If you want to have more energy; balance hormones; lose some weight; sleep more soundly; and/or improve mood and focus…

…let’s talk about improving your metabolic health.

Did you know…only 6.8% of American adults, aged 20 and over, are metabolically healthy?!  Even among American adults, who are of “normal” weight, the prevalence of metabolic health is low (1).

Good metabolic health is key to preventing chronic diseases, including obesity, diabetes, arthritis, cancer, stroke and heart disease.

So…what is metabolic health?

Your “metabolic health” reflects the overall health of your cells in a wide range of biological functions.

Healthy cells are the foundation of cellular energy that powers every function in your body. When your cells are unhealthy, they can’t repair themselves. This causes your tissues to break down, creating an environment that allows chronic diseases to take hold.

Good metabolic health is associated with optimal health. This means your body is properly digesting and absorbing nutrients from the foods you eat, successfully converting this food into energy that your body can use. This digestion-absorption-conversion process takes place without unhealthy spikes in blood sugar, blood fat, inflammation or insulin levels.

Your metabolic health is the cumulative result of your food choices (processed foods or whole foods) and lifestyle habits, including sleep, movement, stress management, relaxation strategies and exposure to toxins, including nicotine, alcohol and other regular substance use.

When you are metabolically healthy, the cells in your body have the energy to keep you nourished, hormonally balanced, immune-protected, heart healthy and of sound mind and mood (2). 

Your metabolic health is a core underlying physiological function that can determine whether you experience good physical and mental health OR poor health and disease.

What does being metabolically healthy look like?

While being overweight or obese is a key symptom of metabolic dysfunction, being metabolically healthy is not just about being at a “normal” weight. Looking fit, having good cardiovascular stamina, and/or having a normal BMI (Body Mass Index) are also NOT reliable indicators of metabolic health. So, yes…you can be an athlete or athletic—even look “fit”—but still be metabolically unhealthy if you overtrain; eat a processed food diet; and/or engage in unhealthy lifestyle habits (3).

If you have good metabolic health… 

• • You can easily maintain a healthy weight or lose weight (if needed).
  • You have steady, stable energy throughout the day—without caffeine, energy drinks, sugar or other stimulants (prescription or otherwise).
  • You have balanced mood. No mood swings. You experience minimal episodes of depression, anxiety or irritability.
  • Your mind is clear and focused. No brain fog, confusion or memory issues.
  • You have a clear complexion. No adult acne flare-ups.
  • Your skin is clear overall. No skin issues or conditions (e.g., eczema, rosacea, psoriasis, etc.).
  • You experience restorative sleep.
  • You have a healthy digestive system. No bloating, diarrhea, constipation, IBS, gastroparesis or other digestive health problems.
  • Your hormones are in balance.
  • Your hunger is in check. You eat when physically hungry due to physiological cues (not emotional) and stop eating when full.
  • Your cravings—for sugar, alcohol, caffeine, refined carbohydrates—are minimal to none.
  • You are pain-free. No chronic joint or muscle pain, stiffness, or ongoing body aches.

5 Biomarkers of Metabolic Health

 Five metabolic biomarkers—interpreted together—give us powerful clues about the state of our metabolic health, including: 1) Waist circumference; 2) Triglycerides; 3) HDL (“good” cholesterol); 4) Blood pressure; and 5) Blood glucose levels—without the use of medications.

When all 5 of these markers are in an optimal range—again, without medication—you are considered to have a reasonable level of metabolic health. Typically, when all five of these markers are in optimal range, you will feel vibrant, healthy and pain-free (4).

Metabolic Syndrome 

Poor metabolic health can lead to “Metabolic Syndrome”, a group of risk factors that raises your risk of heart disease, stroke and diabetes.

Metabolic syndrome was also a culprit for worse COVID-19 outcomes during the initial outbreak. In a retrospective study, published in Metabolic Syndrome and Related Disorders, researchers found that metabolic syndrome—especially obesity, dyslipidemia in particular, high triglycerides, low HDL), hypertension and high blood sugar—was associated with worse outcomes in adult patients who tested positive for COVID-19 between March and May 2020. Those with metabolic syndrome had an increased risk of hospitalization (77%), admittance to the Intensive Care Unit (56%) and death (81%). (5)

Metabolic syndrome increases your overall risk of chronic disease.

