What It Means to Be Metabolically Healthy

Last Updated: Jan 25, 2024

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Over the past few years, I’ve read about dozens of supposedly healthy people who suddenly got seriously ill or even died of metabolic diseases (such as cancer or heart disease), or because they contracted a virus that caused an out-of-control upper respiratory infection.

One example is the Icelandic professional soccer player Emil Palsson — an elite athlete presumably in prime fitness —  who suffered a mid-match heart attack

How is it possible for someone who is in good health to suddenly become severely ill or worse?

To answer this and many related questions, this article will explain the 12 factors that most determine your health. More specifically, it will focus on your metabolic health, which is an indicator of how well your metabolism is functioning. 

I’ll also tell you about the lifestyle changes I’ve implemented to transform from a professional athlete who was metabolically unhealthy (and frequently injured) into a hobby athlete who barely gets sick and is stronger and fitter than he was 20 years ago.

Additionally, I’ll go over the indicators you should watch out for (and which blood tests you should ask for) during your next physical exam, to help you determine how (metabolically) healthy you really are. 

Last but not least, I’ll talk about some of the common misconceptions around health, such as the adage that deteriorating health is a normal part of aging.

Note that this article primarily focuses on metabolic health, which is a key factor in the development of chronic diseases such as Alzheimer’s, autoimmune issues, cardiovascular disease, cancer, Type 2 diabetes, stroke and others. When I use terms like “health,” “sick,” or “disease,” I’m not referring to temporary ailments like the upset stomach you might get after eating spoiled fish. 

But before we get into the nitty-gritty, let’s define health and metabolic health.

Definition of Health

How to Assess Your Metabolic Health [Top 12 Tips]
Click the play button to watch the video version of this article.

By definition, health is the absence of disease. In other words, if you’re not sick, you ought to be healthy. While that’s a very straightforward explanation, it relies on a common understanding of what the term “disease” means. 

For example, most men wouldn’t consider themselves to be sick just because they have a bit of a dad pouch. In fact, I bet few primary care physicians would classify a person as sick just because they have a few extra pounds around their hips. At least, that’s been my experience with friends and family who fall into that category; they were told by their doctors that they’re in perfect health.

The problem is that fat accumulation around the midsection, and specifically around the organs, is often a sign of metabolic dysfunction. If left untreated, it significantly increases your risk of developing a chronic illnesses.

Likewise, nobody would have said that Icelandic midfielder Emil Palsson, who collapsed during a football game in Norway’s second division after suffering a cardiac arrest, was sick before the game. But if he were truly healthy, he wouldn’t have suffered a heart attack on the soccer field.

My point is that there are no consensus definitions — among the general population or even among healthcare professionals — of the terms “health” and “disease.”

That’s the primary reason why I decided to write this article. I hope it helps you both better judge how healthy you are and identify ways to improve your metabolic health.

The latter is crucial if you want to reduce your risk factors for developing an avoidable disease, such as the ones mentioned in the beginning of this article.

What Is Metabolic Health?

Many Americans aren't metabolically healthy and suffer to some degree from what's known as the metabolic syndrome.
Many Americans aren’t metabolically healthy and suffer to some degree from what’s known as the metabolic syndrome.

I’ll be using the term “metabolic health” a lot throughout this article, because it’s arguably the most important indicator of how much you’re at risk for developing a largely preventable chronic disease.

Metabolic health is an indication of how well your metabolism is functioning.

The three main purposes of metabolism are: the conversion of the energy in food to energy available to run cellular processes; the conversion of food to building blocks for proteins, lipids, nucleic acids, and some carbohydrates; and the elimination of metabolic wastes. (Wikipedia)

In other words, if you’re metabolically healthy, your body does an excellent job of converting carbohydrates into glucose, fatty acids into ketone bodies, and proteins into amino acids. The former two can then be used for energy, and the latter are turned into the building blocks of muscle tissue or the signaling molecules that help cells communicate. 

Additionally, a metabolically healthy body is able to efficiently eliminate waste products via the liver and kidneys.

As you can imagine, if your metabolism isn’t working optimally, then your body won’t be able to properly extract energy and nutrients from the food you eat. This can lead to weight gain, inflammation, an impaired immune system and a host of other issues. In the long run, metabolic dysfunction can significantly increase your risk of developing a metabolic disease, and can make you more susceptible to viral infections.

Only 12 percent of Americans are considered metabolically healthy
Only 12% of Americans are considered metabolically healthy.

Unfortunately, many of us are metabolically unhealthy. Dr. Perlmutter — a board-certified neurologist, fellow of the American College of Nutrition, and five-time New York Times bestselling author — estimates that only 12% of Americans are metabolically healthy

That’s a shockingly low number, but it aligns with the proportion of individuals who are overweight or obese, and the skyrocketing rates of cardiovascular disease, cancer and other metabolic issues.

Now that we’ve established the basics, let’s talk about how you can determine whether or not you’re truly (metabolically) healthy.

Top 12 Factors to Determine How Healthy You Are

Most doctors don't have the time to have a comprehensive discussion about health with their patients.
Most doctors don’t have the time to have a comprehensive discussion about health with their patients.

Determining how healthy you are isn’t easy because it involves the assessment of several factors, as listed below.

