Metabolic Health 28 Day Plan

Welcome

Do you want to feel well, have more energy, a better mood and a slimmer waist? 

Learn what metabolic health is, how to measure it, and how to improve it. Then put your 28 Day Plan into action.

A 28 day plan is achievable and it will get significant results. Within one to two weeks many people notice clothes become looser and a slimmer waist. Within two to three weeks my patients report feeling more alive, less hungry and a better mood.

The 28 Day Plan was originally created for patients in the NHS. The results were so impressive I decided it should be openly available so everyone can benefit. I hope you find it useful.

Campbell 

Dr Campbell Murdoch (GP, UK)

Important

This is not medical advice or recommendation. It is only general and non-personalised information. It may not be suitable for your needs. It is only for people aged 18 years and over.

You must seek attention from an appropriate healthcare professional for all your medical needs.

All information and resources have been developed with great care and using up-to-date scientific literature. However, there is no guarantee the information provided is accurate or free from error.

By proceeding you acknowledge, understand, and agree with the above.

Download your 28 Day Plan resource pack then watch the video and read the article below to learn about metabolic health and get the most from your 28 Day Plan.

Download your 28 Day Plan resource pack

Contents

Metabolic health is the engine for life

Metabolic health affects us all. It is the foundation of our physical and mental health.

Metabolic health is the ability of the body to store, release and use fuel, whilst maintaining health and stability.

Good metabolic health means we are more likely to feel well and thrive. Conversely, poor metabolic health causes fatigue, excess belly fat, poor mental health and contributes to most modern diseases.

Fortunately, metabolic health can always be improved.

Good metabolic health

Good metabolic health makes people feel energised, awake, alert, clear thinking and hopeful.

In simple terms, good metabolic health means the engine for life is working well. It runs well and is less likely to break down. It can work harder and stay in good repair.

With good metabolic health people feel energised and are less likely to become unwell. 

Poor metabolic health

Poor metabolic health means the body is at war with itself. The body will feel like a badly maintained car: it is a struggle to start, it runs poorly, and you are forever worried about it breaking down.

People report feeling tired, fed-up, and having no energy. They usually experience increased belly fat and sometimes skin tags. It can be difficult to lose weight or achieve a slimmer waist. 

Most modern health conditions and diseases are related to poor metabolic health. This includes type 2 diabetes, prediabetes, high blood pressure, heart disease, stroke, many muscle and joint problems, fertility problems, many skin conditions, kidney disease, mental health problems, and many more.

Metabolic health can be improved

There is always hope. Metabolic health can always be improved, often by a lot. 

Benefits can be noticed within a couple of days to weeks. 

Looking after your metabolic health will mean you get the best from life. Keep reading to learn more about metabolic health and the specific actions you can take to get the results. 

Contents

How the body works

Having a basic understanding of how the body works will make it much easier to understand how metabolic health can be improved.

Key body parts

Metabolic health involves the entire body, but there are some key organs – body parts – to know.

Digestive tract

The digestive tract, often known as the gut, starts at the mouth, moves on to the oesophagus, stomach, small intestine, large intestine, and then finishes at the anus.  As food transits through the digestive tract, it is digested and the nutrients are absorbed into the blood.

Pancreas

The pancreas sits in the abdomen near to the stomach and liver. It releases digestive enzymes into the gut to help in the breakdown of food. The pancreas also releases hormones into the blood. One of these hormones is insulin which helps to keep blood sugar under control and to build the body’s fat stores.

Liver

The liver sits at the top right of the abdomen. It is the body’s main chemical processing factory. The liver’s duties include: removal and breakdown of harmful substances and the conversion of the food we eat into substances the body needs. 

In addition, the liver makes and stores glucose sugar. It then releases that glucose into the blood when needed by the body. 

The liver also turns excess glucose into fat.

Circulatory system and heart

An average adult has about five litres (eight pints) of blood. This blood is held in a network of blood vessels including arteries and veins. The heart pumps the blood around the body. 

There is also a blood system that goes directly from the gut to the liver. This means digested food can be processed by the liver before it is released into the wider body.

Muscles

There are muscles throughout the body. Muscles create movement.

