Participants: Timothy Howe and Sheryl McWilliams
Series Code: WM
Program Code: WM000393
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00:01 The following program presents principles
00:03 designed to promote good health and 00:04 is not intended to take the place of 00:06 personalized professional care. The opinions 00:09 and ideas expressed are those of the speaker. 00:11 Viewers are encouraged to draw their own 00:13 conclusions about the information presented. 00:36 Hi and welcome to 'Wonderfully Made' 00:38 I'm Sheryl McWilliams and our guest today 00:40 is Dr. Timothy Howe, an internal medicine 00:42 specialist at Parkview Adventist Medical Center, 00:45 welcome Dr. Howe. Thank you, 00:46 it's good to be here with you today. 00:48 We're going to be talking about a topic 00:51 that I don't know a lot about, and it's 00:55 one of that I think many of us don't know 00:57 much about and it's called the metabolic 00:59 syndrome, I believe also Syndrome X. 01:01 What exactly is that and what affect does 01:05 it have on us? Metabolic syndrome 01:07 is not a disease. It is a clustering of signs 01:13 and symptoms that when found together place 01:16 you at higher risk for disease. As I think 01:19 back over the past years in my medical 01:22 practice many patients come to mine and 01:26 I think of watching them go through life 01:30 developing first the metabolic syndrome and 01:34 then later as time goes on developing a whole 01:41 group of diseases, diabetes, hypertension, 01:45 heart disease, cancer and they all go back 01:51 to metabolic syndrome. So metabolic syndrome 01:55 is the seed that develops or grows into a 02:01 whole host of problems, the chronic 02:03 diseases that we here in America have today. 02:09 How is it determined? How do you know if you 02:12 have it or not? Well, metabolic syndrome, 02:15 one definition of it is insulin resistance, 02:19 that is, insulin in our bodies is not 02:23 working well. But how do we tell if someone 02:27 has insulin resistance. There are five things 02:31 that we can look at that give us a clue, 02:33 and to have metabolic syndrome you have to 02:37 have three of those five. So here they are: 02:41 number one, a waist in men greater than 40 02:46 inches or in women of greater that 35 inches. 02:51 Now that's not hard to get. I'm not far off, 02:56 of that myself a little ways and when I did 03:01 study on metabolic syndrome you can bet 03:04 that caught my attention and I started 03:06 thinking now, what size pants do I wear here, 03:09 I want to make sure I don't get into the 03:11 metabolic syndrome. 40 inches for men, 03:15 greater than the, 40 inches or greater 03:17 that's one, for women 35. Another one 03:22 of the five is blood pressure, if your blood 03:25 pressure is greater than 130 over 85, that's 03:30 another one of the signs of metabolic syndrome. 03:34 Now that isn't very high, 130 over 85 is 03:39 in the category that the Joint National 03:42 Commission on hypertension called 03:43 pre hypertension. But remember normal 03:47 blood pressure today is defined as 120 03:51 over 80 or less. So you're ten points high. 03:55 And, if you have a blood pressure of 130 over 85, 03:59 that's another one of the five, and if you 04:04 have those two you're well on the way. 04:06 The third one is a blood sugar over 100. 04:10 Now blood sugar is normal at 100, 04:14 it's actually "normal from 60 to 120 04:19 but we started to find that if you get over a 04:22 100 your blood sugar is associated with 04:27 increase risk, in fact, if your sugar is 101, 04:31 your risk for heart disease is 1% higher 04:34 than if it's 100. If you're at 110 your risk 04:39 for heart disease is 10 percent higher then 04:42 if you're at 100. So for every one point 04:44 your blood sugar exceeds 100 fasting 04:47 your risk of having a heart attack goes up 04:50 1 percent. So that's why it too is another 04:54 sign or of the metabolic syndrome, so that's 04:58 three. Another one is a low HDL, 05:03 now HDL is the good cholesterol, one of my 05:08 patients told me how to remember it, 05:10 it's not true but it works, he said, H 05:13 stands for healthy, it's the healthy cholesterol. 