  1. Feeling
  2. Fitness
  3. Skin
  4. Metabolic flexibility
  5. Gut microbiome
  6. Immune system
  7. Blood markers
  8. Dental health
  9. Pain
  10. Stress
  11. Sleep
  12. Menstrual cycle

The problem is that some of these factors can be misleading if they’re looked at in isolation. For example, I’ve known several bodybuilders who were fit and as strong as tanks, but who still were not (metabolically) healthy. A person’s appearance alone isn’t always a great indicator of health.

Let’s look at each of these factors and how you can use them together to judge your own health.

1. Feeling

Feeling good and free of pain is normal. Everything else isn't.
Feeling good and free of pain is normal. Everything else isn’t.

If you’re healthy, you should feel great on most days. The problem is that unless you’re in-tune with your body, you might not know what it means to feel good. 

For most of my life, I thought I felt good. That was until I started making key lifestyle changes. 

In other words, for most of my adult life, I was feeling 60% but thought that was the best I could do. I didn’t know that I wasn’t hitting my peak potential.

On the other hand, if you truly know what it means to feel 100%, then any deviation from that norm can be a clear signal that something is off. 

Over the past few years, I’ve become relatively sensitive to any factors that impact the way I feel. Examples include stress, certain foods that reduce my mental clarity, and getting as little as 30 minutes less sleep during a given a night. If any of those things happen, I immediately feel worse. 

Of course, “worse” is still worlds better than I used to feel.

2. Fitness

Michael deadlifting 505 pounds
You don’t have to be able to deadlift over 500 pounds, but you should be able to lift heavy everyday objects without pain or injury.

As I said previously, the way someone looks isn’t always a great indicator of their health. 

For example, if you’ve been following the news, you’ve probably heard anecdotes of “perfectly healthy” people (including marathon runners) who contracted COVID and died. 

That’s because a person’s cardiovascular fitness (endurance) and body composition aren’t reliable indicators of their metabolic health.

In my early 20s, I was a professional athlete and worked out up to 13 times per week. So I was in pretty good shape and had excellent cardiovascular markers. That’s one of the reasons why I didn’t pay much attention to sleep or nutrition. In fact, I had an awful diet consisting of fast food, highly processed carbs and sugary soft drinks. 

Needless to say, I wasn’t metabolically healthy. But I didn’t recognize the signs, including irritable bowel syndrome (IBS), frequently being sick and injured (caused by a dysfunctioning immune system and chronic inflammation) and the inability to reach my full potential. 

The latter I only realized when, in my mid and late 30s, I started lifting heavier weights and surpassing the cardio performance I had 20 years earlier. 

The key takeaway here is that someone’s physical appearance, strength and endurance aren’t necessarily indicators of metabolic health. However, if someone is completely out of shape and huffs and puffs after walking up a flight of stairs, chances are that their cardiovascular system isn’t working optimally. And that often goes hand-in-hand with a disturbed metabolism.

More importantly, if someone is overweight or shows signs of central obesity or visceral fat, there is a good chance that their fat and glucose metabolism is severely impaired. Said differently, I don’t know of any mechanism by which someone could be overweight and metabolically healthy at the same time.

3. Skin

My wife used to have a lot of redness and other skin issues. All of that improved when she changed her diet.
My wife used to have a lot of redness and other skin issues. All of that improved when she changed her diet.

The skin is an excellent reflection of someone’s health and diet. Severe skin issues — such as acne, eczema and chronic rashes — are usually solid indications of a dysbiosis in the gut, poor dietary choices or inflammation. 

I had dry skin for decades, resulting in daily use of lotions and creams to reduce the itching. I no longer have that problem and now barely use creams and lotions. I’m grateful for that because most skincare products are loaded with hormone-disrupting chemicals that cause more harm than good.

So if you suffer from any of these conditions, I can virtually guarantee you that you have metabolic issues that can likely be fixed by making the proper lifestyle changes (as we’ll discuss further down).

4. Metabolic Flexibility

Metabolic flexibility is the ability to efficiently burn carbs and fat for fuel.
Metabolic flexibility is the ability to efficiently burn carbs and fat for fuel.

Metabolic flexibility is your body’s ability to efficiently switch back and forth between using glucose (from carbs) and ketone bodies (from fat) as fuel. Most people don’t have that metabolic flexibility, resulting in low energy levels and dizziness (caused by plummeting blood sugar levels and the inability to access body fat for fuel) if they have to skip a meal or fast for extended periods.

When was the last time you fasted for 20 hours and felt great while doing it? 

If you’re metabolically healthy, your body automatically starts burning (body) fat for energy without causing hypoglycemia (low blood sugar) anytime the need arises. That way, you don’t feel crappy when you have to skip a meal or when you miss a snack between meals.

The picture above is a screenshot from the Lumen app. Lumen is a metabolic breath analyzer that tells you whether or not you’re currently burning fat for fuel and, based on your readings over time, gives you actionable tips for improving your metabolic flexibility. At around $300 it’s not cheap, but it works well and can be a helpful tool.

5. Gut Microbiome

Absorption-intestines-copy.jpg - A healthy gut (microbiome) is the foundation of overall wellness.
A healthy gut (microbiome) is the foundation of overall wellness.

The gut plays a major role in your overall health and how well your immune system functions.

If you suffer from a dysbiosis of your gut’s microbiome, chances are that your metabolic health is severely impaired.

Signs of issues with your gut microbiota may include constant bloating after meals, frequent diarrhea, irritable bowel syndrome (IBS), Crohn’s disease, ulcers, frequent heartburn and others.

