As a health and wellness coach, one of your primary roles is to help clients improve their overall health – and we know that building a strong foundation in metabolic health is key. In this article, we provide practical, science-backed tips for optimizing the four key metabolic health markers.

Why Focus on Metabolic Health?

Improving metabolic health is not just about reducing the risk of chronic diseases like diabetes and heart disease; it’s about helping your clients feel better, improve their energy levels, and achieve long-term wellness. The latest statistics indicate less than about 10% of Americans meet the criteria for optimal metabolic health (1). As a coach, you can play a crucial role in raising awareness of metabolic health with clients and reversing the trend by providing personalized, actionable advice.

Before implementing any of the strategies below, ensure they fall within your scope of practice. If a client has a medical condition or is on medications, it’s important their healthcare provider is aware of lifestyle changes to monitor changes in their condition and adjust medications as needed.

Tips to Manage Blood Sugar

Chronically high blood sugar and insulin resistance are precursors to Type 2 diabetes, and improving blood sugar control can reduce the risk of metabolic syndrome. In addition to regular exercise, these actions can support healthy blood sugar levels. Learn more here.

1. Reduce glycemic variability

Glycemic variability is how much blood sugar fluctuates from a person’s average, both higher and lower. Stabilizing blood sugar levels can improve symptoms experienced with large swings such as fatigue, brain fog, irritability, headache, hunger, and cravings for sugar. 

Actions 

• Avoid consuming simple carbohydrates alone. Simple carbs, like those found in sugar, quickly enter the bloodstream and spike blood sugar, which can result in a drop of blood sugar later. Consuming protein, fiber, and/or healthy fat with carbohydrates helps slow digestion and absorption, leading to more stable blood sugar levels throughout the day​ (2, 3). 
• Use meal sequencing. Consuming carbohydrates later in the meal, after some protein, fat, and/or fiber, has been shown to reduce the blood sugar response to a meal (3).

2. Move after meals and throughout the day

Light activity after meals can significantly lower blood sugar levels by promoting glucose uptake in muscles (4, 5). In addition, being sedentary throughout the day is independently associated with increased risk of cardiometabolic disease and glucose control (6, 7). Even if your client is exercising for 30-60 minutes of the day, if they remain sedentary most of the other waking hours, metabolic health suffers.

Actions 

• Walk for 10-30 minutes after meals, particularly after larger or carb-heavy meals and later meals such as dinner. Other movement that contracts muscles such as air squats, dancing, marching in place, or calf raises can similarly lower post-meal blood sugar. 
• Break up periods of sitting or sedentary behavior often with movement such as marching in place, walking, or similar activity. 

Muscle movement promotes glucose uptake independent of insulin, so this post-meal and increased daily movement is particularly important for insulin-resistant individuals.

Tips to Improve Blood Lipids

The two main lipids of concern for metabolic health are triglycerides and HDL cholesterol. The following lifestyle changes can help lower triglycerides and boost HDL to more desirable levels.

1. Focus on sustainable dietary changes

A diet high in simple carbohydrates and saturated fat can raise triglyceride levels (8).

Actions

• Promote a well-balanced diet that prioritizes complex carbohydrate sources over simple carbs, and mono- and polyunsaturated fats over saturated fat. This means swapping refined carbohydrates for whole grain options and replacing foods like butter, red meat, and full-fat dairy, with olive oil, fatty fish a few times a week, low-fat dairy, nuts, and seeds.
• Help clients identify and stick to their daily caloric target. Excess calories from carbohydrates and even healthy fats can be stored as triglycerides.

2. Encourage a combined exercise program

A combined program of aerobic and resistance exercise helps lower triglycerides and increase HDL cholesterol (9, 10). 

Actions

• Suggest at least 30 minutes of physical activity on most days of the week, including both aerobic and strength-training exercises. This is the minimum shown for benefits, with a dose-response relationship between activity level and increases in HDL cholesterol. 
• Higher intensity aerobic exercise may be required (if feasible) for reductions in triglyceride levels. Progress clients towards moderate-intensity aerobic exercise at 85% HRmax and moderate- to high-intensity resistance training at 75-85% 1 RM as is safe to do so.

3. Reduce Alcohol Consumption

Alcohol can increase triglyceride levels, while some research suggests moderate intake may increase HDL cholesterol (11).

