Metabolic Syndrome
Episodes
Continuous glucose monitors, or CGMs, are wearable devices that allow users to monitor their blood glucose levels through a tiny sensor placed under the skin.
In this clip, Dr. Steve Horvath describes research suggesting that caloric restriction, especially when it is reversing obesity or metabolic syndrome, may slow epigenetic aging.
Dr. Charles Raison discusses how a pro-inflammatory environment, such as that which occurs with obesity, can contribute to the risk of depression.
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Continuous glucose monitors, or CGMs, are wearable devices that allow users to monitor their blood glucose levels through a tiny sensor placed under the skin.
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In this clip, Dr. Steve Horvath describes research suggesting that caloric restriction, especially when it is reversing obesity or metabolic syndrome, may slow epigenetic aging.
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Dr. Charles Raison discusses how a pro-inflammatory environment, such as that which occurs with obesity, can contribute to the risk of depression.
Topic Pages
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Sugar-sweetened beverages (SSBs)
Sugar-sweetened beverages such as soda, juice, and sports drinks provide large doses of rapidly absorbable sugar, posing a unique risk to health.
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Ultra-processed Foods (UPFs)
UPFs are formulations of mostly cheap industrial sources of dietary energy (calories) and nutrients plus additives that have negative effects on human health.
News & Publications
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Breastfeeding benefits mothers by promoting post-partum weight loss and reducing the risk of certain types of cancer later in life. A new study suggests that breastfeeding also supports maternal cardiometabolic health. Women who breastfed for at least six months were leaner and had lower blood pressure than those who didn’t.
Researchers conducted health check-ups on 160 mother-child pairs enrolled in Screening Tests to Predict Poor Outcomes of Pregnancy, a long-term study that assessed women’s risk for pregnancy complications. They assessed the women’s cardiometabolic health via blood pressure, body measurements, and serum metabolic markers (glucose and lipids). They determined breastfeeding duration via the children’s health records.
They found that the cardiometabolic health of women who breastfed for at least six months was considerably better than those who did not breastfeed, as evidenced by lower body mass index (BMI) and blood pressure. These differences persisted even after considering factors like BMI, socioeconomic status during early pregnancy, prenatal smoking, and maternal age during early pregnancy. In women who had experienced pregnancy complications (such as preeclampsia or gestational diabetes), breastfeeding for at least six months reduced blood pressure, insulin, and triglycerides, while increasing HDL cholesterol levels.
These findings suggest that breastfeeding for a minimum of six months benefits the cardiovascular health of mothers, particularly those who experienced pregnancy complications. They also highlight the importance of breastfeeding as a potential means to reduce the risk of cardiovascular issues in women following childbirth. However, the investigators conceded that this was a small study, potentially hindering its translatability to a broad audience. Learn more about the maternal benefits of breastfeeding in our overview article.
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Obese when compared to those with normal body fat had much higher inflammation: 53% higher CRP, 30% higher TNF-a, 17% higher WBC count, 42% higher IL6 linkinghub.elsevier.com
Strong link between accumulated visceral fat and chronic inflammation.
A person’s waist-to-hip ratio compares their waist measurement to that of their hips. A high ratio can be an indicator of excess fat accumulation around the waist, often referred to as visceral fat. Findings from a 2005 study suggest that visceral fat is associated with markers of inflammation.
Visceral fat is stored in the abdominal cavity near the liver, pancreas, and intestines. The accumulation of visceral fat is linked to increased risk of cardiovascular disease and other chronic diseases. Many factors drive visceral fat accumulation, including poor sleep, an obesogenic diet, and sugar-sweetened beverage intake, among others.
The study involved more than 3,000 healthy males and females (18 to 89 years old) living in Greece. The investigators calculated the participants' body mass index (BMI) and measured their waist and hip circumferences. Participants provided blood samples for the assessment of inflammatory biomarkers, including C-reactive protein (CRP), tumor necrosis factor-alpha (TNF-alpha), amyloid A (an apolipoprotein secreted in the acute stage of inflammation), white blood cells, and interleukin-6 (IL-6).