Skeletal muscles include the large muscles of the body; such as on the arms, legs, and buttocks. These large muscles play an important role in removing excess glucose sugar from the blood. Big healthy muscles, that are used frequently, can store and use a lot of glucose.

Fat tissue

Fat tissue (adipose tissue) is the main storage site of fat in the body. There are two main types of adipose tissue: subcutaneous and visceral.

Subcutaneous adipose tissue can be considered the body’s healthy fat store. It is the fat that sits under the skin. The fat that can be seen on people. Metabolic health is helped by subcutaneous adipose tissue stores that are not overstuffed. 

Visceral adipose tissue sits inside the abdomen. This fat sits in and on the internal organs. It is strongly linked to poor metabolic health and it is directly harmful to the body. A bigger waist circumference, or waistline, is a sign of more visceral fat.

Brain

The brain plays a central role in metabolic health. In the brain there is the hypothalamus; this can be considered the master controller of the body. It continuously monitors the internal environment of the body, such as the blood glucose level, and creates change throughout the body via the nervous system and hormone system. 

The brain is also intricately involved in our behaviours, such as food choices.

Cells, mitochondria and metabolism

If we zoom-in on organs we find cells and tiny structures called mitochondria.

Cells

The body is made from many trillions of cells. Cells can be thought of as living in a community and collaborating with each other to create organs. Cells specialise depending on the organ they are in, such as muscle cells and liver cells.

Inside cells there are tiny structures called organelles. Organelles work to keep the cell functioning. 

Mitochondria

Mitochondria are one type of organelle. A main task of mitochondria is to create ATP. ATP is what cells use for energy. 

Cells that are very metabolically active require a lot of energy, so they have more mitochondria. For example, a liver cell has thousands of mitochondria. 

Health is very dependent on mitochondria. Healthy mitochondria = healthy body.

Metabolism

Inside cells trillions of chemical reactions are continuously happening. These chemical reactions are needed to convert the food we eat into molecules that are useful for the cells. 

Molecules are constantly being broken down, rearranged, and built-up. Cells also use chemical reactions to extract energy from the food we eat. Mitochondria play a central role in this.

Cells’ ability to access the energy they need, in a controlled manner, is essential for metabolic health. Too little energy will mean the cells cannot function. Too much energy can lead to stress on the mitochondria and cell.

The word used to describe all of these chemical reactions is metabolism.

Homeostasis and blood glucose

The body’s ability to maintain stability in an ever-changing world is essential for survival. Continuous adjustment is required. This adjustment and stability is known as homeostasis. 

Homeostasis

homeostasis, any self-regulating process by which biological systems tend to maintain stability while adjusting to conditions that are optimal for survival. If homeostasis is successful, life continues; if unsuccessful, disaster or death ensues. (Encyclopedia Britannica, 8 Apr. 2022)

There are multiple homeostatic process in the body. For example: regulation of body temperature, water balance, and blood glucose.  

All the body’s homeostatic processes are important for metabolic health. However, the ability to keep blood glucose stable is of central importance. The blood glucose level must be kept within a very narrow range.

Blood glucose homeostasis

Blood glucose homeostasis is essential for health. It is tightly controlled by the body to keep it at just the right level.

Where does the glucose in the blood come from? Glucose is a type of sugar that is found in nature. The glucose in blood can come from two sources. From plants and from our liver.

Plants make glucose sugar. The glucose can be joined into long chains; starch and fibre. Plants also make other sugars called fructose and sucrose (table sugar). When we eat foods containing sugar or starch the gut will break the food down into free glucose molecules. This glucose is then absorbed from the gut in to the blood stream, resulting in a rise in the blood glucose level.

Glucose can also come from our liver. The liver can make and store glucose. If we haven’t eaten any sugar or starch for a short period, the liver will release glucose into the blood. Thus it is possible, for humans to live, without having to eat any sugar or starch.

How much glucose is in the blood? A normal blood glucose after fasting, such as first thing in the morning, is approximately 3.8-5.5 mmol/L (68-99 mg/dL). This is only 4 to 5 grammes (one teaspoon) of glucose in all the five litres (8 pints) of blood in the body. Too little or too much glucose in the blood can be extremely harmful. Potentially fatal. 

The body must ensure blood glucose homeostasis is maintained. To do this the body uses insulin to lower the blood glucose level.

