The Key to a Longer, Healthier Life: Claim Your Metabolic Health

For this article by Sara Gottfried MD on taking charge of your metabolic health the image shows a Black woman holding a continuous glucose monitor between her fingertips.

Taking charge of your metabolic health is the key to a longer, healthier life. Metabolic health is a critical pillar that supports health and energy.  At its most basic function, metabolic health refers to the body’s ability to process and utilize energy from food. However, it’s so much more than that. Metabolism encompasses all the biochemical processes happening within the body, involving metabolic hormones like insulin, cortisol, leptin, testosterone, and growth hormone. These hormones play a significant role in various aspects of metabolic health, influencing your present well-being and, equally crucial, your long-term aging process. 

Poor metabolic health puts you at risk for pre-diabetes, Type 2 diabetes, heart disease, stroke, Alzheimer’s disease, and even cancer. 

The current state of metabolic health in the United States is not good. Only 12% of Americans have achieved metabolic health,1 and shockingly, up to 38 percent of the US population has prediabetes.2

However, while these statistics are depressing to read, it’s important to know that you have the power to understand and take charge of your metabolic health, and in doing so, pave the way for a longer, healthier life.

What Does Metabolic Health Look Like? 

Aspects of robust metabolic health include:

  • Healthy weight
  • Optimal blood sugar levels
  • Insulin sensitivity
  • Optimal blood pressure
  • Balanced blood lipids

Recently I wrote a paper published in the British Medical Journal Open describing the systematic review and meta-analysis I’ve just completed on the early transition from health to prediabetes.

For more on testing read: Metabolic Health: Why You Must Care and How to Measure It

Sex Differences in Metabolic Health

Metabolic health concerns affect men and women alike. However there is a misconception that men are more at risk from cardio-metabolic related diseases such as heart disease and stroke, and it’s just not true. As women move into mid-life, hormonal changes become a prominent part of their lives. These changes make their bodies less sensitive to insulin and more vulnerable to issues with blood sugar. The decline in estrogen levels during this phase leads to a doubling of the rate of fat gain and a decline in lean body mass, changes that persist until two years after the final menstrual period. These shifts in fat distribution are intrinsically linked to hormonal fluctuations in women.

However, this isn’t merely a matter of appearance or vanity. It’s a health concern. Women typically gain an average of 5 pounds over three years during the menopausal transition, and 20 percent of them gain 10 pounds or more. This weight gain is associated with a greater risk of heart disease, high blood pressure, high cholesterol levels, and insulin resistance. Moreover, women show adverse effects of elevated fasting glucose at lower thresholds than men, indicating the urgency of addressing metabolic health in women.

The Role of Insulin: From Fuel to Fat

To truly grasp metabolic health, we must understand the role of insulin. Insulin is a key player in how our bodies derive energy from the foods we consume. It manages glucose, which is the primary fuel for our bodies. When functioning correctly, insulin takes glucose, like that from an occasional treat, and stores it as glycogen in the liver and muscles—a readily available energy source.

However, a high intake of sugary foods and refined carbohydrates can disrupt this process. When our bodies receive excessive carbs, insulin receptors on our cells can become less responsive, leading to insulin resistance, or insulin block as I refer to it. This resistance results in elevated insulin levels in the blood and rising glucose levels. Essentially, insulin, which is supposed to help us burn fat, starts storing it instead, primarily in the liver, waistline, and other organs.

A Powerful Tool For Taking Charge of Your Metabolic Health

One powerful tool for understanding and managing metabolic health is a Continuous Glucose Monitor (CGM). This tiny device has disrupted my health more than anything else I’ve done in the past 10 years. It’s about the size of a quarter and contains a tiny sensor about a hair in diameter that measures glucose in the interstitial space. A CGM is not merely a weight-loss tool, although it can be highly effective in this regard. It provides a window into how your body responds to various foods and lifestyle choices by tracking your blood sugar levels throughout the day. When you observe how certain foods cause blood sugar spikes, it can motivate you to make dietary changes that promote stable blood sugar and, consequently, weight loss.

Moreover, a CGM can reveal the broader impact of factors such as sleep and stress on your metabolic health. For instance, tracking your sleep and blood sugar levels can show how a lack of sleep or disrupted sleep patterns can increase your fasting blood glucose levels. The same applies to stress, which can lead to spikier glucose levels. Remember, what you measure improves, making a CGM a valuable tool for making informed decisions about your health.

CGM Alternative

While CGMs offer comprehensive insights into metabolic health, they are not financially viable for all. The alternative is to use a simple and affordable blood sugar monitor available in any drugstore that requires you to prick your finger. You can track your fasting blood sugar every morning and postprandial (post-meal) blood sugar levels. Even this basic method can give you valuable insights into the impact of food and lifestyle choices on your health. To get the most out of your CGM investment, work with a knowledgeable clinician to personalize how to revise the way you eat based on CGM data. I start with my patients to get mean glucose < 100 mg/dL and variability (standard deviation) < 15 mg/dL. Watch which foods spike you, because spikiness is what tends to cause damage to blood vessels.