I suffered from IBS for most of my life, as did my father. In fact, he still does. Unfortunately, he hasn’t accepted the connection between his lifestyle and gut issues, despite the fact that I’ve shared everything I know about the topic.

When I first realized that constant bloating and pressure in my abdominal area wasn’t normal, I was told that it’s likely hereditary because my dad had it too (and so did his dad). After all, my paternal grandfather died of stomach cancer before I was born.

But I didn’t realize, until a few years ago, that none of these symptoms are normal and that they could be completely avoided by adopting a healthy diet.

In fact, making a few simple and relatively easy changes cured my IBS.

6. Immune System

An overactive immune system is as problematic (autoimmunity) as one that functions poorly.
An overactive immune system is as problematic (autoimmunity) as one that functions poorly.

I used to be sick with viral and bacterial infections several times a year. But I figured it was entirely normal to be sick that often. 

The truth is that being sick frequently is a sign of a compromised immune system that often goes back to metabolic dysfunction. On the flip side, a well-functioning metabolism goes hand-in-hand with a healthy immune system. 

I noticed a dramatic difference in how often I get sick after I changed my dietary habits and became more protective of my sleep. In fact, I went three years without being sick (until I contracted COVID-19). And even then I had only minor symptoms, such as a mild cough and a loss of smell that lasted two or three days.

The bottom line is that if you’re sick a lot, your immune system and metabolism are likely not functioning as they’re supposed to.

7. Blood Markers and Other Tests

I just got my blood drawn at home by a phlebotomist Levels Health sent out
A comprehensive blood panel can give you insights into your metabolic health.

There are several blood markers that I get checked every three months, because they provide an excellent indication of metabolic health. Unfortunately, some of them aren’t even part of the regular blood panel your physician might order during your annual checkup.

While I recommend getting a comprehensive blood panel every few months (below is the entire list of checks my doctor orders), I’ll point out the checks that are most critical (in my opinion) right after the bulleted list:

  • C-reactive protein (CRP)
  • Complete blood count (CBC) with differential
  • Cortisol, morning
  • DHEA
  • Dihydrotestosterone (DHT)
  • Estradiol
  • Ferritin
  • Hemoglobin A1c (HgA1c)
  • Homocysteine
  • IGF-1
  • Insulin, fasting
  • Lipid panel
  • Luteinizing hormone (LH)
  • Metabolic panel comprehensive
  • PSA
  • Testosterone (free and total)
  • Thyroid hormones (TSH, T3, T4)
  • Urine analysis
  • Vitamin D
  • Blood pressure


My CRP has been consistently below 0.3 over the past few years.
My CRP has been consistently below 0.3 over the past few years.

CRP is a protein produced by the liver in response to inflammation. Your CRP usually goes up when you’re sick. I’ve also experienced transient increases in CRP right after intense workouts. Neither of these cases are cause for concern.

However, if your CRP is elevated without an apparent reason (e.g., an acute infection), it’s likely due to chronic inflammation caused by a dysfunctional metabolism. 

My CRP is usually below 0.3. That indicates the absence of inflammation, which is what you want to see when you’re metabolically healthy.

Hemoglobin A1c

How Continuous Glucose Monitoring Can Improve Your Health and Fitness
I’ve been wearing a continuous glucose monitor (CGM) for the past year.

Unlike your fasting glucose, which offers only a snapshot of your blood sugar levels at a given point in time, your A1c tracks your average blood sugar levels over the past 90 days. 

An elevated HgA1c is a sign of blood sugar and insulin sensitivity issues.

For reference, if your HgA1c is above 5.6%, you already have an increased risk of diabetes. Values of 6.5% or higher are consistent with diabetes.

An alternative approach to measuring your HgA1c is the use of a continuous glucose monitor, such as the one from Levels Health that I’ve been using for the past year.

As the name implies, a CGM continuously monitors your blood sugar levels. In combination with a mobile app, the device helps you easily correlate spikes in blood sugar with the food you’ve eaten. More importantly, you can visualize how long your blood sugar stays elevated after a meal. 

For example, I’ve noticed that consuming fruits or raw honey causes a rapid spike in blood sugar that recovers quickly, and that I don’t think negatively impact your metabolic health. 

On the other hand, if I consume refined grains, I see multiple spikes over the course of several hours, thus taxing my pancreas more than necessary. 


Fasting insulin levels are an excellent indicator of your insulin sensitivity.
Fasting insulin levels are an excellent indicator of your insulin sensitivity.

Your fasting insulin levels are perhaps even more important than your blood sugar markers, because they give you an indication of how sensitive your cells are to insulin. 

In the morning (while in a fasted state) your insulin levels should be below 16 ulU/mL, and ideally below 3 ulU/mL. 

I didn’t start testing for insulin until 2020. Since then, my levels have consistently been below 3 ulU/mL.

Vitamin D

Low levels of vitamin D is a major risk factor for several metabolic issues, including cardiovascular disease and cancer. Since Vitamin D is also important for absorbing calcium, low levels can cause bone density issues.

Additionally, studies have shown an association of low vitamin D levels and severe COVID outcomes

Besides using a high-quality supplement, regular sun exposure before noon without sunscreen is the best solution to improve your levels. During the warmer months of the year, I expose my entire upper body to the sun for 15-20 minutes on a daily basis. Additionally, I supplement with a product from Designs for Health that my doctor prescribes — especially in winter when the sun is less strong here in Georgia.

