Metabolic health is a term that’s being discussed more frequently in the health and wellness industry, but what does it actually mean? It’s not simply the absence of metabolic syndrome. Instead, metabolic health refers to having ideal, healthy levels of key measures in 4 areas: blood sugar, blood lipids (fats), blood pressure, and abdominal fat.
Unfortunately, recent research shows less than 10% of American adults meet the criteria for optimal metabolic health. This article provides a foundational understanding of metabolic health and introduces the key metrics used to assess it.
Metabolic health is the foundation of overall well-being. When your metabolism functions optimally, your body efficiently extracts and utilizes nutrients from food, manages blood sugar properly, and controls cholesterol and blood pressure levels, among other critical factors. Proper metabolic function reduces your risk of metabolic syndrome, a condition that drastically increases the likelihood of developing cardiovascular diseases, type 2 diabetes, and even certain cancers.
Despite the critical role metabolic health plays, a study by Araujo et al. examined data from 2009 to 2016 and revealed that just 12.2% of adults had optimal metabolic health (1). A few years later, a study using data from 2017-2018 found that only 6.8% of U.S. adults could be classified as metabolically healthy (2). These statistics should serve as a wake-up call, emphasizing the importance of addressing metabolic health with your clients.
While there is no current medical definition of “metabolic health”, emerging consensus has focused on having ideal levels of the following, without the use of medications:
(1) blood sugar
(2) blood lipids – particularly triglycerides and high-density lipoprotein (HDL) cholesterol
(3) blood pressure, and
(4) abdominal fat, represented as waist circumference.
Dive deeper into the essential tools for better metabolic health here.
These factors directly relate to a person’s risk for heart disease, diabetes, and stroke. Therefore, good “metabolic health” generally means a person has good overall health and a low risk of developing metabolic disease.
Here’s a closer look at why each metric matters in the context of metabolic health.
Blood sugar control is central to metabolic health. Fasting blood (plasma) glucose levels should be below 100 mg/dL (<5.6 mmol/L), and HbA1c levels (a measure of long-term blood sugar control) should be below 5.7% (1, 2). Elevated blood sugar is a hallmark of insulin resistance and diabetes, both of which indicate metabolic dysfunction.
Triglycerides are a type of fat found in the blood. When you eat, your body converts unused calories into triglycerides, storing them in fat cells. High levels of triglycerides can increase your risk of heart disease. Optimal triglyceride levels are less than 150 mg/dL (1).
High-density lipoprotein (HDL) cholesterol is often referred to as “good cholesterol” because it helps remove other forms of cholesterol from your bloodstream. Higher levels of HDL cholesterol are protective against heart disease. Optimal levels are at least 40 mg/dL for men and 50 mg/dL for women (1).
Blood pressure is a critical indicator of heart health and metabolic function. Optimal levels are considered to be less than 120/80 mmHg without the use of medication. High blood pressure is a major contributor to cardiovascular disease, which is closely linked with poor metabolic health (1,2).
Waist circumference is a proxy measure for abdominal fat, which is a key risk factor for metabolic syndrome. Excess abdominal fat is associated with insulin resistance, inflammation, and other metabolic disturbances. According to the guidelines, optimal waist circumference is less than 102 cm (~40 inches) for men and less than 88 cm (~35 inches) for women (1, 2).
The first 3 of the 4 measures are almost always performed at an annual physical: fasting plasma glucose, blood lipids (triglycerides and HDL cholesterol), and blood pressure. Therefore, if a client is willing to share this information with you, all you need is to perform a measure of waist circumference in order to assess a client’s metabolic health status for them. Understanding these metrics and how to use lifestyle interventions to improve them is essential for improving the health status of clients. Coaches can use these metrics to track progress over time and create personalized interventions to help clients improve their metabolic health.
Metabolic health is not just about avoiding disease – it’s about thriving. With only a small fraction of the U.S. population meeting the criteria for optimal metabolic health, there’s an urgent need to raise awareness of individual metabolic health status and take action. By focusing on the key metrics outlined above, health and wellness coaches can guide clients toward improving their metabolic health and reducing the risk of chronic diseases. Watch for more articles in this series for additional information on how to assess these metrics in detail, tips for improving metrics in each area, and solutions to the challenges many encounter on the journey to better metabolic health.
(1) Araújo J, Cai J, Stevens J. Prevalence of Optimal Metabolic Health in American Adults: National Health and Nutrition Examination Survey 2009-2016. Metab Syndr Relat Disord. 2019 Feb;17(1):46-52. doi: 10.1089/met.2018.0105. Epub 2018 Nov 27. PMID: 30484738.
(2) 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.
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.
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