The term “metabolic syndrome” is used to describe a cluster of disease states including blood lipid disorders, hypertension, propensity for thrombus formation, low-grade chronic inflammation, abdominal obesity, and type-2 diabetes.

Insulin resistance is the key to the metabolic syndrome, particularly the relative failure of insulin to exert its multiple biological effects on carbohydrate and lipid metabolism. The current epidemic of obesity and type-2 diabetes in developed and developing countries has focused major attention on the metabolic derangements critical to their etiology.

The Banting lecture of 20 years ago by Reaven sparked great interest in the clustering of diseases, which he termed “Syndrome X” and subsequently is more commonly referred to as the metabolic syndrome (Reaven, 1988). The basic symptomatology included dyslipidemias (high cholesterol and triglycerides), insulin resistance, obesity, and hypertension. With continuing research, subsequent iterations have added central (and in particular visceral) adiposity and chronic low-grade inflammation as key elements.

Diet plays a powerful role in modulating expression of the metabolic syndrome and it is increasingly clear that both amount and type of both fats and carbohydrates, and the interaction between them, are important variables.

PMID: 21452465

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