What are the four factors of metabolic syndrome?
Metabolic syndrome refers to a condition where specific diseases or symptoms occur together. Metabolic syndrome is composed of the following factors or a combination thereof:
- High blood pressure
- Overweight or obesity, with visceral fat playing a particularly significant role in the development of metabolic syndrome
- Nutrition-related disorders of sugar metabolism, such as insulin resistance and type 2 diabetes
- "Bad" blood lipid levels, e.g., elevated triglyceride and cholesterol levels
When is it considered obesity, and why is being overweight often the starting point for the development of metabolic syndrome?
The term "obesity" comes from Latin and means excessive or pathological overweight. The difference between regular overweight and obesity is measured by BMI (Body Mass Index). BMI = body weight in kilograms divided by height in meters squared. However, this formula has some weaknesses because it takes neither age nor muscle mass percentage into account. Therefore, this value can only serve as a rough guide. Being overweight is defined as having a BMI between 25 and 30 kg/m2, while pathological overweight or obesity begins at a BMI of 30 kg/m2.
Here, the distribution of fat is particularly important. Fat deposits in the abdominal cavity and around internal organs are especially detrimental. Fat distribution focused on the hips and thighs is unsightly but actually carries less risk. Being overweight with a focus on the torso is not just an aesthetic flaw but can also significantly harm one's health. For example, fat deposits in the abdominal cavity have a very unfavorable influence on the body's fat and sugar metabolism and thus contribute significantly to the development of metabolic syndrome.
What is visceral fat?
In addition to the visible outer belly fat ("spare tire") that we all know, there is also an inner layer of fat in the abdomen. This deep fat layer wraps around our abdominal organs – this is what is known as visceral fat. Perhaps surprising to many: "Normal-weight" people can also have this fat, for example, due to high stress factors.
It can certainly be the beginning of a cascade of metabolic disorders that initiate metabolic syndrome as its first factor. Originally, the purpose of visceral fat was a kind of "survival protection." Visceral fat differs from "normal" fat in that the body can convert it directly into sugar and energy without detours. This is not a bad thing during food shortages, but it is a health-hazardous condition in the case of overnutrition and poor diet.
Why is visceral fat so dangerous, especially in relation to metabolic syndrome?
Visceral belly fat leads a kind of life of its own. This means it is metabolically active. It is assumed that visceral belly fat contains and produces over 200 messenger substances and inflammatory mediators (biochemical substances that can trigger inflammatory reactions in tissues). These have a hormonal influence, and an extremely unfavorable one at that. If the body's own hormone production is stimulated by these messenger substances in visceral fat at the wrong time and in the wrong amount, it promotes the development of chronic diseases. For example, unhealthy fatty acids can enter the blood and remain there, and inflammatory processes can be stimulated.
Visceral belly fat increases the risk of high blood pressure and type 2 diabetes. This distinguishes normal subcutaneous fat from the much more harmful visceral fat. The normal "love handles" are therefore much more harmless than the fat that lies around our internal organs like the intestines and liver and which plays a significant role in the development of metabolic syndrome and the promotion of its factors.
How does visceral fat develop?
Besides unhealthy overnutrition with "bad" fats and too much sugar, including the "hidden sugar" in many foods, as well as a lack of vital nutrients due to low consumption of vitamin- and fiber-rich fruits and vegetables, there is another influential factor that one does not expect. It is scientifically proven that stress extremely promotes the development of visceral fat.
Why is that? Stress signals that activate certain messenger substances in the body have been emergency and survival signals for the body since ancient times. This means the body is still designed to expect an imminent survival struggle.
To ensure its survival, it tries to accumulate as much quickly available fat as possible in order to survive bad times. It preferably stores this in the abdominal cavity and around the organs, as it is directly available as a reserve there.
What was helpful for survival back then is anything but beneficial to health today, because the resulting side effects, such as permanently high blood sugar levels and high blood pressure, significantly damage organs and blood vessels. Chronic stress can therefore be just as involved in the development of metabolic syndrome as poor dietary habits.
Can visceral fat be measured?
In general, for an initial self-diagnosis, the outer abdominal circumference can be measured in addition to lifestyle. To do this, measure around the waist. A risk for women can begin at a waist circumference of 82 cm, while for men it is 94 cm. However, this is only a rough guideline, as height and muscle percentage also play a role.
If you suspect that you have increased visceral fat, you should consult a doctor, who will confirm this or provide an all-clear, especially for tall and athletic people. In general, athletic people who eat a healthy diet and have a flat stomach will rarely be found to have a dangerous level of visceral fat.
How can I get rid of dangerous belly fat?
