Imagine that you have been diligently tracking your calories and steps. Then, you step on a scale and discover that you have gained two more pounds. How is that even possible? 

Unfortunately, this scenario is playing out in homes across America. Especially as more people work from home and deal with the added stress of the COVID-19 pandemic. The outcomes from the pandemic have starkly highlighted the poor metabolic health¹ of our society.

The media and our doctors report the ever-increasing number of medical conditions linked to obesity² and poor metabolic health, but no matter how hard we try, the needle on the scale is not moving—or it’s moving in the wrong direction. As a result, nearly half of all U.S. adults are obese ³. 

Maintaining a healthy weight is an important goal we should all strive to reach. However, equating ideal weight with good health is a mistake. Muscular athletes commonly have a weight that exceeds their ideal body mass index (BMI), and they are often healthier than those at a “healthy” BMI.

Simply being within the normal weight range on the scale does not imply metabolic health. Between 10% and 25% of all people at a healthy weight have the same metabolic dysregulation⁴ as those who are not. Advances in technology give us the tools we need to get a more complete picture of our metabolic health. 

Learn why taking a proactive approach to managing your metabolic health is a better strategy than reacting to a number on the scale. See what it means to be metabolically healthy and how to track and improve your metabolic health. 

Metabolic health refers to how efficiently and effectively your body uses energy sources from your diet to fuel bodily processes, such as building and repairing body tissue, eliminating waste, growing, and reproducing. 

Measuring your blood sugar, waist circumference, blood pressure, cholesterol, and triglycerides can provide insight into how well your metabolism functions. But you also want strong muscles, bones, and joints, and enough energy to meet your daily needs, all without the use of medications. 

<p class="pro-tip"><strong>Learn how </strong> <a href="/blog/blood-sugar-metabolic-health">metabolic health and blood sugar are related</a>.</p>

How Do You Determine Your Metabolic Health? 

Advances in technology have led to personalized medicine. You can measure and track indicators that provide clues about how well your body functions without needing expensive medical tests. 

Tracking your metabolic health requires knowing where you stand on the following parameters. You can check some of these on your own, while others require lab tests from your annual medical exam. 

Waist Circumference

Measuring your waist circumference can help you understand your risk for weight-related conditions, such as insulin resistance and diabetes. Body fat surrounding your abdominal organs is more dangerous to your health than subcutaneous fat, which sits just beneath your skin. 

To measure your waist circumference⁵, stand and wrap the tape measure around your waist, just above your hip bones. Ensure that the tape measure is horizontal and snug around your waist. Then, measure your waist just before you breathe out. 

Waist Circumference Goal: 

• Male: less than 40 inches
• Nonpregnant female: less than 35 inches

Blood Pressure

Blood pressure is the force exerted by your blood against the walls of your arteries. The more cholesterol and plaque that accumulates on the inner lining of your blood vessels, the more resistance there is to blood flow and the harder your heart must work to pump your blood. 

Systolic blood pressure (the top number) indicates the pressure on your blood vessels when your heart contracts. Diastolic blood pressure (the bottom number) is the pressure on your blood vessels when your heart relaxes. 

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Blood Pressure Goal:

• Normal blood pressure: Systolic less than 120 mmHg and diastolic less than 80 mmHg

<p class="pro-tip"><strong>Learn more about </strong> <a href="/blog/blood-sugar-high-blood-pressure">how blood sugar affects blood pressure</a>.</p>

Blood Sugar

Blood glucose (sugar) is the primary energy source for every cell in your body. Because glucose is essential to fuel every metabolic process in your body, it is kept within a very narrow range. Insulin and glucagon are the two primary hormones that regulate blood sugar. 

When your blood glucose is too high, your pancreas secretes insulin, a hormone that shuttles glucose into your cells to be used for energy or to be stored as glycogen in the muscles or the liver. In either case, glucose is removed from the bloodstream. 

Besides glucose in the bloodstream and glycogen, your body can convert fats and amino acids from proteins into glucose. Ultimately, all energy sources are converted to glucose⁶, which is then used to produce adenosine triphosphate (ATP), the energy currency of the body. 

