December 13, 2013

Is Pasteurized Orange Juice Healthy?

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Is Pasteurized Orange Juice Healthy?There’s a lot of debate about the effects of pasteurization on the nutritional value of orange juice and while some have made a decent effort to focus on the facts, most of it is sensationalist speak.

Yeah, we get it, pasteurized orange juice isn’t 100% the same as freshly squeezed orange juice, but did you really expect it to be?

More importantly, is pasteurized orange juice that much lower in quality and nutrition than freshly squeezed orange juice that we might as well completely avoid it? Is there any point in drinking bottled orange juice?

So let’s dig right in.

How Nutritious is Pasteurized, 100% Orange Juice?

In an effort to provide practical recommendations, I will refer to pasteurized, 100% orange juice as the kind you get pre-bottled in stores (for example Tropicana).

This doesn’t include the ‘diet’ versions or the Vitamin D and/or Calcium fortified kinds though.

Anyways, to answer the above question, we must look at the nutritional value of fresh oranges, because that’s where bottled orange juice comes from and then we’ll look at the effects of the processing techniques used to make the bottled juice.

Fresh Orange Calories and Nutritional Information

Orange Juice Calories & Nutrition InformationSource: USDA

In addition to what’s shown above, 1 orange also contains the following % Daily Values (DV):

  • 6% DV of Vitamin B1 (Thiamin)
  • 4% DV of Vitamin B2 (Riboflavin)
  • 3% DV of Vitamin B3 (Niacin)
  • 12% DV of Vitamin B9 (Folate)
  • 7% DV of Potassium
  • 2% Manganese

Needless to say, there’s a lot of important vitamins and minerals packed into this lovely citrus fruit and it’s a great source of sugar.

Ok, so the important question (especially for those who drink bottled orange juice instead of freshly squeezed) is: does the processing reduce the nutritional value of bottled 100% orange juice?

Well let’s look at the processing methods utilized by one of the largest bottled 100% orange juice makers, Tropicana.

Orange Juice is Pasteurized

1. According to Tropicana, the fresh oranges are washed, then the orange oil is extracted from the peel to capture the orange taste, and then the oranges are squeezed.

2. Following that, the orange juice is flash pasteurized (30-60 second heat treatment) to kill off pathogens and harmful bacteria.

Did you know that Odwalla (the juice company) switched over to pasteurized juices after a mini E. Coli breakout was linked to their non-pasteurized fruit juice back in 1996?

3. Finally, to meet year round demand, some (it’s unknown how much of it, so let’s assume all of it) of the pasteurized juice is deaerated (process by which oxygen is completely removed) and stored for future packaging in light free and temperature controlled tanks to preserve the quality of orange juice.

What Does the Available Science and Research Have to Say About Pasteurization and Deaeration?

In one research paper, which compared the rate of vitamin C loss of deaerated orange juice and non-deaerated orange juice (both batches were flash pasteurized for 15 seconds), the researchers concluded that the rate of vitamin loss is the same and was largely dependent on how much oxygen the liquids were exposed to (the more oxygen exposure, the more vitamin c was lost).

In addition, the researchers observed that the rate of ascorbic acid loss was greater in non-de-aerated juice.

Another interesting observation in the study is that the vitamin c levels of deaerated orange juice were about 20-22% lower than in non-deaerated orange juice.

Here’s what the vitamin c levels look like starting from Day 0 until Day 60 in the deaerated orange juice (A, first graph) and non-deaerated orange juice (B, second graph).

Orange Juice Pasteurization Effect on VitaminsIn case you’re wondering, the different lines correspond to different levels of oxygen permeability (Source)

Another study that looked at the effect of pasteurization (60 seconds) on orange juice nutritional quality, found that Vitamin A content decreased by about 13% after pasteurization at 70 degrees C for 1 min.

Moreover, a slight decrease in vitamin C content was observed after pasteurization (source).

A third study observed a ~15% reduction in Vitamin A content in orange juice that has been pasteurized compared to fresh orange juice (source).

In a fourth study, the reduction of Vitamin A and Flavanone content of pasteurized (30 seconds) orange juice was in the range of 2-10% compared to unpasteuried freshly squeezed orange juice (source).

I think the pattern is pretty clear. Pasteurization and deaeration does have an effect on the nutritional content of orange juice, but this appears to be a non-issue for several reasons:

  1. The decreased levels of the vitamin content is anywhere between 5 to 20%, which in the case of Vitamin C isn’t a big deal since Vitamin C levels in orange juice are already pretty high.
  2. There is a clear benefit for pasteurization in that it prevents the outbreak of pathogens such as E. Coli.
  3. Practically speaking, drinking orange juice from bottled juices is much easier and even cheaper than freshly squeezed orange juice.

