[Treatment of metabolic syndrome: drugs often but diet always - a case report]

A case of a 32-year-old male with obesity and hypertension who was admitted to hospital with suspected acute myocardial infarction (MI) is presented. An initial diagnosis of MI was ruled-out, however, diabetes and marked hypertriglyceridemia were detected. Introduction of diet and proper diabetes control with insulin caused a marked decrease in triglyceride and cholesterol levels. After discharge the patient did not comply to dietary recommendations and stopped fibrates due to gastro-intestinal side effects which resulted in a marked elevation in lipid levels. Finally, statin therapy and better compliance to dietary recommendations resulted in the normalisation of cholesterol level, a marked decrease in triglyceride concentration and a loss of 5 kg of body weight. The need for combined treatment consisting of pharmacologic agents and life-style changes is stressed.

The effect of fiber-rich carbohydrates on features of Syndrome X

There has been much debate among nutritionists and scientists regarding the optimal dietary approach for the treatment of the Insulin Resistance Syndrome, also called Syndrome X. This condition, which may affect as many as 47 million individuals in the United States, significantly increases risk of coronary heart disease and stroke. Major health organizations have historically recommended high-carbohydrate, low-fat (HCLF) diets to reduce chronic disease risk. However, there is evidence that a high intake of carbohydrates may adversely affect one or more of the abnormalities associated with this syndrome. Studies in this area have often had limitations. For example, some studies showing adverse effects of an HCLF diet have not taken into account the dietary fiber content of the diet. This article describes abnormalities often associated with Syndrome X, reviews the beneficial effects of fiber-rich carbohydrates, discusses the effect of fiber-rich carbohydrates on features of this syndrome, and concludes with applications of these findings for those involved in treating individuals with features of this disorder. This review indicates that an HCLF dietary pattern such as that used in the DASH trial, with a level of dietary fiber consistent with the recommendations of the American Dietetic Association (eg, 20-35g/day), containing from 3 to 10 g soluble fiber/day, may be beneficial for treating those with Syndrome X.

Health benefits of low glycaemic index foods, such as pulses, in diabetic patients and healthy individuals

The present paper covers the health benefits of low glycaemic index foods, such as pulses. Nutritional factors potentially play a crucial role in health and disease. A low-fat, high-carbohydrate diet is often recommended as a part of a healthy life-style. Historical works have shown that carbohydrate foods differ in their ability to affect post-ingestive glycaemia. The glycaemic index concept allows a ranking of carbohydrate-rich foods in terms of their blood glucose raising potential. Pulses are foods with very low glycaemic index values. Numerous studies have documented the health benefits that can be obtained by selecting foods of low glycaemic index. These benefits are of crucial importance in the dietary treatment of diabetes mellitus: glycaemic control is improved as well as several metabolic parameters, such as blood lipids. The results of human studies have been confirmed by animal experiments in the field of diabetes. Diets with low glycaemic index value improve the prevention of coronary heart disease in diabetic and healthy subjects. In obese or overweight individuals, low-glycaemic index meals increase satiety and facilitate the control of food intake. Selecting low glycaemic index foods has also demonstrated benefits for healthy persons in terms of post-prandial glucose and lipid metabolism. Several public health organizations have recently integrated consideration of the glycaemic index in their nutritional recommendations for patients with metabolic diseases and for the general population.

[Non-obese obese-like subjects: a new patient to be treated with diet]

Decreased insulin sensitivity patients, although normal-weight, are treated with a "prudent" hypocaloric diet and exercise, in order to reduce insulin resistance. Metabolic (glycolipidic) alterations can be easily diagnosed by combination of clinic and laboratory tests. A diet model aimed at controlling insulin levels and inducing a light weight loss is proposed.

The Metabolic Syndrome: where are we and where do we go?

The Metabolic Syndrome, also known as Syndrome X, refers to a constellation of atherosclerotic risk factors, including insulin resistance, hyperinsulinemia, dyslipidemia, essential hypertension, and abdominal obesity. We review four major published studies involving animals and humans that may be linked together in a unified hypothesis and justify a comprehensive approach in the treatment of this ever-increasing syndrome.

Clinical, physiopathological and dietetic aspects of metabolic syndrome

Hypertriglyceridaemia, diabetes, hypertension and obesity are the deadly quartet indicating a syndrome at high risk for cardiovascular disease for which, in 1998, WHO proposed the definition of Metabolic Syndrome, related to an elevated degree of insulin resistance. Treatment will often include behavioural changes that reduce body weight and increase physical activity A high-carbohydrate/low-fat diet with complex carbohydrates and mainly unsaturated fat is recommended. Replacing refined grain products and potatoes with minimally processed plant-based foods such as whole grains, fruit, and vegetables, and reducing the intake of high glycaemic load beverages may offer a simple strategy for reducing the incidence of coronary heart disease.