Blood Lipids

Despite popular belief, cholesterol and LDL are poor indicators of cardiovascular health.
Contrary to popular belief, cholesterol and LDL are poor indicators of cardiovascular health.

The two blood lipid markers I pay close attention to are my high-density lipoprotein (HDL) and my triglycerides. I largely ignore total cholesterol and low-density lipoprotein (LDL) because they’re meaningless for someone who is already metabolically healthy, like I am.

But even for someone who isn’t metabolically healthy, I don’t think total cholesterol and LDL should be too much of a concern because they’ve been shown to be poor indicators of cardiovascular health. You can learn more about that in this article on the dangers of polyunsaturated fats.

As a rule of thumb, you want your HDL to be as high as possible and your triglycerides to be as low as possible. 

My HDL usually hovers between 45 and 55 mg/dL and my triglycerides between 50 and 80 mg/dL, depending on how many carbs I eat.

A huge gap between HDL and triglycerides (with low HDL and high triglycerides) is usually an indication of metabolic issues. The best way to fix that is by removing industrial seed and vegetable oils, as well as highly-processed carbs from your diet.

Thyroid Hormones

Considering that the thyroid’s job is to control your metabolism, it shouldn’t come as a surprise that out-of-range thyroid hormone levels are a potential indicator of metabolic dysfunction. 

Note that being on a very low carb or ketogenic diet — which is considered healthy by many people — can also negatively impact your thyroid function.

I experienced that first-hand after having been on a strict keto diet for over two years. As soon as I re-introduced clean carbohydrates from raw honey and seasonal fruits, my thyroid levels normalized.

Sex Hormones

Over the past 100 years, testosterone levels in men (but also women) have been on the decline. While it’s normal to see minor declines of certain sex hormones as you age, the drops we’re seeing across the population are anything but normal. 

Very often, the decline in testosterone goes hand-in-hand with a species-inappropriate diet consisting of processed carbs and seed oils, as well as metabolic conditions such as obesity.

As a result, if you suffer from low testosterone levels, chances are there’s something wrong with your metabolism. 

Note that when I say “low,” I don’t mean levels below the “normal” range. I’m referring to levels that are in the lower half of the “normal” range. That’s because the “normal” range merely reflects an average across the entire population. As the population’s levels go down, so does the normal range. In other words, if you’re in the lower half, your levels are already too low.

Calcium Score Scan

Based on my recent calcium score scan, I have zero arterial deposits.
Based on my recent calcium score scan, I have zero arterial deposits.

A calcium score scan, also known as a heart scan or coronary calcium scan, is a test (similar to a CT scan) that identifies calcium deposits inside of your blood vessels.

It’s one of the best ways to determine the health of your blood vessels and your risks of developing atherosclerosis — a disease that has long been associated with the consumption of saturated fats and cholesterol. 

I recently had a calcium score test done and it came back with a perfect score of zero, confirming what many studies have demonstrated as well: saturated fat and cholesterol don’t clog arteries (I consume a fair amount of both every day).

If your score is greater than zero, it means you already have calcium deposits due to your dietary lifestyle. That’s a good indicator of metabolic dysfunction and reason enough to make some changes.

8. Dental Health

The Real Reason Why You Have BAD TEETH (With Dr. Alvin Danenberg)
Did you know that keeping your teeth and gums healthy has little to do with how often (or how well) you brush, floss and rinse with mouthwash?

A few years ago, I heard about a study that correlated bad dental health with an increased risk of developing cardiovascular disease.

As you can imagine, the dental industry jumped on those findings, arguing that you should brush your teeth more often to decrease your risk of developing heart disease.

In reality, bad dental health is likely only a symptom of underlying metabolic issues, nutritional deficiencies and systemic inflammation. In other words, improving your metabolism and reducing inflammation will lead to better dental health (not the other way around).

Anecdotally, I can tell you that I’ve had issues with cavities all of my life, despite brushing my teeth and flossing after every meal. It wasn’t until I changed my dietary lifestyle and fixed my metabolism that I stopped getting cavities. Additionally, the inflammation in my gums has dramatically improved (as measured by a gum score). 

Every time I get my teeth cleaned by my dentist, the technician measures my gum score by poking my gums with a pick to see how much bleeding there is on a scale from 1 to 4 (1 being the best). I used to get a lot of 3s and even some 4s, but over the past two years, I’ve been consistently in the 1s and 2s.

A few months ago, my dentist asked me what I’m doing because he’s never seen scores that good. I told him that I changed my diet, but he was in disbelief.

The point is that if you suffer from bad dental health, it’s likely not because you’re doing a bad job brushing your teeth. It’s more likely due to nutritional deficiencies (i.e., a lack of vitamin K2) and inflammation caused by your diet. That’s why bad dental health is a good indicator of metabolic dysfunction.

9. Chronic Pain

Rheumatoid arthritis is an inflammatory disease caused by lifestyle choices.
Rheumatoid arthritis is an inflammatory disease caused by lifestyle choices.

Chronic pain is a fairly obvious sign that something is wrong. I’m not referring to muscle pain due to an injury or accident, but to pain that doesn’t have an obvious root cause. Great examples are headaches, and especially migraines. 

