Metabolic Vulnerability
In brief
Section titled “In brief”- Metabolic vulnerability is reduced metabolic resilience and flexibility
- Often coincides with insulin resistance, inflammation, fatty liver, and declining fitness
- MVX index combines six biomarkers and predicts mortality more strongly than cholesterol alone
- Greatest benefit: nutrition, muscle/fitness, sleep, stress regulation, not smoking
- Consistency is more important than perfection
Where does the term come from?
Section titled “Where does the term come from?”In the research world, metabolic vulnerability is used for measurable metabolic dysregulation that is difficult to capture with a single marker. In The Lancet Healthy Longevity (2023), researchers therefore developed a multi-marker: a composite score that reflects multiple biological axes simultaneously.
That score is called the Metabolic Vulnerability Index (MVX). ‘Metabolic vulnerability’ describes increased susceptibility to damage from prolonged energy overload and metabolic dysregulation.
What is included in MVX?
Section titled “What is included in MVX?”MVX combines six biomarkers:
| Biomarker | What it reflects |
|---|---|
| GlycA | Chronic, systemic inflammation |
| Small HDL particle count | Often insulin resistance and HDL dysfunction |
| Citrate | Mitochondrial burden and reduced metabolic flexibility |
| BCAAs (valine, isoleucine, leucine) | Often elevated in insulin resistance and reduced amino acid oxidation |
Relationship with mortality
Section titled “Relationship with mortality”In the aforementioned analysis, MVX predicted all-cause mortality more strongly than classical lipid markers alone. MVX remained a strong predictor alongside known risk factors, and the pattern was applicable across different subgroups.
Lifestyle that favorably influences the risk profile
Section titled “Lifestyle that favorably influences the risk profile”Choose an approach you can maintain for 6 to 12 months. Consistency is more important than perfection.
Nutrition
Section titled “Nutrition”- Eliminate sugar-sweetened beverages and ultra-processed foods
- Limit starch to an appropriate level
- Eat 2-3 meals without snacking throughout the day
Muscle
Section titled “Muscle”- Strength training 2-3 times per week
- Move more daily
- Start simple: 10-minute walk after a meal
Fitness
Section titled “Fitness”- 150 minutes per week of easy-to-moderate activity
- Add 1 higher-intensity stimulus if safe to do so
Sleep and stress
Section titled “Sleep and stress”- Fixed rhythm and adequate sleep
- Daily 5-10 minutes of recovery (breathing, gentle walk, relaxation)
Smoking and alcohol
Section titled “Smoking and alcohol”- Do not smoke
- Be cautious with alcohol, especially with elevated triglycerides or fatty liver
What can you monitor without an MVX test?
Section titled “What can you monitor without an MVX test?”- Waist circumference and weight trend (especially abdominal fat)
- Blood pressure
- HbA1c and fasting glucose (and if possible, fasting insulin)
- Triglycerides and HDL cholesterol as directional indicators
- Liver values (ALT/AST) and if needed, assessment for fatty liver
- Fitness and muscle strength (stair climbing, brisk walking, strength exercises)
When additional evaluation is advisable
Section titled “When additional evaluation is advisable”References
Section titled “References”- The Lancet Healthy Longevity (2023). Metabolic Vulnerability Index (MVX) multi-marker study.
Veelgestelde vragen
What is metabolic vulnerability?
Metabolic vulnerability is an umbrella term for a metabolism that is less resilient and flexible. It often coincides with insulin resistance, chronic low-grade inflammation, fatty liver, unfavorable blood pressure, and declining fitness and muscle quality.
What is the MVX index?
The Metabolic Vulnerability Index (MVX) is a composite score from The Lancet Healthy Longevity (2023) that combines six biomarkers: GlycA (inflammation), small HDL particle count, citrate, and BCAAs (valine, isoleucine, leucine). This score predicts all-cause mortality more strongly than classical lipid markers alone.
How can I monitor metabolic vulnerability without an MVX test?
You can monitor: waist circumference and weight trend (especially abdominal fat), blood pressure, HbA1c and fasting glucose, triglycerides and HDL cholesterol, liver values (ALT/AST), and fitness/muscle strength (stair climbing, brisk walking).
What is the most important approach for metabolic vulnerability?
The greatest benefit comes from nutrition (fewer spikes and excess), adequate muscle and fitness, good sleep, stress regulation, and not smoking. Consistency is more important than perfection - choose an approach you can maintain for 6 to 12 months.
When is additional medical evaluation advisable?
When HbA1c/glucose is clearly abnormal or rapidly rising, blood pressure remains persistently elevated, fatty liver is suspected, there is unexplained weight loss or muscle wasting, or high cardiovascular risk due to family history or known vascular disease.
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Medical Disclaimer: The information provided by Stichting Je Leefstijl Als Medicijn regarding lifestyle, diseases, and disorders should not be construed as medical advice. Under no circumstances do we advise people to alter their existing treatment. We recommend that people with chronic conditions seek advice regarding their treatment from qualified medical professionals.