Is Your So-Called Good Diet Slowly Killing You? If you have Syndrome X -- and 60 to 75 million Americans do -- the widely recommended low-fat, high-carbohydrate diet may be the surest route to a heart attack. Now, Gerald Reaven, M.D., the pioneering Stanford University doctor who discovered Syndrome X, explains Even if your total cholesterol level is perfect, it may not shield you from a heart attack. Carbohydrates can be just as harmful as red meat or butter. A diet high in "good" fats (as much as 40 percent of calories) is actually better for you. The Zone diet, the Atkins diet, and the American Heart Association diet can each be dangerous under certain conditions. The failure of insulin, the body's "sugar cop," to process blood sugar is the key to Syndrome X. The Syndrome X diet and exercise program will keep you healthy and protect your heart even if you do not suffer from insulin resistance.
Tested in carefully controlled research settings and in practice, the Syndrome X program is safe, effective, and easy to follow.
Reaven does a good job of explaining insulin resistance (metabolic syndrome) to a lay audience. It's not a laugh riot, but if I wanted cartoons I might have read Insulin Resistance for Dummies. It helped me understand why my triglycerides went up while my HDL went down, all the while my blood pressure was inching up along with my A1c. Most doctors (mine included) treat these situations as separate, inevitable consequences of aging. Mine is too polite even to allude to the usual "wouldn't hurt you to lose weight" tactic most doctors use.
Aside from the explanation that I was craving, Dr. Reaven mostly just recommends a tweaking of the diet to slightly reduce carbohydrate and protein intake and to offset those reductions with poly- and monounsaturated fats. He also wants the obese among us to lose weight, using this same plan. Stop smoking.
Boiling down what was relevant to me: obesity doesn't cause metabolic syndrome (he suggests 50% heritability), it does make it worse. Diet should be 45% carbohydrate/40% fat (30-35% poly- and mono-)/15% protein.
Edited 1/17/11: I've read some more recent studies that contradict Dr. Reaven's assertion that protein affects glycemic response as much as carbohydrates do (e.g. http://jn.nutrition.org/content/136/1...). His explanation of metabolic syndrome is still worth reading, and his diet plan isn't so radical that it will hurt anyone. Still, maybe an updated edition is in order.
Very technical, but I liked it because it helped me understand what is going on in my daughter's body, and how much worse it could be. Understanding that diet change and exercise are the best thing she can do is a relief.