Favorite biomarker of your health?

[imoldernu]

High BMI? Don't panic!

BMI's over 30 are further categorized as 1,2,3 based on risk.

The simplicity of setting standards, has caused some to become discouraged because of the seeming impossibility of losing many pounds to become "healthy". Looking at a year of dieting to lose 25 or 30 pounds... especially for older persons, can cause one to throw up his/her hands and say "it's too late!"

Depending on how deep one goes into understanding BMI, there are cases where the term... "Obese", isn't a be-all. In particular, dense muscle tissue can have an effect.

Another part comes from the "holier than thou" attitude of those who have a low BMI, or even doctors who can lay a guilt complex on their patients.

(I would add that age can have an effect on the ability to lose large amounts of weight quickly)

This in no way is meant to denigrate or deny the benefits of a healthy weight, but to put the rating system into context. As it is, two thirds of U.S. citizens are classified as obese using the current standards.

This article may help understand a little bit more behind the numbers.
https://www.forbes.com/sites/geoffreykabat/2013/01/06/how-useful-is-body-mass-index-in-predicting-long-term-health/#41e55d4f1c38

Excerpt:

The authors used standard categories of BMI: 18.5-<25 (normal weight), 25-<30 (overweight), and >=30 (obese). The last category was further subdivided into 30-<35 (class 1), 35-<40 (class 2), and >=40 (class 3).

What they found is that, compared to normal weight individuals, those in the overweight category had a lower risk of dying of any cause, and those in the obese category had an elevated risk. However, more than half of those in the obese category were in class 1, and these individuals had no increased risk of dying compared to normal weight individuals. Class 2 and 3 individuals did have a significantly elevated risk of death.

 

[bjorn2bwild]

Cedars-Sinai has developed a new simpler and more accurate method to determine body fat - the RFM (relative fat index) -

While the BMI is commonly accepted, many medical experts in the field of obesity consider it to be inaccurate because it cannot distinguish among bone mass, muscle mass and excess fat. BMI also does not account for the influence of gender—women generally have more body fat than men
The new formula developed at Cedars-Sinai is called the relative fat mass index, or RFM, and it uses only height and waist circumference measurements.

https://www.cedars-sinai.org/newsro...rs-develop-more-accurate-measure-of-body-fat/

 

[RAE]

Some people are mentioning cholesterol, so I want to add that most cholesterol labs are fairly useless as indicators of health or cardiovascular risk. There was some very bad science 30 years ago, which was picked up and reinforced by politicians and then the food industry, which resulted in decades of bad advice about nutrition, which many believe is largely responsible for the epidemic in obesity, diabetes, heart disease, etc., over the same period of time.

There are a lot of myths about cholesterol. I've found it very helpful to dig into the issue and get educated myself. It's pretty startling, when you realize how much bad information there is out there. There are plenty of Youtube vids and articles that can be very illuminating.

+1. Big Pharma continues to promote the false notion that "high" cholesterol (over 200) is a warning sign for heart disease/heart attack, when there is zero evidence for that. They promote it, because statins are the biggest money-making drug of all time, so it is in their interest to put as many people on statins as possible.

If you want to look at blood lipids for a better predictor of heart disease risk, look at triglyceride/HDL ratio. That is a fairly good predictor of heart disease risk, as confirmed by many studies. But Big Pharma does not have any good drugs to reduce triglycerides (you can reduce them by lowering your carb. consumption), so you won't hear much about the trig./HDL ratio from them (or from most doctors), unfortunately.


https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2664115/

 

[braumeister]

If you want to look at blood lipids for a better predictor of heart disease risk, look at triglyceride/HDL ratio. That is a fairly good predictor of heart disease risk, as confirmed by many studies.

Yes, and it's easy to check.
Just divide your triglycerides by your HDL.
If it's under 3 you're probably in good shape by this measure.