So yes, pasteurized orange juice isn’t 100% the same as freshly squeezed orange juice, but then again, nothing in life is as cut and dry as we would have wanted it to be.

A cost-benefit analysis is necessary to live life to the fullest and this isn’t any different, especially when considering the nutritional value you get from orange juice.

Bottomline: If you can afford to drink freshly squeezed orange juice all the time, then by all means, that’s your best bet. But when such luxuries aren’t available (whether its affordability or convenience), then bottled orange juice is a very good and practical alternative for a healthy source of vitamins and sugar.

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The Not So Funny Irony of Medical ‘Experts’

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Not So Funny Irony of Medical ExpertsI recently debunked the benefits of raspberry ketones as a weight loss supplement in an effort to shed light on yet another overhyped and useless weight loss pill.

While a lot of people recommend raspberry ketones for weight loss (for example Dr. Oz), there are a few who have reported the truth. Among them is a nutritionist called Kimberly Snyder

So what?

Well the reason I bring this up today is to provide an interesting example of how little trust you can put in medical experts.

If you recall from above, Dr. Oz recommends raspberry ketones for weight loss. In fact, he’s such a staunch supporter of it that he featured it on his show and his website as a “fat burner in a bottle”.

Here’s the YouTube clip of the raspberry ketones segment from his show:

I don’t know Dr. Oz personally so I have no idea how he is off his show, but his unyielding confidence in promoting raspberry ketones as a fat burner on his show is very concerning.

Millions of people watch his show (are you one of them?) and I can only guess that most, if not all, will blindly take his recommendations as the truth.

If you haven’t read my report on raspberry ketones, I recommend you take a look through it, but the bottom line is simple: raspberry ketones do not work as a fat burner.

So what does Kimberly Snyder have to do with all this?

It just so happens that Miss Snyder also believes raspberry ketone pills don’t work and are “gimmicky”, but if you take a look at her website, you’ll notice that she’s “endorsed” by Dr. Oz.

Dr. Oz Endorsement

Moreover, she is also a “reoccurring nutritional and beauty expert on The Dr. Oz Show”.

I won’t comment on any of Miss Snyder’s articles, but accepting an endorsement from someone who has a completely opposing/contradicting view on something as significant as a fat burning weight loss product should be an eye opener to all readers.

As for Dr. Oz, his public relations team definitely needs to do a better job screening for endorsements.

Anyways, my only point with all of this is be careful whom you trust and always scrutinize advice and recommendations (including mine)!

Just because someone is a medical expert or is endorsed by one, doesn’t make them any more credible to hand out medical, health, or nutritional advice.

If you’re bored, go to Google.com and type “raspberry ketones” and try to spot the irony. Or you can just look for it in this screenshot of the Google.com results.

Raspberry Ketones Google Results

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Creatine Guide: Benefits, Side Effects & How to Take

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In Supplements Posted
Creatine Side Effects and BenefitsCreatine (better known as Creatine Monohydrate) is a popular ergogenic aid used by athletes and physically active individuals alike. Not surprisingly, creatine is one of the most widely marketed, widely researched, and highly controversial supplements to date.

Due to its popular use, the numerous media reports linking creatine supplementation to health concerns (liver/kidney dysfunctions, muscle cramping, gastrointestinal) and side effects has caused a lot of confusion.

In my continued efforts to provide you with definitive answers on all things health, nutrition, fitness, and metabolism, I’ve created yet another honest and comprehensive report on creatine to clear up the confusion.

This report will clearly outline the benefits of creatine, the side effects of creatine, the optimal dose for the best and safest results, and address other frequently asked questions.

It goes without saying, everything written in this report is based on the available science literature.

What is Creatine?

Creatine is a dietary amino acid (protein building block) naturally found in meat and fish and is created by the body in the liver, pancreas, and kidneys from the amino acids glycine, arginine, and methionine (source).

Creatine is converted into phosphocreatine and is mostly stored in skeletal muscles (95% of all creatine in the body is found in muscles) where it is used as energy for short-duration intense physical activity (source).

Little was known about its function in the body until a group of researchers from University Medical School in the UK identified creatine’s primary role to be involved in the formation of adenosine triphosphate (ATP) (source).

