One of the foundations of treatment for metabolic syndrome is lifestyle change, including following a healthy, balanced diet. I frequently see patients in my office who have metabolic syndrome, and often there are big benefits to be had from relatively simple changes to their diets. We should remember that each person is unique, and ultimately the diet that works best is the one that can be kept up and become the ‘new normal’ for each person. However, there are some general considerations for thinking about what you eat when you have metabolic syndrome, and I have outlined some important principles below.
Replace simple carbohydrates with complex carbohydrates
All carbohydrates are large molecules made up of lots of smaller sugar molecules. Simple carbohydrates are digested quickly by your body and broken down into simple sugar molecules. This means they are absorbed into your blood very quickly and cause a large spike in blood sugar after you eat them. Unless you have a very active lifestyle, your body cannot use the large spike of blood sugar for energy and will store most of it as fat. Also, because they are absorbed quickly, simple carbohydrates do not keep you feeling full for very long, and therefore can lead to overeating. In contrast, complex carbohydrates are more difficult for your body to digest, and release sugar into your blood more slowly.
It can be confusing to know which carbohydrates are simple and which are complex. I like to use the concept of ‘cellular’ and ‘non-cellular’ carbohydrates (I know this sounds complex but bear with me!). All carbohydrates come from plant sources. Simple carbohydrates are non-cellular – they are carbohydrates that have been processed to remove them from the plant cells that originally contained them and allow fast digestion. This includes carbohydrates like table sugar, most types of flour (this means things made with flour like bread, noodles, pasta, dumplings etc.) and white rice (which has been processed to remove the simple starchy carbohydrate from the rice grain). In contrast, complex carbohydrates are usually cellular – they are carbohydrates that are in their natural form and still contained within a plant cell. This means our bodies have to break down the plant cells first before they can get access to the carbohydrate. Complex carbohydrates include potato, sweet potato, brown rice, oats, fruit, etc.
Swapping simple carbohydrates for complex carbohydrates can have benefits such as lowering blood sugar, helping weight loss and preventing hunger between meals.
Be mindful of the types of fat you are consuming
The general medical advice for people with metabolic syndrome is to reduce total fat to 25% of total daily calories, reduce saturated fat to below 7% of total calories, and choose unsaturated fats over saturated fats. If you are like most of my patients, this is not very easy to understand!
In real terms, this means trying to make sure that for every meal only around a quarter of the calories come from fats. Fat contains almost twice as many calories per gram than either protein or carbohydrate so this can take some getting used to. Luckily there are apps available that can tell you the breakdown of protein, fat and carbohydrate for most common foods.
Saturated fats come from sources such as meat, certain plant oils such as palm kernel or coconut oil, dairy products including cheese, butter, and milk processed meats including bologna, sausages, hot dogs, and bacon and pre-packaged snacks including crackers, chips, cookies, and pastries. Recent research has shown that saturated fats are not as bad for your heart health as once thought, but you should still be mindful of your consumption of these foods. In contrast, unsaturated fats are linked with benefits to heart health and come from sources such as nuts, plant oils such as canola, vegetable, or plant oil, certain fish like salmon, tuna, and anchovy, olives and avocados.
References
Saklayen MG. Current Hypertension Reports (2018) 20: 12