DES MOINES, Iowa — Metabolic dysfunction may be the most serious condition you’ve never heard of, and one in three Americans have it. That’s the bad news. The good news is preventing it is actually pretty simple.

“We have made it way too complicated,” says Dr. Andy Nish. “And why is that? Because we’re always trying to sell something, right?”

Nish has been practicing medicine for nearly 40 years, but it wasn’t until he was more than two decades into his career that he started studying nutrition, stress and sleep, all because of the alarming increase in cancer rates. Now, he’s teaching a class called “Aspire” in an effort to help people help themselves.

“It’s not about just food. It’s not just about movement. It’s not just about, you know, what’s in our food system,” he explains, “It’s about this concept called the exposome. And the exposome is everything we are exposed to from the time of birth till the time of death.”

Annie McCormick was in the pilot class two years ago.

“I knew I needed it,” she says. “I’m diabetic and at that point I was a bad diabetic and I needed help.” She’s been to every class since. “Well, you learn something new in every class, or it’s said a little bit different than it was said in the first class. So, you’re going, ‘Oh, yeah.’ You know, the light bulb will go off.”

Tim McCoy loves seeing those light bulb moments. He’s the reason the Aspire class exists.

“I thought, well, hey, could you come and be the medical director for this new thing? We didn’t have a name at the time. Yeah. So that was two and a half, almost two and a half years ago. “

Heather Charlson has also been there from the beginning.

“Oh, I’ve learned that it’s more than just what people think it is, whether it’s just nutrition and exercise. There’s so many more things that go into it, whether it’s your sleep quality, dealing with stress management or relationships.”

Big picture – that’s called “metabolic health” and many things can impact it. Metabolic dysfunction is when at least three of these symptoms are present — increased waist size, elevated blood triglycerides, low HDL cholesterol, high blood pressure, and elevated blood sugar. Those things increase the risk of having cardiovascular disease, diabetes, liver disease, kidney disease, and sleep apnea. Those conditions increase your risk of dying. That’s why new participants start the class with specific screenings.

“And as I explain to people, that blood test is not the end all, be all. We’re not trying to change a blood test,” explains Dr. Nish, “we’re trying to change how you feel. How do you feel emotionally? How’s your energy level?”

The blood test may not tell the whole story, but it’s definitely part of it. Annie lowered her A1C from eleven down to five, just one indicator of better health.

“When people are suffering, it’s just it’s very rewarding to see,” says Tim McCoy, “changing lives, that’s what it’s about.”