How to Measure Your Metabolic Health

When your doctor orders blood work and checks your vital signs, like blood pressure, weight, and fasting glucose, they are doing a metabolic assessment. These numbers give them a look at your risk of developing a chronic medical condition.

female patient consulting with doctor

Most of us focus on our weight as a measure of our health, but there is more to it than that. Even people at their ideal weight can be “unhealthy.” They may still have risk factors for chronic disease.

The alternative is true as well. Sometimes people who weigh more than the weight or BMI (Body Mass Index) chart says they should, are still metabolically healthy. How your body functions inside is much more important than what the number on the scale says.

<p class="pro-tip"><strong>Learn more about </strong> <a href="/blog/bmi">the limitations of BMI as a measurement of health</a>.</p>

According to a recent study, most Americans do not meet the criteria for metabolic health. Investigators looked at the nationally recognized guidelines for metabolic health data from people who participated in the National Health and Nutrition Examination Survey from 2009 - 2016. They found that only 12.2% of Americans are metabolically healthy.1

Measuring metabolic health using scientifically established markers shows you how metabolically healthy you are. These markers tell what your risk of disease is, regardless of the number on the scale.

This article will look at metabolic health markers and how you can measure your metabolic health.

1: Blood Glucose

Blood glucose (sugar) measures how much sugar is circulating in our blood. It tells us how well our body uses glucose for energy.

Glucose is our primary source of energy. Every cell in our body uses glucose for energy. Most of the time we get all we need from the food we eat. If we eat more than what we need, the extra gets stored as fat for use later.

For our body to use glucose, it requires insulin. Insulin is a hormone that carries glucose from our blood into our cells. Our pancreas secretes insulin in response to the amount of sugar in our bloodstream.2

Normally, the amount of insulin we need is matched to the amount of glucose in our bloodstream.

Sometimes, our body isn’t able to use insulin as well. When we become resistant to it, excess sugar accumulates in our bloodstream. The pancreas responds by, sending out more insulin to keep up. After a while, it may have trouble keeping up or stop working.  This can lead to blood sugar spikes or high blood sugar levels.2

Chronically high blood sugar levels and high insulin levels can lead to diabetes, heart disease, vascular disease, kidney disease, blindness, and other health issues.

Your doctor usually measures your blood glucose when you see them for your annual physical exam, but you can also track it with a Continuous Glucose Monitor (CGM).

According to the ADA, for people without diabetes, fasting blood sugar levels should be between 70 - 99mg/dL. After meals, it should be less than 140mg/dL. (2) Optimal fasting blood glucose levels are likely to be below 90mg/dl. 

<p class="pro-tip"><strong>Learn more about </strong> <a href="/blog/average-glucose-ranges">normal blood sugar levels</a>.</p>

2: Blood Pressure

Blood pressure is another measure of metabolic health. It measures the amount of pressure your blood is putting on your artery walls as it pumps through your body.3There are two numbers to look at.

The upper number is systolic blood pressure. This measures how much pressure is on your arteries as your heart pumps or pushes blood through.

The lower number is diastolic blood pressure. It measures how much pressure is on your arteries as your heart takes a break, or rests between beats.

Your goal for your blood pressure should be less than 120mmHg/80mmHg. If it is higher than that at rest, you should talk with your doctor about what the best treatment is.3

High blood pressure is nothing to mess around with, so it is best to discuss it with your doctor if you notice higher readings.

You can get an inexpensive home blood pressure cuff at most pharmacies and to measure it yourself These aren’t as accurate as the doctor’s office, but they will give you a good indication of how your blood pressure is trending.

The best things you can do to keep your blood pressure in a normal range is:

  • Eat lots of plants, seafood, lean meats, dairy, and whole grains
  • Keep your sodium intake to the recommended level of no more than 2300mg/day
  • Get regular exercise.4

<p class="pro-tip"><strong>Learn more about </strong> <a href="/blog/dash-diet-weight-loss">the DASH diet for blood pressure management</a> and <a href="/blog/blood-sugar-high-blood-pressure">how blood pressure and blood sugar are connected</a>.</p>

five different uncooked frozen entrees
Common high-sodium foods include frozen or canned prepared meals.

3: Waist Circumference

While weight alone is not a good indicator of metabolic health, abdominal obesity is. Carrying extra weight around your middle section increases your risk of developing diabetes, heart disease, high blood pressure, and stroke.5

In one large European study, each 5-inch increase in waist circumference was associated with a 17% increase in the risk of death in men and a 13% increase in women.6

You can measure and track your weight circumference easily with a tape measure:7

  1. Standing up straight, place a tape measure just above your hip bones.
  2. Wrap the tape measure around your waist, keeping it level with your belly button.
  3. Keep it snug against your skin but don’t pull it tight and then breathe out.

Waist Circumference Goals:

  • For men - below 102 cm (40 inches)
  • For women - below 88 cm (35 inches)

While healthy eating is important, one of the best ways to reduce your waist circumference is by increasing physical activity.8 If you have not been very active, check with your healthcare professional to find out what type of activity is best for you.

