More than half of adults in the United States have a chronic disease, and research points to poor metabolic health as an underlying cause.
In the past year, the phrases “metabolic health” and “metabolic dysfunction” have been the focus of many health and wellness podcasts and blogs—and with good reason. An increasing amount of research is pointing to metabolic dysfunction as the underlying cause of many Americans’ rapidly increasing chronic disease rates.
Metabolic Syndrome: An American Problem
According to a
study published in 2019 in the journal Metabolic Syndrome and Related Disorders, the number of American adults who present as metabolically healthy is “alarmingly low.” However, the prognosis clarifies that a mere absence of metabolic syndrome does not equate to metabolic health.
Still, no matter how you define it, the outlook is bleak, according to Dr. Casey Means, a physician and chief medical officer of Levels, a metabolic health company that provides real-time continuous glucose biofeedback. In an
online interview, she states that a majority—
over 90 percent—of Americans live with less-than-ideal metabolic health. Dr. Means believes this percentage should be close to zero. She added that “nine of the 10 leading causes of death in the United States right now are fundamentally rooted in metabolic dysfunction.”
Metabolism refers to how the body processes and generates energy from its primary source, food. Metabolic health measures how efficiently the body performs its metabolic functions without medication.
Typically,
five biomarkers are used to determine whether a person is metabolically healthy or operating with some level of metabolic dysfunction: glucose or blood sugar levels, waist circumference, blood pressure, triglyceride levels, and high-density lipoprotein (HDL) levels. These measurements must be within a specific range for someone to be metabolically healthy.
Metabolic syndrome is defined as failing to meet at least three of these measurements.
While an
increasing number of Americans are becoming metabolically unhealthy, it may not be evident to them. “Many people don’t recognize that they have the condition and underestimate the risks it presents,” Dr. Chiadi E. Ndumele, a cardiologist at the Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, said in a Johns Hopkins article.
Diabetes, Heart Disease, and Stroke
Given that blood sugar levels are a critical metric for metabolic health, it should be no surprise that diabetes, caused by insulin resistance, results from poor metabolic health. Diabetes is the eighth leading cause of death in the United States.
Poor metabolic health is also one of the strongest predictors of heart disease. While there is some debate over clinical guidelines for metabolic syndrome, all five of the biomarkers independently raise the risk of heart disease, according to a report from a study from the
Indiana University School of Medicine. A combination of these risk factors can increase the severity of heart disease.
A study
published in Neurology found that, overall, metabolic syndrome was significantly associated with stroke recurrence.
Metabolic Syndrome Linked to Other Diseases
While most can easily understand the correlation between metabolic syndrome and chronic diseases such as diabetes, heart disease, and stroke, more research is demonstrating the link between metabolic syndrome and other rapidly increasing prevalence of diseases such as cancer, Alzheimer’s disease, and even arthritis.
In its position statement, the
American Society of Clinical Oncology states that “obesity is a major under-recognized contributor to the nation’s cancer toll and is quickly overtaking tobacco as the leading preventable cause of cancer.”
The report offers several direct links between obesity, a major factor in metabolic dysfunction, and a variety of cancers, including breast, prostate, and colon. In addition, it states that obesity is associated with a poorer prognosis after cancer diagnosis and that it can interfere with cancer therapy, leading to morbidity from treatment and second malignancies.
A study published in
Diabetes Care, a publication of the American Diabetes Association, found that with every additional component of metabolic syndrome, the risk of incident dementia increases.
Another study published in
Molecular Psychiatry showed that as some people age, changes occur in how brain cells take up and use glucose to make energy. Glucose dysregulation and impairment or insulin resistance have been associated with both aging and late-onset Alzheimer’s disease, the report found.
Poor metabolic health can also affect joint health. One study published in
Annals of Translational Medicine showed that metabolic syndrome can worsen symptoms of osteoarthritis, including pain. Poor insulin function may damage tendons and cartilage, cholesterol deposits may weaken tendons, and overall metabolic dysfunction causes inflammation, which reduces the body’s capacity to heal.
While more research is needed on what drives the complex and multifaceted triggers for autoimmune disease, studies show that both
insulin resistance and autoimmune disease reflect out-of-balance cytokines, the
key mediators in regulating the normal immune response. A surplus of cytokines can result in excess inflammation in the body and trigger autoimmune diseases, including rheumatoid arthritis, inflammatory bowel syndrome, lupus, and multiple sclerosis. One study in
Frontiers in Endocrinology reported that diabetic patients show an altered number and function of immune cells belonging to both innate and acquired immunity. Not only can poor metabolic health lead to autoimmune conditions, but it also throws fuel on the fire of many autoimmune disease symptoms.
The Cost of Conditions Arising From Metabolic Syndrome
An average of 75 percent of
all health care spending in the United States is allotted to chronic illnesses. According to the
Milken Institute, the overall cost of chronic disease—both direct and indirect—amounts to an average of $3.7 trillion annually, about 19.6 percent of the U.S. gross domestic product. The most significant proportion of that is spent on heart disease and cardiovascular conditions.
An increasing amount of evidence demonstrates that if Americans could get the five benchmarks of metabolic health within acceptable levels, the rate of
chronic disease, and thus
health care costs, would decrease.
Lifestyle Changes Can Reduce Risks
While DNA can undoubtedly be a factor in metabolic health, most medical professionals agree that lifestyle choices profoundly impact these measurements. These choices include the obvious ones like diet and exercise, but stress levels, the amount and quality of sleep, and mental health also play a role in maintaining healthy biomarkers.
Dr. Means explained: “Every one of our 40-plus trillion cells require energy to do their work, and that energy comes from metabolic processes.” She equates metabolic dysfunction to poorly powered machinery, hindering our bodies’ ability to perform everyday tasks. “When our cells are sputtering to do the trillions of chemical reactions they need to do every day, this creates a struggling body … which emerges as symptoms and disease.”
Poor daily habits, as well as what Dr. Means calls a “modern industrial diet and lifestyle,” contribute to preventing efficient energy conversion within the cells. Lack of sleep, eating refined sugars and grains, sitting too much, and even chronic fear can contribute to the inefficient operation of our cells, leading to metabolic dysfunction.
Most research points to lifestyle changes as the first line of defense against metabolic syndrome and, thus, more life-threatening chronic illness. “Understanding that you have metabolic syndrome in the first place can help motivate you to make the needed changes,” said Dr. Ndumele in the Johns Hopkins article.
Most health care practitioners recommend weight reduction through physical activity and improved nutrition to prevent the escalation of
prediabetes and metabolic syndrome.
However, many who struggle with weight loss find diet and exercise are not enough because of the effects dysregulated insulin has on their motivation to make changes. Datis Kharrazian, a Harvard Medical School-trained clinical research scientist, wrote in an
Epoch Times article that it’s almost impossible to manage autoimmunity or improve a chronic health condition if one’s blood sugar is habitually dysregulated. That, paired with a sedentary lifestyle, “feed into each other in a downward spiral that holds their bodies hostage,” he shared.
As consumer concerns over this important biomarker rise, the tech industry seems to respond with apps that help people measure their glucose levels and various other aspects of metabolic function. Companies like Levels, Veri, and InsideTracker are gaining popularity for assisting people in monitoring the key determinants of metabolic health to regain sovereignty over their health. A better understanding of metabolic health can empower individuals to make changes and reduce health risks.