While tension headaches can be triggered by stress (see below), they’re often indicators of metabolic issues caused by the wrong dietary choices. Certain chemicals in food, such as the antinutrients found in many plants and the histamines found in aged foods, can cause headaches — a signal from your body to avoid those substances.

Joint pain is also a common response to the accumulation of oxalates (one type of antinutrients) found in such foods as leafy greens like kale and spinach. 

Pain is an inflammatory response and while short-term inflammation is important for healing, chronic inflammation is the leading risk factor of metabolic diseases. As a result, if you suffer from chronic pain that’s not caused by an injury or accident, chances are your metabolism isn’t functioning optimally and you might be at an increased risk of developing a preventable disease.

Related: Learn how to use low-level laser therapy to treat chronic joint pain (including arthritis).

10. Stress

I leverage meditation and other techniques to better manage stress.
I leverage meditation and other techniques to better manage stress.

As I discussed in my article about the best stress-relief gadgets, stress is a major contributor to weakening your immune system and causing inflammation

Stress can also create hormonal imbalances because it triggers the release of cortisol and other chemicals that, if chronically high, can negatively impact how your metabolism operates. 

Recent studies have shown that chronic tissue inflammation can lead to metabolic disease and insulin resistance.

The important message here is that if you suffer from chronic stress due to your lifestyle, you’re at risk of having a weakened immune system and metabolic dysfunction.

11. Sleep

I’m very protective of my sleep and track the quality of my sleep every night.
I’m very protective of my sleep and track the quality of my sleep every night.

Sleep is the foundation of a healthy lifestyle. You can’t be healthy if you don’t sleep well. Your body needs enough quality sleep to run through certain recovery and maintenance programs; if you cut your sleep short, or if the quality of your sleep isn’t where it should be, you prevent your body and mind from managing the stressors of the day. 

I’ve written about the importance of sleep and how I track how much time I spend in the restorative phases of sleep in separate articles, and I highly recommend you check them out. 

But in a nutshell, if your bed and wake times are inconsistent, if you have trouble falling or staying asleep, if you don’t spend approximately 40% of your sleep in restorative phases (deep and REM sleep), or if you wake up frequently or feel exhausted every morning (despite sleeping more than 7-8 hours), chances are that your body isn’t functioning optimally and that you’re at a higher risk of developing a metabolic disease.

12. Menstrual Cycle

If you’re a person who menstruates, your cycle should be relatively consistent. The average mensural cycle is 28 days (source). If your cycle is significantly shorter or longer, if you frequently miss periods, if your menstrual flow often changes in volume (e.g., becomes much lighter or heavier) or if you bleed or spot in between periods, that could be an indication of an underlying issue.

If the cause of those issues isn’t hormonal contraceptives and if you’ve ruled out conditions such as uterine polyps or pelvic inflammatory disease (often caused by a bacterial infection), your lifestyle might be the reason why your menstrual cycle is off.

For example, stress, sudden changes in weight, or changes in exercise routine can temporarily impact your period.

Additionally, nutritional deficiencies and hormonal imbalances are often the reason why people have menstrual issues. For example, a study from 2018 discovered that those with low vitamin D levels are five times as likely to have menstrual issues.

Studies have also shown that people with polycyclic overly syndrome (PCOS) are often insulin resistant, suggesting a link between metabolic health and PCOS. The latter can also lead to menstrual issues.

As a result, menstrual problems can be another indicator of metabolic issues that you should take into consideration when assessing your health.

17 Checks to Assess Your Health

Indicates you’re healthy🛑 Indicates a potential health issue
You feel energetic all day.You experience significant ups and downs throughout the day.
You’re free of pain and discomfort.You suffer from frequent headaches, joint pain and similar ailments.
You can run up the stairs and lift furniture without major issues.You get winded quickly and don’t have the strength to lift anything heavier than a grocery bag.
Your skin is clear.You suffer from rashes, eczema or acne.
You can easily skip a meal without feeling hangry or dizzy.You need to snack in between meals to prevent your blood sugar from crashing.
You feel good in your stomach after meals.You get easily bloated, constipated or suffer from diarrhea after eating.
You barely get sick even when people around you are.You’re sick all the time.
Your triglycerides are well below 100.Your triglycerides are above 100.
Your good cholesterol (HDL) is above 40.Your good cholesterol (HDL) is below 40.
Your fasting insulin is below 3.Your fasting insulin is above 3.
Your CRP is below 3 (ideally below 1).Your CRP is above 3.
You have normal thyroid markers.Your thyroid markers are out of the normal range.
You have high testosterone levels.You have low or borderline low testosterone levels.
You wake up rested every morning.You wake up feeling tired and have an inconsistent sleep/wake time.
You’re good at managing stress.You’re always on edge and it’s hard for you to relax.
You barely get any new cavities.You get a new filling every time you visit the dentist.
You have a regular menstrual cycle.You have an irregular menstrual cycle.

If you want to assess your own health, the goal isn’t to achieve perfect scores (or better scores than someone else) for each of the factors I listed above. 

Some of these factors (such as stress) are highly individualized, making a comparison difficult. Others, such as blood markers, are relatively straightforward to assess.

Here’s What I Look for When I Assess My Personal Health

I Feel Good

I want to feel subjectively good on most days. I’m able to use how I feel as an indicator of my well-being because I’m fairly in-tune with my body and I already know how it feels when I’m at the top of my game. This technique might not work for you if you’re at the beginning of your wellness journey.

