Understanding Metabolic Health

For too long, people have equated weight with health. If you keep your weight in a “healthy” range and eat well most of the time, you might think you’re doing all the right things. In many ways, you are. But the number on a scale is just one measurement. If you really want to understand your overall health, you need to take a more comprehensive look at your body. To do that, doctors track five key markers of what they call “metabolic health.” What is metabolic health? January AI Chief Scientific Officer Maziyar Saberi, PhD, explains: “Metabolic health goes beyond just maintaining an ideal weight. Glucose, insulin, cholesterol, fatty acids, inflammation, and many other factors contribute.” Doctors look at those signs because they shed light on your current—and future—well being.

A metabolic health assessment takes into account a series of measurable factors that show how healthy you are now, as well as how likely you are to develop serious chronic conditions later in life. And while many of us are going around feeling just fine, we aren’t as healthy as we might think. In fact, according to a 2019 study in the journal Metabolic Health and Related Disorders, only 12 percent of American adults are considered metabolically healthy. That’s a number we should all strive to change.

The five factors of metabolic health, which we’ll cover in depth this article, are:

• Blood sugar
• Waist circumference
• Blood pressure
• Cholesterol
• Triglycerides

For each factor, doctors and scientists have been able to determine what they consider a “healthy” range, which you can use as a benchmark to track how your body’s doing.

The 5 Markers of Metabolic Health

Unfortunately, there isn’t one simple number that lets you know that you’re metabolically healthy or you’re not. Instead, doctors look at a series of measures, typically including these five:

1. Blood sugar

Insulin is a hormone released by the pancreas when you eat or drink something, and you can think of it as a key. Food is digested and turned into sugar (or glucose — read more about what is glucose), which begins circulating in your bloodstream. That glucose in your blood signals the pancreas to secrete insulin, the key that “unlocks” your cells, so they can pull sugar out of your blood and turn it into energy. If sugar is constantly dumped into the bloodstream, and the pancreas over-produces insulin to keep up, your cells stop responding to it. That’s called insulin resistance. Your pancreas works even harder to force the cells to respond, but eventually it can’t sustain the effort. Your body is not able to move the sugar in your blood into your cells, so your blood sugar levels can stay chronically high. This puts you at heightened risk for diabetes, which in turn significantly increases your risk for heart disease. You can also read more about blood sugar and weight loss here.

Recommended blood sugar level: Below 100 mg/dL and above 70 mg/dL following an overnight fast

2. Waist circumference

This one is exactly what it sounds like: the size of your waist all the way around. A simple measuring tape test gives you the info you need. Why is the result a key determinant of health? Because where you store fat is more important than the percentage of body fat you carry overall. Belly fat, in particular, is known to be a red flag because it increases the risk of insulin resistance and diabetes.

Recommended waist circumference: Should measure less than 40 inches for men and less than 34.6 inches for women

3. Blood pressure

High blood pressure occurs when plaque builds up in your arteries, which means your heart must pump harder to circulate blood throughout the body. Over time, the extra strain can cause the heart muscle to thicken and stiffen, which impairs its normal function. High blood pressure is linked to increased risk of heart disease, heart attack, and stroke.

Recommended blood pressure level: At or below 120/80

4. Cholesterol

Cholesterol is needed to build healthy cells, but too much can put you at risk for heart disease. There are two types of cholesterol: Low-density-lipoprotein (LDL) cholesterol is the harmful kind that increases your risk for heart disease. High-density-lipoprotein (HDL) cholesterol, on the other hand, is the good kind that actually helps stave off heart disease.

Recommended cholesterol levels: LDL as low as possible and HDL cholesterol greater than or equal to 40 mg/dL for men and 50 mg/dL for women

5. Triglycerides

A type of fat that circulates throughout the body, triglycerides usually work in tandem with cholesterol, because they’re both lipids that serve slightly different functions. While cholesterol builds healthy cells, triglycerides work to store unused calories. A high triglyceride level combined with low HDL or high LDL can lead to atherosclerosis, which is the buildup of fatty deposits inside arteries. Not only can this restrict blood flow, causing the heart to have to work harder, these fatty deposits can eventually burst causing a blood clot.

Recommended triglycerides level: Below 150 mg/dL

Side note on BMI: Body mass index used to be one of the key factors in determining metabolic health but it’s been found to be a less-than-stellar marker of overall health because it doesn’t factor in body composition (your ratio of fat to muscle) or muscle mass. That’s why doctors don’t harp on it as much as they used to. Plus, keep this in mind: Studies show that about 20 percent of people considered “lean” are still metabolically unhealthy. While it’s not a bad idea to strive to keep your BMI in the healthy range, there are times when having a higher BMI may not be cause for real concern. Talk to your doctor about how to make sense of the number in your unique case, but also look at how it aligns with the other five factors above. Odds are, addressing those areas first will have a positive effect on your BMI.