Action

• Encourage clients to refrain from or reduce alcohol intake, aiming for no more than one drink per day for women and two for men if consumed.

Tips to Lower Blood Pressure

High blood pressure is a significant risk factor for cardiovascular disease and one of the key indicators of poor metabolic health. If a client is already on blood-pressure lowering medication, it’s important for their healthcare provider to be aware they are also making lifestyle changes as their medications may need to be adjusted as their blood pressure improves.

1. Program Aerobic Exercise

Aerobic exercise is an effective way to lower blood pressure, particularly at higher intensities and in people who already have elevated blood pressure (12, 13).

Action 

• Aim for at least 150 minutes of moderate-intensity aerobic activity per week as feasible. While resistance training is important for many reasons, data suggests endurance training is likely most effective over resistance training alone or a combined program for lowering blood pressure.

2. Promote Stress Reduction Techniques

Chronic stress can lead to elevated blood pressure by increasing levels of the stress hormone cortisol, but mindfulness techniques have been shown to lower stress and reduce blood pressure (14).

Action

• Promote 5-10 minutes daily of stress reduction techniques such as mindfulness meditation, deep breathing exercises, or yoga.

3. Dietary Adjustments

Specific hypertension-focused diets like the DASH Diet have been shown to lower blood pressure. 

Action

• If within your scope of practice, you can support clients to understand the DASH Diet or a similar plan. Dietary changes may include reduced sodium and a focus on getting nutrients from the diet that support healthy blood pressure like calcium, magnesium, potassium, and fiber.

Tips to Improve Waist Circumference

Waist circumference is an essential indicator of visceral fat, which can lead to insulin resistance and inflammation. Interventions to reduce waist circumference should focus on improving overall body composition through weight loss as indicated and a maintenance or increase of muscle mass. 

1. Aerobic and Resistance Exercise

A combination of aerobic and resistance exercise can support weight loss and improved body composition.

Action 

• Tailor exercise recommendations based on your client’s goals and needs in other areas of metabolic health improvement.

2. Optimize Diet

If a client has elevated waist circumference, they likely need to lose weight. Supporting them with the right dietary approach can help reduce weight and visceral fat through healthier food choices. 

Action 

• Ensure clients are on a healthy eating plan, tailored to calorie needs focused on healthy weight loss and maintenance of muscle mass through adequate protein intake.
• Reduce intake of processed foods and simple carbohydrates, consuming complex sources for carbohydrates and additional fiber.
• Reduce or eliminate alcohol consumption, aiming for no more than one drink per day for women and two for men if consumed.

Final Thoughts

Improving metabolic health requires a multi-faceted approach that includes regular physical activity, dietary modifications, and stress management. For health and wellness coaches, the key is to provide personalized, actionable advice that clients can implement in their daily lives. By focusing on small, sustainable changes in each of the four key metabolic health metrics, coaches can help clients achieve lasting improvements in their health and reduce their risk of chronic diseases.

References:

(1) O’Hearn M, Lauren BN, Wong JB, Kim DD, Mozaffarian D. Trends and Disparities in Cardiometabolic Health Among U.S. Adults, 1999-2018. J Am Coll Cardiol. 2022 Jul 12;80(2):138-151. doi: 10.1016/j.jacc.2022.04.046. PMID: 35798448.

(2) Tricò D, Baldi S, Tulipani A, Frascerra S, Macedo MP, Mari A, Ferrannini E, Natali A. Mechanisms through which a small protein and lipid preload improves glucose tolerance. Diabetologia. 2015 Nov;58(11):2503-12. doi: 10.1007/s00125-015-3710-9. Epub 2015 Jul 30. PMID: 26224101.

(3) Nesti L, Mengozzi A, Tricò D. Impact of Nutrient Type and Sequence on Glucose Tolerance: Physiological Insights and Therapeutic Implications. Front Endocrinol (Lausanne). 2019 Mar 8;10:144. doi: 10.3389/fendo.2019.00144. PMID: 30906282.

(4) Reynolds AN, Mann JI, Williams S, Venn BJ. Advice to walk after meals is more effective for lowering postprandial glycaemia in type 2 diabetes mellitus than advice that does not specify timing: a randomised crossover study. Diabetologia. 2016 Dec;59(12):2572-2578. doi: 10.1007/s00125-016-4085-2. Epub 2016 Oct 17. PMID: 27747394.