Insulin and insulin resistance

Insulin is required to maintain blood glucose homeostasis. With poor metabolic health the body is insulin resistant. When there is insulin resistance more insulin is required to keep blood glucose under control.

Insulin

Insulin is a hormone. Hormones are the chemical messengers of the body. When released they travel in the blood and give instructions to other body parts and cells.

Insulin is made in the pancreas. When the pancreas senses there is too much glucose in the blood it releases insulin. The insulin is transported around the body and instructs cells – including the liver, muscles, and fat tissue – to reduce the amount of glucose in the blood. Insulin also tells the liver to stop making glucose.

In addition to lowering blood glucose, insulin also plays a very important role in building up the body’s fat stores. Insulin instructs the liver and fat tissue to make fat and to keep it in storage. So, insulin can also be thought of as a fat-storage hormone.

Insulin resistance

Insulin resistance is a core feature of poor metabolic health. Put simply, insulin resistance means the cells in body are not “listening” or responding to insulin’s message. They are resisting it.

Cells become insulin resistant when they don’t want to take glucose in. This is usually because they are already filled with enough fuel, or they are unable to utilise the fuel. Insulin resistance is a cell’s attempt to protect itself from taking in excess fuel and becoming harmed.

Insulin resistance is a significant problem for blood glucose homeostasis. With insulin resistance the body has to fight harder to maintain just one teaspoon of glucose in the body’s five litres of blood. To achieve this the pancreas has to release larger amounts of insulin whenever sugar or starch are eaten. This large amount of insulin attempts to force the cells to take glucose out of the blood.

Insulin resistance combined with high blood insulin means the body is at war with itself. Cells are resisting and fighting for their own survival whilst the body is desperately trying to maintain a normal blood glucose.

In addition, the high blood insulin level also drives the body into fat storage mode. This happens via three mechanisms:

  • Insulin instructs the body not to burn fat.
  • Insulin instructs the liver and fat tissues to turn glucose in to fat.
  • Insulin instructs the fat stores to hold on to fat and for the fat stores to get bigger.

 

This battle of insulin resistance and high blood insulin is responsible for many aspects of poor metabolic health. It leads to difficulty in losing weight and all the associated conditions and diseases of poor metabolic health. 

This would be a sad situation if it was not for the fact that it is possible to measure and improve insulin resistance and metabolic health.

Contents

How to measure metabolic health

Metabolic health can be measured by testing for insulin resistance. Insulin resistance causes many changes in the body. Here are some of the most commonly used measures:

  • Waist circumference
  • Blood glucose
  • Blood lipids (fats): triglycerides and HDL-cholesterol
  • Blood pressure

Measures of insulin resistance vary in different people. For example, insulin resistance will cause high blood pressure in some people whilst in others blood pressure may be perfect. However, by assessing all the measures it is possible to get a reasonable insight into an individual’s metabolic health.

Waist circumference

Waist circumference, or waistline, should be measured about 2cm (1 inch) above the belly button. (The official medical method is to measure “halfway between the anterior-superior iliac spine and the lower rib”.) Trouser size is not waist circumference! 

For consistency, it is best to measure waist circumference first thing in the morning. 

Method: Take a deep breath in, then breath out in a relaxed way, then take the measurement.  

What is the healthy range?

What is deemed to be a healthy waist circumference varies by body type, sex, and ethnicity. So, instead of using just the waist measurement, the waist-to-height ratio provides a more reliable indicator of insulin resistance. 

The waist-to-height ratio is simply your waist circumference divided by your height.

It is generally accepted that, for health, a person’s waist circumference should be less than half their height. If waist circumference is more than half a person’s height they may have insulin resistance.

Tip: If you do not have a tape measure then a piece of string will do. Take a piece of string that is the same length as your height. Fold it in half, and see if it will fit around your waist. 

Why does it increase with insulin resistance?

Insulin resistance and high blood insulin cause increased fat to build-up inside and on the abdomen. This increases waist circumference.

Blood glucose

Glucose is the sugar that is in blood. It comes from food and it is also made in the liver. The body must control blood glucose very carefully.

For an accurate blood glucose reading it is very important for the blood glucose to be measured after a period of fasting. Fasting means no food or calorie containing drinks should consumed in the 8 to 10 hours prior to the test.

