7. Metabolic syndrome in adolescents: role of cholesterol sources, eggs, and others (original) (raw)

Metabolic syndrome (MetS) in adults and now adolescents identifies patients in need of intensive intervention to prevent cardiovascular disease (CVD), type 2 diabetes mellitus, and other chronic diseases. It is based upon the presence of three of five criteria: elevated blood pressure, glucose tolerance, low high-density lipoprotein-cholesterol (HDL-C), high triglycerides, and abdominal obesity. Hormones, etc., from adipocytes, especially from visceral adipose tissue, and/or hyperinsulinemia are considered responsible for MetS and eventually chronic disease. MetS is increasing in adolescents in whom cardiac abnormalities have been noted. Treatment of MetS in adults and adolescents involves reducing fat mass/weight in obese people and dietary changes for each aspect of MetS. In the 1970's dietary recommendations for prevention of CVD were based on misinterpretation of data from epidemiologic studies and animal studies where lipid metabolism differs greatly from humans. Eggs with a high cholesterol and low saturated fat content allow evaluation of the effect of diet on blood cholesterol. Results indicate clearly that dietary cholesterol does not increase low-density lipoprotein-cholesterol but increases HDL-C except in diabetics and cholesterol hyperresponders. This has been known for more than a decade, but dietary guidance for CVD continues to encourage restriction of dietary cholesterol and thus eggs. The positive effect of eggs on blood lipids is accompanied by the best quality protein in our food supply and antioxidants essential for health of the macula of the eye and avoidance of cataracts, i.e. highly bioavailable lutein and zeaxanthin. Milk also provides complete proteins and is the source of the most bioavailable calcium plus vitamin D that is being revealed as vital throughout the body. Milk includes more bioactive peptides than any other common protein food in the diet of the US. Healthful effects of many of them have been identified. Eggs and milk can be powerful allies in management of MetS.