POV 6 - A look into Metabolic Health

WHAT IS METABOLIC HEALTH ?

Metabolic health refers to the body's ability to adapt to challenges and to rapidly return to a state of balance - or homeostasis - after having eaten a copious meal, fled danger (or crushed that last interval) or coped with any stressful situations, for instance. This ability is often coined metabolic resilience or flexibility, and reflects adequate insulin sensitivity.

Metabolic health and its underlying biological mechanisms are involved in a number of bodily functions that support physical and mental health. In doing so, metabolic health is thus equally - if not more - important than physical and mental health.

Repeated accumulation of small deviations from metabolic equilibrium can lead to metabolic dysfunctions at the basis of most chronic diseases. 

HOW IS IT MEASURED ?

Metabolic flexibility is not as apparent and readily assessed than its physical counterpart, which might explain why metabolic health is not properly evaluated or evaluated too rarely during annual medical check-ups.

Metabolic health is normally evaluated by measuring circulating markers of its different underlying biological systems. The key blood markers are : 1- sugar (or glucose), 2- cholesterol, 3- triglycerides, and 4- blood pressure. A fifth visual indicator, waist circumference that, when elevated, hints at increased risk of metabolic dysfunction is also often measured. 

Just like a single snapshot, the conclusions drawn from these blood sample, collected once-a-year, following overnight fast and under white-coat stress are not representative of one's real-life setting. Such conclusions do not inform on how the metabolism adapts to various meal compositions, sizes & timings, exercise types & durations, mental stressors, or time of day, just to name a few. 

Remote blood collection and portable measurement devices that would allow repeated sampling in various situations would be solutions, albeit impractical, to overcome these issues. 

Alternatively, a more practical and increasingly common option is available and leverages the use of glucose as the primary diagnostic basis for insulin sensitivity and metabolic health - CGM devices.

Continuous Glucose Monitoring

As its name suggests, CGM devices measure glucose - within the fluid found around cells - every minute or so throughout the day via a micro-needle stuck to the back of one's arm. First developed for (type I) Diabetes, CGMs are increasingly being integrated to digital health platforms and offered to broader markets to monitoring metabolic health.

Although markedly different in their marketing signature and targeted user persona, the digital health platforms listed below all offer differently packaged but comparable insights on a combination of personalised meal choices & timing, exercise prescription, and stress management aimed ultimately to lessen sugar highs and lows throughout the day. 

• Supersapiens - Optimise athletes’ performance, nutritional strategies and recovery. Energy wristband for real-time glucose visualisation and integration with Apple Health, Garmin, TrainingPeaks, Nolio and Wahoo. Available in select EU countries. 

• Ultrahumans - Supercharge nutrition and exercise performance. Also offering a Biometrics tracking ring. Only available in India. 

• January.ai - Glucose monitoring and AI-based prediction to improve metabolic health. Available in the USA.

• Levels - CGM-derived feedback on dietary and lifestyle influences on metabolic health. Only available in the USA. 

• Nutrisense - Glucose response to foods, exercise, stress, and sleep. Only available in the USA.

• Veri - Find the right foods and habits to lose weight, reverse insulin resistance and extend healthspan. Available in US, UK and select EU countries. 

• Signos - CGM and AI-derived nutritional and exercise plans for optimal health and weight management.

• Glucovibes - Control glucose levels and establish a diet strategy for sports activity and perform. Available in Spain and select EU regions.

• Aspect health - Glucose monitoring to normalise hormone levels and improve metabolic health. Only available in the US.

• Hello inside - Better understand body’s response to meal and fine tune lifestyle choices with particular emphasis on women health. Only available in the US.

WHY IS METABOLIC HEALTH IMPORTANT ?

Maintaining proper metabolic health - and insulin sensitivity - for as long as possible is of utmost importance, as it is pivotal to the many pillars of health and wellbeing discussed below.

First, metabolic health is pivotal to weight management since experiencing important sugar - and insulin - spikes can limit the body's ability to burn calories and turn it into a state of anabolism. In this state, excess calories are stored as fat - predominantly in the highly detrimental abdominal region. Controlling sugar spikes and dips also helps control hunger, cravings & thirst - all allies to better food choices.

Second, metabolic health is also closely related to hormonal health, when adequate levels of endocrine hormones (i.e. thyroid, cortisol, estrogen, testosterone) are reached for various situations. Although relevant to men, hormonal health is more often associated to female health as hormonal are closely linked to PCOS, infertility, menstrual cycle, and menopausal symptoms. Limiting blood sugar fluctuations can alleviate symptoms of imbalance and contribute to normalising hormone levels. 

Finally, mental health & cognitive functions can be improved, or mood swings avoided by keeping a better on controlling sugar spikes and dips as it can also help manage energy and concentration, it can eliminate mid-afternoon slumps and improve sleep quality.

Metabolic health can be reached by maintaining a healthy waist line, reducing dietary sugars and fats, exercising regularly and adopting healthy sleep habits.  

WHY WE INVEST IN METABOLIC HEALTH ?

At LangLeven, we seek to improve physical and mental performances. 

To do so, we want to raise the awareness on metabolic health and accelerate innovations that optimise it as it is the gateway to health(span), wellbeing and longevity. We truly believe in the importance of self-knowledge and self-empowerment in the quest for healthspan. 

We know there is an opportunity for CGM and similar technologies, as lifestyle hacks to control glucose could benefit the near billion of individuals that suffer from diabetes or pre-diabetes worldwide. The usefulness of remote monitoring devices like CGMs can only be increasingly recognised as in-person medical checkups are set to become increasingly rare and be replaced by virtual visits and telemedicine.

Testament to that, increasing popularity of digital health platforms and the recent expansion and insurance coverages to more indications already ignited the CGM field, increasing the demand for the sensors - which risk shortage being produced by a few manufacturers - and accounting for a booming $3.13B USD sensor market.

In a not-so distant future, not without overcoming some technological hurdles, we foresee miniaturisation of topical sensors or temporary tattoo-like patches. Soon should follow non-invasive sensors seamlessly integrated to clothing and optical sensors integrated to wearable devices. These sensing devices will not only track glucose but will measure other biomolecules such as insulin, cortisol, sex hormones or lactate.

We see such technologies being first adopted by biohacking and self-quantifying enthusiasts, but then to be followed by a majority of health-conscious individuals and rapidly become the norm - just as HR monitoring is today.

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