Top 3 Blood Markers for optimal metabolic health and body composition

blood Test Metabolism

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By Rod Navajas

            The ability of the body to handle the food we eat is a massive determinant of overall health – this is called metabolism. If your metabolism is working fine, your body will adequately respond to the food you chew without causing an erratic response. On the other hand, a metabolic impairment will cause the body to process food inefficiently usually triggering a compensatory mechanism that will eventually lead to dysfunction. Whenever the metabolism is not working adequately, body composition gets affected.

       A snapshot of metabolic function through a blood test is a great way to gain more insight on this important piece of the human health puzzle. Some blood markers can be seen as a reflection of our current lifestyle habits and others can give great insight into the future, predicting health outcomes way before a full-blown dysfunction has set in. 

Here are some important markers to be aware of when assessing metabolic function:

Comprehensive Thyroid panel

      Thyroid gland problems are ubiquitous in the general population. Hypothyroidism is believed to affect 10% of the population, in which half of the cases are left undiagnosed (1). Hypothyroidism causes the metabolism to slow down, leading to a lower basal metabolic rate (the amount of energy required to sustain life at rest), ultimately causing weight gain (2). Conversely, hyperthyroidism causes a hypermetabolic state and an increase in the resting metabolic rate. 

      Generally, Thyroid Stimulating Hormone or TSH is the only marker measured when assessing the thyroid gland.   If an abnormal value is returned, your doctor may then request further investigation. The problem is that in some cases TSH may appear normal, but the other hormones in this cascade are not. For this reason, a more complete thyroid blood test panel which includes not only TSH has been recommended in order to fully assess thyroid function (3). 

What to test: TSH, Free T3 and Free T4, rT3 and anti-thyroid antibodies (Anti-TSHR, Anti-TPO and Anti-Tg) 

Fasting Insulin

      Most people have already heard about the hormone insulin. Insulin has an important role in the postprandial phase (post feeding) where the excess energy needs to be stored for later utilization. Once it has done its job, insulin should return to baseline levels. If insulin fails to return to the baseline levels and remains constantly elevated, it means that tissues are not sensitive to its actions as before. One of the main tissues to become resistant to the action of insulin is your muscle cells. As the muscles are not responding to insulin anymore, your liver needs to take out the slack and ends up producing more fat cells in a process called de novo lipogenesis which will further compromise insulin tissue sensitivity – see Fig 1 (4). 

      When elevated insulin blocks fat release from adipocytes – your fat storage cell. If it remains chronic elevated, the ability of the body to mobilize and utilize fat as a source of energy, gets compromise. Fortunately, this is a reversible situation. Exercise and physical training has a massive role in making muscles sensitive to the insulin action once again. 

Optimal level: Optimal fasting insulin level is below 5mU/mL. Anything above 10mU/mL indicate an insulin resistant state. 

Fig 1. Schematic of whole-body energy distribution after high-carbohydrate mixed meals in insulin-sensitive and insulin-resistant individuals.

Triglycerides/HDL ratio

The presence of high levels of triglycerides in blood, is a strong indicator of a faulty metabolism. Consuming an excessive amount of calories or carbohydrates, and having a low intake of protein, have been shown to cause elevation on triglycerides level (7).  HDL is known as the “good cholesterol”. The HDL particles induce the removal of cholesterol from cells, including those in atherosclerotic plaques, and carry them to the liver. HDL particles also have anti-inflammatory and antioxidant properties (8).

            The triglycerides(TG) to HDL ratio has been recently identified as a reliable marker of metabolic health and insulin resistance (5). Having a TG/HDL ratio of >3.5 is a strong indicator of the presence of insulin resistance (6) It’s also a useful assessment to be used with younger and apparently healthy subjects who are insulin resistant (7). Moreover, a high TG to predicts cardiovascular disease and diabetes mellitus (10).

Optimal level: A Triglycerides to HDL ratio below 3

Remember: You can’t manage what you don’t measure. 

Let us know if you need a hand with your training and nutrition program. At Fitness Lab, we see each client as unique individuals who will need a unique approach when it comes down to health and fitness. 

References:

  1. Chiovato, L., Magri, F., & Carlé, A. (2019). Hypothyroidism in context: where we’ve been and where we’re going. Advances in therapy36(2), 47-58.
  2. Mullur, R., Liu, Y. Y., & Brent, G. A. (2014). Thyroid hormone regulation of metabolism. Physiological reviews.
  3. Ling, C., Sun, Q., Khang, J., Lastarria, M. F., Strong, J., Stolze, B., … & Soldin, S. J. (2018). Does TSH reliably detect hypothyroid patients?. Annals of thyroid research4(1), 122.
  4. Petersen, K. F., Dufour, S., Savage, D. B., Bilz, S., Solomon, G., Yonemitsu, S., … & Shulman, G. I. (2007). The role of skeletal muscle insulin resistance in the pathogenesis of the metabolic syndrome. Proceedings of the National Academy of Sciences104(31), 12587-12594.
  5. Luna-Castillo, K. P., Olivares-Ochoa, X. C., Hernández-Ruiz, R. G., Llamas-Covarrubias, I. M., Rodríguez-Reyes, S. C., Betancourt-Núñez, A., … & López-Quintero, A. (2022). The Effect of Dietary Interventions on Hypertriglyceridemia: From Public Health to Molecular Nutrition Evidence. Nutrients14(5), 1104.
  6. Moriyama, K. (2020). Associations between the triglyceride to high-density lipoprotein cholesterol ratio and metabolic syndrome, insulin resistance, and lifestyle habits in healthy Japanese. Metabolic Syndrome and Related Disorders18(5), 260-266
  7. Borrayo, G., Basurto, L., González-Escudero, E., Diaz, A., Vázquez, A., Sánchez, L., … & Avelar, F. (2018). TG/HDL-C ratio as cardio-metabolic biomarker even in normal weight women. Acta Endocrinologica (Bucharest)14(2), 261.
  8. Murguía-Romero, M., Jiménez-Flores, J. R., Sigrist-Flores, S. C., Espinoza-Camacho, M. A., Jiménez-Morales, M., Piña, E., … & Reaven, G. M. (2013). Plasma triglyceride/HDL-cholesterol ratio, insulin resistance, and cardiometabolic risk in young adults. Journal of lipid research54(10), 2795-2799.
  9. Bitzur, R., Cohen, H., Kamari, Y., Shaish, A., & Harats, D. (2009). Triglycerides and HDL cholesterol: stars or second leads in diabetes?. Diabetes care32(suppl_2), S373-S377.
  10. Vega, G. L., Barlow, C. E., Grundy, S. M., Leonard, D., & DeFina, L. F. (2014). Triglyceride–to–high-density-lipoprotein-cholesterol ratio is an index of heart disease mortality and of incidence of type 2 diabetes mellitus in men. Journal of Investigative Medicine62(2), 345-349.

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