What Does it Mean to be Metabolically Healthy?

A study1 conducted in February of 2019 by a research team at the Gillings School of Global Public Health of the University of North Carolina at Chapel Hill set out to define and measure metabolic health among Americans. In their study, they note that, at the time of their study’s creation, there was no consensus-driven definition of metabolic health. The researchers say that metabolic health is more than simply the absence of metabolic syndrome. Metabolic syndrome was defined in 2001 and is an identified cluster of biomarkers (i.e., metabolic indicators) that increase a person’s risk of heart disease, insulin resistance, diabetes, and stroke.2

Someone is diagnosed with metabolic syndrome if they exhibit at least 3 out of 5 of the following:

  • Waist circumference 40 inches or greater in men and 34 inches or greater in women
  • Elevated triglycerides 150 milligrams per deciliter of blood (mg/dL) or greater
  • Reduced high-density lipoprotein cholesterol (HDL) less than 40mg/dL in men or less than 50mg/dL in women 9 Elevated fasting glucose of 100mg/dL or greater
  • Blood pressure values of systolic 130mmHg or higher and/or diastolic 85mmHg or higher

According to the researchers, being metabolically healthy does not simply mean that you don’t have metabolic syndrome, but instead, that your measured metabolic indicators, without taking medication for blood pressure, diabetes, or cholesterol, correspond with optimal health and a low risk of developing cardiometabolic disease. To ascertain these optimal numbers, the researchers compared and compiled recommendations from various health- focused societies and government agencies, finally settling upon these measurements:

  • Waist circumference 39 inches or less in men and 33 inches or less in women
  • Triglycerides less than 150mg/dL
  • High-density lipoprotein cholesterol 40/50mg/ dL or greater in men/women
  • Fasting blood glucose less than 100mg/dL and HbA1c less than 5.7%
  • Systolic blood pressure less than 120mmHg and diastolic blood pressure less than 80mmHg


  1. Araújo J, Cai J, Stevens J. Prevalence of Optimal Metabolic Health in American Adults: National Health and Nutrition Examination Survey 2009–2016. Metab Syndr Relat Disord. 2019 Feb 1;17(1):46–52.
  2. Swarup S, Zeltser R. Metabolic syndrome. InStatPearls [internet] 2019 Feb 28. StatPearls Publishing. NHR

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