You will be diagnosed with metabolic syndrome if you have 3 or more of the following risk factors, which, in turn, increases your risk of heart disease by two-fold and your risk of diabetes by five-fold (6).

3 or More of these 5 Risk Factors = Metabolic Syndrome

If you check “YES” to 3 or more of the following risk factors, you will be diagnosed with metabolic syndrome. (7, 8, 9, 10, 11). Where do you fall?

1.  Large Waist Circumference

This indicates excess body fat around the waist. You are at risk for metabolic syndrome IF your waist size is HIGH:

–For men: 40 inches or more
–For women: 35 inches or more

*Note: Optimal waist circumference is the same for women of all ethnic origins. However, it varies for men, depending on ethnic origin.

Optimal waist circumference: 

For women:  <31.5 inches (Applies to women of all ethnic origins). 

For men:  <37 inches for men of European, Sub-Saharan African, Middle Eastern and Eastern Mediterranean origin.

For men:  <35 inches for men of Southeast Asian, Chinese, Japanese, and South and Central American origin.

2.  High Triglycerides

Triglycerides are fats in the blood that contribute to plaque build-up in your arteries.

You are at risk for metabolic syndrome IF your triglycerides are HIGH—150 mg/dL or higher OR You are using a cholesterol medicine.

Optimal range for triglycerides:  <80 mg/dL

3.  Low HDL “Good” Cholesterol

High-density lipoprotein (HDL) cholesterol, a.k.a. the “good” cholesterol, helps remove excess cholesterol from the blood. You are at risk for metabolic syndrome IF your HDL is LOW:

–For men: Your HDL is less than 40 mg/dL
–For women: Your HDL is less than 50 mg/dL

Optimal range for HDL: 60 mg/dL or higher

4.  High Blood Pressure

Your blood pressure is the force of blood pushing against the walls of blood vessels as the heart pumps blood through the circulatory system. It is expressed as systolic (the top number) over diastolic (bottom number). Systolic refers to the pressure inside the artery when the heart contracts and pumps blood through the body. Diastolic refers to pressure inside the artery when the heart is at rest and is filling with blood.

You are at risk for metabolic syndrome IF your blood pressure is HIGH—consistently 130/80 mm Hg (or higher) OR you are using high blood pressure medication.

Optimal range for blood pressure: 120 (or less) systolic / 80 (or less) diastolic.

5.  High Blood Glucose

A glucose test, commonly done at an annual physical, measures the glucose (sugar) levels in your blood. Glucose is your body’s main source of energy, and it comes from the food you eat.

A fasting blood glucose test measures the amount of sugar in your blood when it should be at its lowest. “Fasting” means that you haven’t had anything to eat or drink (besides water, which is fine) for 8 to 12 hours.

You are at risk for metabolic syndrome IF your fasting glucose is HIGH—100 mg/dL or higher.

–Fasting glucose between 100 and 125 mg/dL = Pre-diabetes.

–Fasting glucose of 126 mg/dL or higher = Diabetes

Optimal range for blood sugar: Between 70 to 85 mg/dL

Why Wait?

In my opinion, even one elevated biomarker—let alone 3!!—is cause for concern and should serve as an impetus to pay attention to your food and lifestyle choices—making adjustments where necessary.

It would be like driving a car with brakes that made grinding or squealing noises every time you braked (a huge red flag that there is likely a problem with the braking system). Would you ignore this major warning sign and hope for the best (e.g., no accidents!!) OR would you take immediate action and have a mechanic look at your car?

For example, I have a family history of hypertension and stroke. My maternal grandfather had multiple strokes before he died of a massive stroke.

Periodically, throughout my adult life, I have experienced hypertension. For example, at age 31, my blood pressure was startlingly high for several months—even though I was running 35 miles a week and working out 2 hours 5-6 days / week. My other 4 metabolic markers—blood sugar, HDL, triglycerides and waistline—were in an optimal range.

However, I did not wait until 2 other biomarkers were elevated before I took action to reduce my blood pressure! I immediately worked on adjusting my sleep routine and food choices as well as incorporating relaxation practices and stress-lowering herbal supplements. While common, hypertension is not “normal”, and it can damage your heart, brain, kidneys and blood vessels (12, 13).