I’m Fit

As long as my fitness (or lack thereof) isn’t an obstacle in my daily life, I’m OK. In other words, I want to be able to sprint up stairs, lift up my kids and throw them in the air, and carry heavy grocery bags to the car. As long as I can do all of that, I’m OK.

I Have Clear Skin

I’m looking for clear skin without major irritation, rashes or eczema. 

Skipping a Meal Isn’t a Problem

I shouldn’t fall apart, or get dizzy or hangry when I skip a meal or fast for 20 hours. Instead, my body should switch to using fat instead of glucose as its primary source of fuel.

I Have No Digestive Issues

I want to feel great in my gut without pain, pressure or bloating, and my stools should be normal. In other words, I don’t want to have diarrhea or constipation.

I Don’t Get Sick Often

I judge the function of my immune system by how often I get sick. In the last three years, I’ve only gotten sick twice — once with COVID-19 and once with a common head cold. Believe it or not, the head cold felt worse than COVID.

My Inflammatory and Metabolic Markers Are Good

I get my blood drawn every three months to ensure my inflammatory and metabolic markers are where they should be. I pay the most attention to my CRP and fasting insulin. If they’re at their usual low levels, I know that I’m doing everything right.

I Don’t Get New Cavities

As long as I don’t get any new cavities and my gum scores stay low, I’m in good shape in terms of dental health.

I Don’t Have Pain

As long as I’m free of pain, except for the occasional CrossFit-induced injury, I know that I’m also free of inflammation.

I’m Able to Manage Stress

Without stressing out about it (pun intended), I aim to manage stress as well as I can by removing “stuff” from my life, prioritizing being present and implementing counter-measures, such as the ones I outlined in this article. Every evening, I assess how stressed I felt during the day; based on that, I adjust my agenda for the next day. 

I Sleep Well

I aim to fall asleep and wake up refreshed (without an alarm) at roughly the same time every morning. If I do that and spend ~40% of my sleep in restorative phases, I’m good.

13 Tips to Get Healthy and Stay Healthy

Living a healthy lifestyle is a family affair in the Kummer tribe.
Living a healthy lifestyle is a family affair in the Kummer tribe.

If you’ve come to the conclusion that you might not be as metabolically healthy as you thought, don’t freak out. If you do, your stress reaction is just adding fuel to the fire.

Plus, getting metabolically healthy isn’t as complicated as you might think. In fact, the steps involved to get healthy are fairly simple — but it does take some determination and planning to execute them. 

  1. Avoid seed/vegetable oils.
  2. Avoid processed carbs.
  3. Center your diet around responsibly-farmed meat (and especially organ meat).
  4. Walk and lift heavy objects every day.
  5. Expose yourself to the sun every day.
  6. Regularly use a sauna or cold plunge.
  7. Maintain a consistent sleep and wake time.
  8. Practice mindfulness and be present more often.
  9. Avoid plastic food storage containers.
  10. Filter your drinking water.
  11. Wear a continuous glucose monitor for a few weeks.
  12. Regularly check your blood work (CRP, insulin, triglycerides, etc.).
  13. Don’t get overwhelmed, and take it step by step.

You can find the details on my strategy in an article I titled “How to Live a Healthy Lifestyle,” but in a nutshell, here’s what I recommend if you’re metabolically unhealthy:

Avoid Seed/Vegetable Oils and Processed Carbs

Immediately remove all seed and vegetable oils, as well as processed foods, from your diet. Both of these cause inflammation and metabolic dysfunction.

Center Your Diet Around Responsibly-Farmed Meat

Increase your intake of responsibly-raised meats and organ meats and limit your consumption of the most toxic plants. Organs are the best source of vitamins and minerals for humans, but if you don’t like how they taste, consider freeze-dried organ meat supplements, such as the ones I sell at MK Supplements. On the flip side, most plants have chemical defense mechanisms that can contribute to metabolic dysfunction and related health issues.

Walk and Lift Heavy Objects Every Day

Move every day, either by going for long walks or going to the gym. Lift heavy objects several times a week if you can. These movement patterns reflect how humans have moved and “exercised” for millions of years, and they help you retain lean muscle tissue and strong bones (as well as cardiovascular health).

Expose Yourself to the Sun Every Day

Expose your naked skin to the sun every day without wearing sunscreen. Sun exposure is incredibly important for your body to produce certain hormones (including vitamin D) and to maintain a proper circadian rhythm.

Regularly Use a Sauna or Cold Plunge

Expose yourself to heat (sauna, sun) and cold (shower or a cold plunge) every day. These natural stressors boost your immune system and help your body become more resilient.

Learn more about the benefits of sauna use and the benefits of ice bathing/cold plunging.

Maintain a Consistent Sleep And Wake Time

Try to go to bed and wake up at roughly the same time every day. That’s the best way to support your circadian rhythm and improve the quality of your sleep.

Practice Mindfulness

If you feel stressed, try to remove stuff from your plate and add stress-mitigating techniques, such as breathing, regular exercise or meditation. Chronic stress causes an imbalance in certain hormones (e.g., cortisol) and inflammation. It also negatively impacts your immune system.

Avoid Plastic Food Storage Containers and Filter Your Drinking Water

Remove as many toxins from your immediate environment as possible, as outlined in this article. Many common household toxins found in plastic and tap water can disrupt your endocrine system and fat metabolism.