<p class="pro-tip"><strong>Learn more about </strong> <a href="/blog/neat-weight-loss">non-exercise activity thermogenesis and weight loss</a>.</p>

4: Lipid Levels

When it comes to metabolic health, your lipid levels are a good measurement of your risk for heart disease, high blood pressure, and stroke. There are two types of cholesterol that tell a lot about your risk.

HDL or good cholesterol is the type of cholesterol that helps to remove excess cholesterol and plaque build-up from your artery walls.

Women tend to have higher HDL levels than men because the estrogen hormone seems to give it a boost. Women should aim for levels higher than 55mg/dL and men should be higher than  45mg/dL.

LDL or bad cholesterol is the type that deposits plaque on the artery walls. Higher levels of HDL help minimize that build-up and decrease the risk of blockages. For LDL levels, both males and females should aim for levels less than 130 mg/dL.9

If your levels aren’t in range, it’s important to monitor your diet closely. Start by cutting back on extra fat and sugar. Getting enough exercise will also help move the needle.

<p class="pro-tip"><strong>Helpful resource: </strong> <a href="/blog/ultimate-guide-low-sugar-foods">the ultimate list of low-sugar foods</a>.</p>

5: Triglycerides

Triglycerides are usually checked as part of the lipid panel we talked about above. Triglycerides are a measure of the amount of fat in your bloodstream. It's normal to have some circulating as your body uses it for energy, but when you have too much it raises your risk of heart disease and stroke.10

For some people, genetics will cause higher triglyceride levels, but for most of us, it has to do with what we eat and our lifestyle.

For healthy people, normal triglycerides should be less than 150 mg/dL.11

If yours are higher than this, take a look at what you are eating and your lifestyle habits. To help keep your triglyceride levels in check, limit the amount of added sugar and fat in your diet. It is also a good idea to limit the amount of alcohol you drink. Other things you can do that can help improve your triglycerides are:

  • Get regular exercise
  • Stop smoking (if you do smoke)
  • Manage stress
  • Get enough sleep

<p class="pro-tip"><strong>Learn more about </strong> <a href="/blog/alcohol-weight-gain">why alcohol can cause weight gain</a>.</p>

two women jumping rope for fitness
Aerobic exercise (cardio) is an effective way to reduce triglyceride levels.

What About Body Weight?

You can’t judge a book by its cover, right? Sometimes the same goes for your weight.

While charts and graphs tell us what we should weigh, it really is very individualized.

Some people who aren’t at their “ideal” weight, have great numbers when it comes to their metabolic health. They don't have any chronic medical issues and live a healthy lifestyle.12

It’s important to recognize that weight is one indicator that we know may be indicative of other health problems. It is a risk factor for developing issues like high blood pressure, diabetes, and heart disease. So it is still a good idea to keep your weight in a healthy range, or work on reducing it if you are overweight.

<p class="pro-tip"><strong>Use these </strong> <a href="/blog/body-positivity-weight-loss">body positive weight loss tips</a> to get started.</p>

What Is a Metabolic Health Score?

What if you meet most of the criteria for being in good metabolic health but have one or two indicators that aren’t where they should be? Is there an overall metabolic health score that tells you what your risk is or how metabolically healthy you are?

There isn’t an official metabolic health score by any accredited health agency. Some researchers have looked at compiling the various metabolic health indicators to come up with a score for subgroups of people with underlying conditions to predict their risk of developing chronic disease. For otherwise healthy people, no official scorecard exists.13,14

If one or two of your metabolic health indicators is higher than it should be, focus on making diet and lifestyle changes to improve them. All small changes add up and will help improve your metabolic health.

<p class="pro-tip"><strong>Learn about </strong> <a href="/blog/mediterranean-diet">health benefits of the Mediterranean diet</a>.</p>

Can a CGM Help Measure Your Metabolic Health?

A Continuous glucose monitor (CGM) is a tool that measures your blood glucose in response to eating, exercise, stress, and more. 

CGMs are an easy, painless way to measure blood glucose, one of the measures of metabolic health. There is some evidence that CGMs can be helpful with weight loss. By improving blood glucose control you may be able to minimize glucose and insulin spikes.

It may also help you track how different behavioral changes you make impact your blood glucose, and therefore your overall health.15

Using your CGM to track your blood glucose as you make changes to your lifestyle is a great motivator. Follow yours and see how those changes can impact your other metabolic health parameters over a few months.

