Are you Metabolically Healthy?
by Dr. Shawna Darou, ND in Nutrition
Since 2020 especially, I have seen an alarming number of women with poor metabolic health, meaning blood sugar levels rising, insulin resistance, weight gain and difficulty losing it and lower energy levels. This is an obvious consequence of a period of time with immensely higher stress, more sedentary lifestyle, eating more comfort foods, and often an increase in alcohol intake. It is extremely important to address these shifts in metabolism, as they are on the trajectory to poor cardiometabolic health, meaning an increased risk of not only diabetes, but also heart disease and stroke. It is also important to note that you can restore metabolic health with very simple lifestyle changes.
A 2019 US study (1) in the journal Metabolic Syndrome and Related Disorders, measured metabolic health in 8,721 adults, and they found that just 1 in 8 adults in the United States had optimal metabolic health. After reviewing the study, a few things that stood out.
Metabolic Health Declines Significantly After Age 40
Key findings from the study included:
That there was a dramatic change in metabolic health after age 40 in the data dropping from 23% in the 20-39 age category to just 9% in the 40-59 age category.
Over age 60, only 2% of study participants were metabolically healthy!
The addition of vigorous activity (along with moderate activity) raised metabolic health significantly from 10.9% to 21.9%.
The rate of metabolic health is overall very low, even for normal weight adults, meaning we can’t simply use weight and BMI as an indicator.
Learn why exercise is non-negotiable in your 40s and 50s here
How is metabolic health defined?
The criteria they used for defining optimal metabolic health can be useful for us too, since these are lab tests that are almost always run with an annual physical exam. If you have a copy of recent lab results, you can check for the following:
optimal levels of waist circumference (WC <102cm / 40 inches for men and < 88cm /35 inches for women);
glucose (fasting glucose < 5.6mmol/L (<100mg/dL) and hemoglobin A1c <5.7%);
blood pressure: systolic <120 and diastolic <80mmHg;
triglycerides < 1.69mmol/L (<150mg/dL);
high-density lipoprotein cholesterol ≥ 1.03mmol/L (40mg/dL) for men and ≥ 1.29mmol/L (50mg/dL) for women, and
not taking any related medication for blood pressure, diabetes or cholesterol
* Waist circumference is measured with a measuring tape just above the top of the hip bone or iliac crest.
From the study, the purpose of defining Metabolic health “is not aimed at clusters of risk factors, but at identification of a health status characterized by levels of metabolic indicators that are consistent with a high level of health and low risk of impending cardiometabolic disease.”
Learn more about brain fog and metabolic health here
How to address poor metabolic health?
After reading this, I am assuming that many of you are noticing markers in your bloodwork that are indicating sub-optimal metabolic health, and it probably comes with no surprise that there are many simple lifestyle changes that can reverse this trend.
The reality is that our modern lifestyle negatively impacts metabolic health by affecting mitochondria function. Mitochondria are the energy centres in your cells that help turn food energy into cellular energy. They are affected by lack of sunlight, not enough movement, too much sitting, chronic stress, poor quality food, blood sugar dysregulation, exposure to toxins, sleep disruption to name a few. When your mitochondria aren’t functioning well, common symptoms are low energy, brain fog, body aches and pains, and this contributes to blood sugar issues. Mitochondrial dysfunction directly impacts blood sugar and insulin levels contributing to insulin resistance and poor beta cell function in the pancreas.
I will be writing more about the lifestyle factors in detail, but here is a short summary, here are things you can start right now for better metabolic health:
Eat whole foods / minimize processed foods – the more real foods you are eating, the more nutrient-dense and satiating they are which prevents overeating.
Watch your intake of carbohydrates – prioritize protein and veggies on the plate first. This will reduce insulin response to your meals and reduce blood sugar levels.
Movement and exercise is essential for metabolic health. Walking and moving regularly through the day is the first part, and then adding in exercise with an elevated heart rate at least 3x per week.
Less sitting – we are learning more and more how a sedentary lifestyle greatly contributes to poor metabolic health, and since so many people now work from home, their daily activity level has plummeted. Get creative with regular movement breaks through the day or set up a work station where you can stand or move around more frequently.
Prioritize sleep and rest – without adequate sleep, blood sugar levels and blood pressures levels tend to rise. Under-resting especially when stress is high will make it hard to see the results of positive changes in food and exercise, and will also impact your food choices through the day.
I know that these recommendations all feel very simple and basic, but the reality is that most of us are not doing them consistently, and stress, workload and fatigue contribute to poor choices over time. Take a close look at your week, and where you can make some positive changes for metabolic health right now.
What’s next?
If you have identified a risk for poor metabolic health based on this article, or would like to do bloodwork to assess your own metabolic health, please ask at your next appointment. Remember that this assessment is to find reversible indicators of future cardiometabolic risk that we can address today. This is also exactly what my Metabolic Mastery program addresses - supporting you to finally make the lifestyle changes needed to reverse metabolic dysfunction.
Take the Metabolic Health Quiz: https://go.drshawnadarou.com/metabolicedgequiz
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FAQs: Metabolic Health, Blood Sugar, and Insulin Resistance
What is metabolic health?
Metabolic health refers to how well your body regulates blood sugar, insulin, cholesterol, blood pressure, and body composition. Good metabolic health is associated with stable energy, healthy weight, and lower risk of cardiometabolic diseases such as type 2 diabetes, heart disease, and stroke.
What are signs of poor metabolic health?
Common signs include weight gain (especially abdominal weight), low energy, blood sugar swings, sugar cravings, difficulty losing weight, elevated triglycerides, high fasting glucose, and insulin resistance. Some people have abnormal lab markers even when their weight appears normal.
Can you have poor metabolic health at a normal weight?
Yes. Someone can have a normal BMI but still have insulin resistance or abnormal metabolic markers. This is why bloodwork — not weight alone — is important when assessing metabolic health.
What blood tests help assess metabolic health?
Helpful tests include fasting glucose, hemoglobin A1c, triglycerides, HDL cholesterol, blood pressure measurements, and waist circumference. In some cases, fasting insulin and additional metabolic markers are also useful.
Does metabolic health decline with age?
Research shows that metabolic health declines significantly after age 40, with far fewer adults meeting optimal metabolic criteria in midlife and beyond. Hormonal shifts, reduced activity, stress, and sleep disruption all contribute.
How does physical activity affect metabolic health?
Regular movement and exercise significantly improve insulin sensitivity and metabolic function. Studies show that adding vigorous activity to moderate activity can nearly double the rate of optimal metabolic health.
How does mitochondrial function relate to metabolic health?
Mitochondria are the energy producers in your cells. When mitochondrial function declines due to stress, inactivity, poor diet, and sleep disruption, it can contribute to low energy, brain fog, and insulin resistance.
What are the most effective lifestyle changes to improve metabolic health?
The most effective strategies include eating whole foods, reducing processed foods, balancing carbohydrates with protein and fiber, moving throughout the day, exercising regularly, reducing sedentary time, and prioritizing sleep.
Can metabolic dysfunction be reversed?
In most cases, yes. Insulin resistance and poor metabolic health are often reversible with consistent nutrition, exercise, sleep, and stress management strategies, especially when identified early.
When should I get metabolic health testing done?
If you have weight gain, low energy, blood sugar concerns, family history of diabetes or heart disease, or are over age 40, it’s reasonable to request metabolic bloodwork and screening with your healthcare provider.
References
1 (https://www.liebertpub.com/doi/10.1089/met.2018.0105)
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