What is the healthy range?

A normal fasting blood glucose is between approximately 4 and 5.5 mmol/L (68-99 mg/dL).

A fasting blood glucose level of 5.6 mmol/L (100 mg/dL) or over could indicate insulin resistance. A fasting blood glucose level above 7.0 mmol/L (126 mg/dL) could indicate diabetes.

Why does it increase with insulin resistance?

Fasting blood glucose increases with insulin resistance because:

  • The liver releases too much glucose into the blood.
  • The body does not easily remove glucose from the blood.

Special considerations

  • Fasting glucose can increase with exercise and stress. Where possible it is important to be mentally and physically relaxed for at least 2-3 hours prior to the test.
  • A fasting blood glucose of 7.0 mmol/L (126 mg/dL) or more could indicate diabetes. People without a previous diagnosis of diabetes should arrange a more formal assessment with an appropriate medical professional. A fasting blood glucose of 11.0 mmol/L (198 mg/dL) or more in someone not known to have diabetes requires an urgent assessment with a medical professional.
  • For people with type 1 diabetes the blood glucose level is not a useful indicator of insulin resistance. So, instead of using blood glucose an approximate equivalent is to use the most recent HbA1c measurement in the % units. (HbA1c is now usually given in the mmol/mol units, the % may need to be calculated from this.)
  • For people with type 2 diabetes and on medication, insulin resistance exists whatever the blood glucose reading.

Blood lipids

Blood lipids are fats in the blood. They can be tested for with a blood test. A blood lipid test typically gives levels for triglycerides, HDL-cholesterol, LDL-cholesterol, and total cholesterol. It is triglycerides and HDL-cholesterol that are useful to give an indication of insulin resistance.

Triglycerides

Triglycerides are a type of fat in the blood. They are essential for the body and are a main source of fuel.

Triglycerides come directly from food, and they are also made in our body, especially by our liver. The liver turns any excess sugar into triglycerides.

The main storage location of triglycerides is in our fat (adipose) tissue.

There should only be a small amount of triglyceride in our blood. The vast majority of triglycerides should be kept in storage in our fat tissue.

It is normal for the amount of triglyceride in the blood to increase after eating fat. So, when measuring blood triglycerides to assess for insulin resistance it is important to fast prior to the test.

What is the healthy range?

A lower triglyceride level indicates a healthier and less insulin resistant state. This low level of triglycerides means the liver is not making excessive amounts of triglycerides, and the body is easily able to remove triglycerides from the blood.

A triglyceride level less than 1.7 mmol/L (150 mg/dL) is considered normal, and a level less than 1.3 mmol/L (115 mg/dL), or perhaps even lower, is ideal.

Why does it increase with insulin resistance?

The fasting blood triglyceride level increases with insulin resistance because:

  • The liver is creating and releasing more triglycerides into the blood.
  • The fat stores struggle to remove triglycerides from the blood.
  • The fat stores constantly ‘leak’ fat into the blood.

Special considerations

  • A fasting triglyceride level of more than 5.6 mmol/L (496 mg/dL) is considered very high. This should be discussed routinely with an appropriate healthcare professional.
  • Blood triglycerides can be high for reasons other than insulin resistance. These include individual genetic profile, alcohol, and pancreatitis (inflammation of the pancreas).

HDL-cholesterol

HDL-cholesterol is the cholesterol that is part of an HDL particle in the blood. HDL stands for High Density Lipoprotein. HDL-cholesterol goes down with insulin resistance.

(A lipoprotein can be thought of as a transporter in the blood. There are many different types of these lipoprotein transporters, with HDL being just one type. Lipoprotein transporters carry molecules including cholesterol.)

What is the healthy range?

A higher HDL-cholesterol level is an indicator of better health. For males the HDL-cholesterol should be 1.0 mmol/L (40 mg/dL) or greater, and for females it should be 1.3 mmol/L (50 mg/dL) or greater.

Why does it decrease with insulin resistance?

Insulin resistance, and the associated high insulin level in the blood, decreases the amount of HDL-cholesterol in the blood by:

  • An increased insulin level reduces the production of HDL-cholesterol in the liver.

