•

Metabolic syndrome diseases comes in different forms. Discus there

diseases their causes and methods of nutrition treatment

•Abstract

Metabolic syndrome is not a disease. It's combination of disorders that occurs together and
increases the risk for developing heart disease, diabetes and stroke. Diagnosis depends on the
presence of risk factors. The patient should have at least 3 risk factors to be diagnosed with
metabolic syndrome. Hypertension, diabetes, coronary heart diseases, and obesity are diseases
of metabolic syndrome. Maintaining healthy lifestyle can be benefit in reducing the risk of these
.diseases

•Introduction

In many countries metabolic syndrome has become a major problem in public health. Metabolic
syndrome involves metabolic disorders that are characterized by dyslipidemia, abdominal
obesity, hyperglycaemia, high blood pressure, and impaired metabolism of glucose. Two main
non communicable diseases that are characterized in metabolic syndrome are Cardiovascular
diseases and type 2 diabetes mellitus.( Bae,S and Lee,M(2005),(Kahn,R., Buse,J., Ferrannini,E.
.and Stern,.M.(2005)

An evidence indicates that metabolic syndrome is a strong predictive factor for developing
Cardiovascular diseases and diabetes type 2. The diagnosis of this syndrome depends on the
presence of the risk factors, if the patient has at least 3 or more risk factors he has metabolic
syndrome. about 25% of adults in US and UK are affected by metabolic syndrome, and about 20
to 25 % of Adult population worldwide has metabolic syndrome. the prevalence of metabolic
syndrome is high in elderly over 60 years and obese people. Increasing regular physical activities,
reducing weight and eating a healthy diet low in carbohydrates and saturated fats can be benefit
.to significantly reduce the risk metabolic syndrome. (Barbara,C,. and George,A.(2008)

• Objectives

To identify metabolic syndrome and it's risk factors. To describe and explain the diseases of
metabolic syndrome. To define and explain high blood pressure. To provide information about
.hypertension prevention and dietary management
• Metabolic syndrome

This syndrome is also called syndrome X or insulin resistance syndrome. It's a combination of
metabolic abnormalities that are associated with increasing risk for developing coronary heart
diseases, stroke, diabetes and cancer. Metabolic syndrome consider a strong predictive factor of
.developing cardiovascular diseases and type II diabetes.(Barbara,C,. and George,A.(2008)

• Risk factors of metabolic syndrome

large waistline: In men with waistline > 101.6cm and women with waistline >88.9 cm the risk of
developing metabolic syndrome is increased

The Level of Triglyceride is high (cholesterol):In cases where triglycerides are more than 150
mg / dl or when medications are used to treat high triglycerides, the risk of developing metabolic
.syndrome is increased

Low HDL cholesterol level : In cases where HDL levels are less than 40 mg / dl in males and less
than 50 mg / dl in females, the risk of developing metabolic syndrome is increased, and also
.increased when cholesterol drugs are used

High Blood Pressure (Hypertension): in cases when Blood pressure is more than 130/85mm HG,
the risk for developing metabolic syndrome is increased, and also increased when hypertensive
.medications are used

High level fasting blood sugar (more than 130 mg/dl): mild high blood sugar level can be an
.early sign of diabetes. Also Having medications to treat high blood sugar increases the risk

The people that are at greatest risk for developing metabolic syndrome are who have :
Abdominal obesity, inactive physically lifestyle and insulin resistance. As the number of risk
.factors you have, the risk for heart disease, diabetes and stroke are increased

Other risk factors includes Age : the risk is increased as the we get older, Race: ethnic people like
Asian and African people are at higher risk for developing metabolic syndrome, other health
problems: the risk of metabolic syndrome is increased in case of having cardiovascular disease,
non alcoholic fatty liver disease and in women with polycystic ovary syndrome. (National Heart,
.Lung, and Blood Institute.(2019)/(WebMD.(2019)

• : Symptoms of metabolic syndrome

 metabolic syndrome is diagnosed when there is at least 3 or more symptoms appear like: 1- the
circumference of waist : In European males the waist circumference is 94 cm or more, and in
South Asian males is more than 90 cm and in European and South Asian females is 80 cm or
more. 2- Low HDL levels and High triglyceride levels in the blood. 3- blood pressure is
140/90mmHg or higher (hypertension). 4- insulin resistance. 5- the risk of developing blood clots
.is increased such as DVT. 6- irritation and swelling of the body (inflammation)