ATP is a crucial coenzyme in the body that powers intracellular metabolic reactions such as muscular contractions.

Creatine Side Effects

The Benefits of Creatine: In a nutshell, creatine supplementation helps to increase energy (ATP) availability by increasing the levels of phosphocreatine in the body. In doing so, creatine helps to prolong the onset of fatigue, thusi allowing you to train harder and longer.

Mechanism of Action: The muscles of your body require ATP to power the contractions needed for movement (source).

When one molecule of ATP is used for contraction, ATP is hydrolyzed to adenosine diphosphate (ADP, which differs from ATP by having one less phosphate) and a free phosphate. This newly formed ADP can be reconverted back into ATP by phosphocreatine.

And it turns out that creatine helps to increase the formation of phosphocreatine (source 1, source 2, source 3, source 4).

In turn, the increased levels of phosphocreatine stimulate the generation of ATP via the metabolic reaction between ADP and phosphocreatine, in which phosphocreatine donates a phosphate to ADP thus yielding ATP (source 1, source 2).

Adenosine Diphosphate has 2 phosphates whereas Adenosine Triphosphate has 3 phosphates.

Does Creatine Increase Muscle Mass?

To be clear, creatine supplementation only helps to replenish the energy available for contraction.

The point being is that creatine does not increase your muscles’ maximal potential contractile force. Instead, it increases the energy available to perform the activity, thereby prolonging the onset of fatigue and allowing you to train longer and harder.

Therefore, creatine doesn’t have a direct effect on muscle mass (no evidence is available to say otherwise). Rather, the effect is indirect and depends on whether you actually train harder as a result of the increased energy availability.

This is a subtle difference, but there appears to be a misunderstanding of how creatine works among weight lifters and supplement marketers so I feel it’s important to point out the distinction.

Are There Any Negative Side Effects to Creatine Supplementation?

Various anecdotal side effects such as gastrointestinal discomfort, muscle cramping, and liver/kidney impairment have been reported. But as with any anecdotal claim, one must put them aside and focus on the scientific literature available.

Luckily for all of us, creatine monohydrate safety has been studied and examined by many researchers and reported on in various publications and studies.

As a result, several academic reviews have analyzed the available data on creatine supplementation safety and found that: there are no adverse health effects associated with long term supplementation of up to 3-5g/day of creatine monohydrate (source 1, source 2, source 3, source 4, source 5, source 6, source 7)

Furthermore, the European Food Safety Authority (EFSA) published a record which stated that oral long-term intake of 3g pure creatine per day is risk-free (source)

So what about doses of more than 5g/day? Unfortunately there isn’t enough evidence for or against long term supplementation of higher doses to make any definitive conclusions, but please read the next section for more insight regarding this.

Is Loading Necessary?

Results from short term studies (28-30 days) comparing the effect of different doses of creatine monohydrate on total phosphocreatine levels demonstrate that cycling is not necessary.

For example, 2 such studies, similar phosphocreatine levels can be achieved by both a mega dosing (20-25g/day for 5-7 days) + maintenance (2g/day for 20-30 days) protocol and a constant (3g/day for 30-35 days) protocol (source 1, source 2).

Moreover, the half-life of creatine is reported to be between 1.5 to 3 hours, therefore a higher dose of creatine is more likely to go to waste. This is the reason why researchers and marketers recommend taking several doses of a few grams throughout the day instead of one larger dose (source 1, source 2).

Therefore, for the two reasons above as well as the lack of sufficient evidence regarding the long term safety of higher (>5g/day) dosages of creatine supplementation, it is best to stick to doses of 3-5g/day.

How Much Should You Take?

In a nutshell, the safest and most optimal dose is 3-5g/day day. This has been covered in the previous 2 sections (Creatine Side Effect and Creatine Cycling).

The reasoning for this recommendation is based on numerous studies reporting on the safety of creatine supplementation, the effect of different doses of creatine supplementation on levels of phosphocreatine in muscle cells, and of course financial considerations.

What is the Best Form of Creatine to Take?

Creatine Monohydrate powder is the best form to take.

Creatine monohydrate is the most extensively studied form of creatine, therefore we have sufficient data to understand its mechanism of action and more importantly, there is enough evidence demonstrating its safety in humans.

Furthermore, creatine monohydrate supplements are the cheapest on the market so why waste money on special, unproven forms of creatine, which are sold at a premium!

What Foods Contain Creatine?