The Good News

Once you optimize your metabolic health, you’ll find it easier to lose weight as well as experience increased energy, improved focus and balanced mood.

The good news is that you can be pro-active NOW in optimizing your metabolic health by  knowing your numbers (as mentioned above); by making different food choices; and, by modifying lifestyle.

What You Can Do:

1.   Test. Don’t Guess.

Have you ever waited months to see your doctor—and then, after the appointment, waited weeks for the results of your bloodwork?  If you want to be proactive about your metabolic health, order your own bloodwork via direct access labs; the results are emailed directly to you within 1 week to 10 days. I do this for myself every 3 months to stay on top of my health.

Once you receive your lab results, you can take them to your doctor OR the health practitioner of your choice, including myself, to review.

For a general overview of your metabolic health….👉order this Essential Labs panel. Save nearly 50% when you buy this bundled Essential Labs panel (just $99 bundled, versus $145 if tests are purchased individually) that includes the Comprehensive Metabolic Panel (includes the Glucose test); Complete Blood Count; Fasting Lipid (Cholesterol) Panel; Hemoglobin A1c; and Thyroid Stimulating Hormone.

2.  Track your blood pressure and waist size.

I like this blood pressure monitor, which I use to take my blood pressure every morning before eating a meal.  I recommend using this soft fabric tape measure for body measurements. If you are tracking waist size, measure 1x / week.

3.  Sleep 7-8 hours nightly.

4.  Cook at home more. Eat nutrient-dense whole foods.

5.  Reset with a whole foods cleanse.

6.  Manage carbohydrate intake.

7.  Sit less. Move more. Strength train.

8.  Engage in relaxation practices, like regular deep breathing or a daily meditation practice (you can start at 1 minute and increase over time).

9.  Limit screen time (phones, iPad, computer).

10.  Cut back or cut out stimulants and/or depressants, including caffeine, sugar, alcohol, nicotine, marijuana and/or other recreational drugs.

11.  Consider working with a functional health coach: schedule a Metabolic Health consultation:👇

👉👉👉Are you tired of making lifestyle choices that leave you feeling physically exhausted, stressed, unmotivated and “stuck” when it comes to your health and well-being? Let’s get clear on what’s been holding you back from better metabolic health.  CONTACT ME HERE.

Sources

1   O’Hearn, M, Lauren, B, Wong J, Kim D and Mozaffarian D. Trends and Disparities in Cardiometabolic Health in U.S. Adults, 1999-2018. Journal of the American College of Cardiology. 12 July 2022. Vol. 80, Issue 2. Pages 138-151.

2, 4, 6  Means, C with Means, C. (2024). Good Energy. Avery.

3  Maffetone, P.B., Laursen, P.B. Athletes: Fit but Unhealthy?. Sports Med – Open 2, 24 (2016).

5  Wu S, Zhou K, Misra-Hebert A, Bena J, and Kashyap 3. “Impact of Metabolic Syndrome on Severity of Covid-19 Illness.” Metabolic Syndrome and Related Disorders. Vol 20, No. 4. May 18, 2022. Pages 191–98.

7  Swarup S, Ahmed I, Grigorova Y, Zeltser R. Metabolic Syndrome. 2024 Mar 7. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan–. PMID: 29083742.

8  International Diabetes Federation. Metabolic Syndrome. 2006.

9   “HDL Cholesterol”. Cleveland Clinic. 11/6/23.

10  “High Blood Pressure/Hypertension”. John Hopkins Medicine.

11  MedlinePlus [Internet]. Bethesda (MD): National Library of Medicine (US); [updated December 30, 2024]. Blood Glucose Test.

12  Bailey, M, Dhuan N, et al. A novel role for myeloid endothelin-B receptors in hypertension. European Heart Journal, Volume 40, Issue 9, 01 March 2019, Pages 768–784.

13  “High Blood Pressure and Chronic Kidney Disease”. National Kidney Foundation.

According to a recent (May 2024) study published in the Annals of Internal Medicine…

Low testosterone in men was associated with an increased risk for all-cause mortality (death) while very low testosterone levels were associated with increased risk of cardiovascular death (1, 2).

