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L’Accademia del Fitness

INTEGRATORS FOR THE METABOLIC SYNDROME The Italian Longitudinal Study on Aging (ILSA) identifies a 25.9% metabolic syndrome prevalence (J Gerontol A Biol Sci Med Sci 2006;61:505-10). The physiopathological mechanisms of this syndrome have not been clearly identified yet, although a fundamental role is certainly played by insulin resistance (IR), by fatty acid accumulation mainly in the abdomen and by oxidative stress which can give rise to variations in the body mass composition of elderly people and not only. (Domiguez L, Barbagallo M. The cardiometabolic syndrome and sarcopenic obesity in older persons. J Cardiometab Syndr 2007;2:183-9.). Moreover, the adipose tissue can produce many biologically active substances, generally known as adipokines, in response to specific extracellular stimuli or to modifications in metabolic conditions. These substances - as well as some inflammatory cytokines such as interleukin 1 (IL-1), interleukin 6 (IL-6), Tumour necrosis factor α (TNFα), which are probably produced also by inflammatory cells which filter into the adipose tissue - include new highly active substances such as ghrelin, leptin and adiponectin (Am J Physiol HeartCirc Physiol 2007). Therefore, in obese subjects adipokines - together with inflammatory cells which spread into the adipose tissue - produce a number of cytokines which not only enhance inflammation but give rise to a process of chronic inflammation which is strictly linked to the appearance of the main complications of obesity such as insulin resistance, diabetes mellitus and cardiovascular disorders. This situation is associated to a clear decrease in cytokine levels and in anti-inflammatory and regulating chemokines such as adiponectin and IL10 (Signalling role of adipose tissue: adipokines and inflammation in obesity. Biochemical Society Transactions 2005). A chronic state of inflammation due to excessive fat can lead to micro-vascular dilation reduction together with capillarization reduction and also to hypertension and modulation of post receptor peripheral insulin signal (IRS – 1, IRS - 2 and P – 3kinases mediators) together with generalised insulin resistance, but above all concerning muscle tissue.

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States of “chronic” hyperglycemia can lead to: Glucotoxicity with mitochondrial disorder and reduction in ATP, fusion proteins and lipid oxidation. There is a possibility of intracellular lipid deposition and reduction of type 1 muscular fibres (sarcopenia) which, moreover, are the most sensitive to the action of insulin, with further deterioration of insulin resistance. Cytoplasmic dysfunction and free radicals increase. Protein glycation of vasal walls with microangiopathy and endothelial alteration. Increased TRG level in VLDL (dyslipidemia) with production by the liver of small and dense LDL which have high levels of apolipoproteins B and are more atherogenic for the same values of circulating LDL, as they tend to penetrate the arterial walls more easily. This determines their involvement in the pathogenesis of an atheromatous lesion independently from other risk factors. As we have seen, various factors are involved in the metabolic syndrome going from chronic inflammation, excessive production of free radicals, glucose disorders, dyslipidemia and so on. Therefore, integration must take into consideration a number of factors and never concentrate on one single disorder (in short, stabilising glycaemia is not enough). Only a small range of integrators which are useful for the metabolic syndrome and which can be used daily are taken into consideration here. Magnesium, chrome and vanadyl help keep insulin sensitivity under control and have an effect on glucose control. A recent study ((2013) (High Dietary Magnesium Intake Is Associated with Low Insulin Resistance in the Newfoundland Population. PLoS ONE 8(3): e58278) puts into correlation the intake of high levels of magnesium with a low incidence of metabolic syndrome and insulin resistance, above all in obese or overweight subjects. Green tea is also useful (Agric Food Chemistry. 50:7182-7186), and so are high quantities of vitamin B such as biotin (9-16 mg per day) and cinnamon extract, which controls disorders in insulin interaction with cells (1-6 g per day). Lipoic acid, or ALA, reduces high glucose levels independently from insulin and acts as an antioxidant in both lipo- and hy-

N. 10 - July 2013  

Wellness & Antiaging magazine

N. 10 - July 2013  

Wellness & Antiaging magazine