  • Beef (~4.5grams of creatine/kg of beef)
  • Chicken (~3.5grams/kg)
  • Cod (~3grams/kg)
  • Herring (~6grams/kg)
  • Pork (~5grams/kg)
  • Salmon (~4.5grams/kg)
  • Tuna (~4grams/kg)

(source 1, source 2)

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How to Get Rid of Cellulite: 8 Super Effective & Practical Tips

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In Guides Posted
8 Super Effective Tips To Get Rid of CelluliteOver the past few months I’ve received a couple emails asking about cellulite and how to get rid of it.

Given that cellulite affects about 85-90% of women, but only 5-10% of men (source), it sounded like the perfect opportunity to do some serious research on female specific health issues.

After endless hours of digging into this topic, I am delighted to share with you some great news:

With the right, optimal techniques, you can get rid of cellulite and improve the appearance of your skin.

And if that wasn’t enough, these solutions are super practical and safe.

If you want to jump straight to the list of recommendations, feel free to scroll towards the end of the article.

Having said that, I do encourage all readers to take a few extra minutes to read through the first few parts as it’ll give you a great understanding of what cellulite is and what causes it.

What is Cellulite?

Cellulite is simply the appearance of dimpled, “cottage cheese-like” skin surface typically seen in women on the thighs and buttocks (source).

Please note that cellulite is not a medical term and tissue biopsy examinations have shown that cellulite is no different from ordinary fatty tissue (source).

Therefore, cellulite should not be seen as a disease or some kind of allergic reaction. Instead, cellulite is just the visible accumulation of fat deposits under the skin.

What Causes Cellulite?

To understand why these fat deposits appear as cellulite in most post-pubertal women but rarely in men, we first need to look at how the layers below the skin are structured.

Cellulite Skin Anatomy

(Source: WebMD)

As you can see, there are several layers just under the skin, but the layer we are most concerned about is the Hypodermis, which contains the fat deposits held together by connective tissue (n white in the pic above).

When fat cells increase in size or in number (for e.g. due to excess calories or unhealthy eating habits), these fat deposits also grow in size and begin to push against the surrounding connective tissue, thus leading to the appearance of cellulite.

Female-Specific Characteristics

Interestingly, microscopic examinations and magnetic resonance imaging comparing men and women reveal several characteristics specific to females that make women more susceptible to develop cellulite (source 1, source 2).

  1. Women with cellulite have a thicker inner fat layer cellulite (i.e. larger fat deposits) (source). This is not surprising when considering women tend to have a higher body fat percentage than men.
  2. Compared with men and women without cellulite, women with cellulite have a connective tissue matrix that is less rigid with fewer criss-crossing. Since the connective tissues hold the fat deposits in place, a weaker connective tissue matrix makes it easier for fat deposits to unevenly bulge upwards against the skin (source).
  3. Men’s outer skin layer is thicker than that of women, therefore any bulges caused by fatty tissue growth will likely be more visible in women than in men (source).

Cellulite Graph Study - How To Get Rid of Cellulite

The figure above shows that women with cellulite have significantly more connective tissue running perpendicular to the skin (instead of parallel or diagonal) therefore making it much more likely that any growth in fat deposits to be visible against the skin (source).

Another interesting thing to note about the figure above is that the connective tissue matrix of women without cellulite resembles that of men very closely.

Therefore, it can be said that females are not necessarily doomed to a life of cellulite.

Although other explanations have been proposed for the appearance of cellulite (for e.g. water retention or disease-induced inflammation), the best evidence supports the notion that cellulite is due to larger subcutaneous (under the skin) fat deposits and differences in the structure of connective tissue (source).

Hormones and Cellulitecellulite-hormones

Given that cellulite is present in the majority of post-pubertal women, but rare in men, it’s not surprising to find evidence linking hormones (for e.g. estrogen) with the appearance of cellulite (source).

For example, in a group of post-menopausal women who were given estrogen, reduced collagen (the group of proteins that make up connective tissue) content was observed in the connective tissue region that supports the pelvis.

On the flipside, this was not seen in the group of post-menopausal women who were not given estrogen replacement (source).

Better yet, the collagen concentration was almost doubled in post-menopausal women compared to pre-menopausal women when estrogen is not replaced.

And that’s not all… the collagen structural organization was also changed towards more cross-linking (i.e. increased strength/stability) after menopause.

Summary of Factors that Contribute to Cellulite Formation

  • Excess fat
  • Weaker connective tissue matrix
  • Reduced collagen content
  • Thinner skin

So it becomes clear that only actions that oppose the above factors can be effective in getting rid of cellulite and improving the look of your skin.