 

[sengsational]

My left pinkie when I wake in the morning. It's a sensitive indicator of inflammation. I think it's better than hsCRP. Sometimes there's no sensation, so yesterday's food, activities, mental state gets a check mark. Or if it hurts a bit, I think about what's different.



But the process got whacked: yesterday during yard work, I scraped a knuckle on, you guessed it, my left pinkie. Now I need for that to heal before the subtle indicator will be useful again.

 

[The Cosmic Avenger]

I started exercising a lot more regularly at the beginning of this year, and I was very pleased to note recently that my resting HR and diastolic pressure both dropped by 10 since last year, to 62 & 65. They were OK for someone who was sedentary, but now they're at least a bit on the healthy side of average, which is fine because that's exactly how I would describe me.

 

[Ronstar]

Resting heart rate, weight, and blood work numbers. Rhr was in low 30’s and weight in my 160’s a couple of years ago when I was running a lot. But I didn’t feel good. Dr convinced me to limit running and gain weight. So I did and I feel a lot better. Rhr is now in mid 50’s and weight in upper 180’s. I need to get the weight down to my normal weight of 180-185, but my last blood work checkup was my best.

 

[msieweke]

I keep my eye on several indicators:

eGFR (53) - kidney function is low due to hypothyroidism and mercury, aiming for >60
25OH-D3 (68) - vitamin D probably helps with heart disease, cancer, and more
triglyceride/HDL ratio (0.75) - indicates heart attack risk (<3 is good)
ferritin (45) - low due to hypothyroidism, aiming for >50
blood pressure (120/80) - reflects kidney and thyroid function
fasting glucose (89) - would like this to be lower

I also track my weight, waistline, pulse (during exercise), and soreness in my feet (gout). If any one gets out of line, I make small changes to fix it. No single biomarker gives me the whole picture. None gives me a free pass, although I don't worry much about heart disease or cancer.

 

[msieweke]

BTW - Low resting heart rate may be an indicator of hypothyroidism. Over-exercising may lower thyroid function.

 

[RAE]

triglyceride/HDL ratio (0.75) - indicates heart attack risk (<3 is good)
ferritin (45) - low due to hypothyroidism, aiming for >50

Your trig./HDL ratio is outstanding. I have a friend (who works out more than I do, and eats an even lower carb diet than I do) who has managed to lower his to 0.56, but 0.75 is very, very good. Mine is a bit higher than that, but still pretty good.

Just FYI, when I was having a bunch of health issues a couple years ago, I finally traced the problem to my ferritin being way too high. Mine was near 400, and it should be around 100 or less. Once I donated blood and got it down under 150 or so, the troubling symptoms I was having all went away. My ferritin is now around 80 or so, and I'm trying to keep it in that area, which I can do if I donate blood at least once or twice yearly.

 

[msieweke]

Some doctors say you can't go too low with ferritin. Other doctors say women may experience hair loss if it's lower than 70. I'm not female, but I think 70 is a good target.

Between May, 2011, and Dec, 2013, mine went from 87 to 9. It may have bottomed earlier, but that's when the doc tested me. Iron is needed to convert thyroid hormone from T4 to T3 (not sure the exact mechanism). T3 is needed to absorb iron. It's a downward spiral. I can say with some certainty that I didn't feel better until ferritin rose above 40.

Edit: I may have that wrong. Iron may be needed to produce T4. The effect is the same.

 

[ER Eddie]

If you want to look at blood lipids for a better predictor of heart disease risk, look at triglyceride/HDL ratio. That is a fairly good predictor of heart disease risk, as confirmed by many studies. But Big Pharma does not have any good drugs to reduce triglycerides (you can reduce them by lowering your carb. consumption), so you won't hear much about the trig./HDL ratio from them (or from most doctors), unfortunately.

Yes, and as an individual anecdote, I'll just say that I my triglyceride level got cut in half when I went low carb.

Yes, and it's easy to check.
Just divide your triglycerides by your HDL.
If it's under 3 you're probably in good shape by this measure.