05:17 Actually H stands for high, high-density 05:20 lipoprotein, high density lipoprotein is a 05:24 very important type of cholesterol, 05:28 actually it's not a type of cholesterol. 05:30 Its cholesterol being carried from 05:33 the blood stream back to the liver. If 05:36 you will, HDL is a like a garbage truck. 05:39 It goes around the body and it picks up 05:42 cholesterol, loads it in and carries it back 05:46 to liver. In metabolic syndrome, your HDL, 05:50 your good cholesterol, the garbage truck 05:53 cholesterol if you will, cleaning the arteries 05:55 is low and if as a woman your HDL is less than 06:00 50 or as a man if its less then 40 you 06:04 have another of the indicators that you have 06:08 metabolic syndrome, very important. 06:11 And lastly triglycerides, triglycerides 06:16 are a blood fat, your triglycerides go up 06:19 in your blood if you've been a lot of sweets 06:23 or a lot of fat, that's the main way you get 06:28 it up or you can have a genetic tendency 06:30 toward high, high triglycerides. But as 06:34 with all genetics, genetics loads the gun. 06:38 But it's environment that pulls the trigger, 06:41 just because your triglycerides are high 06:44 doesn't mean you can't lower them with diet. 06:47 But those are the five and if you have 06:50 three of those five, you are at increased 06:53 risk for a whole host of diseases. 06:56 So, let me see if I can remember this, 06:59 okay, if my blood pressure's elevated, 07:01 over 130 over 85, over 130 over 85, 07:05 if my waist as a female is greater than 35 07:09 or greater than 40 for a gentlemen. 07:11 If my HDL, which is the good cholesterol 07:14 is less than 50 for a female, less than 07:18 40 for men. If I have elevated triglycerides. 07:22 That's right or if your blood sugar is over 07:26 100 and if you have any one, if you 07:29 have three those five you have metabolic 07:31 syndrome. Chances are if you have two of them, 07:34 you'll have a third, because they cluster and 07:37 it's all from insulin resistance. Okay, 07:40 let's say that I did have three of these 07:43 five, what would that mean? It mean you're 07:46 in trouble. Okay. And it would mean as a 07:49 result of being in trouble that you needed 07:52 to take steps to fix those. Now, the question 07:56 is just how do we fix them? But before 07:59 we answer that question. Let's look a 08:01 little bit more at the problems that you have. 08:04 If though you have the metabolic syndrome 08:09 and we mentioned them briefly, but let's look 08:11 again; you have an increased risk for heart 08:14 disease. Now as I said, if your blood sugar 08:18 is up one point above a 100 your risk 08:22 for having a heart attack goes up 08:25 1 percent. That's amazing because 08:27 one point in blood sugar is really that much, 08:30 that's fasting blood sugar. Fasting blood 08:32 sugar after an all night fast, if your fasting 08:36 blood sugar is over a 100 that's one point 08:39 for metabolic syndrome. If your blood pressure 08:42 is over 130 over 85, now, you say, well 08:46 that isn't much and it isn't, but remember 08:49 studies have shown very clearly that for 08:53 every one, every two points that your blood 08:56 pressure exceeds 120, your risk of 08:59 having a heart attack goes up 10 percent 09:01 and your risk of having a stroke goes up 09:04 15 percent. So at 130, you're already 09:09 five times 15 times greater risk for having 09:16 a stroke or a heart attack five times 10, 09:19 50 percent higher risk for a heart attack 09:22 with your blood pressure at 130 over 85, 09:25 wow, so that's how well that one gets in, 09:28 then you come to the waist. That waist 09:32 measure, you say well how come because 09:34 if I'm 6'4 as I am shouldn't I be allowed 09:37 to have a bigger waist. Well as a matter 09:41 of fact now, when we start putting weight 09:44 around our middles that means insulin 09:47 resistance, and insulin resistance as I 09:51 mentioned is what's behind all of these 09:53 pushing, pushing, because insulin puts fat 09:55 around your middle and what we're really 09:58 looking at is where are you putting your fat. 10:00 Are you shaped like a pear, you know 10:02 with large hips and thighs as a woman or 10:06 are you shape like an apple, are you a man 10:08 that has put weight on all over or did you 10:11 put it all on right above your belt. Because 10:15 of course men wear their belt not on 10:17 their waist. But today some where down 10:19 below it, but still do you have where are 10:22 you putting your weight. Because if you're 10:24 putting your weight around your middle you 10:25 have insulin resistance and that's 10:28 is really the key in the metabolic syndrome. 