So without further delay, here’s a list of things you can do today to get rid of your cellulite. You don’t have to do them all, but the more you do the quicker your cellulite will disappear.

Practical, Safe, and Effective Steps to Improve and Get Rid of Cellulite

1. Eat Lots of Protein Everyday for Improved Muscle Maintenance and Increased Fat MetabolismEat Protein to Get Rid of Cellulite

It goes without saying that eating clean is super important, but making sure you consume enough protein every day is crucial to maintaining a healthy metabolism.

In fact, about 50% of a cell’s dry mass is made up of proteins! Thus it can’t be stressed enough how important adequate protein consumption is (source).

If that’s not enough to convince you to eat more protein, you’ll be happy to know there’s a lot of evidence showing that protein increases metabolism twice to three times as much as carbohydrates and fats (source).

Plus, don’t forget that connective tissue is primarily made up of protein.

How much exactly? About 2g of protein per 1kg of body weight is needed on a daily basis (don’t worry too much about hitting that exact number, but do your best to at least come near it).

In case you’re wondering, the 2 grams of protein recommendation is based on studies showing that about 1.8 to 2g of protein/1kg of body weight had the most favorable effect on increasing fat-free mass and burning fat (source).

2. Consume Coconut Oil to Burn More FatEat Coconut Oil to Get Rid of Cellulite

The molecular structure of coconut oil makes it an efficient and more direct source of energy for your cells, thus increasing your metabolic rate, especially in those with underlying health and metabolism issues (source).

I’ve written a detailed report about the health benefits of coconut oil, so feel free to look it over if you want more information.

How much exactly? About 1 tablespoon per day appears to be effective, but feel free to use more to replace your other sources of fat (for e.g. cooking oils).

3. Drink Coffee to Burn Fat and Get Plenty of AntioxidantsDrink Coffee to Get Rid of Cellulite

In addition to being abundant in antioxidants, coffee is also an awesome fat burner.

In fact, the caffeine in coffee is such a significant fat burner that just about any fat burner supplement on the market is made with caffeine.

For those worried about potential adverse effects from drinking coffee, you’ll be glad to know that you have little to worry about. You can take a look at this recent report from Harvard for more information.

How much exactly? 200-300mg of caffeine/day is a safe target. 1 cup of brewed coffee has about 100mg of caffeine (source) and an espresso shot has about 65 to 75mg (source).

4. Eat Lots of Fresh Fruits EverydayEat Fruits Drink Coffee to Get Rid of Cellulite

It goes without saying vitamins and minerals found in fruits also play a very crucial role in maintaining a healthy body and metabolism.

For example, Vitamin C, which is abundant in fruits such as oranges, melons, berries, etc… promotes the synthesis of collagen, which is needed for a strong connective tissue matrix (source).

Vitamin C also promotes the formation of Carnitine, which is an enzyme needed to fully burn fat for fuel. In fact, lower Vitamin C intake leads to decreased levels of fat oxidation (burning of fat) (source).

How Much Exactly? I don’t want to suggest a specific level since these recommendations are meant to be practical so eat at your own pace and don’t be afraid to consume plenty of fruits!

5. Eliminate All Sources of Polyunsaturated FatsEliminate Polyunsaturated Fats to Get Rid of Cellulite

Vegetable oils, nuts, peanut butter, seeds, etc… are abundant in polyunsaturated fats (PUFAs), which are highly susceptible to an inflammatory process called peroxidation.

I cannot stress enough how damaging PUFAs are to your health. In addition to being linked to serious health illnesses,  these fats greatly contribute to fat accumulation (source 1, source 2)

How Much Exactly? Do yourself a favor and avoid ALL sources of polyunsaturated fats like your life depends on it (because it does!).

6. Eat More Gelatin for Stronger, Firmer Connective TissueEat Gelatin To Get Rid of Cellulite

Given the importance of connective tissue in holding the fat deposits together under your skin, it would make sense to improve the overall health and strength/firmness of these types of tissue.

30% of the total protein content in your body is found in connective tissue thus further underlining their importance in your health (source).

The most interesting bit is that the amino acid profile of connective tissue is unique and very different from other types of muscle tissue in the body. Therefore, given modern society’s eating habits, I bet you’re not consuming much, if any, sources of collagen proteins.

