Written by Alex on Wednesday 4 November 2026
On 3 November 2026, I spent the day at the Nutrition4MetabolicHealth Summit, organised by our partner Swiss Food & Nutrition Valley (SFNV) together with Swiss Re. Researchers, doctors, insurers, food companies and start-ups came together around one question: how can we make the healthy choice the easy choice?
I went because I truly believe metabolic health is the future of health. At Eat by Alex, prevention is what we work towards every day: helping people stay well, rather than waiting until something needs to be cured. Eat by Alex took part in the round table that came before this summit, so it was a proud moment to see our logo among the partners on SFNV's "journey to the summit" slide.
Here is what metabolic health actually means, where Switzerland stands, what I learned from the two talks that stayed with me most, and the simple habits I am taking home with me.
What is metabolic health?
Metabolic health describes how well your body produces, regulates and uses energy [1]. In practice, doctors look at five simple markers. If three or more are outside the healthy range, this is called metabolic syndrome, a cluster that raises the risk of type 2 diabetes, heart disease and fatty liver [2]. Swiss Re estimates that poor metabolic health affects roughly half of all adults worldwide [3].
| Marker | Healthy range for women |
|---|---|
| Waist circumference | Below 80 cm, or less than half your height |
| Fasting blood sugar | Below 5.6 mmol/L |
| Triglycerides | Below 1.7 mmol/L |
| HDL ("good") cholesterol | 1.3 mmol/L or higher |
| Blood pressure | Below 130/85 mmHg |
A note on waist size: guidelines differ. The International Diabetes Federation uses 80 cm for European women, the American Heart Association 88 cm [2], and neither takes your height into account. The UK health authority NICE suggests a simple rule instead: keep your waist to less than half your height [4]. I am a good example. I am 179 cm tall and my waist is 85 cm, which is above the 80 cm line but well under half my height, and I am in good metabolic health. Use these ranges as a starting point for a conversation with your doctor, not as a verdict.
Why many women notice it from 40
If you feel that your body changed in your 40s even though your habits did not, you are not imagining it. During perimenopause and menopause, falling oestrogen levels make it easier to store fat around the middle rather than on the hips. At the same time, muscle mass slowly declines with age unless we actively protect it, and muscle is where most of the sugar from a meal ends up. Add busy days, short nights and stress, and the markers above can start to drift. Our article on hormones and menopause explains this in more detail.
Normal weight does not always mean metabolically healthy
Here is the surprising part: being at a "normal" weight does not automatically mean being metabolically healthy. In the United States, researchers found that only 6.8% of adults had optimal cardiometabolic health in 2018 [5]. Many people have one or two markers drifting out of range for years without knowing it.
Metabolic health in Switzerland: where do we stand?
Switzerland often feels like a healthy country, and in many ways it is. But the numbers presented at the summit tell a more nuanced story:
- 43% of people aged 15 and over in Switzerland live with overweight (31%) or obesity (12%), according to the Swiss Health Survey 2022 [6].
- CHF 91.5 billion was spent on healthcare in Switzerland in 2022, and about 72% of it went to non-communicable diseases such as cardiovascular disease, diabetes and cancer [7]. Prof. Simon Wieser of ZHAW showed that only around 1.9% of health spending goes to prevention.
- Women live longer, but not always healthier. Lars Hartenstein of the McKinsey Health Institute presented data showing that women in Switzerland spend around 13 to 14 years of their lives in poor health [8].
The most hopeful slide of the panel compared two futures for Switzerland. Treating obesity once it is there could add around 227,000 healthy life years. Focusing on metabolic health for the whole population, with prevention first, could add around 854,000 [8]. Globally, McKinsey estimates that this prevention path could add 3.5 times more healthy life years than focusing on obesity treatment alone. Prevention is not a nice extra. It is the bigger lever. And it is not only a task for doctors and politicians: it starts with what lands on our plates, whether you grew up with Birchermüesli or moved to Zurich last year.
My highlight: Prof. Ben Bikman on the insulin resistance nobody checks
My favourite talk of the day came from Prof. Benjamin Bikman, a metabolic scientist at Brigham Young University. His message was simple and powerful: insulin resistance is the hidden root of many chronic diseases, and almost nobody looks at it.
Insulin is the hormone that helps move sugar (glucose) from your blood into your cells. When cells start responding less to insulin, the body compensates by producing more of it. For years, sometimes a decade or more, your blood sugar can look perfectly normal on a check-up, while your insulin is quietly working overtime. Only when the body can no longer keep up does blood sugar rise, and by then, type 2 diabetes may already be on its way.
