December is an excellent time to dovetail onto the previous month of November, when we celebrated American Diabetes Month. Diabetes has become the modern-day epidemic. It currently affects 30 million Americans, accounting for 10% of the adult population, most of whom are either undiagnosed or inadequately treated. By 2030, these numbers are expected to increase by over 50% to include over 54.9 million Americans.

Except for type 1 or juvenile onset diabetes, we aren’t born this way. Given the current climate of the American lifestyle, we have evolved into being “metabolically unhealthy.”

Metabolic health presents in varying degrees. Diabetes is metabolic health gone awry. It’s extreme with serious long-term consequences.

Parameters of metabolic health include blood pressure, HDL (healthy) cholesterol, triglycerides, blood sugar, and waist circumference. Metabolic health, as defined by the National Cholesterol Education Program is quite simply the absence of metabolic syndrome. A person has metabolic syndrome when they have abnormalities of any three of the above mentioned five risk factors.

What this means is that someone with high blood pressure, elevated blood sugar, and high triglycerides is unhealthy, metabolically speaking. These risk factors combined places a person at much greater risk for diseases such as type 2 diabetes, stroke, and heart disease.

Now here’s the really bad news: According to a relatively recent study published in the journal Metabolic Syndrome and Related Disorders, only about 12% of adults in the U.S. have perfect levels of all five risk factors without having to take medication.

Conducted at the University of North Carolina at Chapel Hill, the researchers utilized the National Health and Nutrition Examination Survey (NHANES). From 2009-2016, a total of 8,721 subjects were studied. As you saw above, the results were shocking.

Guidelines were defined as:

• Waist circumference <40/34.6 inches for men/ women

• Fasting glucose <100 and hemoglobin A1C <5.7%

• Blood pressure <120/80

• Triglycerides <150 mg/dl.

• HDL (healthy) Cholesterol > 40-50mg/dl for men/women

The data showed that being physically active, female, younger, more educated and a nonsmoker were factors associated with enhanced metabolic health. Being non-Hispanic black or having a higher body mass index meant people were less likely to be metabolically healthy.

Participants who were obese fared the worst, with just 0.5 percent achieving optimal metabolic health. However, less than half of those who were underweight, and less than a third of participants with normal weights had optimal metabolic health.

What that means is that we need to look at metabolism beyond just body weight. This study demonstrates that even people of normal weight seem to be developing diseases that we typically correlate with obesity.

The purpose of this study was to determine what proportion of American adults have optimal levels of the indicators researched in the absence of pharmaceutical treatment. The study should, in no way undermine the efforts of those adhering to a healthy lifestyle who require medication.

OK SO HOW CAN YOU IMPROVE YOUR METABOLIC HEALTH?

It always starts with knowing your risk. Get checked out by your medical professional. Knowledge is powerful because you can do something about it.

Here’s a minimum check list:

• Blood pressure

• Cholesterol values (LDL, HDL and triglycerides)

• Fasting blood sugar and insulin levels

• Waist circumference

Proactive steps making diet and lifestyle changes a priority:

• Smoking cessation

• Low carbohydrate diet

• Anti-inflammatory diet

• Regular exercise

• Adequate sleep

• Intermittent fasting

Living metabolically unhealthy is indeed rampant in our society. Obesity is a huge problem, but if you think you’re blessed with good metabolic health just because you see a “normal “weight on the scale, think again.

Being in poor metabolic health sets us up for disEASE. Doing something about it is a conscious effort. It can be done. As your own medical advocate, I urge you to make this your chief priority in the coming year.

Happy Holidays!

Howard Elkin, MD

Reference: Araujo J, Cai J, et al. Prevalence of optimal metabolic health in American adults: National Health and Nutrition Examination Survey 2009-2016. Metabolic Syndrome and Related Disorders. 2019 Feb 8;17(1)

VERY IMPORTANT NOTE / DISCLAIMER: I am offering—always—only general information and my own opinion on this blog. Always contact your physician or a health professional before starting any treatments, exercise programs or using supplements. ©Howard Elkin MD FACC, 2020.