Luckily for us gelatin is basically made up of the same amino acids as connective tissue (glycine, proline, alanine, arginine, etc…), making it a very good source of amino acids for connective tissue. (source). This shouldn’t be surprising since gelatin is derived from animal connective tissue.

How Much Exactly? 0.6g of gelatin protein per 1kg of body.

I should point out though that there isn’t an exact science behind this recommendation other than 0.6 grams corresponds to 30% of the earlier 2 grams of protein/1kg of body weight (which is based on experimental evidence). Why 30%? Well that’s because roughly 30% of your body’s total protein content is collagen-type proteins (source).

7. Take a Vitamin E Supplement to Counter the Effects of Estrogen and Prevent Collagen Breakdownvitamin-e-cellulite

Not only has Vitamin E been shown to counter the effects of Estrogen on cells (source), it has also been shown to suppress the age-dependent increase in collagenase, which is an enzyme that breaks down collagen (source).

If that’s not enough, Vitamin E has also been shown to also counter the negative effects of PUFAs (source 1, source 2).

If you recall from above, PUFAs damage your health and will contribute to the appearance of cellulite.

Those who regularly read my articles know I’m not one to recommend taking supplements. Instead, I believe getting the vitamins, minerals, and nutrients you need from natural food sources.

However, in rare cases the benefits of taking a supplement dwarf any possible downside of doing so and Vitamin E is one of those cases. Moreover, the availability of Vitamin E in natural food sources is very limited (those who understand why, good for you for seeing the link!)

How Much Exactly? 200-300mg/day.

8. Perform Resistance Training (2x/week) to Burn Fat and Strengthen Your Muscles/Connective TissueResistance Training to Get Rid of Cellulite

Whether you prefer cardio, cross fit, or no exercise at all, you’re doing yourself a disservice by avoiding resistance training.

Resistance training confers the most benefits in terms of muscle and collagen growth, toning (firmer muscles and connective tissues), burning fat, and keeping you healthy (source).

How Much Exactly? Two 60 minute sessions/week is all you need! The reasoning behind this is simple: Since protein synthesis (i.e. the process that builds muscle and collagen) is stimulated for up to 48-72 hours after an intense session of resistance training, it’s optimal to rest 2-3 days between each session to fully recover and avoid any injuries (source).

Final Remarks

So there you have it. You now know what cellulite is, what contributes to its appearance, and most importantly, how to get rid of it.

The wealth information found in this article is very valuable not just for helping you reduce cellulite and improve the overall health and look of your skin, but also for promoting general health.

If you want optimal health, a killer metabolism, and an awesome body, I highly encourage you to incorporate all the above recommendations.

They’re not difficult, expensive, or dangerous. It doesn’t get any more practical than this!

If you have any questions or need any further help, feel free to contact me.

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Metabolic Syndrome Risk Factors

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In Disease, Risk Factors Posted
Metabolic Syndrome Risk FactorsI’m sure you’ve heard of the term ‘Metabolic Syndrome’ associated with an elevated risk of  Type 2 Diabetes, cardiovascular disease incidence, and all-cause mortality (source 1, source 2), but what you may be less aware of are the risk factors associated with ‘Metabolic Syndrome’.

The World Health Organization (WHO) and the International Diabetes Federation (IDF) developed a list of risk factors associated with “metabolic syndrome” (source 1, source 2), so I’ve compiled them here for your reference.

Risk Factors

WHO - Insulin Resistance (high homeostatic model assessment insulin resistance (HOMA-IR)) and/or impaired fasting glucose (110–125 mmol/L) plus at least 2 of the following factors:

  • Body mass index (BMI) >30 kg/m2.
  • Waist-to-hip ratio (WHR) >0.9 and >0.85 for men and women, respectively.
  • High-density lipoprotein (HDL) cholesterol <0.35 and <0.40 mg/dL for men and women, respectively.
  • Triglycerides >150 mg/dL.
  • Hypertension (>140/90 mmHg and/or antihypertensive medication).
  • Microalbuminuria (this happens when urine albumin levels are out of normal range due to abnormal functioning of the kidney) (source).

IDF - Central obesity with waist circumference >94 and >80 cm for men and women, respectively, (values vary depending on ethnicity), plus at least 2 of the following factors:

  • Hypertriglyceridemia (>150 mg/dL).
  • Low HDL cholesterol (<40 and <50 mg/dL for men and women, respectively).
  • Hypertension (>130/85 mmHg or treatment of previously diagnosed hypertension).
  • Impaired fasting glycemia (>100 mg/dL or previously diagnosed T2DM).
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