Metabolic syndrome

Curated by Gerolamo Cavalli and Gabriele Gualandris

HEALTH : that psychophysical well-being from which we move further and further away

We have chosen this topic, the Metabolic Syndrome (or plurimetabolica), because in the last thirty years this phenomenon, which in truth is a set of pathologies, is spreading out of all proportion. It is estimated, in fact, that about 25% of the Italian population, that is one person in four, presents or will present all the criteria to enter this syndrome, also because generally the Metabolic Syndrome is present already for many years, sometimes even up to ten, before diagnosis by the doctor.

The expansion of "well-being", with its industrial food products, causes a huge increase in diseases related to insulin resistance, and according to estimates, in 2010 there will be more than 220 million people with type two diabetes throughout the world.

In Italy, around 23 billion euros are spent on problems linked to obesity, but it is particularly important to point out that, despite the economic effort, the Metabolic Syndrome remains the leading cause of death in Italy.

The term "Metabolic Syndrome" seems to date back to the fifties, but it became common only in the 70s, and we must get to 1988 to have a real complete definition, when Gerald Reaven pointed out the syndrome as a simultaneous manifestation of:

• insulin resistance,
• hyperinsulinemia,
• pre-diabetic states followed by type 2 diabetes,
• dyslipidemia,
• central obesity,
• hyperuricemia, (gout)
• hypertension,

and it was associated with an increased incidence of ischemic heart disease. Thanks to this definition and numerous studies, the syndrome is now also called "Reaver Syndrome" in his honor.

But how can we identify it better?

The Reaver Syndrome can be broken down more clearly into several main factors:

From a medical point of view, having three of these six factors is enough to have a diagnosis of Metabolic Syndrome and, in all probability, be unhappy owners of a single ticket for type 2 diabetes.

As a last factor, to aggravate the whole, we find the age, decisive in men over 40 years and in women aged 50 and over.

But where does it all start?

It is not rhetorical at all, but everything starts from modern society which, with its abnormal and contradictory lifestyle, is trying in every way to unhinge more than two million years of human evolution, made up of as many millions of years of adaptations and genetic selection.

Agriculture has existed for 10, 000 years, but this time, which may seem like an eternity, is not at all evolutionary enough to determine an adaptation for our species; let alone if the radical change in lifestyle and the arrival of industrial products (let's not forget that all food is processed industrially, not just snacks), which has completely changed the way we live and feed ourselves over the last 50 years, it may have been assimilated also from the genetic point of view. This, combined with the lack of movement on which human evolution has always been based, has produced and will produce devastating effects on human health; the Metabolic Syndrome is the clearest example.

For millions of years man has based his life on a similar cycle:

In the first phase it moved in search of game, eating berries, roots, small eggs, etc., all food sources with a low glycemic index.

In the second phase, having killed the prey, almost always with great physical effort, he ate as much as possible (the safest place was the belly, certainly not the refrigerator at home!)

The third phase consisted of absolute rest: there was no reason to do anything else since the belly was full.

So there was a cycle of harvesting, hunting, absolute rest, and let's not forget that the periods when food availability was scarce were frequent.

Let's think about today:

The first phase consists, in the worst case scenario (ie empty pantry), of moving by car to the supermarket, where we conveniently go shopping; an effort that in the end is rewarded with a slice of pizza and a beer, rather than fries, giving us a glycemic peak from upstream K2.

In the second phase we draw on a daily basis, on several occasions, the stock of pasta, pizza, bread and various snacks we bought, raising our blood sugar from K2 to Mount Everest.

The third phase, on the other hand, has remained almost identical: absolute rest with a full stomach, with the only variant of a nice sofa in the warmth of winter and cool in the summer (so as not to waste unnecessary calories in thermal regulation).

Beyond the too easy ironies, these very high and frequent glycemic peaks cause devastating damage to our body; sure, not in a day or a month, but in 10 - 20 - 30 years, depending on the individual buffer capacity.

Believing that with a large amount of food available at any time of the day you can live a long healthy life, it is simply detrimental.

The onset of metabolic diseases in humans coincides with the invention of agriculture, and the consequent use of cereals with high glycemic index to feed. As long as personal availability was low and physical work was very heavy, the problem remained marginal, or exclusive to pharaohs, nobles, etc. (as archaeological research seems to confirm).

In all this evolutionary framework, we also consider that the animals we breed to eat meat are fed mainly on cereals, but, like us, they have evolved by eating something different and living differently. Does this not obviously multiply the risks for humans?