Over time, some people develop insulin resistance. Scientists are not sure what causes insulin resistance⁷, but they suspect a combination of contributing factors, including:

• Genetic predisposition
• Being sedentary
• Being overweight or obese
• Increased inflammation
• Physiological stress

Insulin resistance develops gradually over time, which gives you time to halt its progress. A gradual increase in blood sugar that stays high can signal that you may become insulin resistant. Even though an estimated one-third of all Americans⁸ have insulin resistance, nearly 90% are unaware because of the lack of symptoms. 

Blood Sugar Goal

Fasting: 

• Optimal:  less than 100 mg/dL
• Prediabetes (9): 100 to 125 mg/dL  
• Diabetes: 126 mg/dL or higher

HbA1C is a measurement that gives an average blood sugar for the previous three months. The goal to be metabolically healthy is less than 5.7%¹⁰.

<p class="pro-tip"><strong>Learn these </strong> <a href="/blog/signs-metabolic-health-out-of-balance">six signs your metabolic health is out of balance</a>.</p>

Metabolic Health & Continuous Glucose Monitoring (CGM)

The root cause of most chronic diseases is inflammation. Disordered glucose metabolism¹¹ and excess adipose (fat) tissue¹² are both associated with increased inflammation. Fat cells release chemicals that cause inflammation. Increased inflammation raises the risk of developing chronic diseases associated with obesity. 

A continuous glucose monitor measures your blood glucose just beneath your skin. It intermittently samples the fluid around your body cells. Ideally, you should see a steady glucose number with slight increases after you eat throughout the day. 

Average Blood Glucose Ranges

• Fasting: less than 100 mg/dL
• Before eating: 80–130 mg/dL
• After eating: less than 140 mg/dL 

Fasting glucose is your blood glucose first thing in the morning, before you have eaten anything. If your fasting blood glucose is (chronically) too high, it may indicate that your body is not making enough insulin or that you may develop insulin resistance. 

When your blood glucose rises, a spike in insulin follows. As glucose is removed from the blood, it overshoots and causes your blood sugar to drop too low. This can trigger a craving for high-fat, high-sugar foods. 

A vicious cycle of hunger, poor dietary choices, hunger, insulin release, increased glycogen¹³ and fat storage is put into motion. 

Excess glucose you don’t use gets stored as glycogen or fat.

Wearing a CGM allows you to see which foods or combinations of foods cause your glucose levels to spike. As a result, you can break the cycle of spikes and dips. This can help you maintain a healthy weight and avoid insulin resistance. 

Glucose tracking can alter your approach to weight loss. 

Cholesterol 

A substance that your body needs to stabilize and build cells, cholesterol helps make vitamins and hormones. Your liver produces all the cholesterol required for these purposes. You also consume cholesterol in your diet when you eat foods that come from animals. Depending on your genetic predisposition, cholesterol in your diet can exceed your body’s ability to metabolize it. 

There are two types of cholesterol. High-density lipoproteins (HDL) or “good cholesterol” scavenge cholesterol and fats from blood vessel walls and transport it to the liver. Low-density lipoproteins (LDL), or “bad cholesterol,” deposit excess cholesterol on the walls of blood vessels, increasing your risk of heart disease, high blood pressure, and stroke. 

Cholesterol Goal: 

• HDL cholesterol: above 45 mg/dL in men and 55 mg/dL in women
• LDL cholesterol: below 130 mg/dL

<p class="pro-tip"><strong>Learn about </strong> <a href="/blog/lower-blood-sugar-cholesterol">how to lower cholesterol and blood sugar</a>.</p>

Triglycerides 

Triglycerides are a type of fat that circulates in the blood and is stored in fat cells. Triglycerides can be converted into energy. 

Excess triglycerides can be deposited on the inner lining of blood vessel walls, causing them to harden and thicken, a condition known as arteriosclerosis. High triglycerides are a risk factor for high blood pressure, heart disease, and stroke. 

