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Document 9

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Journal of Metabolic Health

ISSN: (Online) 2960-0391


Page 1 of 2 Editorial

Metabolic health: A new frontier

In the dynamic landscape of medical research and healthcare, the field of metabolic health is
Author:
Caryn Zinn1 gaining prominence. The evolution of ‘Journal of Insulin Resistance’ to ‘Journal of Metabolic
Health’ brings with it not only a collaboration with the Society of Metabolic Health Practitioners
Affiliation: (SMHP) – an organisation working to improve metabolic health through evidence-based
1
School of Sport and
nutrition and lifestyle approaches – but also a broader focus on a growing area that is not just of
Recreation, Auckland
University of Technology, paramount importance but serves as the cornerstone of overall well-being, Metabolic Health.
Auckland, New Zealand

Corresponding author: Metabolic health and chronic conditions


Caryn Zinn, While the study of metabolism and its role in health and disease has been ongoing for many
[email protected]
decades, the broader concept of metabolic health is an evolving area becoming increasingly
How to cite this article: recognised as a linchpin in the understanding and management of chronic conditions.
Zinn C. Metabolic health: Metabolic health primarily focuses on understanding how our bodies regulate energy,
A new frontier. J. metab. process nutrients and maintain homeostasis and is a concept that has profound implications
health. 2023;6(1), a92.
https://doi.org/10.4102/jmh. for both our physical and mental well-being. With the increasing prevalence of chronic
v6i1.92 conditions such as obesity, type 2 diabetes (T2D), cancer, heart disease, among others, a more
critical lens is being placed on the intricacies of metabolic health in both science and
Copyright: practice dimensions.
© 2023. The Authors.
Licensee: AOSIS. This work
is licensed under the Obesity, a widespread health concern of our era, is profoundly intertwined with metabolic
Creative Commons health. Fundamentally, it is a state of excess body fat accumulation, held by the traditional
Attribution License. theory of a chronic imbalance between energy intake and expenditure. A more granular
understanding indicates that its metabolic underpinnings are complex, multifactorial and
intertwined, involving a variety of physiological, genetic and environmental factors. Its
development and persistence are likely influenced by several key metabolic mechanisms
including insulin resistance, leptin resistance, adipose tissue dysfunction, inflammation and
gut microbiota composition, which are compounded by environmental and lifestyle factors.1

Type 2 diabetes is likely to be the biggest global epidemic in human history.2 Considered
a complex metabolic disorder, with both genetic and environmental influences, mechanistic
evidence reveals insulin resistance and hyperinsulinaemia are hallmark metabolic mechanisms
underpinning the condition. Management advancements, particularly around carbohydrate
reduction, have made substantial inroads into targeting the route of the metabolic problem, that
is, reducing hyperinsulinaemia.3 Nomenclature such as ‘diabetes reversal’ and ‘remission’ is now
being adopted to describe outcomes, and what has traditionally been known and referred
to as a chronic progressive condition can and should be revisited.

Cancer is a multifaceted disease, which traditionally has been acknowledged as a genetic


disease, primarily characterised by mutations and alterations in the DNA of cells. A growing
body of research and interest has emerged in understanding cancer as a metabolic disease,
which suggests that changes in cellular metabolism, particularly how cells generate and use
energy, may play a crucial role in the development and progression of the disease.4 One of the
key features of cancer cells is their altered metabolism, known as the Warburg effect, and
which facilitates a favouring of metabolic preference for glucose consumption, even in the
presence of oxygen. Innovative metabolic manipulation of fuel utilisation from a gluco-
centric to a keto-centric environmental context may hold promise for future developments.