(5) Manohar C, Levine JA, Nandy DK, Saad A, Dalla Man C, McCrady-Spitzer SK, Basu R, Cobelli C, Carter RE, Basu A, Kudva YC. The effect of walking on postprandial glycemic excursion in patients with type 1 diabetes and healthy people. Diabetes Care. 2012 Dec;35(12):2493-9. doi: 10.2337/dc11-2381. Epub 2012 Aug 8. PMID: 22875231.

(6) Buffey AJ, Herring MP, Langley CK, Donnelly AE, Carson BP. The Acute Effects of Interrupting Prolonged Sitting Time in Adults with Standing and Light-Intensity Walking on Biomarkers of Cardiometabolic Health in Adults: A Systematic Review and Meta-analysis. Sports Med. 2022 Aug;52(8):1765-1787. doi: 10.1007/s40279-022-01649-4. Epub 2022 Feb 11. PMID: 35147898.

(7) Healy GN, Dunstan DW, Salmon J, Cerin E, Shaw JE, Zimmet PZ, Owen N. Breaks in sedentary time: beneficial associations with metabolic risk. Diabetes Care. 2008 Apr;31(4):661-6. doi: 10.2337/dc07-2046. Epub 2008 Feb 5. PMID: 18252901.

(8) Siri-Tarino PW, Sun Q, Hu FB, Krauss RM. Saturated fat, carbohydrate, and cardiovascular disease. Am J Clin Nutr. 2010 Mar;91(3):502-9. doi: 10.3945/ajcn.2008.26285. Epub 2010 Jan 20. PMID: 20089734.

(9) Mann S, Beedie C, Jimenez A. Differential effects of aerobic exercise, resistance training and combined exercise modalities on cholesterol and the lipid profile: review, synthesis and recommendations. Sports Med. 2014 Feb;44(2):211-21. doi: 10.1007/s40279-013-0110-5. PMID: 24174305.

(10) Smart NA, Downes D, van der Touw T, Hada S, Dieberg G, Pearson MJ, Wolden M, King N, Goodman SPJ. The Effect of Exercise Training on Blood Lipids: A Systematic Review and Meta-analysis. Sports Med. 2024 Sep 27. doi: 10.1007/s40279-024-02115-z. Epub ahead of print. PMID: 39331324.

(11) Klop B, do Rego AT, Cabezas MC. Alcohol and plasma triglycerides. Curr Opin Lipidol. 2013 Aug;24(4):321-6. doi: 10.1097/MOL.0b013e3283606845. PMID: 23511381.

(12) Cornelissen VA, Smart NA. Exercise training for blood pressure: a systematic review and meta-analysis. J Am Heart Assoc. 2013 Feb 1;2(1):e004473. doi: 10.1161/JAHA.112.004473. PMID: 23525435.

(13) Schneider VM, Domingues LB, Umpierre D, Tanaka H, Ferrari R. Exercise characteristics and blood pressure reduction after combined aerobic and resistance training: a systematic review with meta-analysis and meta-regression. J Hypertens. 2023 Jul 1;41(7):1068-1076. doi: 10.1097/HJH.0000000000003455. PMID: 37115856.

(14) Intarakamhang U, Macaskill A, Prasittichok P. Mindfulness interventions reduce blood pressure in patients with non-communicable diseases: A systematic review and meta-analysis. Heliyon. 2020 Apr 28;6(4):e03834. doi: 10.1016/j.heliyon.2020.e03834. PMID: 32373739.

About Erin Glynn, PhD
Dr. Glynn is an expert in metabolism, exercise physiology, weight management, and metabolic disease, with over 30 published research articles in these fields. After a decade conducting academic research in these areas, Erin transitioned to researching and developing dietary supplements and health programs – leading a global R&D team of nutrition scientists. In 2023, she left the corporate world to found Nuchi Health – a company with a mission to provide credible, no-hype nutrition, health, and wellness education for consumers and health practitioners. Dr. Glynn hosts the Nuchi Health Podcast and serves in leadership and advisory roles for the American Society for Nutrition (ASN) and Unicity International.