Triglyceride Goal:

• Triglyceride: below 150 mg/dL

What Benefits Are Associated With Metabolic Health? 

When your body functions optimally, each cell receives the energy it needs to perform its work. The calories you consume equal the amount used to fuel your body. You have plenty of energy to accomplish your physical and mental goals for the day. Your risks of developing chronic diseases such as diabetes, heart disease, fatty liver disease, and stroke are as low as possible. 

Benefits of metabolic health include: 

• More energy
• Stable mood
• Better quality sleep
• Sharper memory (14)
• Healthier weight
• Increased endurance
• Clearer skin
• Improved sexual health
• Optimally functioning immune system
• Decreased risk for chronic disease

What Is Metabolic Syndrome?

Metabolic syndrome is diagnosed when three of the five metabolic health markers fall in a suboptimal range, increasing your heart disease, diabetes, and stroke risk. The more metabolic risk factors you have, the more likely you are to develop these chronic diseases. 

Increasing age and genetic predisposition increase your risk of developing metabolic syndrome. While you cannot change these risk factors, you can dramatically affect the others by being overweight or obese, physically inactive, and insulin resistant. 

Make lifestyle changes now to prevent or postpone the onset of metabolic syndrome. 

Metabolic Syndrome Criteria

Markers used to diagnose metabolic syndrome:

• Waist measurement of 35 inches or more for women and 40 inches or more for men
• Fasting glucose that exceeds 100 mg/dL
• HDL cholesterol less than 40 mg/dL in men and less than 50 mg/dL in women
• Triglycerides above 150 mg/dL
• Blood pressure equal to or higher than 130/85 mmHg

Metabolic Syndrome Diet 

The ideal diet to reverse metabolic syndrome is the same one to prevent its occurrence. See the metabolic health diet section below for more information. 

How Can You Improve Your Metabolic Health?

The key to improving your metabolic health is diet. Choose nutritious and wholesome foods; move your body throughout the day to maintain supple joints, strong muscles, and dense bones; and get plenty of restful sleep to allow your body to heal itself.

Metabolic Health Diet

Pair glucose (carbs) with proteins, fiber, and fats to keep your blood glucose within a normal range. Each person responds to carbohydrates differently. Your gut microbiome, response to stress, and other factors, such as whether you get adequate sleep and engage in physical activity, may all influence how foods are metabolized.  

When planning a heart-healthy metabolic diet, choose: 

• Whole, unprocessed, unrefined foods
• Fresh fruits and vegetables that are nutrient dense
• Whole, complex carbohydrates, such as those found in fruits, vegetables, oats, and quinoa
• Healthy sources of fats, such as avocados, olive oil, nuts and seeds, and unsweetened coconut oil
• Lean sources of protein

Avoid

• Simple carbohydrates such as those found in honey, sugar, corn syrup, and candy
• Highly processed foods with added sugars
• Trans fats
• Omega-6 fatty acids
• Vegetable oils such as safflower, sunflower, soybean, and corn oils
• Large amounts of saturated fats from cheese, milk, and red meat
• Artificial sweeteners; use natural sugar substitutes instead like allulose or monk fruit if you can tolerate them

Tips to Improve Your Metabolic Health

Optimizing your metabolic health is a lifelong endeavor. Every healthy meal you choose, exercise you engage in, effort you make to get enough sleep, and step you take to minimize stress gets you closer to improved metabolic health. 

Some tips to improve your metabolic health:

• Add proteins and fiber to all carbohydrates to minimize blood sugar spikes
• Drink plenty of water
• Choose low-glycemic snacks 
• Get optimal amounts of restful sleep
• Engage in resistance exercises to build muscle and help stabilize your blood glucose
• Reduce processed foods in your diet
• Avoid smoking, excess alcohol use, and drugs
• Manage your stress
• Eat more fiber 
• Avoid eating for non-nutritive purposes, such as relieving stress and boredom
• Get plenty of sunshine to restore your vitamin D. 

<p class="pro-tip">Read the guide: How to Approach Metabolic Health</p>