BagelAn estimated two-thirds of all Americans have syndrome X. This mysterious-sounding term refers to a cluster of conditions many Americans are familiar with: abdominal obesity (a "spare tire" around the middle); high blood pressure, high blood triglycerides and high blood cholesterol levels. These heart disease risk factors tend to occur together, thus the term "syndrome." However, if you have even just one of the conditions combined with insulin resistance — a prediabetic condition that can cause any of the others — you have Syndrome X.

Syndrome X develops over time, primarily from a diet high in refined carbohydrates such as sweets, breads and flour- and sugar-based snack foods. These foods trigger a rapid increase in blood sugar levels, and the body responds by raising levels of insulin, the hormone that moves blood sugar into cells. The more carbohydrates consumed, the more the body pumps out insulin to deal with all the extra blood sugar. Eventually, insulin resistance develops — the body becomes overwhelmed by the volume of insulin and becomes sluggish in response to it. High insulin promotes fat storage, raises blood pressure and worsens blood fat profiles.

The most serious condition resulting from insulin resistance is Type II diabetes. The condition, therefore, can be considered "prediabetes." Not only does Syndrome X set the stage for Type II diabetes and heart disease, it may also increase the risk of Alzheimer's disease and some types of cancer. In addition, Syndrome X generates high levels of cell-damaging free radicals and causes premature aging.

This health issue has become a public problem: 55 percent of Americans are overweight, 50 million have elevated cholesterol levels and 50 million have high blood pressure. Middle-aged baby boomers are the most likely candidates for this prediabetic condition. But it can affect teenagers and children too. Consider that 25 percent of children and adolescents are now obese, and more and more of them are being diagnosed with Type II diabetes, a condition deemedadult-onset.

The early warning signs indicating a fast track to developing Syndrome X include extra weight around the waist; frequent cravings for sweets, breads and other carbohydrates; and tiredness or sleepiness after meals.

ScaleAnti-X diet
However, there is good news about Syndrome X. The condition is a nutritional disease that develops primarily from eating the wrong foods. That means it can be prevented and reversed with a change in diet and a good supplements regimen.

The anti-X diet combats insulin resistance and Syndrome X on all nutritional fronts. In the area of carbohydrates, Rule No. 1 is to avoid the main dietary culprit behind the condition: refined carbohydrates. This includes some of the most common foods in the American diet: bread, pasta, bagels and sweets of all sorts—basically all foods made with sugar, other concentrated sweeteners, white flour and white rice. Although it may seem strange to avoid foods that are so entrenched in the American culture, eating a lot of these foods is exactly what has caused Syndrome X to be such a common health problem. Consider, as well, that women who eat large amounts of refined carbohydrates have double the risk of developing Type II diabetes as those who eat less refined foods (Journal of the American Medical Association, 1997, vol. 277).

Refined carbohydrates are the worst foods for blood sugar control, but too many natural carbohydrate-dense foods — such as whole grains, corn and potatoes — also quickly raise blood sugar to high levels. Include these foods in small amounts in a balanced diet if you're just trying to prevent the condition. However, if you already have Syndrome X, you should avoid these and other carbohydrate-dense foods, such as fruits and legumes, until your weight, blood pressure and blood fats normalize.

Instead of ingesting refined carbohydrates or carbohydrate-dense foods, try nonstarchy vegetables, such as salad greens, spinach, broccoli, green beans and asparagus. Nonstarchy vegetables protect against Syndrome X because they cause minimal rises in blood sugar and insulin levels and are rich in nutrients and fiber.

The types of fats you eat also make a big difference. Be sure to avoid trans-fats, found in fried foods, most margarines and foods that contain partially hydrogenated oils. Make an oil change: Get rid of all vegetable oils in your house, and make the switch to heart-healthy oils made from olives, flaxseeds, hemp seeds, grapeseeds and walnuts. Also, eat cold-water fish several times a week. Research shows that eating a diet that emphasizes monounsaturated fats, such as olive oil, and omega-3 fats, like those found in cold-water fish, are very effective measures against Syndrome X. After one year, people eating a diet relatively high in these healthy fats became more sensitive to insulin and less insulin resistant; had reductions in blood pressure, fasting glucose and triglycerides; and had increases in HDL (good) cholesterol (Diabetologia, 1996, vol. 39, supp. 1). If you don't like fish, you can increase your omega-3 intake by taking omega-3 supplements or eating omega-3-enriched eggs, dark green vegetables, flaxseeds and flaxseed oil.

Protein is important because it stimulates the production of glucagon, a hormone that opposes insulin and allows the body to burn stored body fat. Eating small amounts of protein throughout the day helps prevent the urge to overeat carbohydrates. Good sources include fish, eggs, poultry and game meats. Many people have been led to believe that protein-rich diets promote heart disease — a primary consequence of Syndrome X — because of the saturated fats in meats. However, recent research strongly contradicts this belief. A 14-year study of more than 80,000 women by researchers at Harvard Medical School discovered that women with the highest protein intakes were 26 percent less likely to develop heart disease than those who ate the least protein (American Journal of Clinical Nutrition, 1999, vol. 70).

Vegetarian sources of protein, such as beans, aren't good protein choices for those with Syndrome X because they raise blood sugar and insulin levels significantly higher than meat (American Journal of Clinical Nutrition, 1997, vol. 66). If you prefer, you can follow a vegetarian version of the anti-X diet by emphasizing eggs, high-protein dairy foods such as cottage cheese, and tofu. Be sure to supplement with anti-X nutrients you might miss in a vegetarian diet, such as zinc and omega-3 fatty acids.

Anti-X supplements
Antioxidants such as alpha-lipoic acid, natural vitamin E and vitamin C are nutrients that scavenge cell-damaging free radicals, which are more prevalent in individuals with Syndrome X. They also help normalize blood sugar and insulin function or improve insulin sensitivity (Diabetes und Stoffwechsel, 1996, vol. 5, Supp 3;American Journal of Clinical Nutrition, 1993, vol. 57; 1994, vol. 60).

The three most important anti-X minerals are chromium, zinc and magnesium. All three play critical roles in maintaining proper insulin function; deficiencies of these minerals disturb normal insulin function and increase the risk of Syndrome X and Type II diabetes. Supplementation, however, can prevent or even reverse these conditions. Chromium is so effective at reversing insulin resistance in patients for example, that one 1997 study found that 1,000 mcg of chromium picolinate daily completely corrected Type II diabetes(Diabetes, 1997, vol. 46).

The herb standout for Syndrome X is milk thistle (Silybum marianum). The herb and its active ingredient, silymarin, have long been known to improve liver function, and the liver plays an important role in maintaining normal blood sugar levels. In the largest human study of silymarin in the treatment of Type II diabetes, those taking silymarin experienced a significant drop in their blood sugar levels but did not experience bouts of low blood sugar. The patients' fasting insulin levels decreased by an average of 40 percent — indicating a significant reduction in insulin resistance (Journal of Hepatology, 1997, vol. 26).

Syndrome X is a modern health problem caused from lack of physical activity combined with a diet high in nutrient-poor foods that stress blood sugar mechanisms. The condition can be prevented and reversed with the anti-X diet, supplements and exercise. Studies show that simply going for a daily walk can greatly improve the body's ability to process blood sugar effectively.

Melissa Diane Smith, Dipl. Nutrition, is a nutrition counselor and the co-author of Syndrome X: The Complete Nutritional Program to Prevent and Reverse Insulin Resistance (John Wiley & Sons). For more information see

Photography by: Joe Hancock