The investigators found that approximately 36 percent of the males and 43 percent of the females had excess visceral fat. Approximately 20 percent of the males and 15 percent of the females had obesity. Participants with greater visceral fat had 53 percent higher CRP, 30 percent higher TNF-alpha), 26 percent amyloid A, 17 percent higher white blood cell counts, and 42 percent higher IL-6, compared to participants with normal fat distribution. The relationship between visceral fat and inflammatory markers was stronger than that between obesity and inflammation, even when considering the participants' age, income, education, and other potential confounding factors.
These findings suggest that visceral fat and inflammatory processes are linked. The investigators posited that excess accumulation of visceral fat may increase the risk for cardiovascular disease by driving inflammation.
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Weighted vests may produce changes in body mass through perturbation of a homeostatic "gravitostat," a system regulating appetite by sensing weight www.sciencedaily.com
Exploiting the “gravitostat,” a novel homeostatic mechanism that regulates body weight, promotes weight loss.
Having overweight or obesity increases a person’s risk of developing many chronic diseases. But losing weight loss is challenging, partly due to homeostatic mechanisms that regulate body weight. Findings from a 2020 study suggest that exploiting a novel homeostatic weight-regulating mechanism called the gravitostat promotes weight loss in humans.
The concept of the gravitostat first emerged in 2017, when scientists implanted small weights into the abdomens of mice and found that the animals’ food intake decreased, promoting weight loss and improving glucose tolerance. They suggested that the gravitostat regulates weight via a negative feedback system involving bone cells called osteocytes. Because osteocytes can sense changes in bone strain, the investigators proposed that increasing the animals’ body weight activated a biological sensor that communicated with the osteocytes of weight-bearing bones to drive changes in eating behaviors and subsequent weight loss.
In the 2020 study, the investigators conducted a randomized controlled trial involving 69 adults with mild obesity (body mass index of 30-35). About half of the participants wore a heavy weighted vest (11 percent of their body weight) for eight hours every day for three weeks, while the other half wore a light vest (1 percent of their body weight). Before and after the intervention, the investigators weighed the participants and analyzed their body composition using bioelectrical impedance.
They found that participants who wore the heavy vest lost an average of 1.37 percent more bodyweight than those who wore the light vest, translating to about 3.5 pounds. Those who wore the heavy vests also lost fat mass and gained fat-free mass. These findings suggest that the gravitostat regulates body weight in humans and exploiting it provides a possible strategy for losing weight.
Overcoming other aspects of bodyweight homeostasis might still prove challenging, however. Research from Dr. Eran Elinav’s lab suggests that metabolic parameters normalize with weight loss, but characteristics of the microbiome remain unchanged. In other words, the microbiome holds a memory of past obesity that promotes weight regain. Preclinical studies indicate that repeated weight cycling shifts gut microbes to a configuration with an altered ability to metabolize flavonoids — compounds that usually help promote the burning of excess energy by adipose tissue. Learn more in this clip featuring Dr. Eran Elinav.
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Inadequate sleep may preferentially act as a trigger for visceral fat accumulation (randomized controlled crossover study) www.sciencedaily.com
Inadequate sleep drives abdominal fat gains.
Visceral fat is body fat that is stored in the abdominal cavity near the liver, pancreas, and intestines. The accumulation of visceral fat is linked to type 2 diabetes, insulin resistance, inflammatory diseases, certain types of cancer, cardiovascular disease, and other obesity-related conditions. Findings from a recent study suggest that not getting enough sleep increases the risk of developing excess visceral fat.
Sleep is essential for human health. Not getting enough sleep or having poor, fragmented sleep promotes the development of many chronic illnesses, including cardiovascular disease, hypertension, diabetes, stroke, obesity, and depression. Scientists don’t fully understand the mechanisms that drive these effects, but some evidence suggests that disturbances in circadian rhythms play vital roles.
