An (anti-diet) metabolic health crash course

Metabolic health refers to the state of optimal metabolic function, which involves the body's ability to efficiently convert food into energy and regulate blood sugar, lipid (cholesterol), and hormone levels. 

A thriving metabolism can help us live our best lives (hello, energy, mood stability, and longevity!), but it is important to remember that pursuing metabolic health does not necessarily mean we need to lose weight or force our bodies to be a size smaller than their set point. 

When someone has “good” metabolic health, it means their body is able to regulate their blood sugar, cholesterol, and hormones effectively and efficiently, which can help reduce the risk of many chronic diseases, including type 2 diabetes, heart disease, infertility, and obesity.

However, managing metabolic health can be hard and traditional resources are fraught with diet culture that may be doing more harm than good for your mental health. If your doctor has surfaced metabolic health as a concern for you, chances are it is because you are in a larger body and have a “high” BMI that is flagging concern. 

In this article we will explore: 

• Is there such thing as a “good” metabolism? 
• What are signs my metabolism is thriving versus symptoms that it may need extra support? 
• What are metabolic conditions I should be aware of? What are their symptoms? 
• What are tips for encouraging metabolic health?

Is there such thing as a “good” metabolism? 

First of all, we will be referring to "strong,” “balanced,” “healthy,” or “thriving” metabolisms, not “good” metabolisms. We are not going to perpetuate moralizing our bodies, after all! 

It's important to understand that the term "metabolism" is complex and multifaceted, and can refer to different metabolic processes that occur in the body. In general, a thriving metabolism can refer to an individual's ability to efficiently convert food into energy, which can help keep blood sugar stable. Some people’s metabolisms are higher than others. This is often reflected in a higher basal metabolic rate (BMR), which is the number of calories your body burns at rest.

Factors that contribute to strong metabolic health include regular physical activity, a balanced and nutritious diet, adequate sleep, stress management, and (fortunately or unfortunately) genetics. Age, gender, hormones, and pre-existing medical conditions can also all influence our metabolism.

Additionally, the idea of a "good" metabolism can be subjective as it is oftentimes linked with weight, specifically thinness. While higher weights may be correlated with adverse health outcomes, they are not causative, and current research shows that it is a poor and outdated health marker. 

Instead of focusing on achieving a a number on the scale or measurements, at Pollie we think it is more important to analyze biomarkers that are more indicative of what’s actually going on in our body such as: 

• Fasting blood glucose 
• HbA1c
• HDL
• LDL
• Resting heart rate 
• Blood pressure, and more

What are signs my metabolism is thriving versus symptoms that it may need extra support? 

Now that we’ve Signs that your metabolism is thriving include:

1. Regular bowel movements: You have regular bowel movements and your digestive system is working efficiently.
2. Stable energy levels: You have stable energy levels throughout the day and don't experience significant energy crashes or fatigue.
3. Restful sleep: You're able to fall asleep easily, stay asleep throughout the night, and wake up feeling rested and refreshed.
4. Strong immune system: You have a strong immune system and are able to fight off infections and illnesses effectively.
5. In-range biomarkers: As mentioned above, biomarkers like fasting glucose, HbA1c, cholesterol, resting heart rate, and blood pressure are all indicators of our metabolic health. Having “optimal” levels of these markers when you get your labs done is a good sign. 
6. Steady weight: While we don’t define metabolic health by weight itself, staying within a typical weight range for your body (or your “set point”) is typically a good sign. Be sure to only consider this one if you have a healthy relationship with food and your body image! 

On the other hand, symptoms that may indicate that your metabolism needs extra support include:

1. Low energy: You experience significant fatigue, low energy levels, or energy crashes throughout the day.
2. Digestive issues: You experience digestive issues such as bloating, constipation, or diarrhea.
3. Poor sleep: You have difficulty falling asleep or staying asleep, or you wake up feeling tired and groggy.
4. Frequent illnesses: You're more prone to infections and illnesses, or it takes longer for you to recover from illnesses.
5. Significant swings in weight: It is “normal” for your weight to fluctuate throughout different seasons of life. In fact, as stated above each of us typically has a “set point” or a weight range at which our bodies are most healthy, productive, and happy. If you find your weight dropping below or shooting above that set point, it is possible that a larger imbalance is at play. Note: It may be difficult for you to safely determine your body’s set point if you have chronically dieted or had disordered eating habits. If this is the case, we recommend you do not use weight as an indicator of your metabolic health and rather try working with a HAES or intuitive-eating informed nutrition specialist who can support you in repairing your relationship with food. 

