Metabolic Meltdown: The Hidden Health Crisis (Part 1)
Unpacking the Epidemic: Why We Face a Silent Battle with Their Own Bodies
With an alarming 1 in 3 people in the US being metabolically unhealthy (and numbers worsening), poor metabolic health may be the most common and serious condition that you've never heard of. And a growing body of medical research suggests that metabolic health is the most important indicator of overall health, with some even comparing it to smoking as the new top precursor of major diseases like diabetes, cancer or Alzheimer’s.
So why aren't we all paying attention to this silent epidemic? There is a growing number of health organizations, scientists, and doctors sounding the alarm bell, and some companies are emerging to help address - and reverse - this condition.
In this two-part series, we will explore what metabolic syndrome is, why it is a primary indicator for overall health, and why early screening and addressing of metabolic health will be crucial for the future of medicine and healthcare systems.
Disclaimer: I am not a medical professional and this article is not medical advice. However, its medical review was conducted by a leading, board-certified physician focused on metabolism, performance, and longevity to ensure medical accuracy.
What’s metabolic health and why does it matter?
The mechanism of metabolic health in the body
“One way to think about metabolic disease is as a disorder in fuel processing (…) the fundamental problem is that the body is not doing a good job storing and accessing fuel” — Peter Attia
Metabolism is the biological process by which we take in nutrients and break them down into fuel, for use in the body. In someone who is metabolically healthy, those nutrients are processed and sent to their proper destination to provide the energy we need.
However, when someone is metabolically unhealthy, a significant portion of the calories they consume are stored in areas where they are not needed. These excess calories accumulate as fat in subcutaneous tissues, in the blood (measured as high levels of cholesterol and triglycerides), and around the organs (known as visceral fat), including the intestines and liver, eventually leading to nonalcoholic fatty liver disease. This condition is referred to as metabolic syndrome, or MetS. (We will delve into the precise definition of this condition and how it’s diagnosed below).
Understandably, MetS is then the underlying mechanism that increases the risk for several serious conditions with exploding incidences today, including diabetes and coronary heart disease. The body’s inability to process excess glucose leads to a continuum of metabolic disorders, from insulin resistance to type 2 diabetes. Excess glucose in the bloodstream results in inflammation, oxidative stress (a surplus of damaging free radicals in the body), and glycation (glucose binding to substances in the body, causing dysfunction).
Medical definition of MetS
Medically speaking, you are diagnosed with MetS if you meet any 3 of the following 5 criteria:
Waist circumference of ≥102 cm (≥40 in) in men and ≥88 cm (≥35 in) in women
Fasting blood glucose of ≥100 mg/dL
Systolic blood pressure of >120 mmHg and diastolic blood pressure >80 mmHg (depending on age)
Triglycerides >150 mg/dL
HDL cholesterol of <40mg/dL in men, and 50mg/dL in women
There’s a widely held belief in the scientific community that insulin resistance is the primary cause of MetS, therefore diagnosis by the World Health Organization criteria occurs when patient exhibits one of several markers of insulin resistance, plus two additional risk factors. In reality, meeting any one of these criteria has potential health consequences. Additional methods can help to measure the nuances and earlier stages of MetS, which we’ll go into Part 2 of this series.
Why it’s important
The numbers are alarming, and health authorities, doctors, and patients may not fully comprehend the extent to which metabolic syndrome (metS) can impair an individual's quality of life and put them on a path to developing life-threatening diseases.
Insulin resistance, the precursor to type 2 diabetes, is of particular concern. If your blood sugar and insulin levels are chronically elevated because your cells are resistant to insulin, your body is more likely to create—and less able to break down—fat cells, resulting in weight gain, inflammation and hormone disruptions. Insulin also turbo-powers cell production and inhibits cell death, increasing the odds of developing a malignant tumor. Indeed, insulin resistance has been linked with an increased risk of developing 13 types of cancer, Alzheimer’s disease and cardiovascular disease.