Blood pressure

Blood pressure is usually measured at the upper arm or wrist. It is very important to sit and relax when taking the measurement. When assessing blood pressure two measures are taken, the systolic blood pressure and the diastolic blood pressure.

Systolic blood pressure is the higher reading on a blood pressure measurement. The systolic pressure coincides with the heart squeezing and pumping blood out of the heart. This squeezing of the heart sends a pressure wave through the arteries.

Diastolic blood pressure is the lower reading on a blood pressure measurement. The diastolic pressure coincides with the heart relaxing between beats.

Blood pressure is usually reported as the systolic reading over the diastolic reading. For example, a systolic blood pressure of 124mmHg and a diastolic blood pressure of 76mmHg would be described as ‘a blood pressure of 124 over 76′ and written as 124/76.

There are many other factors that can affect blood pressure other than insulin resistance. Blood pressure can suddenly increase with factors such as mental stress or physical exertion. Therefore, it is important to measure blood pressure after a period (at least a few minutes) of calm. It may be necessary to recheck blood pressure a few times to achieve a more accurate reading. Blood pressure can also be affected by other health conditions and therefore a high blood pressure does not always mean insulin resistance. However, insulin resistance is probably the most common cause for high blood pressure.

What is the healthy range?

A lower blood pressure indicates better health. Blood pressure is graded depending on how high it is.

  • A blood pressure of less than 130/85 is considered normal.
  • A blood pressure of less than 120/80 is considered ideal.

 

In healthcare blood pressure is categorised as:

  • Ideal is a systolic of less than 120 and diastolic of less than 80
  • Normal is a systolic of less than 130 and diastolic of less than 85
  • High-normal is a systolic of 130-139 or a diastolic of 85-89
  • Grade 1 hypertension is a systolic of 140-159 or a diastolic of 90-99
  • Grade 2 hypertension is a systolic of 160-179 or a diastolic of 100-109
  • Grade 3 hypertension is a systolic of above 179 or above 109

Why does it increase with insulin resistance?

Blood pressure increases with insulin resistance due to at least two mechanisms:

  • Insulin resistance of the small muscles that surround blood vessels prevents the muscles from relaxing. This causes the blood vessels to squeeze harder, increasing blood pressure.
  • The kidneys play a central role in controlling blood pressure. A high insulin level, that happens with insulin resistance, alters how the kidneys function and raises blood pressure.

The IR Health Check

If you want to quickly understand what your measures mean you can use the IR (insulin resistance) Health Check form. This form makes it easy to assess your metabolic health. If all your measures are in the green it is likely your metabolic health is good. Whereas, if you have more measures in the amber or red it is likely you would benefit from improving your metabolic health. 

Whenever possible, try to use all the IR Health Check measures to get a more complete view of your metabolic health.

Download a pdf of the IR Health Check  [international version] [US version]

Contents

How to improve metabolic health

Metabolic health is affected by the Health Foundations:  Nutrition, Movement, Sleep, and Mindset. Making improvements to these can make a significant and often rapid difference to health, wellbeing, and performance.

For each of the Health Foundations there are factors that worsen metabolic health, and factors that can improve it.

Use the Health Foundations and take a personalised approach. There is no one size fits all. What is best for you may change over time. The right approach should be enjoyable and get results. 

Each of the Health Foundations is summarised below.  More in-depth information can be downloaded here.

Nutrition Health Foundation

Nutrition refers to what, when, and how much a person eats and drinks. It can have a significant impact on metabolic health. 

There is no one-size-fits-all and there is no good or bad. But there are helpful and unhelpful choices. 

Read through the nutrition factors that can worsen or improve insulin resistance.

Nutrition factors that can worsen metabolic health

Sugar

All types of added sugar. Added sugar is found in confectionary and sweet baked goods as well as many packaged ultra-processed foods. A large intake of fructose may be particularly problematic in increasing insulin resistance.

Sugary drinks

Sugary drinks are highlighted as an individual category as they can provide a large amount of sugar that can be rapidly absorbed from the gut. Examples include sugar-sweetened carbonated drinks and fruit juices.

Ultra-processed foods

Ultra-processed foods have been significantly modified through factory processing. These manufactured foods will often come in a packet and have a list of ingredients. The ingredients list may include items that would not normally be used in home cooking.

