What do we do when we just can’t lose weight?

No, don’t tell me we’re not trying hard enough. Some folks have fallen into the black hole of (no) weight loss- metabolic syndrome. I know that sounds like gobbledygook- and to some degree it is. Because it is not an illness per se, but a combination of risk factors that mean the subject is not losing weight, can succumb to heart disease, and/or diabetes.

There are five risk factors.

-The first is a large waistline (over 40 inches if you are a guy, over 35 if you’re female). Guess what- this is the biggest indicator. Why? Because abdominal fat is the more active fat component in our bodies. Oh, and it is also leads to insulin resistance (which means diabetes)- which is why this syndrome was formerly known as insulin resistance.

-The second is high triglycerides (blood fat) over 150 mg/dL. (Please note that if you are on medication to control these that does NOT mean you don’t have high levels.)

-Low HDL (good cholesterol or high density lipopolysaccharides), below 40 mg/dL, means it is more difficult to flush cholesterol out of your arteries- and puts you at higher risk for cardiac disease. (Again, if you are on medication to control low HDL, you still are at risk.)

-High blood pressure (systolic- or top number- over 160, diastolic- or the bottom number- over 90; some researchers consider 135/85 as the start), which also leads to a slew of diseases (diabetes, cardiac and/or kidney failure). (Again, medication to control high blood pressure still means you are at risk.)

-High fasting blood sugar over 100 mg/dL, which is typically a sign of diabetes onset. (Yes, of course, if you are on medication to treat this, you are still at risk.)

Now, consider that this syndrome describes about 1/3 of adults in the US. And, if you are Black, Hispanic, Native American, even Asian- you have a double whammy. Because these populations have genetic makeups that lessen the ability to lower the risk factors.

One of the best solutions is to switch one’s diet. To the one I mention frequently- the Mediterranean diet. This diet “pigs out” (no bacon, it’s just higher in) on nuts, whole grains, fruits, vegetables, fish, and olive oil. Choosing this diet has shown its ability to lower insulin resistance and blood lipids (compared to more “normal” diets). Cutting alcohol intake to one glass a day is another good choice. As is 140 to 200 minutes of exercise a week.

Know what else this diet does? It seems to preclude the development of both Parkinson’s and Alzheimer’s diseases, as I’ve written before.

It seems that this diet is also critical in mitigating the effects of renal disease.  Drs.  G Strippoli and J Kelly (along with SC Palmer, SN Wai, M Ruospo, JJ Carrero, and KL Campbell) examined seven studies of some 15285 subjects with chronic kidney disease.   Those who followed the Mediterranean diet had significantly lower mortality.

And, one more thing….

Drs. FN Jacka, A O’Neil, R Opie, S Istiopoulos, S Cotton, M Mohebbi, D Castle, S Dash, C Mihalopoulos, ML Chatterton, L Brazionis, OM Dean, AM Hodge, and M Berk reported the results of their SMILES trial. (SMILES is the Supporting the Modification of lifestyle In Lowered Emotional States trial, the protocol of which is described in this link.) This single blind, randomized study of diet over 12 weeks examined if moderate to severe depression could be alleviated. The 176 participants were affiliated with Barwon Health (Geelong) and St. Vincent’s Health (Melbourne), both in Australia.

Drs. Finka et al described the dietary results of 67 of the participants (34 of which were the controls). Of these 67, 55 were undergoing treatment; 21 via both psychotherapy and pharmacotherapy, 25 via pharmacotherapy alone, and 9 by psychotherapy. The mean age of the subjects was 40 y. This study was initiated to discern if nutritional psychiatry has any merit. (This concept becomes more critical as more and more folks don’t respond to medication and/or psychiatric intervention.)

The diet chosen was the Mediterranean one. (Of course, it was. Why else would I be discussing it here, since the ultimate link is the high fruit, vegetable, bean, fish, whole grains, olive oil, and nut diet. [Please note that lean red meat was allowed in this particular study protocol.]) Moreover, the control group had the equivalent of a dietician and social support, so that the only variable would the diet itself.

The good news? 1/3 of the folks met the criteria for remission after the 12 week study. That compares favorably to the (only) 8% from the control group. Now, many psychiatrists caution that this may only be add-on treatment. (After all, neither the dietary group nor the controls ceased their other therapies.) There was no obvious weight loss during the trial, which is fine, since that was not one of the objectives of this study.

Let’s up the ante even more. These are depressed patients. Depressed folks – unless they receive assistance- are unlikely to have the motivation or the planning skills to cook these healthy meals. (I can see it now. Diet-to-Go is now offering Mediterranean diets to cure depression!) Moreover, since the folks were depressed when entering the trial, many had poor dietary habits already.

So, what the heck are you waiting for?   Isn’t it time you also adhere to the Mediterranean diet?