Metabolic dysfunction, a new paradigm!
Most chronic non-communicable diseases like diabetes, hypertension and atherosclerotic vascular events are treated as separate entities. Obesity, high salt intake, smoking and LDL-cholesterol are considered as stand-alone riskfactors. Management consists mainly of polypharmacy with the aim to reduce glucose, blood pressure and LDL-cholesterol. Lifestyle recommendations that focus on weight reduction, salt restriction and quitting smoking are standard of care but unfortunately rather unsuccessful.
For many years it has been appreciated that the metabolic syndrome may precede full blown diseases. If recognized at all, visceral obesity, hypertension, hyperglycemia and dyslipidemia are mostly symptomatically treated.
The term ‘metabolic dysfunction’ is a more appropriate label to be used in clinical care. Signs of fatty liver disease and subclinical atherosclerosis should be included in the syndrome as well as a high fasting insulin levels for earlier detection. Besides medication, stress, smoking and inactivity, years of processed food consumption could be considered as the root cause of metabolic dysfunction. Therefore, a guided switch to low carbohydrate real food is warranted for both intervention and prevention of chronic diseases. Both in primary and secondary care a team-based approach is fundamental to accelerate the road to metabolic health.
Dr. Yvo Sijpkens (1960) is a medical specialist in Internal Medicine. He started his career as nephrologist at Leiden University Medical Center, taking care of transplant and dialysis patients.Since 2008 he works at the Haaglanden Medical Center in The Hague where he started an outpatient hypertension clinic. Initially, treatment of his patients with chronic kidney disease, hypertension and diabetes, was based on polypharmacy. In 2018 he started to advice low carbohydrate real food to many of his patients as a nutritionist guided therapeutic option. As medical advisor he supports the Dutch foundation ‘Jeleefstijlalsmedicijn’.