The prevalence of obesity has increased in the last 20 years as well as that of metabolic syndrome. One in three adults struggles with Metabolic Syndrome. Addressing these health-related concerns through a functional and root cause lens can provide more insight into their etiology and therefore employ more effective means of treatment.
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What is Metabolic Health?
Metabolic Health is a collective term that refers to a group of conditions that together raise the likelihood of diabetes, heart disease, and stroke, such as low-HDL-C, elevated blood pressure and triglycerides, impaired glucose tolerance, and abnormal fasting plasma glucose.
What Happens When Metabolic Health Is Poor?
When our metabolic health is poor, other systems in the body can become compromised. Inflammation is often very much evident, which can further impede health. Inflammation can impact hormonal balance, for instance, making it more difficult to lose weight. Triglycerides are often elevated, in addition to blood pressure and issues with insulin resistance, all of which cause inflammation and oxidative stress in the body.
The gut microbiome has also been found to be out of balance when metabolic health is poor, which can further contribute to systemic inflammation in the body. Therefore, this puts more strain on our liver and immune health.
What Causes Metabolic Syndrome?
The causes of metabolic syndrome are multifaceted but include a combination of genetics, environment, diet, and lifestyle. Often a diet high in refined carbs, trans fat, sugar, and processed foods can contribute significantly to metabolic syndrome and insulin resistance.
Gut health issues may also be an underlying contributing factor to metabolic syndrome. Gut microbiome imbalances can contribute to compromised metabolic health. Insufficient digestion due to enzyme deficiencies can also contribute to metabolic health concerns. We may also have genetic variants regarding enzymes required for sufficient digestion, among other important metabolic processes in the body, such as methylation.
Methylation is a biological process that occurs constantly in our body and is imperative for overall functioning. This process is important for our metabolism and for modulating inflammation, among other important functions for our health. We may also have genetic variants in other genes essential for our metabolic health.
While the etiology of metabolic health conditions is multifaceted, several genes have been suggested to be involved in metabolism, eating behaviors, and weight gain. For instance, the Fat Mass and Obesity Gene (FTO) involves hunger, satiety, food intake, and metabolism. Variants in this gene suggest a strong association with the risk of obesity and inflammation.
Other variants in genes that may make one more susceptible to weight gain include; leptin, leptin receptor, and proopiomelanocortin (POMC), which helps to modulate leptin levels; Melanocortin 4 Receptor Gene (MC4R) and Serotonin Receptor 2C Gene (5HT2C).
MC4R regulates hunger, satiety, food intake, body weight regulation, and energy balance. Variations in this gene have been correlated to metabolic syndrome and obesity.
5H2TC has a role in satiety regulation, weight gain, and food-seeking behaviors. Similar to MC4R, variants in this gene are associated with blocked receptor functioning, resulting in altered regulations in food intake, hunger, and fullness.
Others include tyrosine kinase receptor tropomyosin-related kinase B (TRKB) and brain-derived neurotrophic factor (BDNF), which strongly regulate energy balance and inflammation.
While variants in genes may make us more susceptible to weight gain, diet and lifestyle can greatly support in modulating these factors, highlighting the area of epigenetics (how our lifestyle and environment influence the expression of our genes).
Compromised detoxification and digestion in the body can also contribute to metabolic issues and our toxic load or toxicant status. This includes what we are exposed to on a daily basis in terms of our environment. Toxicants can interact with processes in the body, like our gut microbiome, that influence metabolic health.
Micronutrient insufficiencies can also contribute to metabolic health. A number of vitamins and minerals play important roles in metabolic health. Deficiencies in micronutrients can impair glucose metabolism and cause insulin resistance.
Hormonal imbalances can also affect our metabolic and gut health, which is foundational for metabolic health, as evidenced. Hormonal imbalances can arise from chronic stress, an altered HPA axis, altered gut composition, and a lack of sleep. Hypothyroidism is also evidenced to be correlated with metabolic syndrome as it has effects on one's metabolism.
Alterations in immune and metabolic health can contribute to autoimmune conditions. It has been suggested that those with autoimmune conditions are at a greater risk for metabolic conditions such as obesity. This may speak to inflammation's role in regulating many aspects of our health.
