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The most effective treatment still consists of diet, exercise, and medical intervention. But what diet? How much exercise? What kind of medical intervention? Here is a list of just some of the resources available.



It is universally agreed that an ideal diet consists of protein, vegetables, fruits, unsaturated fats, and complex carbohydrates.

We recommend a lower carbohydrate food plan. We did not say No carbohydrates. You need some carbohydrates for proper brain function.
Counting carbs may be new to some, so here are a few suggestions:
  1. Find the portion size on the package. This is important because if it says that one portion of food is 1/2 cup and you are eating 1 cup, all of the numbers must be doubled.
  2. Add the fiber and sugar alcohol (if any) numbers together.
  3. Subtract these numbers from the total carbohydrates listed. This becomes your NET CARBOHYDRATES. This is number we are referring to when we say "carbohydrates"
The total daily grams of carbohydrates should not exceed 100 grams, and for some, that number must be even lower. If you are uncertain what your number should be, check with a doctor, nutritionist, or dietician who understands the complexities of MSX. A good place to start might also be:
The South Beach Diet
New Diet Revolution, 
Atkins Diet
Glycemic Index Diet
The Schwarzbein Principle www.schwarzbeinprinciple.com

A great site for carbohydrate counting is: www.carbohydrate-counter.org. 
Valerie Berkowitz is a consulting Dietician and Nutritionist for the Syndrome X Association. She works with her husband, Dr. Keith Berkowitz at the  Center for Balanced Health in New York City. If you have any questions for her, please contact us at info@syndromexassoc.org
Dorothy Sprecher, M.D. is the Director of North East Ohio Center for Functional Medicine. She works with us to help provide information about nutritional supplement alternatives and
Functional Medicine.  To find out more about Functional Medicine, check out their website at: www.functionalmedicine.org  
A Few Suggestions:

We’re here to help you develop  a lifelong  eating plan that fits your individual Metabolic Syndrome X needs. Here are a few basics that we’d like to share:

  • Low Carbohydrate/High Protein is the way to go.
  • Fats are a personal decision-some do well with lower fat, others need a higher fat diet.
  • Most of your carbohydrates should come from vegetables and fruits.
  • High fiber foods can be beneficial in small quantities. Whole wheat bread should be heavy enough to be dragged out of the store. Rye, pumpernickel, etc. are all good choices.
  • Snacking is good. Peanuts, almonds, walnuts, cheese, cottage cheese, hard boiled egg, and cubed meats are all good choices.
  • Avoid white and processed foods--Pasta, rice, potatoes, flour, sugar, white bread. Eliminate them if possible.
  • Eat whenever you’re hungry. Just eat the right kinds of foods. (see above).
  • Cheating is a four letter word. When you choose not to follow these suggestions, you’re only cheating yourself!

Try to eat foods as close to their natural state as possible. If you can’t easily tell what the ingredients are, you probably shouldn’t eat it.


NEVER EAT AN UNOPPOSED CARBOHYDRATE. If you choose to eat a piece of fruit (carb.), balance it with some cheese (protein).


As with any health matter, consult your physician or health care provider before beginning any new diet or drastically changing any eating patterns.


We all think that we should exercise more than we do, but for those of us with MSX, exercise is crucial. It helps us maintain healthy blood sugars, good mental health, and body weight. Making a few modifications in our daily life can reap large benefits in our health.

The Surgeon General of the United States recommends 30 minutes of brisk walking at least 5 days a week. However, more than 60% of American adults do not get enough exercise. Twenty-five percent are not active at all in their leisure time. And the lower the income and less education, the less exercise. (1)

Also, regular physical activity has many health benefits:

  • Lowers the risk of developing coronary heart disease, stroke, type 2 diabetes, high blood pressure, and colon cancer by 30%-50%. (1)
  • Helps achieve and maintain a healthy body weight
  • Promotes psychological well-being and reduces the feelings of stress
  • Helps build and maintain healthy bones, muscles, and joints

Are you convinced yet? Here are some more things to consider:

  • Physical activity need not be strenuous to achieve health benefits. In fact, moderate amounts of daily physical activity can benefit men and women of all ages.
  • Previously sedentary people who begin exercise programs should start with short sessions (5-10 minutes) of physical activity and gradually build up to the desired level of activity (2)
  • Any adult with chronic health problems, such as heart disease, diabetes, or obesity should first consult a physician before beginning a new program of physical activity. Also, men over 40 and women over 50 should consult a physician to be sure that they do not have any health problems. (2)


Don’t have half an hour each day to exercise? No problem! Three 10-minute sessions daily are enough to lower your triglycerides, which can increase the risk of heart disease and atherosclerosis..

Researchers from Southwest Missouri State University and the University of Missouri studied seven men and eleven women aged 18 to 45 who were asked to try two different approaches to exercise, one 30-minute session or three 10-minute sessions with 20-minute breaks.

The three 10-minute workouts did a better job of lowering triglycerides after a high fat meal. It’s possible the 10-minute workouts boosted metabolism during the rest periods, thus breaking down the fats from the meals.

“ If we can encourage people to be active and accumulate at least 30 minutes of exercise in 10-minute bouts each day, it will have a positive effect on health overall and more specifically on the amount of fat in the bloodstream,” says researcher Thomas Altena, EdD, in a news release.

SOURCE: Medicine & Science in Sports & Exercise, August 2004.

For a great place to begin, click here or check out these sites:

www.acefitness.com  This is the site for the American Council on Exercise and offers certification for personal trainers. It also offers specific exercises, advice on choosing a trainer, and how to pick an exercise class.

www.cdc.gov  This is the Center for Disease Control. They have many sites that focus on healthy living and fitness.It can be hard to find your way around, but well Worth the effort for information. Give it a try!

www.americanheart.org  The American Heart Association offers ideas for exercise and fitness. Very user friendly, but much of the information is too general. Not a bad place to start for orientation. It also includes information on diet and lifestyle choices.



There are 5 classes of oral medications used for the treatment of diabetes. Some of them can also be used to treat Insulin Resistance and Metabolic Syndrome X.

·         Sulfonylureas are used to stimulate the pancreas to make and release insulin.  These include Orinase, Diabinese, Tolinase and Dymelor, which are referred to as first generation Sulfonylureas.  Diabeta, Micronase, Glucotrol and Amaryl are also in this class. 
For a complete list of medications available for MSX, please consult your physician or health care provider.

·         Biguanides slow the rate at which the liver releases stored glucose and slows the absorption of glucose into the bloodstream.  Glucophage is in this class.

·         Alpha-Glucosidase inhibitors block the enzymes that digest starches thus delaying the breakdown of dietary carbohydrates.  Glyset and Precose are examples

·         Meglitnides stimulate the pancreas to release insulin right after meals.   Prandin and Starlix are examples. 

·         Thiazolidinediones include Rezulin (no longer available), Avandia and Actos.  These medications work by helping muscles make better use of insulin that is released. 

There are also numerous medications for hypertension, dislipidemia (high cholesterol and triglycerides), depression, and other symptoms of MSX.

Insulin Resistance and Pre-Diabetes

(Journal of American Medical Association) article on Metabolic Syndrome:   


(1) Centers for Disease Control and Prevention; www.cdc.gov 
(2) U.S. Department of Health and Human Services


The information provided on this website is intended for your general knowledge only. It is not a substitute for professional medical advice or treatment for specific medical conditions. You should not use this information to diagnose or treat a health problem or disease without consulting with a qualified health professional. Please contact your health care provider with any questions or concerns you may have regarding your condition.