Understanding and taking charge of your metabolic health

Metabolic health is poorly understood in Canada, and too often it’s mistaken for what we can see on the outside only. A person may have markers of poor metabolic health, such as high blood pressure, high blood sugar or elevated lipids, even without visible signs or symptoms.

More than one in four Canadians meets the criteria for metabolic syndrome, a condition that can increase the risk of developing heart disease and type 2 diabetes. The prevalence is even higher among older Canadians, posing growing health concerns for Canada’s aging population.

“Metabolic health is profoundly more intricate than often perceived, extending beyond external appearances like weight or body size,” says Dr. Rasha Eldesouky Abouelabbas, vice president, medical and regulatory affairs, Boehringer Ingelheim Canada.

A complex balancing act between the body’s systems

Eldesouky Abouelabbas explains that metabolic health involves a complex interplay and interconnectivity among the body’s vital organs — a silent conversation especially between the brain, heart, kidneys, pancreas and liver, working together to regulate blood sugar, blood pressure, cholesterol, energy, appetite and inflammation.

“What makes this so significant is how seamlessly this communication happens beneath the surface,” says Eldesouky Abouelabbas. “These organs don’t operate in isolation. They each play critical roles that influence and are influenced by the others. And some people have no idea this constant coordination is taking place, until something disrupts it.”

When this balance becomes dysregulated, which Eldesouky Abouelabbas notes can happen due to chronic inflammation, insulin resistance or persistent stress, the effects ripple throughout the entire system. The consequences can be far-reaching, from disrupted blood sugar regulation and rising blood pressure to increased strain on the liver and kidneys.

The dangers of poor metabolic health

Individuals who have metabolic dysregulation or metabolic syndrome (defined as having at least three metabolic health risk factors) may face an increased risk of developing conditions like type 2 diabetes and heart disease.

Poor metabolic health can also lead to liver disease, specifically metabolic dysfunction-associated steatotic liver disease (MASLD), which can progress to metabolic dysfunction-associated steatohepatitis (MASH). These conditions are associated with metabolic issues such as insulin resistance, high blood pressure and abnormal cholesterol.

People who have poor metabolic health are also more likely to live with obesity, which raises the risk of several other health conditions, including coronary heart disease, type 2 diabetes, asthma, osteoarthritis, sleep apnea and certain types of cancer. Obesity is a chronic disease driven by genetic, biological, environmental and behavioural factors, adding another layer of complexity.

Because of metabolic health’s complexity, its impacts are often deeply interconnected. “An unhealthy liver can contribute to elevated blood sugar and abnormal lipid profiles, increasing the risk for cardiovascular disease and putting a strain on kidney function,” says Eldesouky Abouelabbas. “This relationship works in multiple directions.

“Impaired kidney function can contribute to a cascade of complications — exacerbating high blood pressure, which can lead to heart disease — and may also affect the liver’s metabolic function. This is why we so often see these conditions co-exist and progress in tandem; they’re not independent ailments but rather symptoms of a broader metabolic imbalance.”

A more holistic, integrated approach to metabolic health is critical.

Moving beyond stigma

When it comes to metabolic health, moving beyond stigma means looking past outward appearance and recognizing that body size alone doesn’t tell the full story.

It starts with recognizing that metabolic health is about what’s happening on the inside, rather than what you see on the outside. “Someone can be considered to be within a ‘healthy’ weight range yet still experience metabolic dysfunction internally,” says Eldesouky Abouelabbas. “Conversely, individuals in larger bodies can and do achieve excellent metabolic health.”

“It’s crucial for Canadians to understand this complexity. By decoupling health from body size, we can reduce the significant stigma and bias that many individuals experience within health-care settings and society at large.”

Taking a proactive approach

Because outer appearance alone isn’t indicative of metabolic health, it’s important to take a proactive, preventive approach.

“One of the most significant hurdles is the subtle and often silent nature of early metabolic dysregulation,” says Eldesouky Abouelabbas. “Unlike an acute injury or infection, imbalances in blood sugar, early signs of kidney stress or fat accumulation in the liver rarely present with immediate, obvious symptoms.”

She recommends being informed and speaking with your doctor about your metabolic health pre-emptively. “Come prepared with questions,” she says. “Instead of waiting for your doctor to initiate the conversation, think about what you want to understand.”

Eldesouky Abouelabbas says individuals should ask about specific organ health markers, like: “What are my kidney function numbers, and what do they mean?” or, “How is my liver health reflected in my blood tests?”

“Inquire about your risk factors for conditions like type 2 diabetes, heart disease or MASLD, even if you feel healthy. And articulate your concerns and observations. Your body may give you clues.”

Talk to your health-care provider about your overall organ health, risk factors and screening for metabolic disease.

This story was created by Healthing Content Works, Healthing.ca’s commercial content division, on behalf of Boehringer Ingelheim.