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Writer's pictureDr. Penny Lane

Metabolic Syndrome

Metabolic Syndrome is a constellation of metabolic abnormalities, which are often overlooked in primary care. One would be diagnosed with metabolic syndrome if they suffer from central #obesity, which is when one carries most of their weight around their abdomen, and has elevated cholesterol, elevated blood pressure, and hyperglycemia. These people have increased risk for type 2 diabetes and cardiovascular disease. It has also been called "syndrome X" and included insulin resistance, or the inability of insulin to respond to glucose in an individual as much as it does in the normal population.


In 1992, central obesity became the core component of this diagnosis and it has even been named "insulin resistance syndrome." In 1998, the World Health Organization (WHO) uniformly named it "metabolic syndrome" (MetS) and proposed that insulin resistance is the core of the pathology (Wang et al., 2024). The definition has evolved some through the years, but three of five characteristics (high waist circumference, high blood pressure, elevated blood sugar level, increased triglycerides, and low HDLs) is diagnostic, which is important because these individuals are at increased risk for #diabetes and heart disease, as well as #stroke.


Daily food choices and activity play a huge role in the development of metabolic syndrome (#MetS). I often recommend a continuous blood sugar monitor for these individuals, but this is a major lifestyle change treatment plan, not a one drug solution. We have to get into the mindset of really prioritizing our own health if we want to halt the progression of this condition.



Nutrition and exercise are complex however, as sometimes too much or too little can stress one's nervous and lymphatic system and add weight. Sometimes it is all in the timing. Working with a functional medicine clinician specializing in wellness, really is advantageous, and I do offer a program for weight management that prioritizes a functional approach. However, there are a few interesting points about #flaxseed and #walnuts that I thought you might find helpful if you are on the weight loss journey.


Magnesium Depletion & Metabolic Syndrome


Magnesium is a vital mineral in the human body, serving as an essential cofactor for hundreds of enzymatic reactions (Wang et al., 2024). These include energy metabolism, protein and nucleic acid synthesis, and the secretion and action of insulin. It plays a crucial role in maintaining normal nerve and muscle function, supporting a healthy immune system, and ensuring a steady heartbeat. Despite its importance, #magnesium deficiency is a widespread and often overlooked issue in primary care. More than half of the population however, fails to meet the recommended dietary allowances for magnesium intake, leading to deficiency.


Hypomagnesium is associated with elevated risk and adverse prognosis in those with diabetes, stroke, and coronary artery disease. Increasing magnesium intake can reduce the risk of diabetes, stroke and hypertension (Wang et al., 2024). Serum magnesium isn't really a great way to evaluate one's overall magnesium status, largely because the kidney absorbs about 80% of what is available in our blood. This creates a variable to be mindful when quantifying magnesium, the ability of our kidney to reabsorb magnesium. What studies have shown us is that the higher level at which our bodies eliminate magnesium, via the kidneys into the urine, the higher our incidence of MetS. We therefore believe that magnesium plays an important role in overweight and obesity, insulin resistance, hypertension, type 2 diabetes, and any number of metabolic disorders.


Alcohol causes prompt increase in the body's excretion of magnesium, hence, alcoholism and MetS would be correlated. Diuretics also enhance magnesium excretion. The administration of PPI has been shown to reduce kidney reabsorption of magnesium by down-regulating MRPM6 activity. Chronic kidney disease plays a role, and the urine may be a better way to evaluate this variable.

We know that magnesium supplementation improves hypertension, overall inflammation, improves insulin sensitivity, and glucose and insulin metabolism. We also know it reduces the incidence of diabetes. This really helps us better appreciate those who may be more prone to ridding the body of magnesium, and who might especially benefit from magnesium supplementation.


Flaxseeds & Walnuts


Flaxseeds are a complex food containing high amounts of PUFA, mainly a-linolenic acid (ACA), an (n-3) fatty acid, as well as soluble fiber, lignan precursors, and other substances that may have health benefits. Similarly, walnuts are also a rich source of PUFA and contain several nonfat constituents, such as plant protein (particularly arginine-rich proteins) and fiber. Evidence has demonstrated that integrating each of these into your diet can improve lipid profiles and reduce cardiovascular risk. The study below evaluated their effect on MetS; however, it also evaluated lifestyle counseling, which played a significant role in overall health and particularly at reducing central obesity.


Finding a group or a mentor to hold you accountable and to offer guidance is paramount for sticking to a wellness routine. Our lives are already demanding and can rob us of our ability to commit to ourselves. Connecting with others can be the life preserver we need, and this is why I've developed a comprehensive wellness program for my active primary care clients. Reduction in weight, cardiovascular risk, anxiety and depression have all been demonstrated in the literature with these approaches.


Flaxseeds and walnuts are considered high energy foods because of their high contents of PUFA; however, study participants did not gain weight, rather they lost weight. While they do have high fat content, not all fat is equal, right? What is especially intriguing about the study noted below is that when clients were offered lifestyle counseling or flaxseeds and walnuts, those with the latter demonstrated more weight loss. Combining the two were most advantageous.


Flaxseed incorporation into the diets of those with central obesity seems to decrease fasting glucose and prevent the increase of HgbA1c. Few studies have evaluated the effect of flaxseed on glucose, although I've shared a great deal about its benefits for those with estrogen dominance, particularly within my Detoxification & Wellness program. Studies have also demonstrated that flaxseed can improve glycemic control in those with type 2 diabetes.


Certainly, those with a predisposition to diabetes, central obesity, lipid elevation, and blood pressure concerns should be implementing both flaxseed and walnuts into their daily diets.


References

Wang, X., Zeng, Z., Wang, X., Zhao, P., Xiong, L., Liao, T., Yuan, S., Kang, L., & Liang, Z. (2024). Magnesium depletion score and metabolic syndrome in US adults: analysis of NHANES 2003 to 2018. doi: 10.1210/clinem/dgae075

Wu, H., Pan, A., Yu, Z., Qi, Z., Lu, L., Zhang, G., Yu, D., Zong, G., Zhou, Y., Chen, X., Tang, L., Feng, Y., Zhou, H., Chen, X., Li, H., Demnark-Wahnefried, W., Hu, F. B., & Lin, X. (2010). Lifestyle counseling and supplementation with flaxseed or walnuts influence the management of metabolic syndrome. Nutrition and Disease. DOI 10.3945/jn.110.126300.

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