10:32 So, if I want to avoid the metabolic syndrome 10:35 or let's say I have these three things. 10:38 What I do to fix it? Well, the first thing 10:40 you have to do say to yourself, well why is it 10:43 that insulin isn't working well and more 10:46 importantly what does it do in the first place. 10:48 Insulin is like a key, and it opens the door 10:53 and allows sugar out of your blood and into 10:57 your cells and you get insulin resistance 11:01 when insulin has trouble getting sugar 11:05 into the cell. Now I don't about you, maybe 11:08 you don't have a house like this and of course 11:10 I don't. But you may have seen some 11:12 other people that have a house like this. 11:13 You go over on a Saturday night and you 11:17 sit down and you're going to play some 11:19 board games and they say oh, the game you 11:23 want is in the closet, and so you start 11:24 for the closet and you get to the door and 11:27 you're about to open it. No, no, no, don't open 11:29 the closet, let me do it. And so they go over 11:32 and they put one and they open it about 11:34 3 inches and they put their hand in you 11:36 know to hold that up and then they 11:38 carefully open the door and then despite 11:40 all of their efforts everything crashes down 11:43 on them. That's the same problem that 11:46 we have with insulin resistance. Insulin goes 11:50 knocking on the door of the cell to open 11:53 the door to get sugar in, but there's 11:56 already too much fat or sugar calories 12:00 in the cell and so you know he goes to 12:03 open the door but the cells says I don't 12:05 want anymore, no more here thanks and 12:08 so he has a hard time getting sugar out of 12:12 the blood and into the cell. Now if this goes 12:15 on long enough of course, you develop 12:17 diabetes, frank diabetes and really what 12:20 metabolic syndrome is, is pre diabetes, because 12:24 if your sugar is over a 100 you have pre 12:26 diabetes. If you, that's your fasting sugar, 12:29 if your sugar is over 126 or higher fasting 12:36 then you have diabetes. But remember 12:39 that continue at 126, or you have diabetes 12:43 terrible. But you have a 26 percent 12:46 increased risk of heart disease. How about 12:49 at 125 your not a diabetic, where are you? 12:52 See it's not black and white, yes or no, 12:56 it's a continuum. In metabolic syndrome 12:59 we're really looking at pre diabetes, 13:02 insulin opens a door but it doesn't work 13:06 well if we've over eaten or eaten raw. You 13:11 put the weight around here it's the weight 13:13 you don't need to carry, that spare tire 13:15 it tells you insulin is having a hard time, 13:18 why don't you give him a break. 13:22 So, metabolic trend syndrome is related 13:26 to diabetes, then I would soon then that 13:29 if I wanted to avoid it, then I would do the 13:32 same things I would to do to avoid diabetes, 13:35 that's right. Its, you, the metabolic syndrome 13:39 just catches the problem earlier and 13:41 says, alright you have the precursors, we 13:44 know what road you're on, we know where 13:46 you're headed. Let's catch you before 13:48 you get to trouble and that's the beauty 13:50 of the whole concept of metabolic syndrome. 13:53 It allows you to detect the precursors of 13:58 diabetes and interfere before you get into 14:01 major trouble and that's the beauty of 14:04 the metabolic syndrome, it's other things too, 14:07 but like for instance when you have insulin 14:10 resistance you have thicker blood, the blood 14:13 clots more easily also raising your risk for 14:16 stroke and heart attack and that's an 14:20 important thing to know for very sure. 14:22 Now you mentioned that metabolic syndrome 14:25 being related to the five factors, one of 14:28 which was triglycerides, what exactly is that 14:30 and what I do about it? Triglycerides are 14:33 fat in the blood and in our fat cells that's 14:38 triglycerides as well, your triglycerides go up 14:42 because you've over eaten or eaten too many 14:46 sweets, you see the body when you eat sugar 14:49 that you don't burn, it stores it first if 14:53 there's excess as glycogen in your liver. 