Benefits of Metabolic Health

When your levels for each of the five factors fall within a healthy range, you’re considered metabolically healthy. That has positive ripple effects on your overall health and wellbeing, and they’re not just about warding off diabetes, heart disease, and stroke in the long term. “In the simplest terms, it is about quality of life,” says Saberi. “Do we feel good? Are we able to do the things we want to do? Different people will answer those questions in different ways, but maintaining metabolic health is a prerequisite for all of us.” When your metabolic health is up to code, you’ll notice the benefits, and blood sugar control is key to four of them.

More energy throughout the day: Without blood sugar highs and lows from all that insulin drama, you feel fewer fluctuations, from zoom-y bursts of energy to exhausting crashes.

Consistent, stable mood: Research has begun to uncover the link between blood sugar and anxiety and depression. In fact, according to a study in the journal Diabetes Care by researchers at Washington University School of Medicine in St. Louis, 25 percent of people with diabetes also report suffering from depression. And steady blood sugar may mean you no longer have to deal with the mood swings that come with glucose variability.

More restful sleep: One 2015 study in the journal PLOS One by a group of Japanese researchers found that people with type 2 diabetes report poor quality sleep. The takeaway: improved glucose management could mean better nights, and brighter mornings.

Sharper memory: Simply put, your brain is an energy hog, burning through half of all the sugar you take in. When your body fuels itself efficiently and insulin works as it should, your brain hums along at an optimal level. In fact, better glucose regulation has been linked to better recall.

Fewer hunger pangs: When your blood sugar is on a rollercoaster, you may find yourself feeling ravenous shortly after you’ve eaten, especially if you’ve taken in a lot of sugary, empty calories. The basic reason: A dump of blood sugar triggers your body to release lots of insulin, to quickly suck all that glucose out of your bloodstream. That leaves your body running on empty, and signalling a need for more energy (hunger pangs, loud and clear). On the flip side, when your blood sugar is well regulated and you’re eating well (not processed foods), you’ll notice that you feel fuller longer (thanks in part to consuming more fiber) and cravings don’t drive you to the fridge all day.

Healthier weight: If you’ve ever dealt with a stubborn scale, then you know that losing weight is about more than just counting calories. Maintaining more stable blood sugar and better overall metabolic health has been shown to help unlock more weight loss when you eat in a way that gives your body a chance to burn stored fat.

When You’re Not Metabolically Healthy

If you’re outside of the healthy limits for any one of the five key markers we’ve outlined, you’re at higher risk for metabolic syndrome, which increases your chance of developing type 2 diabetes, heart disease, or stroke. Out of bounds on three or more of the five categories? Research has shown that your risk of developing these chronic diseases goes even higher.

Beyond just blood tests, there are other more subtle symptoms that may show your metabolic health is faltering: Poor sleep, inability to lose weight, infertility, and chronic pain (to name a few) may all be signs that one or more of the main five factors need to be addressed.

So how can you get back on track? “We have to return to the basics,” says Saberi. “Proper nutrition, physical activity, quality sleep, and hydration are all important and all integrated. They work together like instruments in an orchestra to promote metabolic health. The secret sauce is pinpointing what works and doesn’t, for your body.” That’s where a CGM may be helpful, as well as talking to your doctor about what you’re experiencing, so you can start to regain control of your health.

FAQs

What is metabolic health?

Metabolic health is defined by having blood sugar, waist circumference, blood pressure, cholesterol, and triglycerides all within a healthy range, which is a benchmark set by scientists and doctors. These ranges correspond to how likely you are to develop other serious conditions, like heart disease, diabetes and stroke. When you’re beyond the healthy range in three or more of the five factors, you’re at significantly increased risk of developing these disorders. So while having one number that’s a little too high is a cause for concern, doctors get increasingly worried when several of these factors are not at an ideal level because they compound your disease risk.

How do you improve your metabolic health?

You can improve your metabolic health by getting your numbers in each of the five main categories down into a healthy range. A tried-and-true diet and exercise regimen is your health tool here. It’s particularly important to focus on eating and exercising in a way that helps you keep blood sugar levels stable.

How do you measure your metabolic health?

Simple blood tests and a tape measure (for waist circumference) is all you’ll need to figure out how metabolically healthy you are. These measurements are often taken at an annual physical so make sure you set aside time to go over the results with a health professional. Together, you can create a personalized plan if you need to make lifestyle adjustments to move your numbers where you want them.