The burgeoning mental health crisis is inextricably connected to metabolic health. Many neurological
diseases, including Alzheimer’s and Parkinson’s disease, major depressive disorder, bipolar
Read online: disorder, schizophrenia and epilepsy, are characterised by impaired brain glucose utilisation,
Scan this QR insulin resistance, neurotransmitter imbalances, mitochondrial dysfunction, oxidative stress and
code with your
smart phone or inflammation.5 Traditionally, nutrition has not been considered a metabolic therapy affecting the
mobile device structure and function of the brain. However, recent dietary advances in altering fuel provision to
to read online.
the brain and in high-dose micronutrient supplementation6 show promise in influencing biological

http://www.journalofmetabolichealth.org Open Access


Page 2 of 2 Editorial

processes, including mitochondrial energy metabolism,


inflammatory processes, oxidative stress, monoaminergic
A steep learning curve
activity and progression of neurodegeneration. Such dietary Metabolic health is at the forefront of medical research and
strategies are now being considered metabolic therapies holds the potential to redefine and reshape our approach to
themselves. Specialist fields such as nutritional psychiatry and the prevention and management of a myriad of chronic
metabolic psychiatry are emerging and gaining recognition, conditions. Certain conditions like T2D have taken the lead
thereby advancing the metabolic and mental health nexus. with progress, making inroads into research, guideline
change, and practice; other conditions, such as mental
The mitochondrial connection illness, are only beginning their journey of exploration. The
scientific advancement of metabolic health is still in its
The ‘mitochondria as powerhouse’ analogy is outdated; infancy, and the path ahead is likely steep. We are on the
these tiny organelles are so much more than merely a cusp of a new era in the medical field, and we, at the Journal
home for energy production. They are the fundamental of Metabolic Health, hope to be part of the dissemination chain
essence of all life and might very well hold the clues to a of this work helping shape the future of global healthcare.
more comprehensive understanding of metabolic health
and dysfunction. Mitochondria are living, dynamic,
maternally inherited organelles that play multifaceted
References
roles in biosynthesis and cellular signalling and energy 1. Blüher M. Obesity: Global epidemiology and pathogenesis. Nat Rev Endocrinol.
2019;15(5):288–298. https://doi.org/10.1038/s41574-019-0176-8
transformation. They are essentially the master processor of
2. Zimmet PZ. Diabetes and its drivers: The largest epidemic in human history? Clin
the cell. Mitochondria have a unique ability to transform the Diabetes Endocrinol 2017;3:1. https://doi.org/10.1186/s40842-016-0039-3
cells’ inputs and outputs and convert metabolic, biochemical 3. Evert AB, Dennison M, Gardner CD, et al. Nutrition therapy for adults with
diabetes or prediabetes: A consensus report. Diabetes Care. 2019;42(5):731–754.
and neuroendocrine signals into adaptation strategies. They https://doi.org/10.2337/dci19-0014
detect and respond to cells’ cues by reshaping their structure 4. Seyfried TN, Flores RE, Poff AM, D’Agostino DP. Cancer as a metabolic disease:
Implications for novel therapeutics. Carcinogenesis. 2014;35(3):515–527.
and function. They consolidate information via dynamic, https://doi.org/10.1093/carcin/bgt480
network-based interactions and mechanisms and generate 5. Sethi S, Ford JM. The role of ketogenic metabolic therapy on the brain in serious
output signals that fine-tune the functions of other organelles mental illness: A review. J Psychiatr Brain Sci. 2022;7(5):e220009. https://doi.
org/10.20900/jpbs.20220009
and regulate physiology systemically. A deliberate focus on 6. Rucklidge J, Johnstone J, Villagomez A, Ranjbar N, Kaplan B. Broad-spectrum
understanding the intricacies of the mitochondria is needed, micronutrients and mental health. In Dinan T, ed., Nutritional psychiatry: A primer
for clinicians. Cambridge: Cambridge University Press; 2023, pp. 152–171.
as well-functioning mitochondria are essential for sustaining
7. Picard M, Shirihai OS. Mitochondrial signal transduction. Cell Metab.
metabolic health.7 2022;34(11):1620–1653. https://doi.org/10.1016/j.cmet.2022.10.008

http://www.journalofmetabolichealth.org Open Access

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