In a systemic review and meta-analysis, researchers included 11 studies with more than 24,000 participants to analyze the associations of sex hormones with mortality and heart disease risk in aging men. According to the study authors, their data supported the hypothesis—and provided much-needed clarity—that hypogonadism (a condition where the male body is unable to produce normal amounts of testosterone, resulting in low testosterone) is associated with higher cardiovascular and all-cause mortality (3).

This is yet another reason why men—no matter their age—should know their testosterone level—even if it is to establish a baseline for future reference. Simply order your own testosterone and prostate panel—no doctor’s visit required—on sale until July 31st for $149.

In my article Testosterone and Men’s Health, I highlighted the vital role that testosterone plays in men’s health. I also discussed the physicatl and mental health consequences for men with low testosterone; why low testosterone is so prevalent—even among young men; and how to boost testosterone naturally.

Cause or Consequence?

When it comes to testosterone and men’s heart health…

Does having low testosterone cause increased risk of adverse cardiovascular events in men? Or is low testosterone a consequence of having coronary artery disease (CAD)?

Studies have suggested evidence for both.

However, the relationship between low testosterone and an increased risk of developing—or dying from—heart disease is neither simple nor direct. It is a complex and multi-factorial relationship.

One of the main causes of low testosterone levels is male hypogonadism, where the body is unable to produce normal amounts of testosterone, resulting in low testosterone,because of abnormal signaling hormones being released from the brain. For young, healthy men in their 20s, this signaling hormone rapidly messages the testes to make more sperm and testosterone. However, as men age and/or they experience chronic stress, their signaling hormones can lose speed, reducing the amount of testosterone being produced. Low testosterone symptoms can present as low libido (sex drive), changes in sleep patterns, difficulty concentrating, reduced muscle strength/muscle mass, decreased bone density, depression and fatigue.

Hypogonadism, characterized by low testosterone, is categorized as one of two types (4):

Primary. This type of hypogonadism is generally associated with a problem in the testicles, whether a congenital or genetic defect, testicular injury or trauma, autoimmune disorder or an infection affecting the testes (5).

Secondary. This type of hypogonadism is where low testosterone levels can be attributed to a problem in the hypothalamus or the pituitary gland, parts of the brain that signal the testicles to produce testosterone. This is a signaling issue, like a faltering Internet connection.

Secondary hypogonadism can be caused by pituitary disorders or by lifestyle factors, such as taking certain medications (e.g., opioids, anti-psychotics, antidepressants, etc.) that suppress testosterone production and/or having a chronic disease, like Type 2 diabetes, hypertension and/or obesity. (6)

Why Metabolic Health Matters

A common theme that underlines the association between low testosterone and increased cardiovascular risk in men is poor metabolic health.

“Metabolic health” is a term that describes how well we generate and process energy in the body (7). When we are metabolically healthy, the following 5 metabolic markers are at optimal levels—without the use of medications:

1. 1. 1. Blood sugar
      2. Triglycerides
      3. HDL “good” cholesterol
      4. Blood pressure
      5. Waist circumference

Metabolic health is also defined as the absence of “metabolic syndrome” (described below).

Each one of the conditions listed below individually increases your cardiovascular risk. However, “metabolic syndrome” consists of a group of conditions that, together, significantly increase your risk of heart disease, Type 2 diabetes and stroke.

If you have 3 or more of the following conditions, you are considered to have metabolic syndrome (8):

1. 1. 1. High blood sugar. Your fasting blood sugar is 100 mg/dL or higher.

1. 1. 2. Hypertriglyceridemia (high triglycerides). Your triglycerides are 150 mg/dL or greater.

1. 1. 3. Low HDL “good” cholesterol: For men, “low” HDL is less than 40 mg/dL; for women, “low” HDL is less than 50 mg/dL.

1. 1. 4. High blood pressure: Your systolic (top number) is 130 mmHg or higher and your diastolic (bottom number) is 85 mmHg or higher.

1. 1. 5. Large waist circumference. Greater than 40 inches (for men). Greater than 35 inches (for women).

In a 2018 study, published in Metabolic Syndrome and Related Disorders, researchers from the University of North Carolina at Chapel Hill analyzed data from 8,721 adults—consisting of men and women aged 20 and older—from the 2009 to 2016 National Health and Nutrition Examination Survey (NHANES).