There are multiple reasons why ultra-processed foods may increase insulin resistance, including: the food matrix has been destroyed, they often contain large amounts of sugar and refined carbohydrate, they may be low in fibre, there may be additives that could interfere with gut bacteria, they are often low in protein, and they are easy to overeat.

Refined carbohydrate

Refined carbohydrates are starchy foods that have been processed leading to removal of fibre, vitamins, and minerals. They may also have been milled or broken up. Examples include flour and flour-based products, white rice, and many breakfast cereals.

When refined carbohydrates are eaten the starch content is rapidly broken down to glucose sugar which then surges into the blood. The effect of eating refined carbohydrate is very similar to eating pure glucose sugar.

Excessive fat

Natural fats that come as part of whole real foods are well tolerated by most people. However, a sudden large intake of fat will create a short-term increase in insulin resistance for 12-24 hours. If weight loss is desired some people will need to avoid excessive fat intake, particularly if eating a higher amount of carbohydrate.

Frequent snacking

Eating frequently, with snacks between meals, provides a constant flow of food into the body. It also means insulin is frequently released. This leads to increased fat storage and insulin resistance.

Nutrition factors that can improve metabolic health

Real food

More than half the food eaten in the UK is ultra-processed, which is why it is important to pay attention to what we eat. ‘Real food’ is a phrase that is used to describe food that is unprocessed or minimally processed.

Adequate protein

Adequate protein is important for the body’s growth, maintenance, and repair needs. Adequate protein also helps to create a feeling of satiety.

Intermittent fasting

Intermittent fasting is also known as time-restricted eating. The purpose is to give the body a longer period when there is no food coming into the body. This allows the body’s insulin level to fall enabling the utilisation of stored glucose and fat.

A common example is 16:8, where all food is eaten in a 8-hour window, and no calorie containing food is eaten in a 16-hour window.

Personalise carbohydrate

Carbohydrate intake can be personalised to someone’s physiology, health aims, and other lifestyle factors. People that are very insulin resistant will be less tolerant to carbohydrate compared to people that are very insulin sensitive and physically active. 

Adequate hydration

There is no specific recommended amount of water intake, and it will vary depending on factors such as sweating. However, dehydration may drive insulin resistance. People can generally trust their thirst, but for some people daily life distractions may lead to inadequate fluid intake. These people may need to focus on ensuring adequate fluid intake, perhaps two litres a day.

Movement Health Foundation

Movement includes physical activity or exercise, but daily general activity also counts.  Lack of movement, and lack of challenge to the body’s muscles, leads to a gradual decline in metabolic health. Insulin resistance and metabolic health can be improved with regular movement, challenging muscles, and challenging the cardiorespiratory system. 

Movement factors that can worsen metabolic health

Being sedentary

Being sedentary means not moving from the sitting or lying position whilst awake, for prolonged periods. Sleep time is not considered being sedentary.

Over-training

Over-training is a risk for people that enjoy doing a lot of physical activity and for people that lead very busy lives with limited time for adequate rest.

Whilst physical exertion is generally good for improving insulin resistance and metabolic health it is also a stressor. As with all stressors, excessive amounts of exercise will over-challenge the body and create a detrimental stress effect. Inadequate rest will worsen this by not allowing repair and recovery time.

Movement factors that can improve metabolic health

Regular movement

Research indicates it is beneficial for our health to move for at least one or two minutes every hour or so. This does not have to be strenuous exercise. It could simply be pottering around. Any activity that gets the limbs moving is sufficient.

Resistance activity

Challenging the body’s big muscles provides multiple benefits. This includes providing space for excess glucose in the blood to go. In addition, muscles release anti-inflammatory chemicals which is good for the metabolic health.

Challenging the muscles in the arms, legs, and buttocks at least once or twice a week will encourage the muscles to grow, this is known as hypertrophy. The challenge needs to be more than that of everyday life. However, it does not need to be seen as a chore. Just a few minutes of intensive muscle fatiguing resistance activity will have a benefit.

Aerobic activity

Aerobic activity, sometimes known as cardiovascular (CV) exercise, is a form of physical activity that involves movement of our big muscles, with an increase in our heart rate, speeding up of our breathing, and performed for a longer period.