14:55 Glycogen is just a sugar molecule attached 14:58 to a sugar, attached to sugar, attached to a 15:00 sugar and it packs it up there in your liver. 15:02 So you eat a good meal and the next morning 15:07 you go out and run a marathon, your body 15:09 says well he's not eating, lets break down 15:12 some glycogen and burn that. So you can 15:14 keep running and keep going on the glycogen. 15:16 But if you're not out there running and 15:19 you've eaten that big meal and you've filled 15:21 up that glycogen stores, the body says, oh, oh 15:24 where am I going to put it now, and takes that 15:27 sugar changes it to a fat and stores it 15:31 as fat, that fat is triglycerides. So if you 15:37 eat a lot of refined carbohydrates or just 15:40 more than you need, the body changes into 15:43 triglycerides and if you eat more fat than you 15:48 need it stores it as fat in your cells. 15:52 It's interesting, you can see this in some 15:55 individuals if you look in their eyes. 15:57 Most people don't think about it, but if you 16:00 stop and think, now let's see if I was going 16:02 to pour water out of a pitcher it would 16:05 go fast. If I was going to pour margarine 16:09 out of a pitcher or butter it would go slow 16:12 even if it was at room temperature because 16:14 fat is thicker than water. You know 16:17 triglycerides thicken your blood. It makes 16:21 it harder to pump. If you and I had a 16:24 race and I had a glass with water in it and 16:27 a straw and I gave you a glass of molasses 16:30 for instance for one and I say, okay, 16:32 lets have a race, I'm going to sip water, 16:35 you're gonna sip molasses, who'd win? 16:36 I think you would. I would, sure, sugar 16:40 thickens the blood and fat does it even more. 16:43 So, we're really looking at this through, 16:46 what are we doing to the thickness of the 16:49 blood. Because metabolic syndrome is also 16:52 how thick is your blood. How hard 16:55 is it to pump around and when your triglycerides 16:58 go up. Your blood thickens, it can get 17:02 so bad that in your eyes you can see 17:04 what's called box-carrying. And it's 17:07 little globules of fat and you can see the 17:10 marching across the arteries in the 17:12 backs of your eyes; going clunk, clunk, 17:14 clunk like this 'cause it's so thick and the 17:17 big risk is stroke from having too high 17:20 triglycerides, that's quite rare but it 17:22 can happen from excess calorie intake. 17:25 So you mention eating refined carbohydrates, 17:30 so then I would assume that complex 17:32 carbohydrate would be a good choice, sure. 17:36 If you go back to thinking about when we're 17:39 eating and thinking about insulin and his work, 17:42 he wants to move sugar out of the blood 17:45 and into the cell. If you give him a steady 17:48 stream of work and he can work just fine 17:51 all day long, you know, you just feed him 17:54 some whole wheat bread and that goes 17:58 down into your system, you have to chew 18:01 it of course and then you have all that 18:02 fiber there that slows the absorption 18:05 of the sugar and the sugar enters the body 18:08 in a nice smooth stream. On the other hand, 18:11 if you took a soda and just took the same 18:14 amount of calories in the soda as you would 18:16 in the whole wheat bread, 70 to 80 calories 18:19 per slice, it would arrive fast. If it 18:23 hits fast, insulin has to hurry to get it 18:25 out it has to find places to stuff it 18:28 quickly, and it's says hold it, hold it, 18:30 I can't change, get all this into the cell, 18:32 you better make some into fat. And so 18:35 often the fat it goes, your triglycerides go 18:37 up, your blood sugar's up, because it got 18:39 there too fast and we've got trouble, 18:41 we've sludge the blood and we've pushed 18:44 our fats up and raised our risk for heart 18:46 disease, stroke and other things. Interesting, 18:49 it seems that in every thing that we do, 18:53 physical activity plays a part. What role does 18:56 physical activity play in this particular 19:00 syndrome? Another way to define metabolic 19:02 syndrome of course is more food in than energy 19:08 out. We have an energy imbalance. 