Insufficient sleep can also largely contribute to metabolic syndrome for multiple reasons. A lack of sleep compromises the body's ability to detoxify and restore. It also affects the body's gut functioning, energy, and hormones relative to metabolic health. Insufficient sleep and disruptions in circadian rhythm can also further influence hormonal imbalance, including growth hormone, melatonin, cortisol, leptin, and ghrelin.
Symptoms of Metabolic Syndrome
Metabolic Syndrome symptoms include low HDL C, elevated blood pressure and triglycerides, impaired glucose intolerance, and abnormal fasting plasma glucose. Further symptoms may include inflammation, gut microbiome imbalances, compromised digestion, detoxification, and symptoms of chronic stress or hormonal dysregulation.
Functional Medicine Labs for Metabolic Syndrome Patients
A number of functional labs can provide valuable insight into what is going on in the body and could be underlying the pathophysiology of Metabolic Syndrome depending on one's bio-individual genetic makeup. The following functional medicine lab tests may be of particular value:
Comprehensive Stool Analysis
This test provides a comprehensive stool analysis, providing valuable insight into one's metabolic profile. Pathogenic bacteria or patterns of dysbiosis can all contribute to systemic inflammation and poor metabolic health.
Thyroid Panel
This test measures the functioning of the thyroid, which is imperative to the metabolism of nearly all of our body's cells. When the thyroid isn't functioning as it should, this can contribute to compromised metabolic health.
DUTCH Plus
This test measures hormones, including our stress hormones, which could be underlying contributing factors to problems with metabolic health.
Methylation Panel
This test looks at methylation, which can be compromised, and therefore impede many of the body's processes integral to our metabolic and overall health.
Comprehensive Metabolic Panel
This test assesses biomarkers of metabolism that could be affected and influence poor metabolic health, such as liver and kidney function.
Micronutrient Testing
This test assesses 31 vitamins, minerals, and other nutrients to determine nutritional deficiencies.
3 x 4 Genetics
This comprehensive test provides valuable insights into factors contributing to our metabolic health based on our unique genetic makeup.
Environmental Toxins
This test assesses toxicant status in the environment, which can accumulate in fat cells and further contribute to metabolic health.
HbA1C
Hemoglobin a1C is a blood test that measures your average glucose levels over the last 2-3 months. This is important for metabolic health, as a high hbA1C can indicate pre-diabetes.
Fasting Glucose
This test is another important metabolic health biomarker that evaluates fasting glucose or blood sugar.
Insulin
This test assesses for the presence of insulin resistance, which is when the cells don't respond as well as they should to insulin, raising glucose.
Liver Function
The functioning of our liver is imperative for metabolic health as it has an imperative role in breaking down fats. Therefore, assessing liver function may be of value.
Continuous Glucose Monitor
This may be helpful in terms of monitoring glucose levels in terms of regulating energy and metabolism.
Autoimmune Dysfunction
Compromised immunity can lead to systemic inflammation and a host of symptoms that can compromise gut and metabolic health. This is why it is important to assess for an autoimmune dysfunction.
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What is Functional Nutrition?
Functional nutrition is a way to use functional or nutrient-dense foods with therapeutic properties in the body in a thoughtful, evidenced-based way. A functional nutrition approach to health assesses the many layers that may impede one's health and the optimal functioning of the body's systems. It emphasizes restoring balance in the body, which helps restore health. This type of approach acknowledges the biochemical variation that exists within all of us, as well as the many other factors that can influence our health, including lifestyle.
How Can Functional Nutrition Improve Metabolic Health and Weight Management?
Functional Nutrition can help to support the underlying processes in the body that may be compromised and therefore contribute to poor metabolic health. Hormonal and gut imbalances, chronic stress, lack of movement or sufficient rest, and even environmental factors can all illuminate the various reasons we may be having trouble with our metabolic health. What is empowering is that a functional nutrition approach to metabolic health and weight management assesses the bio-individual factors that may be underlying one's metabolic health issues, which can lead to more sustainable and effective strategies for improving one's health.
A functional approach can also assess genetic variants, which provide more insight into how we can favorably influence our genes with nutrition and lifestyle factors.