What they found:  only 1 in 8 adults in the US—(just 12%!)—have optimal metabolic health (9).  Post-COVID, that percentage is likely even less.

 *Keep in mind: you can still be metabolically unhealthy even if you are at a “normal” weight.

 That said, poor metabolic health often goes hand-in-hand with being overweight or obese, which also increases risk of heart disease. According to the latest NIH statistics, among men aged 20 or older, 34% are overweight and 43% are obese (10).

And…being overweight or obese can lower testosterone levels in men.

How? There are two ways…

First, a large waist circumference (greater than 40 inches for men) indicates excess abdominal fat. An enzyme called “5-aromatase” is present in belly fat; and this enzyme is responsible for converting testosterone into estrogen (the female sex hormone). More belly fat = increased aromatase activity, which leads to an undesirable hormonal imbalance for men: less testosterone and more estrogen. This is why obese men typically have higher levels of estrogen than men who are of normal weight.

.

What you can do

The best defense is a good offense. If you discover that your testosterone is less than optimal…that good news is that lifestyle modifications can help you raise testosterone levels naturally.

1.  Start by getting tested. Click here to order your own testosterone and prostate panel—no doctor’s visit required—on sale until July 31st for $149.

2.  Maintain a healthy weight or lose weight.

3.  Commit to lifestyle modifications that support metabolic health, including:

1. 1. 1. Food choices. Reduce consumption of ultra-processed foods; choose whole foods; reduce intake of refined carbohydrates, seed oils and sugar.
      2. Movement. Sit less. Lift weights. Interval train.
      3. Stress. Reduce!
      4. Sleep. Prioritize!
      5. Supplement. As appropriate.
      6. Endocrine-disrupting toxins.

4.  Get support. Feeling overwhelmed or confused about how to start making better food choices? Click here to schedule a FREE 15-minute Discovery phone consultation with me to see how I can best support you.

Sources

1, 3  “Low testosterone levels in men associated with mortality risk.” I.M. Matters from American College of Physicians (ACP). Endocrinology. May 14, 2024.

2   Yeap, B. B. et al. “Associations of Testosterone and Related Hormones with All-Cause and Cardiovascular Mortality and Incident Cardiovascular Disease in Men: Individual Participant Data Meta-analyses”. Annals of Internal Medicine. Vol. 177, No. 6, pp. 768-781. June 2024.

4, 5, 6  Kumar P, Kumar N, Thakur DS, Patidar A. Male hypogonadism: Symptoms and treatment. J Adv Pharm Technol Res. 2010 Jul;1(3):297-301.

7  Means, C. (2020, June 18). “The Ultimate Guide to Metabolic Health”. Levels | Metabolic Insights.

8  “Metabolic Syndrome”. Cleveland Clinic. 9/13/23.

9  Araújo, J., Cai, J. and Stevens, J. “Prevalence of Optimal Metabolic Health in American Adults: National Health and Nutrition Examination Survey 2009–2016.” Metabolic Syndrome and Related Disorders. Vol. 17, Issue 1, pp. 46-52. Feb. 2019.

10  NIH, National Institute of Diabetes and Digestive and Kidney Diseases. Overweight & Obesity Statistics.

11  Arnarson, A. “Can Boosting Your Testosterone Help You Lose Fat?” Healthline. June 13, 2023.

12  George JT, Millar RP, Anderson RA. Hypothesis: kisspeptin mediates male hypogonadism in obesity and type 2 diabetes. Neuroendocrinology. 2010; 91 (4):302-7.

13   Lee HK, Lee JK, Cho B. The role of androgen in the adipose tissue of males. World J Mens Health. 2013 Aug;31(2):136-40.

 
When it comes to having a healthy heart, it’s important to know your numbers. Even if you’re in your 20s or 30s, you’re not “too young” to start making heart-healthy food and lifestyle choices. Two of my friends who wrestled with heart disease experienced two different outcomes. One—a hard-driving 37-year-old tech entrepreneur, who was motivated to change his diet and a few bad habits after his heart attack—survived. The other, a talented 46-year-old photographer, who lived and ate on-the-run—working long hours and sleeping too little—unexpectedly died of a cardiac arrest during a conference he was attending.