19:11 We're eating more calorie than we're burning 19:13 and metabolic syndrome can be reversed simply 19:17 by increasing our exercise. Now, for 19:20 some people that's an awful lot of exercise, 19:23 they say that you can run from Boston 19:26 to New York on the calories in one pound 19:28 of fat, well. Well, that's a lot of running 19:31 some people might have to do. So if you're a 19:34 big eater you need to be a big exerciser, 19:37 you can push the body too hard of course, 19:40 it's better to be a moderate eater, and a 19:44 moderate exerciser always, if you push, 19:48 you say well I want to eat 2400, 3000, 19:52 3500 calories a day. You're gonna have to 19:57 exercise very, very hard to keep your body 20:00 from expanding and getting clogged up. 20:04 But exercise is the key or the one of the keys 20:07 to reversing the metabolism syndrome. 20:09 The other of course is to eat less calorically 20:13 dense food and that's the food that 20:17 the creator made for us. It's whole grains, 20:21 it's fresh fruits, it's vegetables, staying away 20:26 from the refined foods that are more 20:29 calorically dense. They are the ones 20:31 that's easy to eat a lot of and get in 20:34 trouble with. This concept of eating whole 20:38 grains I find very interesting because 20:41 there are a lot of folks that know we 20:42 should eat whole grains. But when you go 20:44 to buy a package. It says whole grain on the 20:47 outside of it, but I understand that if a 20:50 manufacturer can promote itself as whole grain 20:54 and it only has to have 51 percent. So what 20:57 exactly is a whole grain and how 20:59 do I get more of it into my diet? 21:01 I think it's very important for us to 21:04 become smart shoppers, intelligent 21:08 consumers, label readers, you know 21:11 you go to the store and it says wheat bread 21:15 and you say, oh this is good for me, 21:19 wheat bread and you pick up the package 21:21 and flip it over and the first ingredient 21:24 is wheat flour. If it says wheat flour and 21:28 not 100 percent whole wheat flour it's 21:32 white flour and white flour they've taken 21:36 out the germ and they've taken out the 21:39 fiber and they've taken out many of the 21:41 B vitamins and the minerals and then 21:44 they say well we've taken all those out, 21:47 let's throw a few vitamins back in and 21:49 they call it enriched. You know you never 21:52 buy white flour in the store, but it says 21:54 enriched. Now I don't about you, but if I took 21:57 20 bucks from you and gave you five back 21:59 would you think you were enriched? 22:01 I think I was whipped off, yeah, that's 22:03 what happens with white flour and with our 22:06 grains, so you have to be careful, you have 22:08 to be a labeled reader unless you make 22:10 your own. And it's very important to get 22:13 all of those nutrients in our foods, especially 22:18 in our grains. It helps us avoid delivering 22:23 the calories the sugar particularly, 22:25 too rapidly to the body, if it's delivered 22:29 too rapidly we're in trouble. No question 22:32 about it. So, we're talking about eating a 22:35 100 percent whole wheat bread versus 22:37 white bread, or a brown rice as opposed to 22:40 white rice. Another way to look at this 22:42 whole problem is using the concept of 22:46 Glycemic Index. Now Glycemic Index does 22:49 not work a hundred percent because when 22:52 we figure out the Glycemic Index, we're 22:55 looking at various foods, we give you 22:58 this and that's all and measure it, but 23:00 it's still a useful concept, it goes like 23:03 this, we give sugar the number 100, 23:06 pure glucose you eat it, how fast does it 23:09 get to your blood stream and then we compare 23:12 other foods. For instance, white rice 23:16 boiled a good time until it's really cooked 23:19 has a glycemic index of 95. The sugar from 23:24 white rice gets into your body almost as 23:26 fast as pure sugar. Whereas brown rice has a 23:30 glycemic index of 68, it delivers the sugar 23:34 into your system much more slowly. 23:36 Orange juice has a higher Glycemic Index 23:39 than an orange, a baked potato has a lower 23:43 Glycemic Index than mashed potatoes, 23:46 just the fact you mash them up the 23:48 Glycemic Index goes up. So you want 23:51 whole foods naturally prepared. 