Along with cardiovascular disease, cancer and neurodegenerative disease, metabolic disease is one of the greatest threats to living a long and healthy life.
These chronic diseases typically develop over many years − long before symptoms appear. By the time these conditions are diagnosed, it is usually too late to cure. This is where reactive medicine fails. Patients and doctors should not wait until a disease diagnosis to intervene and make meaningful changes in lifestyle with the help of drugs when needed.
By definition, metabolic disease is when our body does not process fuel (food) into energy in the normal way. It encompasses a range of progressive conditions, including hyperinsulinaemia (when your body produces too much insulin), insulin resistance and eventually full-blown type 2 diabetes. Type 2 diabetes is characterised by elevated blood sugar levels, however, the mechanisms involved are complex and would have been getting progressively worse over many years.
In healthy individuals, blood sugar levels are kept under tight control by the hormone insulin which is produced by our pancreas. It functions by moving glucose out of our bloodstream and into our tissues − mainly liver, muscle and fat − thereby keeping blood glucose levels within optimal ranges.
When excessive amounts of calories are consumed consistently, our bodies respond by storing fat which, in turn, impairs our tissues from taking up sugar from our bloodstream − a condition referred to as insulin resistance. As a result, blood glucose levels become persistently elevated and, in response, the pancreas produces more and more insulin.
This insulin resistance plays a central role in the development of type 2 diabetes, as well as other chronic diseases of ageing, including cardiovascular disease, cancer and Alzheimer’s disease. Preventing and even reversing this condition is possible through lifestyle changes with the help of medication when required.
Increasing or maintaining muscle mass is equally important as reducing fat mass for our metabolic health
The slow and gradual progression of such metabolic conditions, as well as their central role in the development of full-blown diseases such as type 2 diabetes, make identification of any signs of metabolic disease critical to our long-term health. Patients and doctors can regularly monitor metabolic health through specific blood tests and simple body measurements.
As metabolic disease develops due to chronic excessive calorie intake, perhaps the most obvious lifestyle intervention is nutrition. Indeed, reducing your total calorie intake, and in particular restricting carbohydrates, is a powerful way to prevent and restore metabolic health as it allows for significant reduction in body fat.
Importantly, it is reduction in visceral fat that improves metabolic health. Therefore, it is the quantity of calories (food and beverages) which must be decreased such that you take in less calories than your body is using. Secondly, it is the quality of your diet − ensure that the majority of your diet comes from whole foods including vegetables, fruit, whole grains, lean protein, and healthy fats.
Increasing or maintaining muscle mass is equally important as reducing fat mass for our metabolic health. Muscle acts as a reservoir for glucose, therefore the more muscle mass an individual has, the greater capacity for bringing sugar out of circulation in the blood. This is just one of the important roles of strength training − regular strength training, along with sufficient intake of protein from diet, are vital to having optimal amounts of muscle mass which are an integral part to ensuring healthy ageing. From an exercise perspective, aerobic training (cardio) is also very important as it increases muscle response to insulin.
Consistently getting good sleep, as well as actively managing your stress levels, are central lifestyle factors in combating poor metabolic health. Getting inadequate amounts of restful sleep significantly reduces your body’s response to insulin, even in the short term.
Consistently getting good sleep, as well as actively managing your stress levels, are central lifestyle factors in combating poor metabolic health
Good sleep hygiene, including keeping to a consistent sleep schedule, sleeping in a cool, dark and quiet room, avoiding caffeine, alcohol and large meals close to bedtime, and avoiding screens before bed are all central to a good night’s rest which allows your body to maintain metabolic stability.
Metabolic diseases, such as type 2 diabetes, are on the rise, and perhaps most concerningly, in the young population. Adopting these lifestyle practices throughout our lifetimes increases the chances of us living a long life while maintaining our independence and functionality.
Type 2 diabetes doesn’t just occur overnight but would have been developing over many years during which time there are many signs to look out for. It is during this time that we are able to effectively reverse metabolic dysfunction through adopting healthy lifestyle practices.
Do not wait till signs appear. Prevention is better than cure.
Philip Borg is a longevity medicine specialist, as well as a consultant interventional radiologist. He leads The Longevity Clinic at St James Hospital.