Not just weight: What does metabolic health actually look like?
By willowt // 2025-08-30
 
  • Less than 7% of U.S. adults have optimal cardiometabolic health.
  • High consumption of ultraprocessed foods is linked to a higher risk of Type 2 diabetes.
  • The ability to switch between burning carbs and fats is essential for metabolic health.
  • There are significant health disparities based on race, ethnicity and education.
  • Early lifestyle changes can significantly reduce the risk of metabolic diseases.
Imagine waking up refreshed, with steady energy levels throughout the day and a sharp mind. This is what metabolic health feels like, but for most Americans, it's a distant dream. According to a recent study by Tufts University, fewer than 7% of U.S. adults have optimal cardiometabolic health. This alarming statistic underscores a silent epidemic of metabolic dysfunction, a condition affecting 93% of Americans and contributing to the rise of chronic diseases such as Type 2 diabetes, cardiovascular disease and fatty liver disease. Dr. Adonis Saremi, a triple board-certified obesity medicine physician, emphasizes the urgency: "The sooner you act, the higher the likelihood you’re going to live longer and healthier, and have a better health span."

The modern lifestyle’s perfect storm

Urban Kiernan, a doctorate holder in bioanalytical chemistry, highlights the challenges in defining "normal" metabolic health in an era where the baseline is skewed by widespread metabolic dysfunction. "When the vast majority are unwell, it’s hard to establish a true baseline," he says. The modern lifestyle, characterized by ultra-processed foods, sedentary habits, chronic stress and poor sleep, creates a perfect storm for metabolic imbalance. Karen Hawkins, a registered dietitian and certified diabetes educator, adds, "It’s very challenging to be physically active because of our lifestyle. We drive everywhere and do very little walking."

Defining metabolic health

Metabolic health is not just about weight. Dr. Saremi explains, "You don’t need to look metabolically unhealthy to be metabolically unhealthy." Key biomarkers used to assess metabolic health include fasting blood sugar, blood pressure, lipid profile and waist circumference. Lean muscle mass, often overlooked, is also crucial. A metabolically healthy person can manage their weight, maintain steady blood sugar levels and efficiently use energy. Metabolic flexibility—the body's ability to switch between burning carbohydrates and fats—is a vital component. This flexibility ensures that the body can handle a carb-heavy meal without a prolonged blood sugar spike and efficiently tap into stored fat when needed.

The impact of ultra-processed foods

A population-based study published in JAMA Internal Medicine found a 5% increase in Type 2 diabetes risk for every extra 100 grams of ultra-processed food consumed daily. Hawkins emphasizes the importance of whole, unprocessed foods: "If you are eating carbs, it’s important to do so in a responsible way. Complex and fiber-rich carbs like vegetables and fruits digest slowly, helping steady blood sugar levels."

Building metabolic balance

Achieving metabolic health requires intentional choices in diet, exercise and lifestyle. Dr. Saremi advises, "Build your meals around whole, unprocessed foods. Timing your carbs is important, too. Eating higher-carb meals around workouts can improve glucose handling." Hawkins recommends meal prepping to make healthy eating sustainable: "It doesn’t have to be complicated. Steam some salmon, roast vegetables, build a salad—anything you can portion out for the week helps." Regular physical activity is non-negotiable. Dr. Saremi highlights the importance of non-exercise activity thermogenesis (NEAT), which includes everyday movements like walking and climbing stairs. "Small changes, like parking farther away or taking the stairs, add up," he says.

Addressing health disparities

The study by Tufts University also revealed significant health disparities. Adults with less education were half as likely to have optimal cardiometabolic health compared to those with more education. Mexican Americans had one-third the optimal levels compared to non-Hispanic white adults. Dr. Dariush Mozaffarian, dean of the Friedman School, stresses the need to address these disparities: "Social determinants of health such as food and nutrition security, social and community context, economic stability and structural racism put individuals at an increased risk of health issues."

A call to action

Metabolic health is not a fixed state but a spectrum. With the right tools, individuals can move in a positive direction. Dr. Saremi concludes, "Health is a lot more than specific numbers or metrics. You have to look at the whole picture—your lifestyle, work, activity level, diet, relationships, community and how much sleep you’re getting." Lifestyle and culinary medicine, as Hawkins suggests, are key to managing metabolic health and preventing chronic diseases. Early intervention and consistent, sustainable changes can significantly improve health outcomes and well-being. The crisis of metabolic dysfunction requires urgent action, but the potential for positive change is within reach. Sources for this article include: TheEpochTimes.com Tufts.edu JAMAnetwork.com PubMed.gov