This is why Bikman argues we often measure the wrong thing, or measure it too late. Routine check-ups usually look at blood sugar, not insulin. Swiss Re's own analysis makes the same point: insulin can be elevated up to a decade before blood sugar starts to climb, yet insulin resistance testing has not yet entered mainstream medicine [3]. If you want to go deeper, his episode Why does insulin resistance matter? on The Metabolic Classroom podcast is a great place to start.
And if you have 37 minutes, this is the talk that really inspired me personally: Prof. Bikman on the mechanisms of high insulin, filmed at Swiss Re's Food for Thought conference in 2023. It is quite technical, but it changed the way I think about insulin.
The roots of insulin resistance shown at the summit were very familiar to me: a poor quality diet, lack of sleep, chronic stress and too much sitting. For many women juggling work, family and everyone else's needs, at least three of those four are part of daily life. It is not a willpower problem. It is physiology, and the good news is that physiology responds to small, consistent changes: insulin resistance can, through lifestyle and nutrition, be prevented and significantly reversed [3].
Fatty liver (MASLD): the rising disease Prof. Mojgan Masoodi wants us to talk about
The second talk that stayed with me came from Prof. Mojgan Masoodi, Associate Professor and Head of Research at Inselspital, the University Hospital of Bern. She spoke about a disease she sees rising and that very few people outside medicine have heard of: MASLD, short for metabolic dysfunction-associated steatotic liver disease. It used to be called non-alcoholic fatty liver disease (NAFLD), and it means that fat builds up in the liver cells for reasons that have nothing to do with alcohol [9].
The numbers she showed are striking. MASLD affects an estimated 38% of adults worldwide, around 65% of people with type 2 diabetes and 70 to 85% of people living with obesity [10]. It is closely linked to insulin resistance, which is why her talk and Bikman's fit together so well. And it is usually silent: most people find out by chance, through a blood test or an ultrasound done for another reason. If you want to know more, your doctor can check your liver values and, if needed, order an ultrasound or a FibroScan, a quick scan that measures liver fat and stiffness [9]. A DEXA scan, which many people use to track body composition, does not measure liver fat, but it does show how much visceral fat you carry around your organs, which is a useful warning sign.
Fatty liver can progress in stages: from a healthy liver, to fat in the liver cells, to inflammation (MASH), to scarring and, in some cases, to liver cancer. It also raises the risk of heart disease and chronic kidney disease [9]. The hopeful message: the early stages are reversible.
On the food side, Prof. Masoodi named the main drivers as a high intake of ultra-processed foods, fructose-sweetened drinks and added sugars, and a lack of healthy food choices. Then she showed what nutrition can do:
- A Swiss result: in the CoLaus cohort from Lausanne, people who followed a Mediterranean-style diet most closely had about half the risk of developing a fatty liver over five years [11].
- The type of fat matters: when volunteers ate 1,000 extra kcal a day for three weeks, liver fat rose by 55% with saturated fat (coconut oil, butter and cheese), 33% with sugar and only 15% with unsaturated fat [12]. Not all saturated fats are alike, though. Medium-chain fats (MCTs, as in MCT oil) are absorbed and burned differently from the long-chain saturated fats in butter, cheese and meat: they travel straight to the liver and are used quickly for energy rather than stored [13].
- Plants make a difference: in the DIRECT-PLUS trial, a "green" Mediterranean diet, rich in plants, walnuts and green tea, reduced liver fat by 38.9% over 18 months, compared with 19.6% for a classic Mediterranean diet and 12.2% for standard healthy eating advice [14].
As someone who has built a business on whole food, plant-based nutrition, that last result made me smile.
What actually helps: 5 takeaways I am applying
1. Eat your carbs last, and make them whole
Bikman showed that of the three macronutrients, carbohydrates raise insulin the most, protein raises it moderately and fat very little. So the order in which you eat matters. In a small study of people with type 2 diabetes, eating the vegetables, protein and fat of a meal before the bread and juice lowered the rise in blood sugar by about 73% and the rise in insulin by about 49% [15]. A follow-up study confirmed a similar effect [16].
These studies were small and done in people with diabetes, so the effect in healthy people may be smaller. But it is free, easy and costs nothing to try: start with your salad or vegetables, then your protein, and finish with the rice, pasta or bread.
And when the carbs come, make them whole: wholegrain bread, brown rice, quinoa, oats, potatoes with their skin or lentils, rather than white bread, white rice or juice. Whole carbohydrates come with their natural fibre, which slows down how quickly sugar reaches your blood.
A note on fat: as Prof. Masoodi showed, the type matters [12]. So when you start your meal with fat, choose olive oil, nuts, seeds and avocado.
