We all know this saying, especially Nigerians. It’s a staple of Nigerian Pidgin, a piece of street logic that cuts through excuses: “Choose your hard.” Life guarantees struggle. You don’t get to opt out of difficulty. But you do get to choose which difficulty you will carry. You can choose the discomfort of discipline or the pain of regret. You can choose the strain of preparation or the stress of crisis. Both paths are hard. The wisdom is in choosing the hard that builds you up, rather than the one that tears you down.
We see this choice everywhere:
- Health: The hard of waking up to exercise vs. the hard of living with low energy and chronic illness.
- Finances: The hard of budgeting and saving vs. the hard of being broke and facing financial emergencies.
- Career: The hard of learning a new skill vs. the hard of being stuck in a dead-end job.
- Relationships: The hard of honest communication vs. the hard of resentment and broken homes.
Nowhere is this choice more critical (more life-or-death) than when we talk about Metabolic Syndrome. What is Metabolic Syndrome? It is not a single disease, but a cluster of conditions that occur together, dramatically increasing your risk of heart disease, Stroke, and Type 2 diabetes. Metabolic Syndrome is diagnosed when you have three or more of these risk factors:
- Large waistline: (Abdominal obesity) – 40 inches+ (men), 35 inches+ (women).
- High triglycerides: A type of fat in the blood.
- Low HDL cholesterol: The “good” cholesterol.
- High blood pressure: Consistently 130/85 mmHg or higher.
- High fasting blood sugar: A sign of insulin resistance.
The scary part? Metabolic Syndrome is often a “silent threat.” You can feel fine while the fires are burning inside.
When facing Metabolic Syndrome, you arrive at a crossroads with two distinct paths. Both are difficult. Which one will you choose?
Hard #1: The Hard of Lifestyle Intervention
This path requires immediate, conscious effort. It’s the hard of taking control.
- Dietary Change:Swapping sugary drinks for water. Choosing whole grains over white flour. Saying “no” to that extra serving.
- Regular Exercise:The hard of a 30-minute daily walk, of finding time for strength training, of choosing the stairs.
- Weight Loss:The hard of consistency to lose just 5-10% of your body weight, enough to dramatically improve insulin sensitivity.
- Stress & Sleep:The hard of prioritizing 7-9 hours of sleep and actively managing stress.
This path is a controlled hard. You are steering the ship. It builds self-efficacy, confidence, and energy for the long haul.
Hard #2: The Hard of Doing Nothing
This path seems easier today. You eat what you want, rest when you want, and ignore the numbers. But the “hard” is just delayed, and it returns with interest.
- Progressive Disease:The hard of worsening insulin resistance, rising blood pressure, and an eventual diagnosis.
- Complications:The hard of managing heart disease, kidney failure, or stroke. The hard of daily insulin injections.
- Medical Dependence:The hard of endless doctor visits, hospital stays, and mounting bills.
- Loss of Autonomy:The hard of becoming a burden on the ones you love.
This is an uncontrolled hard. The disease dictates the terms. It builds fear, anxiety, and dependency.
The Science is clear. This isn’t just philosophy. The evidence is overwhelming. Lifestyle modification is metabolic medicine.
- Weight Loss: A 5-10% reduction in body weight improves how your cells respond to insulin.
- Exercise: 150 minutes of moderate activity per week lowers blood pressure.
- Diet: A fibre-rich diet with minimal processed foods improves your cholesterol profile.
- Programs Work: Systematic reviews confirm that structured lifestyle programmes can reduce the incidence of metabolic syndrome by 20% to 69%.
Actionable Steps: Choosing Your Hard
If you are at risk, you don’t need to overhaul your life overnight. You just need to start choosing the right hard, one small step at a time. Start with these five actions:
- Walk Daily: Commit to a 30-minute brisk walk every day. It’s free and accessible.
- Cut Liquid Sugar: Eliminate all sugary drinks such as bottled or canned fizzy drinks, packaged juices, extra sugar in your tea. This one change is monumental.
- Prioritize Sleep: Set a goal of 7-8 hours of quality sleep per night. It’s when your body repairs.
- Know Your Numbers: Don’t guess. Get your blood pressure and fasting glucose or HbA1c checked
- Shrink the Waist: Aim to reduce your waist circumference by even 2-5 cm. It’s a powerful indicator of improving health.
There is the illusion of “It’s Not That Bad.” Many people say, “My sugar is just slightly high,” or “My BP is only borderline.” Metabolic Syndrome is dangerous precisely because it feels harmless in the early stages. Biology does not negotiate with denial.
A Reframe for the Mind
Instead of asking, “Why is exercise so hard?” ask yourself:
“Which hard do I prefer — structured discipline now, or structured disease later?”
Instead of, “Why must I cut down sugar?” ask:
“Do I want to manage cravings now, or insulin injections later?”
The Bottom Line
“Choose your hard” is not about self-punishment. It is about agency. It’s about recognizing that you have the power to decide which future you will fight for. You cannot choose whether life will be hard. But you can choose which hard you carry.
In metabolic health, that choice determines how long and how well you live.
I wrote about Lifestyle a decade ago on the Perfect Score as well as Knowing Your Numbers and more recently as a LinkedIn aritcle. I have been ‘choosing my hard’ (small small). What was my crossroads moment? A landmark age, unacceptable changes in crucial numbers, exceptional family / peer support and a determination to be fir noguht to run after my grandchildren in the park. Which path did I choose, and how has it shaped my life in the last month?
Here are some examples of my hard:
Only four weeks down the path, body weight has gone from 99.3kg to 91.1kg. Now that’s “insane” as it has been my desire to achieve 10% weight loss in a year. Whinmoor Fields provide breath-taking views for a walk or run. No excuses and when the weather is inclement, the treadmill at home is a worthy substitute.
Next step consistency in exercise and choosing another hard – regular sleep. I know it is not a sprint but a marathon. I have chosen my hard and you can bet my future self will thank me for it. What’s your hard?
Please comment if you have chosen your hard and perhaps inspire someone reading to do likewise.
Abiye Hector-Goma is a Leeds-based GP whose primary interest is in the broad determinants of health followed by supporting people to take responsibility for their health and wellbeing. Treating diseases is the least favoured part of his work because a stitch in time saves nine (diseases).