Addressing underlying causes of metabolic health may include achieving good glycemic control, reducing inflammation and abdominal or central obesity, increasing physical activity and movement, reducing stress, addressing gut health and hormonal imbalances (such as thyroid), and correcting any nutrition deficiencies or problems with sleep.
An integrative and holistic approach to metabolic health and weight management has been found to be the most effective for sustaining weight loss and addressing the underlying mechanisms. Addressing a combination of nutrition and lifestyle, such as movement, stress, and sleep, is likely to have the strongest impact in terms of improving glycemic control and restoring insulin sensitivity. Strength training, in particular, has been found to be of value for improving these factors.
While nutrition should be individualized, a Mediterranean diet has been shown to be effective in improving glycemic index and inflammation while providing nutrient density to the body. The Mediterranean diet also tends to be high in plant-based sources of fiber, which has been found to improve blood glucose levels and inflammatory markers. Also, this diet is full of Monounsaturated fats (MUFAs), which have been suggested to be beneficial in restoring beta-cell function and insulin sensitivity.
Consuming foods rich in antioxidants such as phytochemicals and polyphenols support the reduction of toxicants, among other factors relative to metabolic health. Colorful fruits and vegetables such as broccoli, spinach, raspberries, and blackberries all support detoxification in the body and have antioxidant and anti-inflammatory properties helping to combat oxidative stress.
Addressing any gut health or hormonal imbalances with adequate nutrition and lifestyle factors is also important. Therefore, probiotic-rich food sources, such as fermented foods, and nutrient-dense sources of iodine or selenium may be recommended. This may also entail part of the 5 R Protocol, such as removing foods that irritate the gut and adding in foods and nutrients that support it, as this helps with autoimmunity in conjunction with metabolic health.
Supplements & Herbs That Improve Metabolic Health and Weight Management
Fiber Supplementation
Obtaining adequate fiber from whole foods has been suggested to improve glucose control, GI health, and insulin sensitivity. Sufficient fiber has also been shown to help modulate weight as it helps to reduce appetite. Fiber can help address many underlying factors contributing to insulin resistance.
Probiotics
Probiotics are living beneficial bacteria that reside in the gut with implications for overall health, including metabolic health, as probiotics help modulate several processes in the body, like digestion, inflammation, and metabolism.
Multivitamin/Mulitimineral
A good-quality multivitamin that also covers a broad range of essential minerals is often found to be effective in improving metabolic health and modulating weight. For instance, notable improvements have been shown for B vitamins, chromium, and antioxidants.
Antioxidant Support
Research suggests that mitochondrial dysfunction is involved in insulin resistance. CoQ10 has been shown to be effective in improving oxidative status, glycemic control, insulin resistance, blood pressure, and HbA1c.
Vitamin C may effectively support the adrenals if an individual has difficulty managing stress, in addition to its oxidative stress support. Vitamin C has also been shown to improve glycemic control, hypertension, and endothelial function.
Vitamin E has been found to have a role in reducing inflammation.
Magnesium has been indicated to improve HDL while lowering plasma glucose levels with support for reducing central obesity. It also improves insulin resistance and supports inflammation.
Vitamin D
Sufficient Vitamin D status is important in terms of insulin resistance and inflammation.
Omega-3 fatty acids
Omega-3s have been indicated to reduce triglycerides and very low-density lipoproteins (VLDL).
Chromium has been suggested to improve insulin sensitivity by increasing the insulin receptor tyrosine kinase activity.
Botanical Support
Various herbs have been shown to benefit metabolic health, encompassing diabetes and insulin resistance.
Alpha-lipoic acid supplementation in those with type 1 diabetes improved fasting glucose and oral glucose tolerance.
In a randomized trial, a reduction in HbA1c was found in those with type 2 diabetes taking a green tea extract. It has also been suggested that green tea exerts thermogenic effects supporting weight loss.
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Summary
The etiology of compromised metabolic health is multifaceted, owing to a combination of genes and lifestyle factors. Becoming curious about how metabolic syndrome arises can be valuable in assessing root underlying factors, such as chronic stress, insufficient sleep or movement, as well as nutrition and imbalances in the body's systems that may further contribute to symptoms.
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