• : The Diseases of metabolic syndrome

• Hypertension

Blood pressure is the force of blood pushed against walls of the blood vessels. Hypertension is a
condition that occurs when the blood pressure is abnormally high (higher than 140/90 mmHg),
high blood pressure is divided into two types, idiopathic or primary hypertension and secondary
hypertension. There are factors that are involved as a cause of hypertension such as the
sympathetic nervous system activity is increased, the kidney reabsorption of sodium, chloride
and water is increased, increased rennin angiotensin and aldosterone systems activity, insulin
action resistance, and decreased vasodilation of the arteries. (Smeltzer,S.,Bare,B.and Nokes,K.
.(2010).Brunner ,12th. ed )

• : Causes of Hypertension

Primary hypertension causes: there is no identified reason for essential hypertension. But
genetic influences has an important role in the incidence of primary hypertension.
(Smeltzer,S.,Bare,B.and Nokes,K.(2010).Brunner ,12th. ed ). Risk factor that may play a role in the
occurrence of primary hypertension such as smoking, diet high in salts, decreased physical
.exercise, abdominal obesity, high caffeine intake, lack of vitamin D and insulin resistance

Secondary hypertension causes: these causes are renal, endocrine, cardiac and neurological
causes that includes: Kidney problems such as acute and chronic Glomerulonephritis, chronic
pyelonephritis, stenosis of the renal artery. Endocrine conditions such as Cushing's syndrome,
hypothyroidism, hyperthyroidism, hyperaldosteronism and adrenal hyperplasia. Heart disorders
such as congestive heart failure. Oral contraceptives that accounts about 1% of all hypertension
cases. Neurological conditions such as rised ICP and sleep apnea syndrome. Surgery
interventions. maternal disorders like preeclampsia. Pheochromocytoma. Drugs that can
increase blood pressure as NSAIDs medications, corticosteroids and appetite suppressants.
.(Medical Surgical Notes. (2019-2020). Hypertension)

The prevalence of hypertension: Around 31% of adults in the US have hypertension and the
incidence increases considerably as people grow older or have other risk factors for
cardiovascular disease. The prevalence also varies by race, with the highest prevalence among
African Americans at about 37% (Wong, Lopez, L’Italien, et al., 2007). 90 per cent to 95 per cent
of the overall U.S population of people with hypertension has primary hypertension, the
remaining 5 to 10 percent have secondary hypertension. (Smeltzer,S.,Bare,B.and Nokes,K.
.(2010).Brunner ,12th. ed )

The major cause of worldwide deaths is high blood pressure, hypertension accounts about 40%
of deaths caused by diseases of heart and blood vessels, chronic kidney diseases and diabetes
.type 2 (WHO. World health organization(2018)

• :Hypertension prevention

primary prevention high blood pressure includes maintaining healthy normal body weight (BMI
between 20 to 25kg/m2). Restrict the dietary intake of sodium to 1500 to 2400mg. encourage
physically active lifestyle such as brisk walking ( for about 30 min of more per day, most days of
the week). Limit the intake of alcohol. Encourage increasing intake of vegetables and fruits (at
.least five portions per day). (US National High BP Education Program.(2004)

• : Nutritional management of hypertension

Hypertension can be controlled by : maintaining healthy weight, physically active on most days
of the week, follow a healthy diet plan (DASH diet), restrict the intake of alcohol, and limit the
.dietary intake of sodium. (Smeltzer,S.,Bare,B.and Nokes,K.(2010).Brunner ,12 th. ed )

DASH Diet : This nutrition therapy for elevated blood pressure is called DASH Plan which -
means Dietary Approaches to Stop Hypertension. The DASH diet is focused primarily on fruit,
vegetables, meat free from fats, whole grain, fish, poultry, legumes, and nuts. DASH plan also
focuses on limiting dietary intake of salts, saturated and trans saturated fats. And increasing
intake of potassium, magnesium, protein and fibers that are benefit for reducing and controlling
.hypertension

The goal of the therapy is to lower blood pressure to normal level to prevent heart attack and
stroke

Limiting sodium intake : even when taking high blood pressure medications, restricting intake -
of sodium is important. Limiting sodium intake to 1500- 2400mg of sodium per day. Read the
food label carefully to know how much sodium this food contains. Don't add table salt on food
or add very small amount when cooking. Canned and some frozen foods should be avoided.
 Common preparations like backing soda should be avoided. Smoked canned foods should be
avoided and also smoked fish products should be avoided. (Medical surgical notes.
.Hypertension.(2019-2020)

Dietary modifications of Fats: DASH diet focuses on reducing intake of saturated fats and -
.increase poly unsaturated fats intake