Ah, thanks for the formula. I didn't know. My ratio is a little under 2, so that's good. It was over twice that before I went on a low-carb diet, though. It troubles me, to think about all the damage I did to myself, eating the SAD. Oh well, can't change the past, only the future...

Excerpt:

"What they found is that, compared to normal weight individuals, those in the overweight category had a lower risk of dying of any cause, and those in the obese category had an elevated risk. However, more than half of those in the obese category were in class 1, and these individuals had no increased risk of dying compared to normal weight individuals. Class 2 and 3 individuals did have a significantly elevated risk of death.

Yeah, that's an interesting result that has apparently been widely replicated. I've read about it elsewhere. Apparently obesity researchers don't like to hear it, but it keeps getting demonstrated.

BMI is another one of those indicators that is not all it's cracked up to be. I think they use it because it's so easy to measure/calculate, not because it's particularly informative.

Even so, if I have to make an "eyeball" assessment of someone's health, I'll look at their belly fat. I think that's a pretty good correlate of insulin resistance, which seems to underlie a lot of health problems.

I'm not judging. Six months ago, I probably looked like I was pregnant. It was not good.

 

[Bamaman]

My wife is a Medical Technologist, and she managed laboratories in a number of major hospitals. A full blood chemistry panel is where doctors first look to analyze a patient's physical well being. If there are problems in one area, they may do other more specialized testing.

When I started dating her in 1981, I was young and fancy free. She brought home her vacutube and drew blood from me for a chem analysis. The blood workup showed indications that I was taking in entirely too much alcohol. (I no longer drink.)

At the same time, I was pulling a credit bureau report on her to make sure she was fiscally healthy and in decent financial condition. LOL!

What really gets us is adults thinking they're invincible in the health department. So many adults fail to get periodic physicals that include blood tests, chest X-rays and PAP smears (in ladies).

My wife had a bad PAP smear, and she was referred to a GYN Oncologist in a major medical center. He did surgery and found her to have an extremely fast growing uterine cancer. Had she been skipping PAP smears or not having physicals, she would have been terminal in six months. She's 12 years cancer free right now.

Our favorite niece was married to a Belgian and living outside of London. She had not been taking a proactive stance on her healthcare and going to the doctor. When they found out she had uterine cancer, they first tried radiation and chemo. Treatments were not aggressive enough and the surgery was too late. We buried her a year later in Memphis.

We had one friend recently die of lung cancer. When he failed to go to the doctor about his hacking cough or get a periodic physical, the cancer was stage IV when discovered. Unfortunately, this is the norm rather than a specialized case.

So you can see how important that aging people get yearly physicals and also need to go to quality doctors.

 

[sengsational]

What they found is that, compared to normal weight individuals, those in the overweight category had a lower risk of dying of any cause, and those in the obese category had an elevated risk.

Yeah, that's an interesting result that has apparently been widely replicated. I've read about it elsewhere. Apparently obesity researchers don't like to hear it, but it keeps getting demonstrated.

BMI is another one of those indicators that is not all it's cracked up to be. I think they use it because it's so easy to measure/calculate, not because it's particularly informative.

Even so, if I have to make an "eyeball" assessment of someone's health, I'll look at their belly fat. I think that's a pretty good correlate of insulin resistance, which seems to underlie a lot of health problems.

I'm not judging. Six months ago, I probably looked like I was pregnant. It was not good.

There's a basic problem here...As a person starts getting less healthy (not sick yet, just less healthy), they begin to drop some pounds. Then they get sick and they lose even more. So by the time they discover some culprit that's going to end-up killing them, they're not as fat as they used to be, and the study rates them as a non-overweight person who died of "X". I recall several of these studies suffered horribly from this problem, but the popular press got lots of clicks from overweight people that wanted to believe that being fat was healthy.

 

[Teacher Terry]

It is interesting that a pap smear intended to find cervical cancer found uterine cancer. I looked it up and it can happen so wow your wife was lucky. They don't recommend pap smears anymore after age 65. I think it is because cervical cancer is rare in women older than that.

