AS YOU MAY have noticed, the term metabolic health is all over social media, hyped by influencers, credentialed doctors, and crafty marketers who want to sell you the next book or tool that’s going to right-size your metabolic health and fix your whole life.
Your metabolism involves so much more than your weight, science now knows. It’s the engine that drives every chemical process that happens in our cells: movement, core temperature, the body’s ability to fight off disease, how fast aging happens.
Get your metabolism in order, the influencers say, and you’ll have more energy, increased focus, less stress, and a longer life overall. Plus, okay, you might even lose a pound or two (or 10, or more!). Surely all this can’t be true. Right?
Let’s hope it is true, because the most recent data available shows that more than 30 percent of American adults have metabolic syndrome—and its prevalence is rising. What’s more, a 2022 study in the Journal of the American College of Cardiology found that among 55,081 American adults, just 6.8 percent “had optimal cardiometabolic health.”
So the field is ready for disruption.
Enter the Metabolic Disruptors
PERHAPS NO ONE has done more to bring metabolic health into public conversation over the past year than the Stanford-educated brother-sister duo Calley Means and Casey Means, MD. The siblings coauthored that 2024 best seller Good Energy: The Surprising Connection Between Metabolism and Limitless Health.
“I think we have a crisis of chronic disease in the country, and it’s just demonstratively tied to metabolic health,” says Calley, a 39-year-old former consultant for food and pharma companies.
The Meanses each have their own health-care start-up. Calley cofounded Truemed in 2022. The company aims to help consumers use their HSA and FSA accounts to buy healthful food, gym memberships, and dietary supplements. Casey has Levels, a company she cofounded in 2019. Levels has pioneered the mainstream spread and adoption of tech that allows users to track their blood glucose with a proprietary app and a continuous glucose monitor (CGM).
Calley Means (left) and Casey Means, MD (right), with Joe Rogan.
Casey’s company, Levels, uses an app to track multiple factors in metabolic health, including A1c and triglycerides.
CGMs promise to revolutionize your metabolic health by meticulously tracking blood glucose. Last August, Stelo, from Dexcom, entered the chat as the first over-the-counter CGM in the U.S., followed closely by Abbott’s Lingo CGM. (Stelo is Levels-compatible.)
The Meanses are regulars on the podcast circuit, too: Casey on Andrew Huberman’s Huberman Lab last spring, Calley on Gary Brecka’s Ultimate Human in the fall, both on The Tucker Carlson Show and Joe Rogan’s podcast last year.
Combined, the siblings have more than a million followers on Instagram. Their messaging around metabolic health largely centers on making the unknown known: “We know less about what’s going on inside our bodies than we know about what’s going on inside our car,” says Calley. Sleep trackers, glucose monitors, at-home blood pressure cuffs—they all offer us valuable insights, he says.
Some critics fault the Meanses for buddying up to Robert F. Kennedy, Jr. The siblings do have a lot in common with some of the fringe elements of the MAHA (Make America Healthy Again) public health agenda. You’ll often hear them champion the supposed benefits of raw milk or lambaste seed oils for their dangers.
Yet the Meanses are broadcasting the benefits of metabolic health—something doctors and dietitians have been doing for decades.
The Dangers of Dysfunction
WHAT WE KNOW about our metabolism is well established. “Metabolism is basically everything that your body ever does,” says Matthew Rodeheffer, PhD, a metabolic researcher at the Yale School of Medicine. “Literally anything that your body does to convert one thing into another thing.”
For a doctor to diagnose you with metabolic syndrome, they’d need to be able to check at least three of five boxes. Weight is one of them, but in this case, doctors typically talk about the circumference of a person’s waistline, as extra abdominal fat puts someone at a higher risk of heart disease. High blood pressure is another, as is a blood glucose level that’s higher than average, which can lead to type 2 diabetes. Having an elevated level of triglycerides is the fourth box. Triglycerides are a type of fat found in the blood, and higher levels can raise your cardiovascular risk, a perfect segue into the fifth box: a low level of HDL, the good cholesterol.
How to address metabolic dysfunction can be challenging. We know the factors: a poor diet with lots of ultra-processed foods, a lack of exercise, poor sleep habits, smoking, excessive alcohol intake, and chronic stress. As a result, metabolic dysfunction tends to build over time. But there isn’t exactly one moment you wake up and know you have some sort of metabolic problem.
“Dysfunction is a continuum,” says Prasanna Santhanam, MD, an associate professor in the division of endocrinology, diabetes, and metabolism at the Johns Hopkins University School of Medicine. “When does this [metabolic] process get disrupted is the major question.”
And so it is within this continuum that the quest for metabolic health has become monetized and, as some critics say, politicized. “Health doesn’t happen in the doctor’s office,” Calley says. “Health happens when we have actual information to allow us to change our micro-decisions every day.”
Real Metabolic Management
PRIOR TO LEVELS’ ascension, if people wanted to monitor their metabolic health, they’d have to go to the doctor, who would conduct a clinical assessment, ordering blood tests for glucose, lipids, and organ function based on factors like age, and gauging metabolic syndrome risk. The doctor would look for red flags and review the clinical and lab tests with the patient. (For example, a fasting glucose level above 100 mg/dL, as Dr. Santhanam points out, is a sign that your blood glucose level is moving in a bad direction.)
Calley says that Levels puts the patient—rather than their doctor—in control of their data. “Anything that can give us insight into the leading indicators of our metabolic health is a good thing. It frankly lets us know what to optimize.”
It’s a message that sells. Levels reported $21 million in revenue in 2023 alone. But who actually needs a continuous glucose monitor and tracking app is still up for debate among health professionals.
Someone with type 2 diabetes absolutely needs one, but for someone who isn’t diabetic, CGM usage is more nuanced. Health zeitgeist heavyweights such as Peter Attia, MD, extol the benefits of CGMs for people who don’t have diabetes but are interested in optimizing their health and, specifically, in seeing how blood glucose levels fluctuate with different kinds of food, stress, sleep, and exercise.
Some nutritionists recommend doing an audit (like a digital food diary) with a CGM, so you can see exactly how what you eat and drink affects your blood glucose level. Yes, you probably know your blood glucose will spike if you drink a soda, but actually seeing that chart race up (and seeing how long it takes to decline) can be more motivating and empowering than just knowing the science.
However, Abby Langer, RD, a Men’s Health nutrition advisor, notes that CGMs can lead to obsessive tracking of blood glucose, which can distract people from basic, solid health habits. “Let’s stop majoring in the minors and focus on the basics: Protein, fat, and carbs at meals. Three-plus cups of vegetables a day. Lots of plants, lots of fiber. Activity. Sleep. Less stress. How many of us are achieving that?”
A temporary CGM can be the shot in the arm you need to adhere to your diet and exercise plan, but there are also plenty of no-tech ways to go about improving your metabolic health. As Langer says, eating whole foods can help balance out blood sugar.
Going outside instead of staying seated indoors all day helps with our stress level and blood pressure. Exercising regularly—anywhere from at least 75 minutes of vigorous aerobic activity per week to 150 minutes of moderate-intensity aerobic activity per week, or a combination of both—will improve our cholesterol and help us regulate our weight. It’s because this is what our bodies—and cells—have always thrived on.
That prescription is too boring for the podcast circuit, but it’s time- and research-tested: “As long as you are eating healthy, engaging in physical activities, avoiding smoking and alcohol, living healthy overall, and getting periodic checkups,” says Dr. Santhanam, it’s possible to prevent or reverse many metabolic health-related dysfunctions.