<p class="pro-tip"><strong>Keep reading about </strong> <a href="/blog/what-is-a-continuous-glucose-monitor">how CGMs work</a> or learn some <a href="/blog/how-to-approach-metabolic-health">easy approaches to metabolic health</a></p>

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References

  1. Araujo, J., Cai, J., & Stevens, J. (2019). Prevalence of Optimal Metabolic Health in American Adults: National Health and Nutrition Examination Survey 2009–2016. Metabolic Syndrome and Related Disorders, (46-52). http://doi.org/10.1089/met.2018.0105
  2. Insulin Resistance & Prediabetes. (n.d.) National Institute of Diabetes and Digestive and Kidney Diseases. Retrieved August 24, 2022, from: https://www.niddk.nih.gov/health-information/diabetes/overview/what-is-diabetes/prediabetes-insulin-resistance
  3. High Blood Pressure Symptoms and Causes. (2021). National Center for Chronic Disease Prevention and Health Promotion, Division for Heart Disease and Stroke Prevention. Retrieved August 24, 2022, from: https://www.cdc.gov/bloodpressure/about.htm
  4. How much sodium should I eat per day? (2021). American Heart Association. Retrieved August 24, 2022, from: https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/sodium/how-much-sodium-should-i-eat-per-day
  5. Ross, R., Neeland, I. J., Yamashita, S., Shai, I., Seidell, J., Magni, P., Santos, R. D., Arsenault, B., Cuevas, A., Hu, F. B., Griffin, B. A., Zambon, A., Barter, P., Fruchart, J. C., Eckel, R. H., Matsuzawa, Y., & Després, J. P. (2020). Waist circumference as a vital sign in clinical practice: a Consensus Statement from the IAS and ICCR Working Group on Visceral Obesity. Nature reviews. Endocrinology, 16(3), 177–189. https://doi.org/10.1038/s41574-019-0310-7
  6. Pischon, T., Boeing, H., Hoffmann, K., Bergmann, M., Schulze, M. B., Overvad, K., van der Schouw, Y. T., Spencer, E., Moons, K. G., Tjønneland, A., Halkjaer, J., Jensen, M. K., Stegger, J., Clavel-Chapelon, F., Boutron-Ruault, M. C., Chajes, V., Linseisen, J., Kaaks, R., Trichopoulou, A., Trichopoulos, D., … Riboli, E. (2008). General and abdominal adiposity and risk of death in Europe. The New England journal of medicine, 359(20), 2105–2120. https://doi.org/10.1056/NEJMoa0801891
  7. Assessing Your Weight. (2022).  National Center for Chronic Disease Prevention and Health Promotion, Division of Nutrition, Physical Activity, and Obesity. Retrieved August 24, 2022, from: https://www.cdc.gov/healthyweight/assessing/index.html
  8. Ross, R., & Bradshaw, A. J. (2009). The future of obesity reduction: beyond weight loss. Nature reviews. Endocrinology, 5(6), 319–325. https://doi.org/10.1038/nrendo.2009.78
  9. Wilson, P.W.F., & Grundy, S.M. (2003). The Metabolic Syndrome, A Practical Guide to Origins and Treatment: Part II. Circulation, 108(13) 1537-1540. https://doi.org/10.1161/01.CIR.0000089506.12223.F1
  10. Triglycerides Test: What is a Triglycerides Test? (n.d.) U.S. Department of Health and Human Services, National Institutes of Health, MedlinePlus. Retrieved August 24, 2022, from: https://medlineplus.gov/lab-tests/triglycerides-test/
  11. Araujo, J., Cai, J., & Stevens, J. (2019). Prevalence of Optimal Metabolic Health in American Adults: National Health and Nutrition Examination Survey 2009–2016. Metabolic Syndrome and Related Disorders, (46-52). http://doi.org/10.1089/met.2018.0105
  12. Goossens G. H. (2017). The Metabolic Phenotype in Obesity: Fat Mass, Body Fat Distribution, and Adipose Tissue Function. Obesity facts, 10(3), 207–215. https://doi.org/10.1159/000471488
  13. Bello-Chavolla, O.Y., Antonio-Villa, N.E., Vargas-Vazquez, A., Viveros-Ruiz, T.L., Almeda-Valdes, P., Gomez-Velasco, D., Mehta, R., Elias-Lopez, D., Cruz-Bautista, I., Roldan-Valadez, E., Martagon, A.J., & Aguilar-Salinas, C.A. (2019). Metabolic Score for Visceral Fat (METS-VF), a novel estimator of intra-abdominal fat content and cardio-metabolic health. Clinical Nutrition, 39(5) 1613-1621. https://doi.org/10.1016/j.clnu.2019.07.012
  14. Wang, Z., Xie, J., Wang, J., Feng, W., Liu, N. & Liu, Y. (2022). Association Between a Novel Metabolic Score for Insulin Resistance and Mortality in People With Diabetes. Frontiers in Cardiovscular Medicine,  9:895609. https://doi.org/10.3389/fcvm.2022.895609
  15. Ehrhardt, N., & Al Zaghal, E. (2019). Behavior Modification in Prediabetes and Diabetes: Potential Use of Real-Time Continuous Glucose Monitoring. Journal of Diabetes Science and Technology, 13(2), 271–275. https://doi.org/10.1177/1932296818790994

About the Author

Laura M. Ali Headshot
Laura is an award-winning food and nutrition communications consultant, freelance writer, and recipe developer.
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