If you're experiencing symptoms that your metabolism may be struggling, it's important to talk to your healthcare provider to assess your risk and discuss strategies for better supporting your metabolic function. Pollie’s memberships can also help you better support your metabolism in a way that works for your lifestyle, goals, and preferences. 

What are metabolic conditions I should be aware of? What are their symptoms? 

Metabolic conditions, also known as metabolic disorders, are a group of disorders that affect the way the body uses and processes nutrients, hormones, and energy. 

These conditions can be genetic or acquired and can affect any part of the body's metabolic processes, including digestion, absorption, transportation, and storage of nutrients, and the production and utilization of energy.They can also fit into buckets of autoimmune disorders (e.g., Celiac disease) and hormone imbalances (e.g., PCOS). 

Some examples of metabolic conditions include:

1. Diabetes: Diabetes is a condition characterized by high blood sugar levels due to a lack of insulin or resistance to insulin in the body
2. Insulin resistance: Insulin resistance occurs when cells in the body don't respond effectively to insulin, which is a hormone produced by the pancreas that helps regulate blood sugar levels. If left untreated it can lead to other metabolic issues such as type 2 diabetes, obesity, and cardiovascular disease. Insulin resistance is often associated with other metabolic changes, such as changes in lipid metabolism, inflammation, and oxidative stress.
3. Polycystic ovary syndrome (PCOS): PCOS is a common hormone imbalance that impacts at least 10% of menstruating person. At least 70% of PCOS also have insulin resistance
4. Hyperthyroidism and hypothyroidism: Conditions in which the thyroid gland produces too much or too little thyroid hormone, respectively, which can affect metabolism
5. Metabolic Syndrome: Metabolic syndrome is a cluster of conditions that includes high blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol or triglyceride levels. It increases the risk of heart disease, stroke, and diabetes
6. Non-alcoholic fatty liver disease (NAFLD): This is a condition in which there is excess fat in the liver, not caused by alcohol consumption. It can progress to liver inflammation and scarring, which can lead to liver failure over time.
7. Celiac disease: An autoimmune disorder that damages the lining of the small intestine, interfering with the absorption of nutrients
8. Phenylketonuria (PKU): A genetic disorder in which the body cannot break down the amino acid phenylalanine, leading to a buildup of toxic substances in the blood
9. Wilson's disease: A genetic disorder in which copper builds up in the body's tissues, leading to liver disease and other complications.

These conditions can have a range of symptoms and severity, and treatment may involve medication, lifestyle changes, and dietary modifications.

What are tips for encouraging metabolic health?

Health-promoting habits such as eating an abundance of whole foods, moving your body regularly in a way that brings you joy, prioritizing rest and recovery for your body and mind have all been shown to encourage healthy metabolic markers. 

Nutrition

1. Eat a balanced diet: Focus on eating a variety of nutrient-dense whole foods, including fruits, vegetables, whole grains, lean proteins, and healthy fats.
2. Be mindful of added sugars and refined carbohydrates: These types of foods can lead to insulin resistance and other metabolic issues. Instead, choose whole foods that are high in fiber, which can help regulate blood sugar levels.
3. Eat at regular intervals: If you go too long without eating, your body may go into “starvation mode” which is harmful for your metabolism and overall health. Avoid letting your blood sugar dip too low or going so long without eating that it is difficult to listen to your hunger cues.  
4. Develop a mindful eating practice

Exercise

1. Get regular physical activity: Aim for at least 150 minutes of moderate-intensity exercise per week, such as brisk walking, cycling, or swimming.
2. Incorporate strength training: Building muscle mass can help improve metabolic function and increase your resting metabolic rate, which can help with weight management. 
3. Incorporate interval training: Interval training, which involves alternating periods of high-intensity exercise with periods of rest or lower intensity, has been shown to improve metabolic function and burn more calories than steady-state cardio.

Stress management/sleep

1. Practice stress management techniques: Chronic stress can lead to metabolic dysfunction, so it's important to find ways to manage stress. Techniques such as deep breathing, meditation, yoga, and mindfulness can help.
2. Get adequate sleep: Lack of sleep can disrupt hormones that regulate metabolism, so aim for 7-9 hours of sleep per night.
3. Maintain a consistent sleep schedule: Going to bed and waking up at the same time each day can help regulate circadian rhythms and improve sleep quality.