In heart disease research, younger groups (between ages 25-55) have historically been considered “low risk”. This may be changing. In a 2015 study published last year in Circulation, researchers tracked heart disease death rates among adults aged 25 years and older. Between 1979 and 2011, heart disease deaths fell dramatically among those over age 65. However, there was considerably less improvement in heart disease death rates among those under age 55, especially for women—attributed to increasing rates of diabetes and obesity in younger adults, as well as non-traditional risk factors, such as stress and depression, common among young women with early-onset heart disease.
 

Symptoms of inflammation (and why it matters)

 
The sooner you get familiar with your numbers, the greater your success in lowering—even reversing—your risk for heart disease, as well as other chronic conditions and diseases.
The most relevant numbers are markers of inflammation.

Why? Inflammation is your body’s response to stress—whether from your diet, lifestyle or environment. Think of what happens when you sprain your ankle or burn your hand: you experience immediate pain, swelling and redness.

This kind of acute inflammation is good, but our modern, convenience-oriented lifestyle contributes to an epidemic of chronic, low-grade inflammation that most of us experience in the form of skin disorders (rashes, “adult acne”, eczema, psoriasis), joint aches and pains, chronic headaches, digestive distress, IBS, allergies, or fatigue—our body’s way of communicating with us that things are out of balance.When your body’s systems experience a constant inflammatory response, you are more susceptible to accelerated aging (internally and externally) and chronic diseases and conditions, including heart disease, stroke, cancer, diabetes, obesity and arthritis.

One of the main factors contributing to chronic low-grade inflammation are the foods that we eat. Typical culprits include sugar, junk food / processed / fast foods, gluten, grains and dairy.
 

Markers of Inflammation:  Know your numbers!

 
You will also want to get familiar with other markers of inflammation (see list below).

High Sensitivity C-Reactive Protein (hs-CRP). Your level of CRP increases in response to inflammation. Higher levels of CRP are linked with greater risk of heart attack. Ideally, your hs-CRP is <1.0 mg/L (low risk for developing cardiovascular disease). An hs-CRP level of >3.0 indicates high risk for heart disease. *Note: “Normal” values may vary slightly among different labs.

Vitamin D (25-hydroxy vitamin D). Recent studies link low levels of vitamin D to an increased risk of heart disease. Optimal vitamin D levels are between 50-70 ng/ml. In cases of cancer or heart disease, the recommended level is even higher: 70-100 ng/ml.

Hemoglobin A1c. If you have a family history of diabetes, heart disease or overweight / obesity this is an important number to know. This is a blood test that reflects your average blood sugar level for the past 2-3 months. Optimal is <5.7% (low risk of diabetes). An A1c of 6.5% or higher indicates diabetes.

Homocysteine. At high levels, homocysteine, an amino acid, can damage the lining of the arteries and promote blood clotting, raising your risk for heart disease, heart attacks, blood clots and strokes. Ideally, your homocysteine levels are below 15 mmol/L. Above 15mmol/L is considered “high”.
 

Metabolic Syndrome

 
This is a group of risk factors that raises your risk of heart disease, stroke and diabetes. Three (3) or more of these risk factors (listed below) = metabolic syndrome = increased risk of heart disease.

1. Large waist size. This indicates excess body fat around the waist.
–For men: 40 inches or larger
–For women: 35 inches or larger

2. High triglycerides.
Your triglycerides are 150 mg/dL or higher OR You are using a cholesterol medicine

3. Low HDL “good” cholesterol.
–For men: Your HDL is less than 40 mg/dL
–For women: Your HDL is less than 50 mg/dL

4. High blood pressure.
Your blood pressure is 135/85 mm Hg OR You are using high blood pressure medicine

5. High fasting blood glucose. *This is a leading indicator of inflammation.
Optimal: your fasting blood glucose is  less than 85 mg/dL.  Note: most labs define “normal” as under 100 mg/dL.

*Note: If your blood glucose level is between 100 and 125 mg/dL, you have pre-diabetes. At this point, it is still possible — and important —to make diet and lifestyle changes to prevent pre-diabetes from developing into Type 2 diabetes.
 

Get Guidance and Support

 
Need help making sense of your numbers?  Contact me to schedule a Lab Consultation.  Or, if you want to be pro-active in improving your numbers, consider my video-only service: Optimize Your Wellness.
 

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