 

[ER Eddie]

There's a basic problem here...As a person starts getting less healthy (not sick yet, just less healthy), they begin to drop some pounds. Then they get sick and they lose even more. So by the time they discover some culprit that's going to end-up killing them, they're not as fat as they used to be, and the study rates them as a non-overweight person who died of "X". I recall several of these studies suffered horribly from this problem, but the popular press got lots of clicks from overweight people that wanted to believe that being fat was healthy.

Another possibility is that having a slightly 'elevated' BMI is protective of health in some ways, e.g., in an emergency (which is where much of this data comes from). After all, our bodies were designed to store fat for emergencies.

There are a lot of potential explanations, though. That's the problem with correlational data, whether it's BMI or whatever. There are always a multitude of uncontrolled confounds. It's very difficult to reliably draw conclusions.

It's counter to what the researchers expected or wanted, though, which means it's worth paying attention to, because it may signal an error in underlying assumptions.

Or it may just point to a limitation in BMI. After all, it's a rather crude, simplistic index. I wouldn't expect it to be a 100% reliable marker of "health," which is a complex concept.

 

[6miths]

How I feel.

That's not a flippant answer. I think that's the best indicator, above any one particular lab value.

Do I feel good, healthy, vibrant? Do I feel like I have good energy? Do I feel mentally sharp? Is my mood pretty good and stable? Do I feel a sense of well being? That's my most important gauge.

I like this one. I usually aim for a wailing James Brown version!

Outlook and mental health are so important to true well being. I liked Braumeister's 'Full length mirror' comment too. It is not unreasonable to consider RHR, waist:hip ratio, or even VO2 max but the thought that so many folks have come to believe that a lab value is the best indicator of health or well-being is a bit disconcerting in my mind. Seems to me that people have been sold a bill of goods.

 

[RAE]

I like this one. I usually aim for a wailing James Brown version!

Outlook and mental health are so important to true well being. I liked Braumeister's 'Full length mirror' comment too. It is not unreasonable to consider RHR, waist:hip ratio, or even VO2 max but the thought that so many folks have come to believe that a lab value is the best indicator of health or well-being is a bit disconcerting in my mind. Seems to me that people have been sold a bill of goods.

I look at it a little differently. I absolutely take note of how I feel (both physically and mentally), and what I see when I look in the mirror, as an important gauge of my health and well-being. But you can feel good and look pretty good and still have some things slowly going off-course, which is where the value of certain lab tests comes in. For example, my blood triglycerides are good now, and I hope they stay that way, but I won't know that for sure unless I have that blood test done periodically. If the test indicates that trig. are starting to creep up, I know that I probably need to tweak my diet, or do something else, to bring that back into line. So, I think lab tests like that can be important in that they can give you an early warning if something is starting to deteriorate. But certainly, how you feel and look (generally) is always the first thing to take note of.

 

[6miths]

Yes that's probably exactly the way that the labs would like people to look at it but the truth is that once one has done a few baseline tests to rule out that one has a genetic abnormality of lipid metabolism then lab tests are of little value if one lives a reasonably active life, maintains a normal weight and eats reasonably. If one is using a normal lipid profile, Hb A1c or other lab test to reassure oneself that they are healthy when they are not doing the aforementioned then they are likely doing themselves a disservice.

 

[RAE]

Yes that's probably exactly the way that the labs would like people to look at it but the truth is that once one has done a few baseline tests to rule out that one has a genetic abnormality of lipid metabolism then lab tests are of little value if one lives a reasonably active life, maintains a normal weight and eats reasonably. If one is using a normal lipid profile, Hb A1c or other lab test to reassure oneself that they are healthy when they are not doing the aforementioned then they are likely doing themselves a disservice.

