We have a fundamental problem with how our bodies make energy from food – so says Stanford-trained physician, Dr Casey Means, whose recent book Good Energy explores the link between metabolism and disease. This problem with our metabolic health – something Dr Means calls “metabolic dysfunction” – is impacting our wider wellbeing and can be linked to “almost any health condition, ranging from acne to irritable bowel syndrome, depression to migraines, cancer to Alzheimer’s and dementia, obesity to type 2 diabetes and bad menopausal symptoms.” It is time, she says, that we took note of it.
Calling the lack of education around this tenet of our health “the biggest blind spot in the Western conventional healthcare system”, Dr Means explains that metabolism underlies every aspect of what it is to be human – fundamentally, it’s how our bodies power themselves. We’re made of a cool 40 trillion cells and each one of them needs energy to do its job – everything we do, say, think or feel, subconsciously and consciously, is a result of the chemical reactions that happen within our cells every single second of the day. The problem is that our cells are “underpowered”, more on why later, which means that they don’t function as they should. That’s when things can go wrong.
“When a blood vessel lining cell is underpowered, that might create high blood pressure or blockages that can lead to a stroke or a heart attack, while in an ovarian theca cell, it might lead to polycystic ovarian syndrome. In an immune system cell, it can create autoimmune diseases [examples of which include multiple sclerosis, psoriasis, rheumatoid arthritis and lupus],” explains Dr Means. When the cells don’t get what they need to work properly, they become distressed and subsequently recruit the immune system, which goes into defence mode. That defence mode results in widespread inflammation. Cue potential illness.
So while it’s buzzwords like “longevity” and “biohacking” that have permeated the wellness world in recent years, actually tackling the root cause of illness, like autoimmune diseases – which recent studies suggest are rising – could help us transform our collective health, while easing pressure on strained healthcare systems.
What’s causing poor metabolic health?
“It’s rooted in how our environment and the changes in the world across food, movement, sleep, stress and toxins are crushing the body’s core metabolic machinery,” she says. “There is a profound environmental mismatch between what our cells need and expect to function properly, and what the current realities of the modern world are giving them.”
As an example, two thirds of our calories now come from ultra-processed and industrially manufactured foods that are nutrient depleted, while we’re sleeping about 25 per cent less on average than we were 100 years ago. We’re more isolated than ever, with nearly one in four of us reporting feeling lonely on a daily basis. And sedentary lifestyles are the norm in the Western world – most of us are sitting for about 80 per cent of the day. “There’s also more than 80,000 synthetic toxins and chemicals that have entered our food, water, air, personal and home care products, furniture and electronics over the past 100 years, many of which are direct metabolic disruptors,” says Dr Means. “And the average American gets 19 prescription medications per year – the cumulative impact of taking that like it’s candy is having a profound impact on our metabolic health.”
She also notes that our relationship with light – seeing very little sunlight during the day and lots of blue light from our devices at night – has disrupted our circadian rhythms, which define our metabolic pathways during the day and night, subsequently confusing our bodies. And finally, there is our relationship to temperature: beneficial metabolic activity is stimulated by swings in temperature, but most of us end up spending our time in rooms that are always the same temperature, care of central heating. “These are the things that the bodies of today are dealing with – 50 years ago they just weren’t,” says Dr Means.
Phew. There’s no doubt that it’s an exhaustive list of lifestyle circumstances that can – if you let them – feel overwhelming. Sadly, many of us will be suffering from some form of metabolic dysfunction, but when I point out how terrifying this is, Dr Means is nothing but positive. “It’s actually very optimistic news, because if we can understand that there is a central underlying factor that’s leading to most of the health problems we’re dealing with, it gives us an area to focus our efforts on,” she explains. “Part of what makes people feel overwhelmed in their health and wellness journey is it feels like there are infinite things to do, but understanding and working with our metabolism will give us the best results.”
How to improve your metabolic health
The first step, according to Dr Means, is to really get to know the basics of your health by asking your doctor for a blood test to measure a basic set of biomarkers. Some of the key things to know are your fasting glucose, haemoglobin, triglyceride levels, total cholesterol to HDL ratio and blood pressure, as well as your waist circumference, which you can do at home (look for under 88cm for women or under 102cm for men). “These are all fundamental metrics of health, and they’re not expensive to do either. I recommend testing every quarter.”
Once you have them, you can track and watch how they improve based on simple lifestyle habits you make, which can pay dividends in as little as a month. “If you track them over time, and they’re moving in the right direction, then you know you’re doing the right things for your health.”
Most of us are already aware that food is fuel, but it’s also worth remembering that it’s what our cells need to rebuild, regenerate and do their jobs well. “Eliminate ultra-processed foods from your kitchen – that means processed white flour, added sugars, industrial seed oils… anything that’s made in a factory and subsequently does nothing to support our health,” she says. “Then, it’s about incorporating the five elements of metabolically healthy meals into every meal, something I discuss in the book.” These include fibre, probiotics, omega fats, antioxidants and healthy protein. If you can commit to six weeks of forgoing UPF in favour of these foods, she says you’ll feel “drastically different”.
Sleep is of paramount importance to our cellular health because it’s at night when our bodies clear out metabolic waste and fix all of the damage that occurs during the day. When we don’t get enough sleep, these regenerative processes don’t happen as well, so we face poor health that can get worse over time. Prioritise sleep, making sure you dim the lights in your home a couple of hours before bedtime to signal to your body that it’s time for rest. Likewise, try and ensure you get enough light within the first 30 minutes of waking up to improve sleep later on – during the winter months, a SAD lamp can help replicate sunlight.
Our emotional health matters much more than we think, which is why it’s crucial that we find ways to nurture our mind and soul, as much as our bodies. Much of this starts with community and finding people to spend time with, in whatever capacity that may take. Feeling isolated “generates inflammation and can also directly hurt our mitochondria, the energy hub of the cell that’s responsible for metabolic processes”, says Dr Means. With our phones constantly in our hands, news apps firing on all cylinders (especially recently), we sometimes think we’re more connected than we are – actually, it pays to see people in real life. Your cells will thank you.
Our ability to connect with ourselves and understand – and listen to – our bodies implicitly is something Dr Means is really passionate about. She wants us to slow down and spend time connecting with the body and what it’s trying to tell us. “Reflect on the miraculousness of life, the fact that we’re here and living,” she says. “Female bodies tie in with other natural cycles, including tides, the moon and seasons, so start your health journey from a place of awe and appreciation. It helps empower us to make decisions about our health.”
While this might sound a little woo-woo to some, fundamentally it’s key to understand that any symptoms you’re experiencing are a conversation the body is trying to have with us about its needs not being met in some way. While many of us automatically try and squash our symptoms with medication or other habits, Dr Means says it’s about considering what can be done to meet the body’s needs. “Run through a simple checklist: how has my food been? What’s my sleep been like? Have I been getting enough light? How are my emotions? And so on.”