We use a whole-house water filtration system to ensure that we have clear drinking water throughout our home. The system we purchased lasts for about 10 years and averages out to around $30 per month, which isn’t bad if you’re used to paying for bottled water. You can learn more about the benefits, installation and required maintenance (almost none) in my Radiant Life purification system review.

Wear a Continuous Glucose Monitor

I recommend wearing a continuous glucose monitor for a couple of weeks to get an idea of how your current diet impacts your blood sugar levels. While the goal isn’t to avoid blood sugar spikes at any cost, I think it’s prudent to avoid foods that cause your blood sugar to remain elevated for hours. 

Regularly Check Your Blood Work

Check your blood work every couple of months to see if you’re making progress. Certain blood markers (like the ones I noted above) are a great indicator of your overall health and well-being.

If you decide to sign up with Levels Health and experiment with continuous glucose monitoring, you can order your lab work directly through the app for $199 per blood draw.

The service includes most of the metabolic markers I’ve mentioned in this article, and you can do it from the comfort of your home. In other words, they’ll send a phlebotomist to your home to draw your blood and you’ll have the results within a day or two.

Don’t Get Overwhelmed

Understand that living healthy is a journey that doesn’t happen overnight for most people. There is no quick fix or shortcut. Instead, making the right choices that are conducive to your health is a lifestyle that you will have to carry on for the rest of your life. So find improvements that work for you and that you can carry forward. It’s taken me several years to get where I am and I’m still making regular adjustments as I move forward.

Now that you have guidelines on how to judge (and improve) your metabolic health, let’s address some of the misconceptions around health.

Top Misconceptions About Health

While I appeared to be healthy in my early twenties, neither my immune system nor my metabolism were working optimally.
While I appeared to be healthy in my early 20s, neither my immune system nor my metabolism were working optimally.

Misconception #1: You Can Tell How Healthy Someone Is by Their Appearance

As we discussed above, physical appearance isn’t always a good indicator of health. Of course, excess body weight and fat are good indicators of metabolic dysfunction, but the lack thereof doesn’t guarantee good health. I know several skinny people among my circle of friends and family who aren’t metabolically healthy.

Misconception #2: Plant-Based Diets Are Healthy

I firmly believe that a species-appropriate diet for humans is centered around animal meat and organs, paired with a few of the least-toxic plants. As I discussed in my article comparing plants vs. meat, most plants don’t want to be eaten and thus deploy defense chemicals (i.e., antinutrients) to deter humans and animals from eating them.

If your diet predominantly consists of plants, you’re consuming more of those defense chemicals than your body can handle. Plus, you’re likely not getting enough micronutrients (vitamins and minerals) because some of them you can’t find in plants (such as vitamin B12) or they only exist in poorly absorbed variations (e.g., non-heme iron instead of heme iron or beta-carotene instead of retinol).

The combination of poor micronutrient availability and defense chemicals make most plants a less-than-ideal (i.e., unhealthy) source of food for humans.

Misconception #3: If You Work Out Every Day, It Doesn’t Matter What You Eat

I strongly believe that you can’t out-exercise a bad diet. I experienced that first-hand when I was a professional 100-meter sprinter in my youth and ate whatever I wanted. Not appreciating what impact good nutrition has on my body, I performed below my capabilities and got sick and injured a lot. Only after changing my dietary habits did my physical and mental performance dramatically improve, and did I stop getting sick and injured all the time.

There are countless other examples out there of supposedly “fit and healthy” individuals who suddenly fall ill or even die of diseases that a healthy metabolism and immune system can easily fight off

That’s why I believe physical activity alone won’t save your butt if you don’t also take care of your sleep, diet, tribe and environmental toxins. You can learn more about that in my article about the pillars that make up a healthy lifestyle.

Misconception #4: Deteriorating Health Is a Normal Part of Aging

I used to believe that getting sick and frail are normal signs of aging (for example, breaking your hip when you fall down the stairs at an advanced age is just how it works). I no longer believe that to be the case.

In fact, I strongly believe that if you live a lifestyle that’s consistent with how humans have evolved over millions of years, there is no reason why someone in their 80s shouldn’t be able to do most, if not all, of the things I can do right now in my 40s.

In other words, I believe that a deteriorating health is a sign of an inappropriate lifestyle rather than a normal part of aging. You can learn more about all the steps that I’ve taken to slow down aging in this article.

Misconception #5: Detoxing (Cleansing) Helps Me Stay Healthy

Many people believe that doing a juice cleanse or a detox protocol once a year is going to help them stay healthy. Unfortunately, that’s not the case.

Your body, and in particular your liver and kidneys, work to remove waste from your body 24/7. There isn’t anything you need to do other than not being in their way. Drinking plant-based juices, coffee and alcohol only increases your toxic load and makes it harder for your organs to do their job.

However, there is such a thing as a gut reset. For example, if you’re suffering from chronic GI issues due to an imbalance in your gut microbiome (too many “bad” and not enough “good” bacteria), consuming a strict carnivore diet for 30 days can help reset your gut by removing the foods (usually carbohydrates from plant-based sources) that your bad bacteria thrived on.

