Some 40 million Americans are thought to have syndrome X,1 and there are likely to be several million who are rapidly moving in that direction. Syndrome X is thought to be a driver of heart disease, hypertension, cancer, diabetes mellitus, obesity, depression, and other diseases.2 Syndrome X refers to an abnormal metabolic state that is characterized by insulin resistance, hyperinsulinemia, hypertriglyceridemia, small dense LDL’s, decreased HDL’s, postprandial lipemia and some other changes.2 More recently, other metabolic abnormalities have been associated with syndrome X, including an increase in inflammatory markers such as C-reactive protein (CRP), plasminogen activator inhibitor (PAI), fibrinogen, and interleukin-6 (IL-6).3
An increase in plasminogen activator inhibitor and fibrinogen results in an increase in fibrin deposition, which ultimately correlates to an increase in fibrous tissue deposition…certainly an enemy to joints and muscles and long thought to be associated with reduced joint motion and subluxation. Indeed, research suggests that with certain patients, their back pain is due to excessive fibrin deposition that leads to spinal tissue fibrosis and chronic pain.4 So, it seems quite possible that syndrome X promotes joint dysfunction and back pain in certain patients.
Most docs and many lay people are aware of the term “glycemic index,” which generally refers to the blood sugar response to a given food. Foods with a high glycemic index (GI), such as glucose and white bread, produce elevated levels of blood sugar, compared to foods with a low GI, such as most vegetables, meats, and most fruits. If people eat high GI foods, the result will be an increase in blood sugar and increased levels of insulin, that is hyperinsulinemia.
It is thought that eating high GI foods over time will drive syndrome X. Diets that are high in carbohydrates and low in protein and fat are also thought to the drive syndrome X. Several other nutritional factors are thought, though, to promote hyperinsulinemia, and syndrome X, including deficiencies in magnesium, chromium, biotin, potassium, and vitamin E; elevated ratios of omega-6 to omega-3 fatty acids; physical inactivity; and even stress (elevated cortisol and reduced DHEA).2
It is reasonable to assume that any patient who has the nutritional imbalances listed above, has an increased chance of developing syndrome X. To be sure about one’s sugar handling capability and insulin status, you can perform a glucose tolerance test.
Assuming a patient does not have diabetes, the treatment approach is straight-forward. Patients must eat low GI foods. It is best to eat five small meals per day, or three moderately sized meals and 2-3 low GI snacks. Water is the preferred beverage. This dietary regimen will help reduce body fat, which is a key goal in the fight against syndrome X. It is known that fat cells release tumor necrosis factors that can block the insulin receptor, thereby promoting hyperinsulinemia and syndrome X.5
As several vitamins and minerals are involved in glucose handling, it also makes sense to take a multivitamin and a magnesium supplement. Omega-3 fatty acids help to stabilize blood sugar, so a fish oil supplement is also a wise measure to consider.
Most people in America literally begin a dietary mission to reach the goal of syndrome X by the time they reach forty years of age. Our dietary habits are abysmal in America, a land in which abundant health is a viable option. In early December of 2003, ABC television aired a special show about diet in America. Sugar foods and fast foods are the most common foods consumed in America. In the era of “fat free” foods, Americans still managed to pack on additional pounds; the reason for this…sugar replaced the fat, in fat-free foods.
While many patients and doctors are not interested in preventing syndrome X, heart disease, cancer, back pain, subluxation, and the like, there are many patients who very much want to be free of their health burdens. The approach described in this short article is very easy to follow. If you want to motivate your kids and younger patients, let them know that acne is driven by hyperinsulinemia6, which should get their attention.
Dr. Seaman is the Clinical Chiropractic Consultant for Anabolic Laboratories, one of the first supplement manufacturers to service the chiropractic profession. He is on the faculty of Palmer College of Chiropractic Florida and on the postgraduate faculties of several other chiropractic colleges, providing nutrition seminars that focus on the needs of the chiropractic patient. Dr. Seaman believes that chiropractors should be thinking like chiropractors, while providing nutritional recommendations. Doctors and patients who follow his programs report improved feelings of well-being, weight loss, dramatic increases in energy, and significant pain reduction. Dr. Seaman can be reached by e-mail at
Isomaa B. A major health hazard: the metabolic syndrome. Life Sci 2003;73(19):2395-411
Seaman DR. Clinical nutrition for pain, inflammation, and tissue healing. Hendersonville (NC): NutrAnalysis; 1998: p.89-100
Sakkinen PA, Wahl P, Cushman M, Lewis MR, Tracy RP. Clustering of procoagulation, inflammation, and fibrinolysis variables with metabolic factors in insulin resistance syndrome. Am J Epidemiol 2000;152(10):897-907
Jayson MI. Chronic inflammation and fibrosis in back pain syndromes. In Jayson M. Ed. The lumbar spine and back pain. 3rd ed. New York: Churchill Livingstone; 1987: p.411-418
Grimble RF. Inflammatory status and insulin resistance. Curr Opin Clin Nutr Metab Care 2002; 5:551-559
Cordain L, et al. Acne vulgaris: a disease of western civilization. Arch Dermatol 2002; 138:1584-90