In the last decade, Syndrome X has taken on a variety of names as authorities, institutions, and associations have slowly come to accept its validity. It is often referred to as insulin resistance syndrome. The National Heart, Lung, and Blood Institute belatedly recognized the existence of Syndrome X in 2001, calling it metabolic syndrome. It has even been referred to as insulin resistance/metabolic syndrome X, or MSX, by those investigators attempting to cover all bases.*39 By any name, this metabolic syndrome is as much a disorder of carbohydrate metabolism as is adult-onset diabetes, and is certainly a consequence of the carbohydrate content of the diet, particularly, as Cleave would have predicted, such refined, easily digestible carbohydrates as sugar and white flour.

It wasn’t until the late 1990s that the evolving science of metabolic syndrome began to have any significant influence outside the field of diabetes, at which point the media finally began to take notice.†40 The potential implications of metabolic syndrome for heart disease and other chronic diseases have only just begun to be appreciated by the research community. As a result, a hypothesis that emerged from research in the 1950s as an alternative explanation for the high rates of heart disease in Western nations has been accepted by medical researchers and public-health authorities a half-century later as a minor modification to Keys’s dietary-fat/cholesterol hypothesis, even though this alternative hypothesis implies that Keys’s hypothesis is wrong. The bulk of the science is no longer controversial, but its potential significance has been minimized by the assumption that saturated fat is still the primary evil in modern diets.