Metabolic Health: The Health Problem You May Not Know You Have
When the tests look normal, but you don't feel normal, there may be more to the story.
By Dr. Charlie Roach, D.Ac., L.Ac., FMP
Most people don't think about their metabolism until something goes wrong.
Maybe your doctor tells you that your blood sugar is getting high. Or your cholesterol has gone up. Maybe you've gained twenty pounds around your waist over the last ten years and can't seem to get it off. Your blood pressure is creeping up. You're tired after meals. You crave something sweet in the afternoon.
Eventually someone says, "You need to watch your blood sugar."
But metabolic health is much bigger than diabetes.
In fact, metabolic problems can develop for years before someone is diagnosed with diabetes.
That's one of the reasons I like to talk about metabolic health before there is a disease to treat.
What Is Metabolic Health?
Your metabolism is essentially the way your body handles energy.
You eat food. Your digestive system breaks it down. Nutrients enter the bloodstream. Insulin helps move glucose into your cells. Your muscles and other tissues use that energy. Your liver stores and releases fuel when needed.
It's a remarkably sophisticated system.
When it is working well, your body is generally good at switching between different sources of fuel, maintaining relatively stable blood sugar and storing energy appropriately.
When it isn't working as well, things can gradually begin to change.
And those changes aren't always obvious.
You can have a "normal" blood glucose result and still have a metabolism that isn't functioning as well as it could.
Insulin Is Part of the Story
One of the most important hormones involved in metabolic health is insulin.
Insulin helps your body move glucose out of the bloodstream and into cells where it can be used or stored.
The problem is that the body can compensate for declining insulin sensitivity for quite a while.
Your cells become less responsive to insulin, so your pancreas produces more.
For a period of time, your blood glucose may remain completely normal.
That's why looking at glucose alone doesn't always tell us the entire story.
Over time, however, the system can become less efficient.
Insulin resistance can progress. Triglycerides may rise. Blood pressure may increase. Abdominal fat may accumulate. Eventually blood glucose and A1c can begin moving in the wrong direction.
By the time someone is told they have prediabetes or diabetes, the metabolic problem may have been developing for years.
Your Waistline Can Tell You Something
I'm not talking about trying to look like a fitness model.
I'm talking about where your body is storing fat.
Increasing abdominal or visceral fat is associated with greater metabolic risk. This is one reason I pay attention to waist circumference along with weight.
Two people can weigh exactly the same and have very different metabolic health.
That's also why I don't like making weight the only goal.
Body composition matters. Muscle matters. Waist circumference matters. Blood pressure matters.
The goal is not simply to weigh less.
The goal is to become metabolically healthier.
Muscle Is One of Your Best Metabolic Tools
This is one of the most overlooked pieces of the conversation.
Your muscles are major consumers of glucose.
When you exercise your muscles, they become better at taking up and using glucose.
That's one reason resistance training is so valuable as we age.
You don't have to become a bodybuilder.
You don't need to spend two hours a day in the gym.
But maintaining muscle becomes increasingly important as we get older.
Strength training, walking, hiking, cycling and other forms of regular movement all contribute to metabolic health.
And there is another benefit: muscle gives you somewhere to put the fuel you eat.
What You Eat Still Matters
There is no single diet that works perfectly for everyone.
But there are some fundamentals that are hard to argue with.
Eat enough protein.
Eat real, minimally processed foods most of the time.
Eat vegetables and fruits that you tolerate well.
Choose healthy sources of fat.
Get enough fiber.
Limit the constant stream of refined carbohydrates, sugary drinks and ultra-processed foods.
And pay attention to what happens after you eat.
Do you feel energized?
Or do you feel like you need a nap?
Are you hungry again an hour later?
Do you have strong cravings in the afternoon?
These aren't diagnostic tests, but they are useful observations.
Sleep Is Metabolic Health
Sleep is often the first thing people sacrifice when life gets busy.
It shouldn't be.
Poor sleep can affect appetite, insulin sensitivity, blood pressure, mood and exercise recovery.
You can eat a pretty good diet and exercise regularly, but if you're chronically sleep deprived, you're making metabolic health harder than it needs to be.
Sometimes improving metabolic health starts with something that doesn't look very "metabolic" at all:
going to bed earlier.
Stress Matters Too
Chronic stress can affect eating patterns, sleep, activity levels and many of the body's regulatory systems.
Some people eat less when they're stressed.
Others eat more.
Some stop exercising.
Others exercise compulsively.
Some sleep all the time.
Others can't sleep.
There isn't one stress response.
That's why metabolic health isn't just about carbohydrates and insulin. It's about the whole person.
What Should You Know About Your Numbers?
There are several markers that can help us understand metabolic health.
Glucose and A1c are obvious ones.
But I also like to consider fasting insulin, triglycerides, HDL cholesterol, waist circumference, blood pressure and body composition.
Depending on someone's situation, there may be other markers worth looking at as well.
And for some patients, cardiovascular risk markers such as ApoB can provide useful information that a standard cholesterol panel doesn't fully capture.
The point isn't to order every possible test.
It's to ask a better question:
"How well is my metabolism actually working?"
You Don't Have to Wait for a Diagnosis
This is probably the most important part.
You don't have to wait until someone tells you that you have diabetes.
You don't have to wait until your blood pressure becomes a problem.
You don't have to wait until you've gained forty pounds.
You can start taking care of your metabolic health now.
Walk after meals.
Lift weights.
Eat enough protein.
Build meals around whole foods.
Get adequate sleep.
Maintain a healthy waist circumference.
Spend less time sitting.
Find ways to manage stress.
And most importantly, do these things consistently.
Metabolic health isn't created by one perfect diet or one supplement.
It's built through thousands of ordinary decisions.
That's good news because it means you have considerable influence over it.
At Root & Branch, I look at metabolic health as one piece of the larger picture of healthy aging. My goal isn't simply to help you avoid diabetes. It's to help you maintain energy, muscle, cardiovascular health and independence for as long as possible.
You don't have to wait until something is broken to start taking care of it.