The trial involved 12 healthy young adults (aged 19 to 39 years) who engaged in an in-patient sleep study. Participants were allowed to have either a full night of sleep (nine hours of sleep opportunity) or restricted sleep (four hours of sleep opportunity) for two weeks. After a three-month washout period, participants repeated the study with the opposite sleep experience. The investigators measured the participants’ caloric intake, energy expenditure, body weight, body composition, and fat distribution throughout the study period.
They found that when participants were sleep-restricted, they consumed approximately 13 percent more protein and 17 percent more fat (translating to about 300 calories) daily, but their overall energy expenditure did not change. Sleep-restricted participants also gained weight. Much of this weight was in the abdominal area, with a 9 percent increase in total abdominal fat area and an 11 percent increase in visceral fat, compared to when they got a full night’s sleep.
These findings suggest that insufficient sleep increases caloric intake and promotes weight gain and visceral fat increases. Learn more about the harmful health effects of insufficient sleep in this episode featuring sleep expert Dr. Matt Walker.
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Seventy percent of adults living in the United States have overweight (BMI greater than 25) or obesity (BMI greater than 30), putting them at increased risk of metabolic disease. Extra fat stored around the body promotes inflammation and insulin resistance, but extra abdominal fat is particularly dangerous. Findings of a recent report suggest consuming foods rich in unsaturated fat and dietary fiber may improve fat distribution in females.
Fat stored in the lower body, called subcutaneous fat, is located just under the skin. Fat stored in the abdominal region, called visceral fat, is wrapped around the internal organs (e.g., the liver, pancreas, and intestines). Visceral fat interferes with lipid metabolism in the liver, promoting insulin resistance, type 2 diabetes, and non-alcoholic fatty liver disease. A diet that includes avocados, which are rich in mono-unsaturated fats and dietary fiber, is associated with lower abdominal obesity.
The investigators recruited 105 adults between the ages of 25 and 45 years who had overweight or obesity. They assigned participants to receive meals with avocado (about one Hass avocado) or meals without avocado that were matched for calories and total fat. The two meals contained different amounts of saturated fat, unsaturated fat, and fiber. Participants consumed their assigned meals once per day for 12 weeks and were told not to change their diet in other ways. Participants completed an oral glucose tolerance test to measure insulin resistance and had their body composition measured using X-ray.
In females, avocado consumption decreased visceral adiposity and the ratio of visceral to subcutaneous fat, indicating an improvement in body fat distribution. Both males and females in the control group experienced a loss of subcutaneous fat and an increase in the ratio of visceral to subcutaneous fat, indicating a worsening of body composition over the 12 weeks. Avocado consumption had no effect on insulin resistance.
The authors concluded that avocado consumption improved body fat distribution in females, but had no effects on body fat distribution in males or on insulin resistance in either males or females.
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Chloroquine or hydroxychloroquine, when used in combination with metformin, increased risk of death in mice blogs.sciencemag.org
Chloroquine and hydroxychloroquine are antimalarial drugs currently being used under Emergency Use Authorization as treatments for COVID-19. Recently published data from a mouse study suggest that these drugs carry a significant risk of death when either is given in combination with metformin.
Metformin is a drug commonly used to treat type 2 diabetes. It is the fourth most commonly prescribed medication in the United States, with more than 80 million prescriptions for the drug written yearly.
Previous research has demonstrated that chloroquine and metformin, when used independently, exert anti-cancer effects. The current study investigated whether the two drugs, when used in combination, would have a synergistic effect against cancer.
The authors of the study injected mice with saline, chloroquine, hydroxychloroquine, and/or metformin for four weeks. They found that the combination of chloroquine and metformin killed 40 percent of the mice. The combination of hydroxychloroquine and metformin killed 30 to 40 percent of the mice. All the treated mice exhibited high levels of lactate dehydrogenase and creatine kinase – indicators of tissue damage. Some of the mice treated with hydroxychloroquine and metformin exhibited signs of increased autophagy in their hearts, livers, and kidneys.
These findings suggest that when chloroquine or hydroxychloroquine are given in combination with metformin, they can increase the risk of death in mice. Further clinical trials are needed to determine if these findings translate to humans.