You can do a great deal to prevent the development of dangerous belly fat. Even while you sleep! You read that right: A simple and effective method to get rid of your visceral fat is sufficient sleep. A multi-year study showed that people under the age of forty, in particular, gained belly and visceral fat if they slept five hours or less per night. Too little sleep means stress for the body, and stress promotes the development of trunk-centered overweight just as much as other factors of metabolic syndrome.
Of course, just getting enough sleep is not enough. Another important influencing factor is exercise. This refers to moderate endurance training, because while primarily carbohydrates are burned during short and intense exertion, longer, moderate endurance training gets down to the fat reserves. It is optimal to cycle, swim, or jog 2–3 times a week, for 45–60 minutes at low intensity. That is, moderate, so that you do not get out of breath. Likewise, relaxation exercises and techniques such as meditation, yoga, or Qigong can have a positive influence when stress levels are high. It is best to combine activity and relaxation to achieve an optimal result.
How can I avoid obesity and visceral fat through the right diet?
Of course, diet has an overriding influence on the development of visceral belly fat, pathological overweight, and metabolic syndrome in general. The radical reduction of sugar in any form, including "hidden" sugar, such as in fruit juices or popular soft drinks, is indispensable. Many processed foods also hide these invisible weight gainers without you suspecting it.
When buying these foods, pay special attention to the following endings on the label. Everything that ends in "-ose" is a sugar. Examples are: glucose, fructose, or dextrose. In addition, healthy plant-based fats with polyunsaturated fatty acids such as olive oil and linseed oil should largely replace animal and saturated fats. Fresh fruit and vegetables should be a fixed component of the menu several times a day. 4–5 small portions of fruit and vegetables per day can effectively prevent nutrition-related diseases such as pathological overweight or metabolic syndrome as a whole, with all its consequences.
However, be aware that certain types of fruit and especially fruit juices can naturally contain a lot of fructose. Avoid very sweet fruits such as bananas and grapes, as well as fruit juices, if you are already suffering from being overweight or another factor of metabolic syndrome. If you have trouble implementing this into your diet on your own, talk to a doctor or see a nutritionist.
What does the body's own hormone "cortisol" have to do with the development of dangerous belly fat and metabolic syndrome?
As already described, stress generally has negative effects on weight regulation and the development of dangerous visceral fat. We owe this primarily to one of the body's own hormones – cortisol! Cortisol is a stress hormone. It is produced in the adrenal cortex and is involved in many metabolic processes in the body. It increases, for example, blood pressure, blood sugar, and heart rate.
Cortisol acts as protection against stress and inflammation and helps the body to quickly provide glucose in the blood in extreme situations to use as an energy source. So far, so good! However, it also has a direct influence on our blood sugar levels and fat metabolism.
When cortisol levels are chronically elevated due to constant stress, this hormone is no longer helpful but harmful to health and is then considered a "weight-gain hormone," which is involved in the formation of internal belly fat (visceral fat) through the rapid provision of the body's energy reserves.
In addition to the measures already mentioned, such as sufficient sleep, regular exercise, and a healthy diet with plenty of fruit and vegetables, the psyche plays a decisive role in cortisol release. So, if you notice that there are more and more psychologically burdensome and stress-inducing situations in everyday life and, for example, sleep problems and restlessness occur concurrently, you should definitely address the resolution of these causes, if in doubt with therapeutic help.
Meditation and other relaxation techniques are not always enough – often the general life situation must also be reconsidered and changed. Chronic stress makes you physically ill and can contribute significantly not only to the development of metabolic syndrome and dangerous belly fat but also to other diseases.
Conclusion
Metabolic syndrome consists of four factors: high blood pressure, overweight (especially in the torso area), nutrition-related sugar metabolism disorder (e.g., insulin resistance or type 2 diabetes mellitus), and lipid metabolism disorders (elevated blood lipid levels (triglyceride and cholesterol values)). In combination, they are a risk factor for cardiovascular diseases. A healthy diet with plenty of fruit and vegetables, sufficient sleep, and anti-stress training can prevent or counteract this.
Mini-series in the online magazine on health and nutrition with nutritionist Heike Erner
Together with Ms. Erner, Medicom will provide simple health and nutrition tips in a mini-series to support the optimization of the individual factors. This allows everyone to individually adopt tips and advice. This does not replace a visit to the doctor, but serves as motivation to find ways to begin a healthy lifestyle.
For each of the four factors of metabolic syndrome (overweight, sugar metabolism disorders like type 2 diabetes mellitus, and lipid metabolism disorders like elevated cholesterol levels), you will find an article with explanations and health-promoting advice. We are convinced that everyone should and can actively do something for their health. Taking active responsibility for one's own health means self-love and self-care, and it pays off twice in the end.
• Did you miss the interview with Heike Erner "Metabolic syndrome is treacherous"? You can read it here.
• Do you want to know how healthy eating can be easy? Then listen to the podcast interview: How to succeed with a healthy diet according to Anne Fleck.
