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Which is better for treating metabolic syndrome: Dietary changes or new drugs?

A new drug shows promise of treating metabolic syndrome. However, those developing drugs may or may not be educating the public enough on dietary changes and natural remedies that have reversed metabolic syndrome without drugs in some people. You also may wish to check out articles such as, "Metabolic Syndrome - Dr. Weil's Condition Care Guide," "Natural remedies show real benefit in metabolic syndrome," " Traditional Chinese Medicine in Treatment of Metabolic Syndrome," and " Healing Food—Metabolic Syndrome | Alternative Medicine."

Which is better for treating metabolic syndrome: Dietary changes or new drugs?
Anne Hart, photography.

So few articles get into the hands of the public or their health care teams about using food changes such as reducing portion sizes. Large amounts of foods, particularly carbohydrates, have a greater impact on glucose tolerance. You also may wish to check out, "Effective treatments for insulin resistance: trim the fat and douse the fire." Some recommendations suggest a Paleo diet. Others a modified Mediterranean diet. And still others a vegan reversal diet focusing on small portions and a reduction in fats, salt, and sugars.

You have metabolic syndrome if you have three or more of the following signs:

•A waistline of more than 40 inches if you are a man or 35 inches if you are a woman. (Use a tape measure placed over your belly button. Bear in mind that an estimated 25 percent of thin people also have insulin resistance.)
•Elevated fasting glucose (blood sugar) above 100 mg/dl.
•Fasting insulin levels above 10 mcIU/ml.
•Blood pressure above 140/90 mm Hg.
•Triglyceride above 150 mg/dl.
•LDL (low-density lipoprotein cholesterol) above 130 mg/dl.
•HDL (high-density lipoprotein cholesterol) below 35 mg/dl.

University of Utah researchers have discovered that an enzyme involved in intracellular signaling plays a crucial role in developing metabolic syndrome, a finding that has a University of Utah spinoff company developing a drug to potentially treat the condition. You also have few mainstream news articles touting studies on the effects of fructose compared to foods with high sugar contents on the blood, defects in genes that show up in family histories of metabolic syndrome, and more information for thin people who make up 25% of the population with metabolic syndrome.

Notice how many universities or educators have "spinoff companies" that develop drugs rather than to do clinical trials in using food as medicine. In the case of the new drug that shows promise in treating metabolic syndrome, the researchers, led by Jared Rutter, Ph.D., professor of biochemistry, hope to begin human clinical trials of a drug in the next couple of years. Nothing wrong with that, of course. But how many universities have a focus on using food as medicine to reverse conditions exacerbated by unhealthy diets or highly-processed foods?

“The approved drug therapies do not treat or prevent this condition in most people,” says Rutter, according to a July 3, 2014 news release, "Drug shows promise for effectively treating metabolic syndrome." Rutter is the senior author of a study describing the research published July 3, 2014, in Cell Reports. “But given the results of our research with mouse and rat models, we are hopeful that metabolic syndrome can be effectively treated with drug therapy someday soon.”

Metabolic syndrome, a group of conditions that increases the risk for developing heart disease, diabetes and stroke, is estimated to affect up to 25 percent of adults. Public health officials believe metabolic syndrome has reached epidemic proportions in the United States and elsewhere.

Metabolic syndrome includes disorders such as high blood pressure, high blood sugar levels, abnormal cholesterol readings, and obesity. One of the prominent features of the syndrome is the excessive production and storage of fatty acids and triglycerides.

In research with rodents, Rutter, doctoral student and first author on the Cell Reports study Xiaoying Wu, and Allen Nickols of BioEnergenix, a company Rutter co-founded in 2009, discovered that an enzyme known as PASK stimulates the overproduction of fatty acids and triglycerides. PASK works by chemically modifying other proteins in order to alter their specific functions. One of the proteins it modifies is SREBP-1c, which functions as the master regulator of all of the enzymes that make fat.

Using a drug candidate being developed by the University of Utah spinoff company BioEnergenix, the researchers prevented PASK from modifying SREBP-1c. This, in turn, prevented SREBP-1c from increasing the production of enzymes that make fat, resulting in a drop in the levels of fatty acids and triglycerides in mouse and rat livers. Insulin resistance and diabetes were also partially reversed in diabetes-prone animals.

“We hope that this is an example where science leads us not only to a better understanding of how the body works, but also to the discovery of approaches that we can use to treat human disease,” Rutter says, according to the news release.

Researchers don’t know what causes fatty acids and triglycerides to be overproduced, and that will be a focus of Rutter’s ongoing research as well as trying to understand how PASK activates SREBP-1c.

This study is a prime example of a public/private partnership to advance research and health care, a model becoming more common in medical and other scientific research. In this case, a U of U spinoff company is using a University of Utah-developed technology to improve the knowledge and clinical treatment of an issue with a major impact on U.S. health.

To address this health issue, the University of Utah recently established the Center for Diabetes and Metabolism, which pairs researchers and clinicians who work side by side to develop treatment and prevention options. Rutter serves as co-director of this center.

The University of Utah Diabetes and Metabolism Center (DMC) brings together an interdisciplinary team of clinicians, scientists and educators to discover the root causes of diabetes and diabetic complications, to translate that knowledge into treatments and cures, to provide seamless head-to-toe diabetes care, and to prevent diabetes in those at risk. The DMC was launched as a University of Utah Health Sciences strategic research initiative in 2014.

In one study, if you take a look at the abstract of that study, "Diet-Induced Alterations in Gut Microflora Contribute to Lethal Pulmonary Damage in TLR2/TLR4-Deficient Mice," you can read about how a chronic intake of Western diet has driven an epidemic of obesity and metabolic syndrome. Ji et al. now show that chronic intake of a Western diet leads to lethal pulmonary damage in immunodeficient mice. The lethality is mediated in part through gut dysbiosis, given that it is transmissible to wild-type immunocompetent mice upon cohousing or fecal transplantation and blocked by antibiotic treatment.

Another noteworthy study is about an "Anti-Aging Hormone That Could Make You Smarter." Or see another study's abstract, "Pressing Mitochondrial Genetics Forward." Or see, "Autophagy in neurons: it is not all about food." There's also another noteworthy study, "NUCKS Is a Positive Transcriptional Regulator of Insulin Signaling."

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