23:53 Now some people say well then I shouldn't 23:55 cook my food at all. Well now, lets not 23:57 go overboard, lets be you know sensible. 24:01 Something ought to be cooked, 24:04 something need not be cooked. Carrots, 24:06 you get more beta carotene and vitamin A 24:09 from them if you cook them as far as 24:11 absorption, but I like raw carrots too and 24:14 there are some enzymes and other things 24:15 that come through better when its raw. 24:17 So some raw, some cooked, that is very 24:20 good balance, but avoid those refined 24:23 carbohydrates that get right into your system, 24:26 the worst thing you can do and I think it's 24:29 really the cause of much of the metabolic 24:32 syndrome and of what's coming right 24:34 behind of diabetes and obesity is refined 24:39 carbohydrates between meals. Did you 24:41 know that the average American male teenager, 24:46 the average young man drinks a liter of 24:49 soda a day, wow, a liter of soda a day. 24:53 That's enough to give you metabolic syndrome 24:56 over time. And then diabetes and heart 24:59 disease. We have an epidemic of excess 25:03 refined calorie intake particularly between 25:06 meals. Grazing on this snack and that 25:11 snack and the other one is, it really causes 25:15 this whole problems. If we just eat 25:18 natural foods, whole foods, get them from 25:21 the farmer before they go in a box, if you eat 25:24 them that way. Spaghetti's another 25:26 one or some of the other Pastas. 25:29 You can get wonderful whole wheat pasta 25:33 today. Now I didn't think so at first 'cause 25:35 I tasted a few that were kind of nasty 25:37 but if you shop around there's some that 25:40 really taste good. Whole wheat pasta and 25:43 that slows that sugar absorption down. It's so 25:46 much better for you, get your foods the way 25:49 God created them. Cook them simply and 25:53 you'll be much healthier and you'll avoid that 25:55 heart diseases, that stroke, you'll also 25:58 lower cancer risk. It really does help 26:01 to good food the way it comes. 26:04 So, if we choose to eat our food the way 26:07 God grew it and we chose to get some physical 26:09 activity then it will help us to reduce that 26:12 risk of metabolic syndrome. Absolutely, 26:15 and reducing risk of metabolic syndrome 26:18 as we mentioned is very important. It helps 26:22 reduce your need for medication. It helps 26:25 reduce your problems with a whole host 26:29 of diseases. It'll reducer your doctor 26:32 bills just from thinking about what you're 26:35 eating and how you're eating it, you know 26:38 if you're going to spend money on food, 26:40 don't buy the fanciest in a box. 26:43 Buy wonderful fruit. There are fruit on 26:46 the market today I live in Maine and I'm 26:49 telling you in Maine they still have fresh 26:50 oranges from Florida, you can get oranges 26:53 from California. You can get fruit from Chile. 26:56 You can get it from anywhere, it's all 26:58 available, even that far north. We are 27:01 without excuse today to get fresh food. 27:05 Fresh frozen's fine, it's very good in some 27:09 cases better if you can't get that canned 27:12 but as near natural as near from the 27:15 farmers field as you can, that will 27:18 really help. So we should pay attention 27:22 to our blood pressure, our waists, 27:24 our blood sugar, our triglycerides levels. 27:27 Make sure that we're getting plenty of whole 27:29 grains and natural foods the way God 27:32 grew them and prepared them for us. 27:34 And in this way will help to reduce our 27:36 risk of the metabolic syndrome and diabetes 27:39 and heart disease and all of the other things 27:42 that go along with it. It's something that 27:45 we can do and it's simple and it doesn't 27:47 cost any money, it will save us money 27:50 and give us health, you can't beat that and 27:53 I think that's important, the more 27:54 simple we can make things, the better 27:57 off I think we often are. We tend to 27:59 make things more complicated then 28:00 they are. Thank you for joining us today 28:02 on Wonderfully Made. I hope that you've 28:04 enjoyed it as much as I have and thank you 28:06 Dr. Howe for being with us, thank you. |
Revised 2014-12-17