Remember that good metabolic health is not achieved overnight and requires consistent effort and lifestyle modifications. If you have concerns about your metabolic health, talk to your healthcare provider for personalized advice and guidance.

How female hormones impact our metabolism

Female metabolic health can differ from that of males due to the influence of female hormones. Changes hormone levels during the menstrual cycle, menopause, conditions like PCOS, and pregnancy can all affect metabolic function in women and menstruating people.

The below reproductive hormones can play a big role in female metabolic health: 

• Estrogen and progesterone: The menstrual cycle is a monthly process that involves changes in hormones and metabolic function. During the menstrual cycle, estrogen and progesterone levels fluctuate, which can affect insulin sensitivity and glucose metabolism. Studies have shown that insulin sensitivity is highest during the follicular phase of the menstrual cycle (days 1-14), and lowest during the luteal phase (days 15-28), which can increase the risk of insulin resistance and other metabolic issues. This is largely because estrogen has been shown to improve insulin sensitivity, increase glucose uptake, and decrease inflammation, while progesterone can have the opposite effect (1,2,3). 
• Androgens: Another class of hormone relevant to metabolic health for menstruating people are androgens. Androgens are typically thought of as male hormones, but women also produce androgens, including testosterone and dehydroepiandrosterone (DHEA), albeit in smaller amounts than men. These hormones can influence metabolic function in women in a number of ways. For example, research has shown that androgens can have a negative impact on insulin sensitivity in women, increasing the risk of insulin resistance and type 2 diabetes. High levels of androgens, such as those seen in conditions like polycystic ovary syndrome (PCOS), have been associated with insulin resistance (4,5,6).

Female metabolisms also experience changes during big life transitions: 

• Pregnancy: During pregnancy, a woman's metabolic rate increases to support the growth and development of the fetus. This increase in metabolic rate is driven by changes in hormone levels, particularly an increase in progesterone and estrogen. These hormonal changes also affect insulin sensitivity, with pregnant women becoming more insulin resistant as pregnancy progresses. This helps ensure that glucose is available to the developing fetus. As a result, pregnant women may be at increased risk of gestational diabetes, a type of diabetes that develops during pregnancy.
• Postpartum: After pregnancy, a woman's metabolism may also be affected by changes in lifestyle and sleep patterns that can accompany caring for a newborn. This can lead to changes in body weight, insulin sensitivity, and overall metabolic health.
• Menopause: During perimenopause, women experience a decline in the production of estrogen and progesterone, which can lead to changes in metabolism. Women may experience a decrease in metabolic rate and an increase in body fat, particularly abdominal fat. During this time, menstruating people are at increased risk of metabolic diseases like diabetes and heart disease. Additionally, menopause can be associated with insulin resistance and an increased risk of metabolic syndrome.

Conclusion

Maintaining good metabolic health is important for overall health and can help reduce the risk of many chronic diseases. If you have concerns about your metabolic health, it's important to talk to your healthcare provider to assess your risk and discuss strategies for improving or maintaining optimal metabolic function.

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Sources

1. Santosa, S. & Jensen, M. D. (2015). Adipocyte fatty acid storage factors enhance subcutaneous fat storage in postmenopausal women. Diabetes, 64(3), 775-782. doi: 10.2337/db14-0686
2. Campbell, S. E., Febbraio, M. A. (2001). Effect of ovarian hormones on mitochondrial enzyme activity in the fat oxidation pathway of skeletal muscle. American Journal of Physiology-Endocrinology and Metabolism, 281(4), E803-E808. doi: 10.1152/ajpendo.2001.281.4.E803
3. Mauvais-Jarvis, F., Clegg, D. J., & Hevener, A. L. (2013). The role of estrogens in control of energy balance and glucose homeostasis. Endocrine Reviews, 34(3), 309-338. doi: 10.1210/er.2012-1055
4. Dunaif, A., Segal, K.R., Futterweit, W., et al. (1989). Profound peripheral insulin resistance, independent of obesity, in the polycystic ovary syndrome. Diabetes, 38(9), 1165-1174. doi: 10.2337/diab.38.9.1165
5. Ehrmann, D. A. (2005). Polycystic ovary syndrome. New England Journal of Medicine, 352(12), 1223-1236. doi: 10.1056/NEJMra041536
6. Ibáñez, L., de Zegher, F. (2006). Low-dose flutamide-metformin therapy for hyperinsulinemic hyperandrogenism in non-obese adolescents and women. Human Reproduction, 21(7), 1894-1900. doi: 10.1093/humrep/del104

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