What comes to mind when you think about what it means to be healthy? A big piece of the puzzle is your metabolic health, which is how well your body can convert food into energy, says Megan McElroy, PA-C , a physician assistant at Parsley Health. “A metabolically healthy person has great energy, normal blood pressure, great blood sugar dynamics, and no evidence of inflammation caused by cholesterol,” she says. It’s important to pay attention to metabolic health because these measures are early warning signs of and risk factors for diseases like type 2 diabetes, heart disease, and more.
At this point, most of us could use some improvement in our metabolic health: A study from The University of North Carolina at Chapel Hill found that only 12 percent of American adults were in optimal metabolic health. Even groups traditionally thought of as “low risk” had shockingly high levels of poor metabolic health, reported the study authors. While non-smokers, women, younger people, those who were more highly educated, regular exercisers, and those with a low BMI were more likely to have good metabolic health, less than a third of adults considered to be normal weight were metabolically healthy.
How do you know if you meet the definition of optimal metabolic health? Testing in the following areas can uncover health issues to address. Fortunately, many of these can be improved through lifestyle changes like nutrition tweaks, exercise, and better sleep . See below for more on what to test for, what the results mean, and the holistic changes you can make to improve your metabolic health.
How much sugar is in your blood, and how efficiently your body converts sugar to energy. High levels of blood sugar can harden your blood vessels over time. It can also damage your ability to respond to insulin, a hormone that controls blood sugar levels.
There isn’t one perfect test to tell you how your body is managing sugar; instead, your healthcare provider can get a good picture using four different blood test measures:
If only one test is elevated, there may actually be something else going on. For example, McElroy says that if only fasting glucose is high, it might mean you need to work on stress reduction . Or, if your A1C comes back high but the others are normal, you may want to have your iron checked, as low iron levels can affect it, she says.
If multiple measures point towards blood sugar issues, you’ll want to make some changes to your diet . Balancing carbs with protein and fat can help, she suggests. “When you eat protein, the blood sugar spike is about half of what it is with sugar. When you eat fat, it doesn’t spike insulin and blood sugar,” says McElroy. And the timing of your meals can also make a difference. “If you have orange juice before your eggs and avocado, you’re more likely to have a spike than if you have it the other way around,” she says.
Triglycerides are a type of fat in your blood. Foods like sugar, saturated fats, and refined grains can elevate triglyceride levels, but your body can also create them as a way to store excess calories. High levels of triglycerides not only raise your risk of diabetes, as mentioned above, but they also increase your risk of heart disease.
A triglyceride test, which is a blood test that measures the amount of these fats in the bloodstream, is part of a lipids profile, which also measures different types of cholesterol.
If your triglycerides are high, your provider will likely suggest you start with diet changes, like reducing carbs, sugar, and trans fats. “Alcohol is a big cause of high triglycerides,” says McElroy. “So we advise people to get lower sugar wines or reduce their alcohol consumption.” Genetics can also be a cause, she says, and in that case suggests omega-3 supplements , which studies show may be helpful.
Cholesterol is a waxy substance in your cells that your body uses to make hormones and vitamin D , among other things. It’s found in foods, but your body can also make as much as it needs. When you have too much cholesterol, it can build up and form a plaque in your arteries, which can then lead to coronary artery disease.
The lipid panel (measured by a blood test) run by most conventional providers looks at how much of three types of cholesterol you have: high-density lipoprotein (HDL), commonly known as “good” cholesterol; low-density (LDL), the “bad” type that builds up in your arteries; and very low-density lipoprotein (VLDL), which some also consider a “bad” type. At Parsley, providers are looking at the quantity as well as the quantity of your cholesterol, says McElroy, and will also look at oxidized LDL, which is inflammatory.
If your cholesterol is slightly or moderately elevated, you’ll want to, again, take a look at sugar and carbs. (And make diet changes .) Your provider may also ask you about sleep —poor sleep can affect levels of leptin, a hormone involved in regulating satiety that may also be involved in regulating cholesterol levels, says McElroy. She will refer higher-risk patients for a CIMT test or triple vascular screen, which are imaging tests that look for deposits of plaque in the arteries.
Blood pressure is the force of blood pushing against blood vessel walls. A too-high level causes inflammation in the arteries and puts you at risk for a host of conditions such as strokes, heart disease, heart attacks, and more.
Blood pressure can be measured in your healthcare provider’s office using a cuff around your arm or at a local pharmacy. You can also get a home blood pressure monitor so that you can measure how your blood pressure changes throughout the day.
Standard advice for managing blood pressure is to not smoke, eat a healthy diet (and watch sodium intake), limit alcohol, and exercise. But looking deeper at the root of high blood pressure can help you make additional changes, says McElroy. If your BP readings are typically elevated in the morning, she advises focusing on stress management, like with yoga or meditation . If you have endothelial dysfunction (an issue with the cells lining your blood vessels), McElroy suggests increasing your intake of flavonoids, a group of phytonutrients that counteract inflammation and are found in fruits, vegetables, chocolate, and more. Eating these regularly can up your metabolic health.
All of these measures—and your metabolic health overall—are connected. At Parsley Health , providers do a deep dive into lab tests, evaluating these markers as well as your nervous system, immune system , and more, says McElroy.
Parsley’s clinicians and health coaches work with each member to make the necessary nutrition and lifestyle changes that help them reach optimized lab ranges for each marker, not just normal ones. By keeping an eye on these measures, and making appropriate lifestyle changes, you can improve your health and potentially prevent disease, rather than treating it after it develops.
Marnie is a freelance writer with experience covering health, food, nutrition, fitness, and personal finance for publications including Shape, Good Housekeeping, Men's Journal, Women's Health, and more. She is a graduate of Northwestern University's Medill School of Journalism.