As we saw in the previous post, metabolism is the engine that keeps your body running. When the metabolic machinery gets clogged up, health problems ensue.
Metabolic health worldwide is declining, affecting quality of life and driving up healthcare costs. U.S. government data suggest that 93% of Americans have less-than-optimal metabolic function. You might be one of them.
Might you have metabolic dysfunction?
Metabolic dysfunction isn’t all-or-nothing; it can range from mild metabolic imbalances to metabolic syndrome, a well-defined medical condition characterized by a cluster of metabolic abnormalities that together increase the risk of cardiovascular disease, stroke, type 2 diabetes, and certain types of cancer and dementia.
- Mild issues: You might notice modest changes in your blood work, like higher glucose levels, triglycerides, blood pressure, liver enzymes (or fatty deposits revealed by a liver ultrasound), or low HDL (“good”) cholesterol. Other signs include fatigue, mood swings, or weak immune function. If these show up — and even if your numbers are borderline (for instance, “pre-diabetes”) — it’s worth discussing this with your doctor within the context of your overall metabolic health. Single out-of-range numbers may not necessarily indicate that you have metabolic dysfunction; an elevated HA1c number, for instance, can be due to low iron levels.
- Metabolic Syndrome is typically diagnosed if you have three or more of the following:
- Fasting glucose above 100 mg/dL
- HDL cholesterol less than 40 mg/dL (men) or 50 mg/dL (women)
- Triglycerides above 150 mg/dL
- High blood pressure (130/85 or higher)
- A waistline of 35 inches for women and 40 inches for men, indicating elevated stores of visceral fat (take this with a pinch of salt; some people have higher waist circumferences without carrying much visceral fat — for instance, due to intestinal bloating or hernias)
Health issues linked to poor metabolic function
Poor metabolic function isn’t a disease that sets in suddenly and has distinct symptoms and treatments. Rather, it shows up in many different guises and creeps up on us over years and decades. Here are just some of the ways metabolic dysfunction can manifest:
- Insulin resistance, prediabetes, and type-2 diabetes: Poor metabolic function can cause glucose (blood sugar) levels to rise through a mechanism called insulin resistance, which is when the body’s cells don’t respond properly to insulin, a hormone that helps glucose enter cells to be used as energy. When cells are resistant to insulin, glucose builds up in the bloodstream. The pancreas produces more insulin to try to overcome the cells’ insulin resistance and rising blood glucose levels. If the body can’t produce enough insulin to keep glucose in a healthy range, this leads to prediabetes or type-2 diabetes. Type-2 diabetes, in turn, is linked to an increased risk of other health issues, like cardiovascular disease, kidney disease, vision loss, foot ulcers, nerve damage, gum disease, cancer, and thyroid disease.
- Impaired brain function: Metabolic imbalances may contribute to brain fog and cognitive dysfunction, depression, anxiety, and Alzheimer’s disease. It is also linked to psychiatric diseases such as schizophrenia, bipolar disorder, and major depression.
- Blood vessel damage: In the blood vessels, it can contribute to cardiovascular disease (like heart attacks and strokes) and microvascular disease (like erectile dysfunction, retinopathy, and kidney disease).
- Fatty liver: Metabolic dysfunction can lead to non-alcoholic fatty liver disease (NAFLD), where excess fat is stored inside liver cells, making it harder for the liver to function. This can progress to inflammation, scarring, and even cancer. Some 100 million people (about 25%) in the United States are estimated to have NAFLD (recently renamed metabolic dysfunction-associated steatotic liver disease, or MASLD).
- Cancer: Long thought to be a largely genetic disease, cancer is increasingly being viewed as a metabolic disease amid research showing that all types of cancer, but particularly those of the breast, endometrium, prostate, kidney, liver, colon & rectum, are closely linked to metabolic imbalances.
- Increased visceral fat storage: Impaired metabolic function drives fat storage in the abdominal cavity. This type of fat is called “visceral” since it wraps around our inner organs (called viscera). It is considered less healthy than subcutaneous fat (the harmless, pinchable fat beneath our skin). Reducing visceral fat–even without losing weight!–may improve cardiometabolic health.
- Other health issues: Poor metabolic health can show up as the aches, pains, and frustrations of everyday life, such as fatigue, balding, fertility problems, acne, gout, irritable bowel syndrome, chronic pain, osteoarthritis, food cravings, and more.
It’s Reversible
If your cardiometabolic biomarkers (labs like fasting glucose, HA1c, HDL cholesterol, or blood pressure) are outside the recommended reference ranges, take heart: these imbalances can be reversed.
Behavior changes involving nutritious food, regular physical activity, good sleep, and stress management practices may help. Moreover, medications to treat elevated blood sugar, high blood pressure, and cholesterol may be prescribed. There’s absolutely no shame in taking these; you don’t owe the world a naturally perfect metabolism! 🙂
One way to learn about nutrition, movement, and stress-management behaviors that support metabolic function is to join my online community, Savor, where we offer cook-along classes and recipes, in-person walks and online exercise classes, interviews with leading medical researchers, mindfulness & stress-management resources, and more.
Another is to work with me in one-on-one coaching. If you want to chat with me about how that might look, feel free to schedule a 30-minute discovery call by clicking on this link.
In Part 3 of this series on metabolism, we look at factors that undermine metabolic function.