Healthy Eating Tip: Synergy; Use the Helpful Aspects – Avoid the Harmful Aspects!

Synergy can be defined as the interaction or cooperation of two or more organizations, substances or other agents to produce a combined effect greater than the sum of their separate effects. Synergy happens when many elements are combined in the same effort and together become something more than they are alone. They become “more than the sum of their parts.”

A sommelier (pronounced suh-mel-yay) is a wine steward you will find in a very high-end restaurant or hotel with an extensive wine list of several thousand bottles. This person keeps track of and stores the wine properly and assists guests and clients when making wine selections. A sommelier will tell you that a truly exquisite wine shows a synergetic balance between all the flavor and texture elements of the grape and even the barrel it is stored in. These aspects all come together to create something that is greater than any of those elements is alone. Learning to single out those flavor and texture elements in wine is a skill that takes years to develop. Chefs use the same skill when cooking. A primary goal when teaching people how to cook at a high level is to distinguish the individual flavor components of different ingredients so that a few years later, they can recognize when a dozen different components come together to create something more than the sum of their parts. The most humble vegetable soup can exhibit the characteristics of a course worthy of being served in a Michelin Star restaurant if it is done properly. In soups, flavors “open up” like flowers and yield their essence, each at a different time. Capturing the moment when all of the elements of a dish open up, yielding their essence to create something more than individual parts, is what great chefs do. At the highest level, both sommeliers and chefs understand the concept of synergy.

The body does the same thing, and sometimes not in a good way!

In healthcare, we refer to “clustering,” the grouping of illness characteristics into a single diagnosable disorder. The Framingham heart study first popularized the “clustering of risk factors” concept in the late 1950s and early 1960s. Smoking was first identified as a “risk factor” associated with those that had heart disease meaning that if you smoke, you have a significant risk of developing heart disease. Later the Framingham study revealed that high LDL or “bad” cholesterol and low HDL or “good” cholesterol were both risk factors associated with heart disease. The Framingham study eventually identified a list of risk factors for heart disease that are still used today. In the late 1980s, the risk factor concept was taken a step further, and researchers started thinking in terms of “clustering” of illness characteristics. The term “Syndrome X” was coined in 1988 as the clustering of the following cardiovascular risk factors: hyperinsulinemia (elevated blood insulin), hyperglycemia (high blood sugar), hypertension (high blood pressure), high triglycerides and low HDL cholesterol concentrations with the suggestion that insulin resistance was the underlying pathological factor. Also, in 1998 the World Health Organization proposed unifying the definition under the term “metabolic syndrome” and started to identify specific physiological markers with which to make a definite diagnosis. Today the following criteria are now generally accepted as a definition of metabolic syndrome.

  • Elevated waist circumference (abdominal obesity) ≥ 40″ in men, ≥ 35″ in women.
  • Elevated triglycerides ≥ 150 mg/dL or drug treatment for elevated triglycerides.
  • Reduced high-density lipoprotein (HDL)-cholesterol < 40 mg/dL in men, < 50 mg/dL in women, or on drug treatment for reduced HDL-cholesterol.
  • Elevated blood pressure ≥ 130 mm Hg or ≥ 85 mm Hg, or treatment for and history of hypertension.
  • Elevated fasting glucose ≥ 100 mg/dL or on drug treatment for elevated glucose.

Any three of these will earn you a diagnosis of metabolic syndrome. Metabolic syndrome is a cluster of conditions that occur together, increasing your risk of heart disease, stroke and type 2 diabetes. This unifying definition for metabolic syndrome allowed researchers to test whether the clustering of risk factors was associated with an increased risk of disease in addition to the risk associated with the individual components; that is, whether there is a synergetic relationship between risk factors. Using data collected by NHANES II, one study in 2004 found that “in US adults 30 to 74 years of age, MetS (metabolic syndrome) confers an increased risk of CHD (coronary heart disease), CVD (cardiovascular disease) and total mortality and persons with diabetes and/or pre-existing CVD are at even higher risk. Even 1 or 2 MetS risk factors confer increased risks of CHD and CVD mortality. MetS is a serious clinical condition associated with a worse prognosis than its individual risk factors.” A synergetic relationship exists between the individual physiological markers that define the metabolic syndrome that makes your risk even greater. The metabolic syndrome is greater than the sum of its parts. If that is not concerning to you, then you need to go back and reread it! In 2021 it is probably time to coin another phrase for those of us that show signs of all five physiological markers, which would confer even higher risk!

You can start dealing with all five physiological markers that characterize metabolic syndrome by changing your diet!

By far, the diet shown in many well-done studies published in peer-reviewed journals to be most effective in reducing weight, cholesterol, triglycerides and blood pressure is the plant-based whole foods diet. It also helps stabilize blood sugar significantly. But if you think that is something you can’t do at the present time, start with a more moderate diet and gradually move in the direction of the plant-based whole foods diet. The closer you get to the plant-based whole foods diet, the more results you will see!

For further reading on the plant-based whole foods diet, I suggest “Undo It” by Dean and Anne Ornish.

The DASH diet is the most conservative or moderate diet that has been shown in well-done studies published in peer-reviewed journals to be at least moderately effective in lowering blood pressure, but as a side effect, DASH dieters also lose small amounts of weight and lower cholesterol and blood sugar a little. The DASH diet is a great place to start if you have assessed your willingness to change as moderate or low. The further you can reduce fat, saturated fat, cholesterol and sodium, the more weight you will lose and the more significant health benefits you will realize, so slide down the spectrum when your willingness level changes.

Try to make synergy work for you, not against you, this week!

Here are the references for today’s Healthy Eating Tip.

Dawber T.R., W.B. Kannel, N. Revotskie, J.I. Stokes, a. Kagan, t. Gordon. 1959. Some factors associated with the development of coronary heart disease; six years’ follow-up experience in the Framingham Study. Am.J.Public Health 49:1350.

Malik S, Wong ND, Franklin SS, et al. Impact of the metabolic syndrome on mortality from coronary heart disease, cardiovascular disease and all causes in United States adults. Circulation. 2004;110:1245-1250.

Ornish D, Scherwitz LW, Billings JH, et al. Intensive lifestyle changes for reversal of coronary heart disease. Journal of the American Medical Association. 1998;280:2001–2007.

Ornish, Dean, and Anne Ornish. Undo It!: How Simple Lifestyle Changes Can Reverse Most Chronic Diseases. Ballantine Books, 2019.