2. Take a short walk after meals
Another point from Bikman's talk: muscle is the main consumer of glucose in the body. When your muscles move after a meal, they take up sugar from the blood. A review of studies found that light walking breaks lowered blood sugar after meals by about 17% on average compared with sitting, and improved insulin too [17]. Even 10 to 15 minutes after lunch or dinner counts. A walk along the lake or the Limmat after Zmittag (lunch) is one of my favourite habits. It's also a great opportunity to take my dog out.
3. Make protein a priority from 40
Paolo Colombani of Notabene Nutrition presented data suggesting that many of us need more protein as we age than the classic 0.8 g per kg of body weight. In a study of adults aged 50 to 70, those eating 1.5 g per kg gained lean mass, while those eating less did not [18]. In a large study of adults aged 60 to 75, intakes around 1.2 to 1.6 g per kg were linked to a lower risk of death [19]. Protein helps protect muscle, and as Bikman reminded us, muscle is your biggest ally for blood sugar. Plant proteins such as tofu, tempeh, lentils, chickpeas and edamame all count. Our easy high-protein recipes are a good place to start.
4. Choose whole, plant-rich foods
Matthew Watkins of the World Economic Forum showed how the average daily calorie supply worldwide has grown from around 2,200 kcal in 1961 to around 3,000 kcal today, with more sugar, oils and fats. Whole foods bring fibre, which slows down how fast sugar reaches the blood and feeds your gut bacteria. The green Mediterranean diet results Prof. Masoodi presented point in the same direction: more plants, more benefit [14]. For more ideas, read our gut health diet plan.
5. Protect your sleep and manage stress
Two of the four roots of insulin resistance shown at the summit were lack of sleep and chronic stress. Short nights also make evening cravings more likely, which I wrote about in our article on cravings vs hunger. A regular bedtime is one of the most underrated metabolic habits.
Metabolic health on a busy day: simple swaps
None of this needs hours in the kitchen. Here is how these ideas fit into a typical Swiss day, from Znüni (the mid-morning snack) to Znacht (dinner):
| Moment | Instead of | Try |
|---|---|---|
| Breakfast | Croissant and orange juice | Overnight oats with seeds and plant yogurt, or our ready-made Morning Mixes with Skyr |
| Znüni Snack | Gipfeli or biscuits | A handful of nuts and an apple |
| Zmittag Lunch | Sandwich eaten at the desk | A side salad first, then the sandwich, then a 10 minute walk |
| Zvieri Snack | Something sweet from the office kitchen | Hummus with vegetable sticks or edamame |
|
Znacht Dinner |
A big bowl of pasta | Vegetables and tofu or lentils first, a smaller portion of pasta last or alternatively use lentil pasta |
Know your numbers
If you want to know where you stand, ask your GP (Hausarzt) for a check of the five markers above: waist, fasting blood sugar or HbA1c, triglycerides, HDL cholesterol and blood pressure. Many pharmacies in Switzerland also offer quick checks for blood pressure, blood sugar and cholesterol. Given Bikman's talk, you can also ask whether measuring fasting insulin makes sense for you.
My next experiment: a glucose sensor
Every participant at the summit received a continuous glucose monitor (CGM), a small sensor that tracks your blood sugar day and night. I cannot wait to test it, and I will share what I learn. One thing I already keep in mind: blood sugar rising after a meal is completely normal. The goal is not to avoid every rise, but to understand your own patterns.
Where Eat by Alex fits in
The theme of the summit, making the healthy choice the easy choice, is exactly why I started Eat by Alex. Our programs are plant-based, made from whole foods and prepared locally in the canton of Zurich, so that eating well does not depend on having time to cook.
Many of our customers use reSET, our 5-day fasting-mimicking program, as a structured break from their usual routine a few times a year. If you are not sure which program suits you, our guide Which nutrition program is for you? can help. And if you are curious how fasting-mimicking relates to metabolism, read Does fasting-mimicking boost metabolism?
We are also working with Prof. Dr. med. Pierre-Alexandre Krayenbühl, specialist in general internal medicine, on a special program tailored to his patients who wish to maintain their weight. More on that soon.
Frequently asked questions
What is metabolic health?
Metabolic health is how well your body produces, regulates and uses energy. It is usually assessed with five markers: waist circumference, blood sugar, triglycerides, HDL cholesterol and blood pressure.
Can you be metabolically unhealthy at a normal weight?
Yes. Some people have a normal weight but raised blood sugar, blood pressure or triglycerides, or fat stored around the organs. Weight alone does not tell the full story.
What are the signs of insulin resistance?
Insulin resistance often has no clear symptoms for years. Possible signs include weight gain around the waist, raised blood pressure or triglycerides, and energy dips after meals. Only a doctor can assess it properly and a blood test is necessary.
Does the order you eat food in affect blood sugar?
