What Is Metabolic Health?
While there is no strict medical definition, metabolic health generally refers to the absence of “Metabolic Syndrome” without the use of medications (1). Metabolic Syndrome is based on five risk factors, with the threshold for diagnosis being in the high-risk category for three of the factors.
Excess Fat Accumulation Around the Waist [Visceral Fat]
Adipose comes in two forms, subcutaneous and visceral. Subcutaneous fat cells are those just below the surface of the skin while visceral fat accumulates around your waist and surrounds your vital organs. Studies have shown that levels of visceral fat are a greater predictor of risk for metabolic syndrome, insulin resistance, and fatty liver disease than BMI (2).
Range: Women with a waist measurement >35” and men with >40” are at risk for health problems associated with high levels of visceral fat. With more complex measurements, such as body fat analysis and imaging (MRI, CT), visceral fat may be measured on a 1–59 scale with <13 being considered healthy.
High Blood Sugar Levels [Insulin Resistance]
Insulin’s primary purposes are to help the cells absorb and use glucose (sugar) for energy, and to instruct the liver to store some glucose to maintain an energy reserve. Chronic hyperglycemia (high blood sugar levels) is one of the hallmarks of dysfunctional metabolism as it damages the vessels that supply blood to vital organs, increasing risk for numerous long-term health issues.
Range: Generally “normal” blood sugar levels are <100mg/dl after an 8+ hour fast and <140mg/dl two hours after a meal. The threshold for “hyperglycemia,” the technical term for high blood glucose, is >140mg/dl for non-diabetics and >180mg/dl for diabetics within 2 hours of a meal.
High Triglycerides [Hypertriglyceridemia, Dyslipidemia, Lipid Disorder]
Chronically elevated blood serum triglycerides (the most abundant form of fat in our bodies) are one of the primary risk factors for atherosclerosis, the buildup of fat on the walls of our arteries that may ultimately lead to a number of cardiovascular-related disease states.
Range: Triglyceride levels are generally measured with a simple blood test (along with cholesterol levels) as part of a full lipid panel. Anything over 200mg/dl is considered high.
High Blood Pressure [Hypertenstion]
As blood circulates, transporting oxygen to vital organs, it exerts a force on the walls of the arteries it travels through. The amount of this force is your blood pressure. If this pressure is chronically high, it can damage the blood vessels, increasing risk for a number of serious health concerns. Hypertension (chronically elevated blood pressure) is one of the primary risk factors for almost every cardiovascular-related disease (3).
Range: blood pressure has two separate readings: systolic (upper number) and diastolic (lower number). Stage 1 hypertension is characterized by anything higher than 130/80.
Low HDL Levels [“Good Cholesterol”]
High-density lipoprotein (HDL) is called so because it is far more dense than its low-density (LDL) counterpart. Low HDL levels is one of the primary factors associated with risk for chronic cardiovascular and metabolic health issues (4).
Range: HDL levels are generally measured with a simple blood test as part of a lipid panel. >60 mg/dL (1.6 mmol/L) is considered desirable while <40 mg/dL (1.0 mmol/L) (for men) and <50 mg/dL (1.3 mmol/L) (for women) is the risk threshold.
In a recent study analyzing the data collected from the 2009 to 2016 National Health and Nutrition Examination Survey (NHANES), researchers found that only 1 in 8 U.S. adults met the accepted markers for optimal metabolic health (1). While the study found that individuals above BMI thresholds for obesity had the lowest rate of metabolic health (under .5%), less than 1/3 of individuals in the “normal” BMI category and half in the “underweight” category did not exhibit at least one metabolic dysfunction risk factor. Researchers noted that, separate from weight status, lifestyle factors such as regular exercise and abstaining from smoking were strongly correlated with metabolic health.
How Can I Support a Healthy Metabolism?
Metabolic rates are all unique, influenced by various (and sometimes, uncontrollable) factors such as size, age, gender, hormonal disorders (especially those that affect the thyroid), and other genetic factors, but obesity and the lifestyle habits associated with the inability to manage weight is the greatest risk factor for metabolic dysfunction (5). Metabolic health is primarily affected by lifestyle.
Outside of the normal thermic effect of food, what we eat has only a minor effect on metabolism, but a healthy and consistent diet is important for healthy metabolic function. Minimizing total caloric intake and limiting the consumption of processed food has been shown to be one of the most important factors to support metabolic health and also in treating metabolic dysfunction (6).
Increased physical activity is the most controllable way to acutely increase metabolism, but the effects are not just short-term. Not only is increased physical activity important for managing weight, but in isolation, it may improve biomarkers of metabolic health even when there is no loss of weight (7). It is especially important to integrate strength training into your routine as you age, as lean muscle mass is “metabolically active tissue” and resistance training has been shown to improve biomarkers of metabolic health in older individuals, separate from changes in weight (8).
Research has shown that sleep deprivation is associated with increases in risk for poor lifestyle behaviors and obesity. A recent study also showed that dysfunctional sleeping patterns are directly associated with increased risk for metabolic disorders separate from weight status (9, 10).
One of the landmark health science studies of 2019 (the REGARDS study), evaluating over 20,000 participants, found that the level of perceived stress one reports is strongly associated with metabolic dysfunction (11). Researchers found that those who reported high levels of stress were at greater risk for high levels of visceral fat and c-reactive protein (biomarker of inflammation), and low levels of HDL cholesterol.
With recent research suggesting that less than 12% of Americans are metabolically healthy and the CDC reporting that approximately one in three meet the criteria for Metabolic Syndrome diagnosis, metabolic health is unquestionably something everyone should be taking seriously (12). Fortunately, metabolically-related health issues are primarily avoidable with healthy lifestyle behaviors, the same behaviors that are the foundation of the Prime Meridian™ Physician-Guided Coaching Program. Talk to your trusted Prime Meridian™ provider about how you can get involved.
Prevelance of Optimal Metabolic Health
Araujo J., et al.
HDL Cholesterol and Coronary Heart Disease
Williams J., et al.
Cardiorespiratory Fitness and Metabolic Syndrome
Myers J., et al.
Sleep Regularity with Metabolic Abnormalities
Huang T. and Redline S.
Fat and Cardiovascular Disease
Lee J., et al.
Metabolic Syndrome and Cardiovascular Risk
Mongraw-Chaffin M., et al.
and Metabolic Health
Ihalainen J., et al.
Depressive Symptoms and Metabolic Health
Gowey M., et al.
Hypertension and Cardiovascular Risk
Dietary Strategies and Prevention of Metabolic Syndrome
De la Iglesia R., et al.
Sleep and Obesity
Beccuti G. and Pannain S.
Metabolic Syndrome in the United States
Moore J., et al.