Instructions on reducing unhealthy fats in diet : restrict all foods that contain saturated fats like
fatty meats, butter, cream, cheese sauces and foods make with whole milk, Instead of using
butter, use margarine and vegetable oil. increase intake of food that contain omega 3 fatty acids
like fatty fish as salmon, tuna and fish oil. Increase intake of foods that contain unsaturated fats
.like canola, olive, or sunflower oil

Weight reduction and maintaining healthy weight : having a healthy weight can be very -
helpful for reducing and controlling High blood pressure. DASH diet can help maintain healthy
weight because it restricts high fat foods, carbohydrates, high salt foods, and focuses on
.increasing food intake of vegetables and fruit

• :Diabetes mellitus

Diabetes mellitus is a category of metabolic disorder that has been identified over a long period
of time by high blood sugar levels due to the inability of the pancreas to produce enough insulin
or body cells that do not respond to the insulin produced. World Health Organization.(2014).
There are two types of diabetes. First type of diabetes, which known as insulin dependent
diabetes mellitus, type 1 diabetes accounts about 5% to 10% of all diabetes. The second type of
diabetes is referred to non insulin dependent diabetes mellitus, it accounts about 90 – 95
percent of all diabetes, and 80% of cases with type 2 are obese, and only 20% of these cases are
not obese. Other type of diabetes called gestational diabetes that occurs during pregnancy. It
accounts about 2 to 5 percent of all pregnancies. (Britannica Academic, Encyclopedia Britannica,
31 May. 2017)

Causes of Diabetes: The fist type of diabetes mellitus is caused when the immune system
attacks the pancreatic cells that produces insulin. this process called autoimmune reaction. This
type of diabetes has no specific cause, but there is a triggers that cause this type which are
infection with viruses or bacteria, toxins in food, unknown component makes the immune
.system attacks the body

Type 2 diabetes occurs due to genetic and lifestyle factors such as obesity, increasing age, bad
.dietary habits, a sedentary lifestyle
 The causes of gestational diabetes is unknown. But there is a risk factors that increases the
chance of getting this type includes, obese, family history of gestational diabetes, poly ovary
.syndrome and have had a large baby, and his weight was more than 9lb

there's also other causes of diabetes that includes inflammation of pancreas or panceratectom,
polycystic ovary syndrome, Cushing's syndrome, patients with glucagonoma, and a condition
occurs from long term use of gluccorticoid therapy which known as steroid induced diabetes.
.(Diabetes.co.uk (2019)

Diet management of Diabetes : encourage intake of dietary patterns that involves

carbohydrates from vegetables, fruits, whole grains, legumes, and milk low in fat. Monitoring
dietary carbohydrate intake carbohydrate counting plays an important role in maintaining the
balance between insulin intake and the food. Encourage intake of a variety of fiber containing
foods. It is safe to consume sugar alcohols and non-nutritive sweeteners based on the daily
intake levels established by the Food and Drug Administration. The foods that contains sucrose
can be replaced with other carbohydrates in the meal plan, if these foods are added to meal
plan, the meal plan should be covered with insulin and the other medications of glucose
.lowering, so It's important to provide care to prevent excessive energy intake

Dietary management of fats and cholesterol in patients with diabetes includes limiting the
intake of saturated fats to less than 7 percent of total calories. Decreasing the intake of trans
fats. Limit the dietary intake of cholesterol to less than 200mg per day.( American Diabetes
.Association.(2010)

• : Coronary heart disease

When coronary arteries become too narrow due to the build-up of cholesterol on the walls of
the arteries and the creation of plaques, coronary heart disease develops. Coronary heart
disease is the most common cause of death worldwide. In 2015, 110 million people were
affected by the CAD and 8.9 million died. Coronary heart disease account about 15.6 percent of
all deaths. (GBD 2015 Mortality Causes of Death Collaborators (2016). For a given age the risk of
death from CHD is decreased between 1980 and 2010, particularly in developed countries.
About 20 percent of those over 65 had CAD in the United States in 2010, Although it was found
in 7 percent of those between 45 and 64 years of age and 1.3 percent of those between 18 and
.45 years of age (Centers for Disease Control Prevention (CDC) (2011)

Obesity : is an excessive or abnormal accumulations of fats in the body. About 1.9 billion people
aged 18 years and over were overweight in 2016. And about 650 million of these adults were
 obese. About 39 percent of people aged 18 years or more were overweight (39 percent of males
and 40 percent of females). Overall, in 2016 about 13 percent of the world's adult population
(11 percent of males and 15 percent of females) was obese. Between 1975 and 2016 the global
prevalence of obesity nearly tripled. (WHO. World Health Organization.(2019) Obesity and
.overweight

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