It’s also worth noting that certain fat-soluble toxins, such as endocrine-disrupting chemicals from plastics, can stay in your adipose (fat) tissue for months. As a result, it might take quite a while for your body to rid itself of these toxins as you’re losing weight as the result of your lifestyle changes

You might even experience significant side effects from these chemicals as they leave your fat tissue and enter your bloodstream, before your liver and kidneys can remove them. That’s called a Jarisch–Herxheimer reaction.

The bottom line is that short-term diets and cleanses are usually not long-term fixes. Assuming a healthy lifestyle that you can sustain for the rest of your life is.

Misconception #6: Mental Health and Physical Health Are Two Separate Things

While certain traumatic events can surely impact one’s mental health, regardless of your physical health, there are many mental health problems that are directly related to lifestyle choices.

For example, Alzheimer’s is known as Type 3 diabetes (or diabetes of the brain) because it’s caused by a dysfunctional glucose metabolism in the brain. Specifically, the brains of people with Alzheimer’s appear to be insulin resistant — the same issue that leads to Type 2 diabetes. 

Guess what causes insulin resistance? 

The consumption of industrial seed oils and highly-processed carbohydrates. 

Much like our dietary lifestyle is the major contributing factor to increasing our risk of developing Alzheimer’s, other lifestyle choices (e.g., poor stress management) are closely related to anxiety, ADHD and other mental illnesses. 

As a result, I believe there’s a strong connection between physical and mental health — one which most of us, including health care professionals on all sides of the spectrum, tend to ignore.

Misconception #7: The Body Mass Index (BMI) is a Good Indicator of a Healthy Weight

Despite having a BMI of 28.5, I wouldn't consider myself to be overweight.
Despite having a BMI of 28.5, I wouldn’t consider myself to be overweight.

The BMI is supposed to measure body fat based on the height and weight of an adult person. The higher the BMI, the more body fat someone has, indicating an unhealthy weight. Unfortunately, the BMI is highly flawed because it doesn’t take lean muscle mass into account.

For example, I’m 6 feet tall (182 cm) and weigh approximately 210 pounds (95 kg). These figures mean I have a BMI of 28.5, putting me square into the overweight category.

Misconception #8: Everything in Moderation is the Key to a Balanced Diet

I’m not a fan of the “everything in moderation” strategy because I don’t think including unhealthy foods in your diet is a good idea for the same reason I don’t make a little bit of tobacco part of my lifestyle: there’s no benefit of doing so in the long run, and the potential damage is huge.

That doesn’t mean I never consume any unhealthy foods.

Everything in moderation is good advice if your goal is Moderately Good Health.

Ken D Berry, MD

For example, the night before drafting these lines, I enjoyed some of my mom’s homemade Christmas cookies that just arrived in the mail from Austria. But that doesn’t mean I consume cookies made from grains (flour) and processed sugar as a part of my everyday life.

I occasionally make exceptions that I know my body can handle because I treat it well most of the time. In other words, I make healthy choices based on nutritious foods the rest of the time.

Wrap-Up: What it Means to be Healthy

When my mom or grandma send their homemade Christmas cookies from Austria, we eat them without hesitation.

Being healthy means different things to different people. But my hope with this article is to give you the right tools to better judge your metabolic health so that you can make lifestyle changes that dramatically increase your chances of living a truly healthy life free of illness.

Ultimately, your well-being is the result of healthy habits (that are consistent with human evolution), including healthy eating, stress management, appropriate sleep patterns, spending time with your loved ones and avoiding environmental toxins.

If you take care of these areas of your life, you’ll likely extend your life expectancy, improve your quality of life and avoid many of the chronic health conditions that so many Americans suffer from.

Now I’d like to hear from you! What are your health goals and what are you doing to make them stick in the long run?

Medical Disclaimer

The information shared on this blog is for educational purposes only, is not a substitute for the advice of medical doctors or registered dieticians (which we are not) and should not be used to prevent, diagnose, or treat any condition. Consult with a physician before starting a fitness regimen, adding supplements to your diet, or making other changes that may affect your medications, treatment plan or overall health. MichaelKummer.com and its owner MK Media Group, LLC are not liable for how you use and implement the information shared here, which is based on the opinions of the authors formed after engaging in personal use and research. We recommend products, services, or programs and are sometimes compensated for doing so as affiliates. Please read our Terms and Conditions for further information, including our privacy policy.

7 thoughts on “What It Means to Be Metabolically Healthy”

  1. You mentioned that keto diet for two years caused you having thyroid problems.
    I understand that you became hypothyroid.
    My questions are:
    Did you have a baseline thyroid function test before the said diet?
    Did you run a full thyroid panel test after your 2 years of keto diet?
    What symptoms did you have that prompted you to run the thyroid test? Did you feel that something was really off which you attributed to the diet?

    • Hi Marlena,

      to be fair, my statement in the blog is observational evidence and I can’t say for sure that keto caused lower thyroid function. But I get comprehensive blood panels every 3-6 months to understand how my lifestyle impacts certain blood markers and I noticed an increase in thyroid function after switching from keto to an animal-based diet.


  2. This was one of the best summaries of how to measure one’s health I have ever read. One question for you, Michael. Will a scoop of this multi-collagen powder break my fast in the morning? (The article mentions that some amino acids can do this.)


    Rochester, MN

  3. Wow, that’s a lot of information to take in! I’m a 58 year old post menopausal woman who is quite overweight! I’m exhausted most of the time and have pain in all my joints. I am going to follow, read more and learn more. Thank you.


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