Imagine waking up refreshed, with no grogginess or need for a caffeine fix. Your energy remains steady throughout the day, and your mind is always sharp. You feel satisfied after eating: no cravings, no bloating, no discomfort. For most of us, that may sound like a fantasy. However, it is what metabolic health feels like, and it’s becoming increasingly rare.
With roughly 93 percent of Americans experiencing some degree of metabolic dysfunction and chronic diseases continuing to rise, understanding metabolic health has never been more critical.
“The sooner you act, the higher the likelihood you’re going to live longer and healthier, and have a better health span,” Dr. Adonis Saremi, a triple board-certified obesity medicine physician, told The Epoch Times.
The Quiet Culprit
Metabolic dysfunction is a silent epidemic. Its early signs are often unnoticed, and its effects go far beyond visible body fat. While many equate metabolic health with weight, that’s only part of the story. Whether metabolic dysfunction precedes obesity, follows it, or presents simultaneously remains unknown.
You can have a normal weight yet still be metabolically unhealthy. Someone overweight or obese might have healthy metabolic markers. Body mass index doesn’t distinguish muscle from fat nor reveal fat distribution, so a normal screening isn’t a guarantee of metabolic health.
“You don’t need to look metabolically unhealthy to be metabolically unhealthy,” Saremi said.
Saremi suggested that today’s environment is priming us for disease. Our modern lifestyle of ultra-processed foods, sedentary habits, chronic stress, and poor sleep, when combined with genetics, creates a perfect storm for metabolic imbalance.
A population-based study published in JAMA Internal Medicine pointed to an association between eating higher levels of ultra-processed foods and risk of Type 2 diabetes. Specifically, diabetes risk was increased by 5 percent for every extra 100 grams of ultra-processed food eaten each day, such as one can of Coke or one slice of frozen pizza.
“It’s very challenging to be physically active because of our lifestyle,” registered dietitian and certified diabetes educator Karen Hawkins told The Epoch Times. “We drive everywhere and do very little walking.”
Furthermore, the norm of metabolic health has become unclear.
Skewed Norm
Defining the state of metabolic balance today is tricky. Urban Kiernan, who holds a doctorate in bioanalytical chemistry, told The Epoch Times that the challenge lies in how science defines “normal.”
“It’s really hard to create a definition, simply because of the way science as a whole is set up,” he said. “It’s all based around statistics, and you have to find the statistical norm. If you are already skewed towards disease, it’s really hard to establish a baseline.”
In other words, when the vast majority of Americans are metabolically unwell, the statistical average doesn’t reflect true health.
Kiernan has a point. A study published in 2022, led by a team of researchers from Tufts University, found that fewer than 7 percent of U.S. adults had optimal cardiometabolic health. The terms metabolic health and cardiometabolic health are often used interchangeably because they both reflect how well your body regulates energy and maintains cardiovascular function.
Perhaps a time machine would help us find an accurate baseline. We’d need to look back to the 1960s or ’70s to see what metabolic health looked like then. For now, we rely on key concepts and biomarkers to provide a clearer picture, according to Kiernan.
A Metabolically Healthy Person
At its core, metabolic health is about balance.
Hawkins defined metabolic health as “when all your body systems are in balance in regards to maintaining your weight, your blood pressure, your glucose levels.”
“It’s really balanced health in general,” she said.
Metabolic health also depends on metabolic flexibility: your body’s ability to switch seamlessly between burning carbohydrates and fat for fuel, depending on what’s available. A metabolically flexible person can handle a carb-heavy meal without a prolonged blood sugar spike, fast for several hours without feeling shaky or hangry, and efficiently tap into stored fat for energy when needed.
When your body efficiently turns food into energy (or calories), fueling everything from digestion to movement to cell repair, and these body systems work harmoniously, you’re considered metabolically healthy.
When screening for metabolic dysfunction, physicians typically check the following key biomarkers:
- Fasting Blood Sugar: Measures blood glucose after fasting. Optimal is less than 100 milligrams per deciliter (mg/dL).
- Blood Pressure: Ideal is about 120/80 millimeters of mercury (mmHg). Readings above 130/80 mmHg indicate hypertension.
- Lipid Profile: Triglycerides should be below 100 mg/dL, high-density lipoprotein or “good” cholesterol should be above 60 mg/dL, and low-density lipoprotein or “bad” cholesterol should be kept low.
- Waist Circumference: Less than 35 inches for women, less than 40 inches for men.
