Tuesday, February 05, 2008

Estimated 10% of Teens in US Have Metabolic Syndrome!

The February issue of the Journal of Pediatrics reports a recent study finding an alarming increase in the prevalence of Metabolic Syndrome (MetS) in teens in the United States.

First, let's look at the definition of MetS for teens used to determine how many teens are estimated to have the condition:
  • a waist circumference at or above the 90th percentile for age and sex;
  • blood pressure at or above the 90th percentile;
  • a high triglyceride level at or above 10 mg/dL;
  • a low HDL cholesterol level at or above 40 mg/dL;
  • and an impaired glucose metabolism at or above 100 mg/dL (pre-diabtes)

Using data from the National Health and Nutrition Examination Survey (NHANES) from 1999-2002, the researchers found that an estimated 9.4% of teens meet the definition MetS; and that 33% of obese teens, classified by BMI, fall within the definition.

This is pretty disturbing when we consider the last time such data was reviewed, back in 2003 (using earlier-years NHANES data), it was found that 4% of teens met the difinition of MetS above.

To be fair, some quibble that the definition for teens is less stringent than adults, and that if the adult definition is used, then 5.8% of teens meet the adult definition of MetS and 25% of obese teens meet the adult definition.

The bottomline is that no matter how you slice and dice the data, there is a rising prevalence of metabolic syndrome among teens in the United States.

Back on October 2006 I wrote about the increasing prevalence of hyperinsulinemia in the adult population in the United States. At the time, I wrote, "[l]ike the canaries in the mine, slowly dying in the presence of odorless but harmful gases, we're slowly dying in the presence of seemingly logical yet harmful dietary recommendations. All the researchers can keep repeating is eat less and move more; while encoraging us to eat more more whole grains, more fruits and vegetables, more skim milk and non-fat dairy, more beans, more soy and limit saturated fat by eating less meat."

Now today, we're seeing an alarming rise in the incidence and prevalence of metabolic syndrome in our teens - tomorrow's adults - and being spoon-fed the pab that "that the increased prevalence is driven by the rise in obesity."

As the Editor's Perspective noted in the journal, "The obesity epidemic in children is out of control. Our children are living in an obesiogenic environment that fosters all of the components of the metabolic syndrome, regardless of the definition used. It is very likely that a high proportion of youth today who have all the components of the metabolic syndrome will go on to develop cardiovascular disease and type 2 diabetes in adulthood. Clinicians must continue to increase their awareness of the existence of the syndrome and begin to treat it before it becomes even more of a health hazard for our youth."

Here's the big, glaring problem - the elephant in the room if you will - it isn't weight gain per se that is driving up the incidence of metabolic syndrome in our young population - it is the diet they're consuming that's driving up their blood glucose and insulin; and that is causing elevated triglycerides, suppression of HDL, hypertension, visceral fat accumulation and impaired glucose metabolism in a state of chronic hyperinsulinemia!

This is happening despite improvements to school lunches, greater awareness about limiting sweetened beverages, increasing activity in and out of school, and consistent messages about healthful "low-fat" eating inundating our kids today; this is happening because they're still being encouraged to consume a diet rich with carbohydrate, the message now being whole grains are better than refined grains.

It's excessive carbohydrate driving the bus here and until we're able to, as a population, wrap our head around the idea that we cannot continue to feed our children a diet rich with excessive carbohydrate - whole grain or otherwise - that is also concurrently deficient in micronutrients and essential fatty acids and amino acids, we will not see these trends reverse.


  1. Regina,

    It is just as likely that it is the plastics that have been in the bloodstreams of these teens since birth which has caused the damage that makes their bodies unable to handle carbs.

    If you haven't seen it, do check out this article How Plastic We've Become" in Science News and then look at the report about plastics recently found in baby's bloodstream.

    These chemicals seem to disrupt the normal carbohydrate metabolic pathways which is why carbs become a problem. For a person with a truly normal metabolism, eating carbs is not the problem it is for people who have sustained damage.

    Unfortunately, with the rising levels of plastic poisoning in our society over the past decades, the damage now extends to a lot of us.

  2. Plastic is probably IMO contributing to an already existing problem of excessive carbohydrate in our diet. Long before plastics we had T2 diabetes, heart disease and the various disorders now considered metabolic syndrome clustering in humans.

    I do believe that much of the "acceleration" we're seeing today - in younger and younger individuals presenting with MetS, pre-diabetes, T2 and such - is due largely to our dependance on highly refined carbohydrate as the mainstay of our diet, and even excessive levels of carbohydrate overall, even when someone is choosing the "whole grain" options claimed to be healthful.

    Carbohydrate per se is not problematic IMO when it is contextually in a diet rich with nutrients and not an excessive source of calories each day....the type of diet we begin even infants on in this country is truly deplorable - refined cereals as the first food? Talk about loading the deck against the metabolism from the start!

    But, yes, I do think in some way much of the chemical assaults also play a role somewhere - be it plastics disrupting endocrine function or pesticides interrupting the CNS....diet is one part, our environment and exposure another. I just don't think the plastics are greater than the diet IMO.

  3. I really wish the officials would get it into their heads that obesity is not a cause of MetS - it is a symptom. Treating the symptom won't make the problem go away.

    As for plastics - I was born in 1969, and I ate a terrible diet going up - lots of starch, lots of sugar, and refined/hydrogenated vegetable oils everywhere. But I didn't start getting fat until my 20s. I have always attributed that to the fact that my mother did not attempt to limit fat (and therefore, protein) in our diets until my late teens, when the lowfat vogue really started to catch on! So I ate a fair amount of fat and protein with all that starch and sugar until around 1984 or 1985. By the mid-nineties, I was showing signs of disordered BG, including hypoglycemia and weight gain of nearly 10 lbs a year.

    Nowadays, the official guidelines are that children should be fed a low-fat diet starting at age 2. Surely that's at least as likely a culprit as environmental contamination?

    So I don't really know what to make of Jenny's hypothesis, except to caution against fatalism. Ridding our world of plastics will be so difficult that most people will thow up their hands and say, "Guess I'm stuck with diabetes." But whatever the causes of diabetes, we know the most effective means to delay its progression - carbohydrate avoidance.