Over the last year, I’ve become more interested in my health. It led me on a journey to better define what good health means – where I came across the term ‘metabolic health’.
What is metabolic health? This is the best description I found:
Metabolic health is having ideal levels of blood sugar, triglycerides, high-density lipoprotein (HDL) cholesterol, blood pressure, and waist circumference, without using medications. These factors directly relate to a person’s risk for heart disease, diabetes, and stroke.
That opened my eyes to a whole new world. I came across stories of people who look really healthy – yet their blood panels showed signs of metabolic dysfunction. I guess it’s similar to a great looking car that breaks down by the side of the road. Things can look great on the outside, but under the hood there might be a problem brewing.
If you take the description of metabolic health above, only 12% of Americans are metabolically healthy. In many cases, these are people who look fairly normal, go to the gym etc. – but they have a heightened risk of heart disease, diabetes, and stroke.
I wanted to find out where I stood. So, I took the plunge and ordered a blood test that checked for 45 biomarkers. The good news was that 98% of my results were in the normal range. That was reassuring, but there were two problems. Firstly, 45 measurements is a lot of things – what are the ones that matter the most? (think 80/20 principle). And secondly, what are optimal levels (not normal) for these. Once I’m clear on these, I can start to figure out what I should focus on to improve my metabolic health.
I’ve started my research. What’s difficult is there are lots of varying opinions. But, so far I’ve narrowed it down to these five northstar metrics:
Blood Pressure
High blood pressure increases your risk of serious problems such as heart attacks and strokes. This one is straightforward, because everyone seems to agree what optimal is:
- Less than 120/80 mm
HbA1C
The HbA1C test is used to identify the concentration of glucose (sugar) in the blood. It gives an average reading of glucose levels over a duration of 2-3 months. The HbA1C result highlights the risk of developing diabetes.
My research led me to a good (not normal) and optimal benchmark:
Good:
| mmol/mol | mg/dl | IFCC |
| <32.5 | <100 | <5.1% |
Optimal:
| mmol/mol | mg/dl | IFCC |
| <21 | <70 | <4.1% |
Note: the reasons for 3 different measurement types is because different parts of the world use different ones (in the UK we use mmol/mol).
C-reactive protein (CRP)
CRP measures the amount of inflammation in your body. High levels are associated with an increased risk of developing cardiovascular disease and stroke. It doesn’t pinpoint the source of inflammation, but a high number here is going to cause problems down the road.
CRP benchmarks seem to be fairly well agreed upon:
- Good: <1 mg/l
- Optimal: < 0.5 mg/l
Triglycerides
Triglycerides are a type of fat (lipid) found in your blood. It’s important for maintaining energy and provides the fuel for muscles to work. High levels of triglycerides increase your risk of heart disease and pancreatitis.
Again, most people seem to agree on the below benchmarks:
Good
| mmol/ml | mg/dl |
| < 1 | < 90 |
Optimal:
| mmol/ml | mg/dl |
| < 0.85 | < 75 |
HDL cholesterol
HDL is short for high-density lipoprotein. It works as a scavenger, picking up and carrying away excess cholesterol in your arteries and transporting it to the liver where it can be eliminated. It’s what we call ‘good cholesterol’. High levels of HDL will lower your risk of heart disease.
From what I can research, these appear to be pretty solid optimal levels:
Optimal:
| mmol/ml | mg/dl |
| > 1.93 | > 75 |
That’s where I’m up to so far.
Next steps:
I have a few other metrics floating around that I need to look into further and decide if they are important enough to be considered a northstar metric for metabolic health (25-OH Vitamin D, Haemoglobin, LDL – bad cholesterol, total cholesterol, resting heart rate, heart rate variability etc.).
I also want to sanity check the above five with some smart people who understand this stuff better than me. Are these the right North Star metrics? Do the optimal levels feel right? Am I missing something?
I’ll cover my progress in the next post. I’ll also eventually bring it full circle and compare my own results to the optimal benchmarks – along with what I’ll be focusing on over the coming months.
P.S. I did the biomarker test with Forth. I highly recommend them. I had all 45 biomarker results with doctors notes within 48 hours of sending off the blood samples. Their platform for viewing and understanding your results over time looks super good too. And they’re really affordable too at £139!
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