Syndrome X: Avoiding Chronic Disease
A foundational framework to maintain great health & avoid disease
Obesity is the hot topic that is, more often than not, given the spotlight.
But it’s only a small part of the health story.
We’d be wise to use the term “metabolic dysfunction” because it encompasses everything in regards to chronic disease, not just obesity.
Keep this distinction in mind from now on.
Being obese means you’re at a greater risk for developing chronic disease, so naturally, a lot of attention is placed on it. I have nothing against discussing obesity as a single (and damaging) factor in the public health crisis.
Yet again, it doesn’t take a holistic perspective of the global situation.
Obesity is ONE symptom of an underlying health issue.
But here’s the thing:
Not everyone who is obese is metabolically unhealthy.
Not everyone who is metabolically unhealthy is obese.
Tattoo this onto your mind because most people don’t understand this.
Metabolic health goes so much deeper than just your outwards appearance. We must be comprehensive in our approach to assessing our health.
Before obesity had become a widespread issue, a Stanford endocrinologist by the name of Gerald Reavan observed that excess weight was in company with other certain markers of poor health.
He and his colleagues noticed that heart attack patients often had high fasting glucose levels, high triglyceride levels, elevated blood pressure and abdominal obesity.
The more of these boxes a patient checked, the greater their risk of cardiovascular and other chronic diseases.
In the 1980s, Reavan labeled this collection of related disorders as “Syndrome X.”
The X factor, from his research, was determined as insulin resistance.
We now call this cluster of issues “metabolic syndrome.”
It’s defined with the five following criteria:
High Blood Pressure (Greater than 130/85)
High Triglycerides (Greater than 150 mg/dL)
Low HDL Cholesterol (Lower than 40 mg/dL for men & 50 mg/dL for women)
Central Adiposity (Waist circumference of greater than 40 inches in men & 35 inches in women)
Elevated Fasting Glucose (Greater than 110 mg/dL)
If you meet three or more of these criteria, then you have metabolic syndrome.
About 120 million Americans had metabolic syndrome in 2020 according to JAMA, but I’m sure the number is higher now, especially considering the pandemic.
This stat is insane: 90% of Americans tick at least one of these boxes.
It goes to show how sick our society us due to the lifestyle and mentality.
Keep this in mind: There’s much more to your health than these five metrics, but they are STRONG indicators of general health.
Notice that obesity is just one of the the criteria. It’s not required for metabolic syndrome to be diagnosed which is especially tricky for the skinny types because they think they’re in good health when, metabolically, it’s a different story.
Studies have found that one-third of people who are metabolically obese by BMI are actually metabolically healthy (and by the exact same five parameters I mentioned above).
Many elite athletes, especially football players, rank alarmingly high in the BMI department and yet they are generally in elite shape and have great metabolic health.
On the flip side, about 20-40% of non-obese adults have metabolic syndrome.
I’m sure the number is even higher since I’m not using exact stats.
Don’t misunderstand my point here. It’s not advantageous to you in any way to become obese. What I’m doing here is illustrating the point that it’s not just about how much you weigh. It’s deeper than that.
Here’s an example.
One of the biggest problems out there which doesn’t display any symptoms until late stage progression is a fatty liver. Non-alcoholic fatty liver disease is a silent epidemic which stems from an unhealthy lifestyle in general, but mainly the consumption of processed junk in combination with a caloric surplus.
You can be skinny and have horrendous liver health.
You can be fat and still have a relatively healthy liver (although excess fat accumulation generally worsens liver health).
The first signs would generally show up on a blood test using the liver enzyme alanine aminotransferase (ALT). Rising levels of ALT are often the first clue something is going wrong with your liver.
Yet, there are countless people whose physicians have no idea they’re in the early stages of this disease because their ALT levels are still “normal” according to conventional reference ranges.
This goes to show that blood testing is just one metric to keep an eye on.
It’s a great way to assess metabolic health over time, but it’s not perfect.
According to Labcorp, a popular blood testing company, the acceptable range for ALT is below 33 IU/L for women and below 45 IU/L for men.
But does normal mean healthy? Not at all.
These reference ranges are based on current percentiles. As the population becomes less healthy, the average can diverge from optimal levels.
The American College of Gastroenterology revised its guidelines for ALT liver values to recommend clinical evaluation for liver disease in men with an ALT above 33 IU/L and an ALT above 25 IU/L for women. That’s significantly below normal ranges.
But that might not be good enough either.
Even if your testing range lands in the “normal” zone, that doesn’t mean your liver is actually in good health.
In closing, I want you to keep track of those five metrics over the course of your life to make sure you don’t meet any of those criteria for metabolic syndrome.
We aim for excellence here.
What if you do have metabolic syndrome?
The good news is you’re in control. You can improve all of those metrics with a holistic lifestyle based on sleep, hydration, nutrition, movement & training, supplementation and more.
Much love,
Zaid