Small studies suggest that eating vegetables, protein and fat before carbohydrates can lower the rise in blood sugar and insulin after a meal [15, 16].
Is walking after a meal good for blood sugar?
Yes. Light walking after eating helps your muscles take up glucose and lowers blood sugar after meals compared with sitting [17].
The bottom line
Metabolic health is not about a number on the scale. It is about how well your body handles energy, and insulin is at the heart of it. The summit reminded me that the most powerful tools are also the simplest: eat your carbs last, move after meals, prioritise protein and whole plant foods, sleep well and know your numbers. Small steps, repeated every day, are what prevention looks like.
Disclaimer
This article is for information only and does not replace medical advice. reSET isn't suitable for everyone, including if you are pregnant, underweight, taking medications, or managing diabetes, a thyroid condition, or another medical condition. Please consult a doctor or dietitian before starting. For more information, refer to our reSET FAQ page.
Sources
- World Economic Forum. Catalysing Cross-Sector Leadership for Metabolic Health. Briefing paper, January 2026.
- Alberti KG, Eckel RH, Grundy SM, et al. Harmonizing the metabolic syndrome. Circulation. 2009;120(16):1640-1645.
- Swiss Re. Life & Health Trend Spotlight: Metabolic Health. Tackling wellbeing from the inside out. October 2023.
- National Institute for Health and Care Excellence (NICE). Keep the size of your waist to less than half of your height. April 2022.
- O'Hearn M, Lauren BN, Wong JB, Kim DD, Mozaffarian D. Trends and disparities in cardiometabolic health among U.S. adults, 1999-2018. Journal of the American College of Cardiology. 2022;80(2):138-151.
- Federal Statistical Office (BFS). Swiss Health Survey 2022: overweight or obesity in 43% of the population. 21 November 2024.
- Federal Office of Public Health (FOPH). Study on the costs of non-communicable diseases (ZHAW, University of Lucerne, BFH). November 2025. Presented by Prof. Simon Wieser (Stucki et al., 2025).
- McKinsey Health Institute. Presentation by Lars Hartenstein at the Nutrition4MetabolicHealth Summit, 3 November 2026 (data: Global Burden of Disease, IHME, 2021); and El Turabi A, Ungerman D, Ahlawat H, Hartenstein L. The path toward a metabolic health revolution. McKinsey Health Institute, May 2025.
- European Association for the Study of the Liver (EASL), EASD, EASO. EASL-EASD-EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD). Journal of Hepatology. 2024;81(3):492-542. Presented by Prof. Mojgan Masoodi.
- Younossi ZM, Kalligeros M, Henry L. Epidemiology of metabolic dysfunction-associated steatotic liver disease. Clinical and Molecular Hepatology. 2025;31(Suppl):S32-S50. Presented by Prof. Mojgan Masoodi.
- Khalatbari-Soltani S, Imamura F, Brage S, et al. Prospective association between adherence to the Mediterranean diet and hepatic steatosis: the Swiss CoLaus cohort study. BMJ Open. 2020;10(12):e040959.
- Luukkonen PK, Sädevirta S, Zhou Y, et al. Saturated fat is more metabolically harmful for the human liver than unsaturated fat or simple sugars. Diabetes Care. 2018;41(8):1732-1739.
- Schönfeld P, Wojtczak L. Short- and medium-chain fatty acids in energy metabolism: the cellular perspective. Journal of Lipid Research. 2016;57(6):943-954.
- Yaskolka Meir A, Rinott E, Tsaban G, et al. Effect of green-Mediterranean diet on intrahepatic fat: the DIRECT PLUS randomised controlled trial. Gut. 2021;70(11):2085-2095.
- Shukla AP, Iliescu RG, Thomas CE, Aronne LJ. Food order has a significant impact on postprandial glucose and insulin levels. Diabetes Care. 2015;38(7):e98-e99.
- Shukla AP, Andono J, Touhamy SH, et al. Carbohydrate-last meal pattern lowers postprandial glucose and insulin excursions in type 2 diabetes. BMJ Open Diabetes Research & Care. 2017;5(1):e000440.
- Buffey AJ, Herring MP, Langley CK, Donnelly AE, Carson BP. The acute effects of interrupting prolonged sitting time in adults with standing and light-intensity walking on biomarkers of cardiometabolic health in adults: a systematic review and meta-analysis. Sports Medicine. 2022;52(8):1765-1787.
- Church DD, et al. Journal of Nutrition. 2025;155:1364-1372. Presented by Paolo Colombani, Notabene Nutrition.
- Carballo-Casla A, et al. JAMA Network Open. 2024;7(8):e2426577. Presented by Paolo Colombani, Notabene Nutrition.