These markers provide a report card for your body. If one or more are outside optimal ranges, it’s a signal of metabolic dysfunction. When three or more are abnormal, it’s officially classified as metabolic syndrome.
One often overlooked yet highly relevant marker is muscle mass. Lean muscle supports insulin sensitivity, metabolic flexibility, and healthy aging, yet it’s rarely assessed in routine screenings.
“We have a lack of lean muscle mass epidemic, and that’s possibly even more important than the obesity aspect,” Kiernan said, noting that “muscles are major metabolic drivers.”
Beyond the Labs
Numbers matter, but they’re not the whole story. How you feel, function, and recover is just as important.
“Health is a lot more than these specific numbers or metrics,” Saremi said. “You have to look at the whole picture—your lifestyle, your work, activity level, diet, relationships, community, and how much sleep you’re getting.”
Loss of Metabolic Balance
Frequent blood sugar spikes trigger your body to release insulin, the hormone that absorbs glucose into your cells. Over time, repeated spikes can dull your cells’ sensitivity to insulin. This phenomenon is insulin resistance. Your body compensates by making even more insulin, which keeps blood sugar in range for a while, but underlying dysfunction builds silently.
Insulin resistance goes hand-in-hand with chronic, low-grade inflammation, which is subtle and systemic, acting as both a cause and consequence of metabolic dysfunction. Over time, the inflammation damages tissues, disrupts hormonal signaling, and puts your metabolic system under stress.
Left unchecked, this cycle can lead to a wide range of chronic diseases, including Type 2 diabetes, cardiovascular disease, fatty liver disease, kidney disease, and cognitive decline. What starts as a quiet shift in insulin sensitivity can snowball into full-blown metabolic dysfunction.
What drives insulin resistance in the first place? Too many calories or the wrong kinds?
Build Metabolic Balance
Metabolic flexibility starts with consistent, intentional choices across several key areas.
First of all, food quality matters. Build your meals around whole, unprocessed foods. Not all carbohydrates are created equal. According to Saremi, if you are eating carbs, it’s important to do so in a responsible way. Complex and fiber-rich carbs such as vegetables and fruits digest slowly, helping steady blood sugar levels. Whereas refined carbs and added sugars, such as white bread or crackers, can spike insulin, promoting fat storage and metabolic dysfunction.
Timing your carbs is important, too. Eating higher-carb meals around workouts can improve glucose handling. Prioritize protein and healthy fats to promote satiety and stabilize blood sugar throughout the day.
“If you’re going to be active, working out or doing cardio, consume carbs before that,” Saremi said. “Don’t load up right before bed when you’re not going to be metabolically active. That’s when excess calories are more likely to be stored as fat and may contribute to insulin resistance or inflammation over time.”
Although Hawkins emphasizes the Mediterranean diet as well-researched and widely recommended, she thinks that one size does not fit all. Personalization is key to long-term adherence.
“It really comes down to working one-on-one to figure out skill level, interests, budget, and whether you cook or want to,” she said.
Hawkins suggested setting aside weekend time for simple meal prep to make healthy eating sustainable.
“It doesn’t have to be complicated,” she said. “Steam some salmon, roast vegetables, build a salad, anything you can portion out for the week helps.
“Managing metabolic health is doable. It’s about applying sound nutrition and science consistently over time.”
Beyond diet, movement is a nonnegotiable pillar of metabolic health. Regular physical activity improves insulin sensitivity and helps burn excess energy, but it’s not just about structured workouts.
Saremi said the value of non-exercise activity thermogenesis includes all the ways we move outside the gym: walking, fidgeting, climbing stairs, even singing or dancing.
“That’s where you have the most wiggle room,” he said.
Small changes, such as parking farther away or taking the stairs, add up.
Movement isn’t just about burning calories. It’s a long-term investment in your body, according to Hawkins.
“We want to build and maintain our muscle, our bones, our cardiovascular system while we’re young,” she said. “It’s like a bank. You’re putting your investment into the bank, and it’s going to grow. By the time you hit your 50s and 60s, you’ll be able to use those investments to help you continue to build.”
What if you didn’t start early?
“The sooner the better, but you can still go to the bank anytime,” Hawkins said.
Metabolic health isn’t a fixed state; it’s a spectrum. With the right tools, you can move in a positive direction. By understanding your risks, aiming for metabolic flexibility, and taking small, consistent steps, you can build a more resilient foundation for long-term metabolic health.
The big picture, according to Hawkins, includes “lifestyle medicine and culinary medicine.”
“I truly think those two things will help people manage their metabolic health and prevent the long-term disadvantages of chronic disease,” she said.
