What is cardiometabolic health?

What does your heart have to do with your kidneys or liver?

More than you might think.

Cardiometabolic health has become a key focus as researchers continue to discover how closely metabolism is linked to heart health and other conditions that affect the whole body.

Metabolism is your body’s way of converting food into energy. When your metabolic system isn’t working as well as it could, your chances go up for developing heart conditions, type 2 diabetes, kidney disease and non-alcoholic fatty liver condition. 

But the good news is that by improving your cardiometabolic health, you can reduce your risks for the other conditions as well.

"What's good for your heart is good for your head," says Kristin Linzmeyer, MD, a PeaceHealth cardiologist in Springfield, Oregon. “Making lifestyle changes to improve your heart health usually will improve other organ systems in your body as well.”

Metabolic risk factors

The American Heart Association notes the following metabolic-related conditions that are risk factors for many chronic conditions:

1. High blood glucose (sugar). High blood sugar causes damage to blood vessels, organs and nerve cells. Consistently high blood sugar is diagnosed as diabetes or prediabetes. For most adults before meals, the suggested target blood glucose range is 80 to 130 milligrams per deciliter (mg/dL). At 1 to 2 hours after meals, it should be lower than 180 mg/dL.
2. High blood pressure. High blood pressure puts strain on and can damage blood vessels and the heart. Consistently high blood pressure is diagnosed as the condition called hypertension. The ideal level is 120/80 millimeters of mercury (mm/Hg).
3. Imbalanced cholesterol levels in the blood. Your levels of low-density lipoprotein (LDL) and high-density lipoprotein (HDL) affect your risk. LDL is the “bad” kind that leads to blocked blood vessels. HDL is the “good” kind that can help prevent blockages. Consistently high cholesterol is called hyperlipidemia. LDL should be under 100 mg/dL and HDL should be 60 mg/dL or more.  Watch a video that explains cholesterol.
4. High levels of triglycerides in the blood. Triglycerides are a type of fat in the blood. At the right level, they’re good for energy. Too high, triglycerides can negatively affect the function of the pancreas and liver. They can also contribute to a buildup of plaque (a sticky fatty substance) inside blood vessels. The optimal reading for these is less than 150 mg/dL.
5. Large waist circumference. This measure may indicate excess fat around internal organs. This can make it difficult for organs to work well. A waist circumference of more than 35 inches in women and more than 40 inches in men is associated with an increased risk of heart disease and diabetes. Especially for women, increased weight around the middle (as opposed to the hips), increases their risk for cardiovascular events. Dr. Linzmeyer says, “I tell my patients it's healthier to be pear-shaped than apple-shaped."

Read what mg/dL means.

Measuring metabolic progress

“Objectively measuring these key signs of health can be game-changing. It’s a powerful way to help you track success and hopefully prevent conditions from getting worse,” says Dr. Linzmeyer.

With two metrics, you can see right away how your levels can change based on what you do. A home blood pressure device lets you see how your blood pressure goes up and down throughout the day. That can help you understand what you can do to keep it lower. And blood glucose test strips or a wearable monitor can show near real-time effects on your blood sugar from the foods you eat or exercise you do.

It can be harder to see the effect of day-to-day choices on the other three measures.

Weight is not gained overnight and likewise will not be lost overnight. It takes time and work to develop healthy habits and lose unhealthy ones, Dr. Linzmeyer notes. You can gauge your progress on waist circumference with a tape measure.

And while at-home cholesterol tests are available, they can be expensive. Testing too frequently might make you feel frustrated if you don’t see much change in your levels after following healthier practices.

“I usually do not recommend rechecking lipids more frequently than every 3-6 months for this reason,” she says.

Action planning

If your readings or test results in any of the metabolic risk factors are high or low, you can work with your healthcare team to create an action plan to bring those areas into the recommended ranges. (This wellness action plan worksheet can help you get started.)