[For more information on optimal blood sugar and insulin ranges, download my free guide to tracking your blood sugar.]

Metabolic Health: Beyond the Numbers

Metabolic health is not solely about the numbers on the scale or glucose monitor. Even if you don’t face issues with weight gain, you can benefit from understanding and managing your metabolic health. It’s crucial to remember that you can’t judge metabolic health by appearances alone. Many individuals with normal body weight or body mass index (BMI) may still have metabolic health issues.

Consider my own experience: In my 40s, I maintained a normal weight, but under the hood, so to speak, I was developing hidden conditions associated with obesity. These included insulin resistance, rising blood pressure, and prediabetes. Without monitoring my metabolic health, these issues might have gone unnoticed until they showed up in later years as severe health problems.

Practical Steps for Better Blood Sugar Regulation

Now that we understand the significance of metabolic health, let’s explore some practical steps to improve metabolic health:

1. Prioritize Protein at Breakfast: Protein does not cause an immediate spike in glucose in the same way that a carb-filled breakfast does. When you start the day off by keeping your blood sugar stable, with fewer excursions, then you are less likely to have sudden cravings for a sugary snack to compensate for a drop in your blood sugar.

2. Exercise After Meals: Exercise makes your muscles more sensitive to insulin so they ‘soak’ up the glucose and help to maintain stable glucose levels.

3. Fuel Your Good Microbes with Fiber: Consuming a mostly plant-based food plan lowers blood sugar, inflammation, and weight. Increased soluble fiber helps to balance blood sugar.3

4. Vinegar Before, During, or After Meals: Drinking a glass of filtered water with apple cider vinegar lowers blood glucose and perhaps resets insulin.4

Becoming metabolically flexible and optimizing your metabolic health is the foundation for your health and well-being as you age. Remember, you don’t need to outsource your metabolic health to your doctor. By taking control of your metabolic health through monitoring, understanding, and making informed choices, you empower yourself to lead a longer, healthier life.

Want more? Watch Understanding Predictive Markers of METABOLIC Dysfunction (Dr. Sara Gottfried & Dr. Casey Means)

  1. Araújo, et al., “Prevalence of Optimal Metabolic Health in American Adults: National Health and Nutrition Examination Survey 2009–2016,” Metabolic Syndrome and Related Disorders 17, no. 1 (2019): 46–52.
  2. Stefan et al., “Causes, Characteristics, and Consequences of Metabolically Unhealthy Normal Weight in Humans,” Cellular Metabolism 26, no. 2 (2017): 292–300; N. Stefan et al., “Obesity and Impaired Metabolic Health in Patients with COVID-19,” Nature Reviews Endocrinology (2020): 1–2.
  3. A. Meyer et al., “Carbohydrates, Dietary Fiber, and Incident Type 2 Diabetes in Older Women,” The American Journal of Clinical Nutrition 71, no. 4 (2000): 921–30; A. A. Qureshi et al., “Effects of Stabilized Rice Bran, Its Soluble and Fiber Fractions on Blood Glucose Levels and Serum Lipid Parameters in Humans with Diabetes Mellitus Types I and II,” The Journal of Nutritional Biochemistry 13, no. 3 (2002): 175–87; F. M. Silva et al., “Fiber Intake and Glycemic Control in Patients with Type 2 Diabetes Mellitus: A Systematic Review with Meta-analysis of Randomized Controlled Trials,” Nutrition Reviews 71, no. 12 (2013): 790–801; R. D. Gibb et al., “Psyllium Fiber Improves Glycemic Control Proportional to Loss of Glycemic Control: A Meta-analysis of Data in Euglycemic Subjects, Patients at Risk of Type 2 Diabetes Mellitus, and Patients Being Treated for Type 2 Diabetes Mellitus,” The American Journal of Clinical Nutrition 102, no. 6 (2015): 1604–14; A. S. Abutair et al., “Soluble Fibers from Psyllium Improve Glycemic Response and Body Weight Among Diabetes Type 2 Patients (Randomized Control Trial),” Nutrition Journal 15, no. 1 (2016): 86.
  4. S. Johnston et al., “Vinegar: Medicinal Uses and Antiglycemic Effect,” Medscape General Medicine 8, no. 2 (2006): 61; J. Lim et al., “Vinegar as a Functional Ingredient to Improve Postprandial Glycemic Control: Human Intervention Findings and Molecular Mechanisms,” Molecular Nutrition & Food Research 60, no. 8 (2016): 1837–49; F. Shishehbor et al., “Vinegar Consumption Can Attenuate Postprandial Glucose and Insulin Responses: A Systematic Review and Meta-analysis of Clinical Trials,” Diabetes Research and Clinical Practice (2017): 1–9