The Metabolic 6-Pack: Why true health isn’t just about looking good

True health vs aesthetic fitness

When we think of fitness, many of us picture a lean, chiseled physique with defined muscles—a traditional "6-pack." And to be fair, most of us young men prioritize this over anything at our age. Perhaps, we can afford to live off certain diets that are unconventionally “unhealthy” as long as we hit our macros for the day, thanks to our high metabolism. During my college years, I’ve met so many men and women who objectively look fit and muscular, yet are on a budgeted diet consuming pizza, ramen, leftover chicken tenders, fast food, etc.

However, it’s an unsustainable lifestyle, and the habits we build now are the building blocks for the rest of our lives. In other words, it’s not just about looking healthy—it’s about being healthy from the inside out, especially given our genetic predisposition to chronic illnesses.

As we navigate our fitness journeys, it’s important to recognize that the markers of health go far beyond how we look in the mirror. In fact, achieving something called the Metabolic 6-Pack (term coined by Dr. Ronesh Sinha, MD) can be far more beneficial for our overall well-being than working toward an ideal body image.

Hidden health risks in south asian bodies

As a South Asian, you may have heard about the growing concern around insulin resistance in our community. It’s a condition that is alarmingly common, and for many, it goes unnoticed until it leads to serious health issues like type 2 diabetes or heart disease. Our genetic predisposition, reliance on carbs and foods high in refined sugars, and sedentary habits, can set the stage for insulin resistance over time. Even if we appear “slim,” excess fat can accumulate internally around the liver and other vital organs—what we call "skinny-fat." This visceral fat is much more dangerous than the fat you can see on your belly.

Dr. Ronesh Sinha, a prominent physician in this field and author of The South Asian Health Solution: A Culturally Tailored Guide to Lose Fat, Increase Energy and Avoid Disease, has pointed out that we need to stop seeing insulin resistance and metabolic dysfunction as invisible or "normal." Instead, we should aim for a health framework that isn’t just about what we see on the outside but rather what’s happening inside our bodies. This is where the concept of the Metabolic 6-Pack comes in.

Metabolic 6-Pack: A healthier approach to fitnessUnlike a traditional 6-pack abs, the Metabolic 6-Pack isn’t about how you look—it's about how well your body is functioning internally. It’s a comprehensive set of markers to assess and improve your metabolic health. When you focus on achieving these goals, you are giving your body the tools it needs to fight insulin resistance, inflammation, and prevent diseases like heart disease and diabetes.
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Dr. Sinha’s Metabolic 6-Pack consists of six key metrics that he recommends we should strive for. These targets offer a more holistic and actionable approach to health, especially for South Asians.


1. Waist Circumference:

Less than 35 inches (90 cm) for men and less than 31 inches (80 cm) for women


2. Triglycerides:

Below 100 mg/DL (1.13 mmol/L).


3. HDL Cholestorol:

Above 40 mg/dL (1.03 mmol/L) for men and above 50 mg/dL (1.29 mmol/L) for women.


4. Blood Pressure:

Less than 120/80 mmHG


5. Fasting Blood Glucose and HbA1C:

Fasting blood glucose below 100 mg/dL (5.6 mmol/L) and HbA1c below 5.7%.


6. High-Sensitivity C-Reactive Protein (hs-CRP):

below 1.0 mg/dL


As mentioned earlier, South Asians are more likely to experience insulin resistance, even if they appear slim. Focusing on the Metabolic 6-Pack can help address the root causes of health problems that many South Asians face as they age.

South Asians are also at a higher risk of heart disease and diabetes, even at lower body weights. In fact, studies show that South Asians tend to have a higher level of visceral fat compared to other ethnic groups, even when their overall weight is within a normal range. This is why targeting metabolic health is crucial for us.

Shifting the focus

Here are some simple steps one may take to start a journey toward a healthier metabolic profile:
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1. Prioritize whole foods:

Vegetables, lean proteins, and healthy fats, while limiting refined carbs and sugars.


2. Stay Active:

Regular exercise, including both cardio and strength training. Physical activity helps regulate blood sugar, improve cholesterol levels, and reduce belly fat.


3. Monitor your numbers:

Get regular check-ups and ask your doctor to assess your waist circumference, triglycerides, HDL, blood pressure, and blood glucose. Keep track of these numbers, and use them as benchmarks to guide your health journey.


The next time you’re working on your fitness goals, remember: it's not about the number of abs you can see; it's about the health markers you can’t see. Achieving a Metabolic 6-Pack means you’re giving your body the tools to stay strong, prevent long-term disease, and live a long, healthy life.