Are you "metabolically healthy"? New research from Obesity Week, 2018.

Your new secret goal: achieving metabolic health

You are doing your best. You make time to exercise a few days a week. Maybe you are especially dedicated to the weekly ritual of Saturday morning bootcamp or a long hike on Sunday. You always take the stairs. You eat mindfully, perhaps a daily salad, but you have kids and they only want chicken nuggets and pizza, so you indulge a few times a week. You are within 10 lbs of your college weight. Close enough, you figure, better than most of your peers. Your doctor tells you your labs and blood pressure are fine. You have never smoked and drink very little. You consider yourself healthy.

But are you really healthy? What does that even mean? We know a growing majority of Americans are obese (along with the majority of the civilized world), but is one single metric sufficient to be declared unhealthy.? What about that 95 year old lifetime smoker!

Clinical researchers have been trying to define the concept of health for some time. Enter the concept of “metabolic health”. This focus is necessary considering the massive epidemic of high blood pressure, diabetes and obesity, along with the knowledge that any single definition often fails to described health well enough. While the best singular definition of health is not yet agreed upon, metabolic health is a good start:

- Systolic blood pressure under 130 AND diastolic blood pressure under 80

- Waist circumference less than 35 inches for a man and 40 inches for a woman

- Fasting glucose under 100

- Triglycerides under 100

- HA1c under 6.7%

New research was presented last week that suggests only 1 in 8 Americans meet all of these metabolic metrics. That is 87.5% of Americans! This was true even in people with normal weight - only 1/3 of folks with normal weight met all criteria for metabolic health.

For those of you who love to chase goals… ready, set, go! For the rest of you, it is best to understand that metabolic health exists on a continuum, just like diabetes and blood pressure control - there is value is improving your data where ever you start. The researchers also studied which factors made the most difference. Vigorous exercise was number 1. Engaging in light or moderate intensity exercise did NOT increase your chances of being metabolically healthy. Short duration, high intensity work was most protective in this model.

And for the skeptics out there who feel the criteria are too strict, based on data is that is too variable (blood pressure is almost never static), consider this. Even when adjusting for short term variability in every individual metric, the “healthy” group rose only 7% to 21%.

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