Sleep Health Foundation

The quality and quantity of sleep is important for metabolic health. Sleep is essential for repair, recovery, and restoration. During refreshing sleep the body moves into a more relaxed state. Activity in the fight-flight nervous system reduces. Sleep plays a central role in the control of hormones and blood glucose.

Sleep factors that can worsen metabolic health

Alcohol

Alcohol can have a significant impact on the quality and quantity of sleep. It can have a significant impact on the fight-flight nervous system, preventing the body moving into a state of repair and recovery. The amount of alcohol required to disrupt sleep will vary for different people, however small amounts of alcohol can be detrimental to many.

Late screen time

Screen-time from mobile phones, computers, and televisions present a range of problems for sleep. These include:

  • Distraction from attempting to go to sleep.
  • Stimulation of the mind when it should be moving into a sleepy state. This may be particularly problematic if screens are used in bed.
  • Blue light emitted from screens. It is thought this can trick our brain into thinking it is daytime and thus not the time to go to sleep.

 

Late caffeine

Caffeine is a stimulant found in coffee, tea, soft-drinks, and chocolate. Caffeine is thought to interfere with sleep by blocking a chemical called adenosine in the brain. Adenosine is an important promotor of sleep.

Late eating

A large meal late in the evening can cause the fight-flight nervous system to remain active, thus preventing the body moving into a relaxed state with refreshing sleep. This delay in reaching a relaxed state may last for 3-6 hours.

Late intensive exercise

Exercise is generally considered helpful for insulin resistance and metabolic health. However, late-evening intensive exercise can activate the sympathetic nervous system, preventing refreshing repair and recovery.

Sleep factors that can improve metabolic health

Adequate time

Most adults require between 7 to 9 hours sleep. For some people 6 hours may be sufficient, whilst others may need 10 hours. Getting adequate sleep is important. However, it is equally important not to worry about insufficient sleep and insomnia. A helpful perspective is to prioritise sleep, but don’t worry about it.

Regular timing

The body’s “clock” controls many processes including our sleep timing. Keeping to a regular bedtime and wake up time is helpful for falling asleep. Shift-working, and other life demands can prevent regular bed and waking times. This may at times cause disrupted or inadequate sleep. In these circumstances it may be best to do what is possible, and not be concerned about achieving perfection.

Pre-bed wind-down

Preparing the body and mind for sleep in the 30-60 minutes prior to bed can assist in in falling asleep. This wind-down period ideally involves doing activities that aid relaxation, and where possible avoiding stressors.

Morning routine

Our morning routine can have an impact on what time we will fall asleep in the evening. Research suggests that daylight plays a role in adjusting our body clock and setting a sleep stopwatch.

Mindset Health Foundation

Mindset means the way of thinking, beliefs, and how someone may respond to information and events. Mindset can contribute to chronic stress and this can have a significant impact that increases insulin resistance. Conversely, a mindset that provides a sense of control and certainty over life can reduce stress.

Mindset factors that can worsen metabolic health

Being an outsider

This can occur if people are spending the majority of time with others that do not share their goals, purpose, and values.

Social isolation

Whilst some people may be quite content with their own company much of the time, others prefer to spend most of their time with other people. But the vast majority of people benefit from spending some time with others. Research suggests that social isolation can lead to an increase in chronic stress.

Disempowering focus

A constant focus on negative or “bad” events, that a person has no control over, will trigger a heightened threat response in the brain.

Judgement of self

Self-judgement, especially when it involves negative criticism of who we are or how we look, can create unhelpful thinking patterns and feelings of worthlessness. This can increase chronic stress.

Mindset factors that can improve metabolic health

Connect

Spending time with people that share goals, purpose, and values can provide a sense of belonging and relatedness. Finding the common ground and connecting with these people will create a feeling of being in the ‘tribe’ and contribute to a reduction in stress.

Influence

If people have a sense of control and certainty in their life it can help to lower the threat response and thus reduce chronic stress. Where attention is directed can alter the perception of how much control and certainty a person has. By focusing on the aspects of our life that can be influenced the brain perceives a greater sense of control.

Notice

Noticing when our actions have achieved a beneficial outcome can provide a sense of achievement. A sense of achievement can help to lower the stress response, and thus improve insulin resistance.