We are basically in agreement. It's pretty easy, though, to slowly slip a bit in regard to some of the lifestyle things you mention (diet, activity, etc.) without really realizing it or acknowledging it. If that happens, sometimes a poor lab test result could be the thing to wake you up so that you can make a course correction.
There was one instance for me where a poor lab test result was critical to figuring out what was wrong with me. I felt terrible a few years back, and had no idea why. Nothing much had changed with my diet or activity level. The docs had no idea what was going on either, until a lab test revealed that my ferritin (iron) level was way higher than normal. Iron is something that can slowly creep upward in some people over your lifetime (guys, especially), since the male body really has no way of getting rid of excess iron. Without taking some corrective action based on that one lab test (donating blood a few times, in my case), I'm sure I would have gotten even sicker. So there can be some value to lab tests, even if you think your lifestyle and diet are okay.

 

[John Galt III]

Blood glucose. Weight. Blood pressure. HDL/cholesterol ratio. My so-called bad chol is always high, but my ratio is OK. Glad I resisted my pcp's urgings to go on statins. I get moderate exercise by walking uphill. Can't work out upper body since it just aggravates an upper back soreness, and I don't want to make worse whatever is going on in there.

 

[O2Bfree]

I've become interested lately in Heart Rate Variability, which is the change in time between heartbeats.

https://www.datasci.com/solutions/cardiovascular/heart-rate-variability-(hrv)

Factors that can affect HRV

• Reflexes (baroreceptors, chemoreceptors, cardiopulmonary receptors)
• Respiration
• Renin-angiotensin System
• Physical or Mental Stress
• Exercise
• Cardiovascular (CV) and Non-CV Disease States
• Age
• Drugs (beta-blockers, atropine, glycosides, anesthetics, etc)

I haven't invested in a measurement tool for HRV, but do notice that when I'm feeling my best physically and mentally, my heart rate slows down very noticeably when I exhale. If I'm feeling ill or stressed, the rate change is not so noticeable.

 

[mpeirce]

I haven't invested in a measurement tool for HRV

I was playing with the Apple Watch's EKG this week (the software was released in the US this week) and was looking at the various heart related stats it has. I noticed that it logs a daily Heart Rate Variability number.

Just FYI

 

[ejman]

With retirement I have more time for exercise and awareness of my health. My weight is fine and I don't follow running distances, exercise durations, max lifts, etc. Doctor visits and blood work is not done often enough for my near term feedback.

The metric that works best for me in Resting Heart Rate. I wear a Fitbit and monitor the RHR daily because I have seen a personal correlation between healthy living (good diet, exercise, regular schedule) and lower RHR. There is some related research below.

What biomarker do others use?

https://www.health.harvard.edu/blog...an-reflect-current-future-health-201606179806

Orgasms/week.

 

[6miths]

We are basically in agreement. It's pretty easy, though, to slowly slip a bit in regard to some of the lifestyle things you mention (diet, activity, etc.) without really realizing it or acknowledging it. If that happens, sometimes a poor lab test result could be the thing to wake you up so that you can make a course correction.
There was one instance for me where a poor lab test result was critical to figuring out what was wrong with me. I felt terrible a few years back, and had no idea why. Nothing much had changed with my diet or activity level. The docs had no idea what was going on either, until a lab test revealed that my ferritin (iron) level was way higher than normal. Iron is something that can slowly creep upward in some people over your lifetime (guys, especially), since the male body really has no way of getting rid of excess iron. Without taking some corrective action based on that one lab test (donating blood a few times, in my case), I'm sure I would have gotten even sicker. So there can be some value to lab tests, even if you think your lifestyle and diet are okay.

So it turned out that you had hemochromatosis? Sorry if that was the case.

There are many problems with unnecessary tests being done. Lots of money to be made treating numbers rather than people. False positives. Patients and doctors not understanding what test results mean and why they can be 'abnormal'. There are many reasons that the US far outspends the rest of the OECD countries in the realm of healthcare - unnecessary diagnostics is definitely one of them.