Depending on your condition(s), your provider might recommend medications to help control blood sugar, blood pressure and blood cholesterol. You might also explore weight loss options with your care team if they suggest you lose several pounds.

But medications aren’t usually the whole solution. There are many important — and easy — steps you can try every day to help manage your metabolic health.

Here are the basics and how each can make a difference:

1. Movement helps even out blood sugar levels. 
Based on the latest research, physical activity is one of the best things you can do for overall health. 

Talk to your doctor or physical therapist about adopting some of these:

• Go for a 5-minute walk after each meal. The timing is intentional as it helps level off blood sugar. And walking is a great low-impact, weight-bearing exercise that supports bone health. Read the study findings.
• Get 20 minutes of moderate physical activity every day (or 150 minutes per week). Here is a rule of thumb on the intensity of exercise: light means you can easily have a conversation with someone while exercising; moderate means it's difficult to speak a full sentence or more while exercising; strenuous means you can only speak a few words during exercise. Here’s how to sneak movement into your daily routine.
• Lift weights a few times a week. If you don’t have equipment, use an old dictionary or a bag of flour instead. Exercise bands are another option to help you maintain muscle strength.
• Stretch daily. Warm up your muscles and joints to stay flexible and support balance. Here are moves that can help your back and spine.

2. A healthy diet can lower your cholesterol, blood sugar, blood pressure and weight.
Getting the right amount of the right fuel for your body has far-reaching effects on all aspects of how you feel. “Nutrition is the biggest thing I emphasize during my clinic visits for everything from hypertension to hyperlipidemia to diabetes to heart disease,” says Dr. Linzmeyer. “Fiber is arguably the biggest nutrient deficiency in the standard American diet and fiber is only found in plants. Plants have protein too!” 

Check with your provider or a dietitian to see how to make these tips work for you: 

• Eat nutrient-dense food.  Low-starch/high-fiber vegetables, lean proteins and healthy fats can fill you up. With practice, you can train your body to crave nutritious fare, which can make you feel less hungry. Learn more about quality “fuel” for your body.
• Limit daily sodium to 1500 milligrams. Salt can make your body hold onto fluid, which can raise your blood pressure.
• Cut added sugar. Sugar and simple carbs are “empty” calories. They don’t satisfy your body’s needs, and they can make you want to eat more. That leads to blood sugar spikes and weight gain. Consider these ideas for going “sugarless.”
• Stop eating a few hours before bedtime. This gives your system a break from processing food. It also helps to reset your hormone levels. See what fasting might do for you.

3. Well-managed stress can lower blood pressure.
Your thoughts and feelings can have a greater impact on your physical health than you might realize. “What I like to tell people is that each of these things is not in a silo. for example, when you are sleep deprived, it will affect your nutrition choices, exercise choices and stress management,” says Dr. Linzmeyer. 

Ask your healthcare professional or a counselor for guidance on these and other ways to manage stress:

• Make sleep a priority. Sleep can help you lose or maintain weight. It can also give you more mental and physical energy. Ask your doctor about treating conditions that disturb your rest such as sleep apnea, enlarged prostate or insomnia. These tips might help you get better sleep.
• Quit or avoid tobacco. Smoking decreases oxygen in the blood and causes damage to blood vessels. It increases blood pressure. See more reasons to quit smoking.
• Watch your alcohol intake. Alcohol can raise blood sugar. It can also increase your blood pressure and lead to other kinds of damage. Explore other drink options.
• Try daily journaling. Overwhelming feelings release stress hormones, which can lead to higher blood pressure and higher heart rates. Studies show that writing down your thoughts and feelings can help calm your thinking. It can also help you understand the situation better and see what you could do to change it.  Learn how gratitude can make a difference.

Using tried–and-true daily habits like these can help you achieve metabolic health goals.  See examples of SMART goals you might try.

“If you’re feeling stuck or want more direction, your healthcare team at PeaceHealth is here to help,” says Dr. Linzmeyer.