Helpful coping strategies

Coping strategies are techniques or activities that work to reduce sudden stress. Whilst all coping strategies help to alleviate the immediate feeling of stress, not all coping strategies are beneficial for our long-term health.

Unhelpful coping strategies may help in the moment of sudden stress, but at the same time they run the risk of making tomorrow worse. This includes the use of alcohol and drugs.

Conversely, helpful coping strategies are those that help improve the sudden stress whilst also not having negative impact on life, or even better, they benefit long-term health. Examples include going for a walk or speaking with a friend.

Contents

How to achieve your goals

Success in achieving your goals starts with focusing on an important aspiration, what matters to you. Smaller checkpoints, or achievements, can help create focus on energy for success. And, it is daily actions and habits that make change happen. 

Aspiration

Aspiration is the better future you can visualise. You may like to think of the big goal you want to reach. Alternatively, your aspiration may not be a goal, but instead the direction you want to travel in. Perhaps most importantly, your aspiration needs to matter to you. The more you care the more likely you are to succeed. Think about what really matters to you. Why do you care? What inspires and excites you?

Example: “In three months I am going to have lost 8 inches from my waist, improve my type 2 diabetes, and do a 5km walk for charity.”

Achievements

Achievements are your checkpoints. They are shorter-term goals and ideally they need to be frequent, perhaps every few days, weeks, or months. These Achievement checkpoints give you something to focus on and work towards in the near future. They may be challenging but they also feel exciting and achievable. When you reach each checkpoint, you feel good and are inspired to continue your journey.

Actions

Actions are what you do today. They are the specific activities you can do every day, or most days, that will help you to reach your Achievements. Actions should be specific enough to be able to write down in a tick-list, then mark them off once you have done them. By repeating actions every day they can, over time, develop into habits. Habits require much less effort to perform and keep doing.

Contents

The 28 Day Plan

It is now time to put your metabolic health knowledge in to action with a 28 day plan. You can choose the 28 Day Rapid Results Plan or create your own 28 Day Personal Health Plan.

Over 28 days metabolic health can dramatically improve. In fact, improvement starts to happen within days with significant and lasting benefits noticed within a few weeks.

You have two plans to choose from:

  • The 28 Day Rapid Results Plan. This is ten specific actions you will do every day for 28 days. It will get results, but only follow this plan if it looks and feels right for you. If necessary, do speak with your healthcare professional before starting the plan.
  • Create your own 28 Day Personal Health Plan. This is suitable for everyone because you can tailor the daily actions to your personal preferences and needs. Consider the Health Foundations and the create specific daily actions you will take every day for 28 days. Go easy or hard, it us up to you.

 

Download and print the Metabolic Health 28 Day Plan resource pack. This has everything needed for the Rapid Results Plan or to create your Personal Health Plan.

Download your 28 Day Plan resource pack

Reviewing your progress

Taking a brief moment to review your progress can significantly increase your success. Make sure you do this with a helpful mindset. 

The Daily Review

Every day record your daily actions on your chart. At the end of each day, write down your total score. If you are doing the Rapid Results Plan your maximum daily score is 10 (the number of actions you successfully took). Take time to notice what went well each day.

The 7, 14 and 21 Day Reviews

At each 7 day interval review your progress. Ask yourself the following questions:

  • What happened and what was my total score over the past 7 days.
  • What has gone well?
  • What will I focus on for the next 7 days?

The 28 Day Review

At the end of day 28 it is time to reflect and celebrate. Ask yourself these questions:

  • Looking at your chart, how many ticks have you achieved?
  • What has gone well?
  • How do you feel? Have you noticed more energy, a clear mind, or improvements in your mood?
  • Have you noticed any changes in your body? Has your waistline changed? Is your body more toned?
  • What daily actions are you going to keep doing?
  • What will you do next? Do you want to repeat the same 28 day cycle? Do you want a short break? Or, do you want to create a new 28 Day Personal Health Plan?

Contents

Reflections

Metabolic health affects us all. It is the foundation of our physical and mental health.

I hope this article and the Metabolic Health 28 Day Plan has given you confidence in your health choices and helped you to achieve results that matter. Do share this resource with other people that may benefit from improved metabolic health and better physical and mental health.

Dr Campbell Murdoch