Scientific evidence has further linked metabolic syndrome to the most significant contemporary causes of mortality, as well as disabling symptoms in daily life.
It's simple: once you develop metabolic disease, you're on a highway to developing the “horsemen” diseases (ie our biggest killers cardiovascular disease, cancer, Alzheimer's disease, and diabetes).
All-cause mortality increases by 58%
Cardiovascular disease risk increases by 135%, cardiovascular mortality by 140%, and stroke by 127%
Age-adjusted mortality related to cancer increases by 56%, with specific cancers like endometrial cancers increasing 7-fold, and gastric, liver, and kidney cancers doubling
Parkinson's disease increases by 24% (a 66% increase if you have the 5 hallmarks of metabolic disease), Alzheimer's disease increases by 10%, and vascular dementia increases by 37%
Source: Early, Peter Attia
Metabolic dysfunction is also in some cases a critical factor responsible for fatigue and increased appetite (as a function of prediabetes), sleep quality and duration, brain fog, depression, anxiety, lack of exercise endurance, infertility, hair loss, erectile dysfunction, acne, chronic pain, and more. Addressing the root cause of these symptoms—including metabolic dysfunction—is the core goal of “functional” medicine.
So, it’s bad. In fact, it’s an epidemic.
The Metabolic Health Epidemic
Metabolic health is deteriorating, with recent studies painting a grim picture: only 12% of Americans are considered metabolically healthy, and a mere 6.8% of adults exhibit optimal cardiometabolic health (given that the data stems from a study conducted in 2018, it's safe to assume that these numbers have only worsened)
What’s causing MetS? Why now?
Knowing the mechanisms of metabolic health, it's no surprise that our modern lifestyle is causing metabolic syndrome (MetS). Our bodies are not equipped to cope with the ultramodern diet. In general, we are overfed with the wrong kinds of foods. Ultra-processed foods, which tend to have high levels of added salt and sugar, make up roughly 60% of the typical American diet. We also eat 10 times the sugar we did 100 years ago - thus triggering insulin resistance. Our food landscape has reached crisis levels.
What’s more, we aren’t doing the things that allow us to make up for our dietary pitfalls: We are also under-moving, under-sleeping and over-stressed - all of which can have serious consequences on the body’s hormone levels and glucose control.
MetS is not only prevalent, but it also disproportionately affects individuals of low socioeconomic status. Despite having knowledge on how to avoid an unhealthy diet, issues related to access and affordability pose significant challenges, thereby making it a public health concern.
MetS affects people who are overweight AND ‘thin’
Based on the information provided, it is clear why being overweight greatly increases the risk of MetS (Metabolic Syndrome). Considering that 40% of the population is obese and one-third is overweight in the US (with numbers increasing in Europe), it is evident that this is a significant issue.
However, what’s less known is that you CAN have a normal body weight and still have MetS: 1 in 5 people with a normal BMI are metabolically unhealthy. This growing understanding challenges the belief that weight or muscle mass is a reliable indicator of health. Even if you consider yourself healthy, you may still be metabolically unhealthy. Personally, many of my own friends have discovered they are pre-diabetic and have glucose deregulation, even though they consider themselves “healthy.”
Even if you think you’re healthy, you may still be metabolically unhealthy. Personally, many of my own friends have discovered they are pre-diabetic and have glucose deregulation, even though they consider themselves “healthy.”
Metabolic disease is a crucial aspect of an individual’s overall health and serves as a strong predictor of future diseases. Additionally, it significantly hampers our daily quality of life due to the associated symptoms, thereby increasing the burden of healthcare costs. Since metabolic disease is primarily influenced by our lifestyle, it has the potential to be reversed. Therefore, shouldn’t we prioritize early screening and intervention? If metabolic disease is as harmful to health as smoking, why is there a noticeable absence of public health policies addressing it?
In the next chapter of this series, we are going to explore:
Protocols to preserve metabolic health and to reverse metabolic disease
Challenges in screening and reversing MetS
New services for screening and reversing MetS