You can’t manage what you can’t measure. -Peter Drucker
For years, people have known that if you track a metric (like calories, or weight for examples), you’re more likely to change them. Take the study done in 2015 on the effect of adherence to dietary tracking on weight loss. In the study, participants were encouraged to do the following:
The findings were clear.
Those that consistently tracked these metrics more than 66% of the time had significantly higher weight loss than those that tracked these metrics less than 66% of the time. This study is just one of many that shows the importance of frequent tracking for consistent, long-term, positive health changes.
But here’s the thing. Counting calories and stepping on a scale are old school metrics that may have seemed helpful at the time, but aren’t quite cutting it anymore. Today, we have so many other more useful tools available to us to give us better data about our health, are easier to use, and are becoming more and more accessible and affordable to everyone.
Measuring optimal health is complicated. I recently listened to a podcast from a well known fitness coach who was arguing that as long as you feel great, it doesn’t matter if your A1c is high, your hormones are imbalanced and your cholesterol is less than ideal.
I agree that these maybe aren’t the best (certainly not the most affordable) methods of measuring your wellness, but they are certainly a player in the game and should not be ignored just because you feel good!
If our western culture has done anything “great” over the last couple of centuries it has taught us to “suck it up” and ignore the signals our body is telling us. So pardon me if I’m going to advise against the “yeah, I feel pretty good” measure and actually take advantage of the now more affordable and more accessible tools we have that help us prioritize prevention. I’d rather not wait until I don’t feel good to start trying to figure out what might be out of balance.
First, let’s start with WHAT you might want to consider measuring.
GENERAL BLOOD MARKERS
One of the most common questions I get from private clients is, “I’m going to my doctor for my annual check-up. What should I ask him/her to pull?”
Well...this depends. Mostly on what your goals are, what your family history is, and if you have any current symptoms.
Let’s assume for the sake of ease, that your goal is to be as healthy as possible, that you have a clear family history and that you don’t currently have any symptoms. AKA- you “feel pretty good”.
Here is my basic panel I personally pull on my private clients and myself at least 1x per year:
CBC + DIFFERENTIAL + PLATELET
Hb, Hct, RBC, MCV, MCH, MCHC, RDW
WBC, Lymphocytes Absolute, Neutrophils Absolute, Monocytes Absolute, Basophils Absolute, Eosinophils Absolute
Lymphocytes %, Neutrophils %, Monocytes %, Basophils %, Eosinophils %
BASIC CHEM PANEL
Uric Acid, BUN, Creatinine, BUN/cr, eGFR
Sodium, Potassium, Chloride, Calcium, CO2, Phosphorus
Total Protein, Albumin, Globulin, A/G Ratio
Alkaline Phosphatase, LDH, AST/SGOT, ALT/SGPT, GGT
Iron & TIBC, UIBC
LDL, HDL, Total Cholesterol, Triglycerides, Chol/HDL ratio
Lp(a), Apo B
TSH, T4, T3, T3U, Free Thyroxine Index (FTI)
TPO and Anti-thyrogolubulin Antibody (every 5th year if they are negative)
Free T4, Free T3, Reverse T3
VITAMIN D + INFLAMMATION
25-OH Vitamin D
Ferritin, Iron Saturation
Hemoglobin A1c, Fasting Insulin
Let me just give you a fair warning now. Most doctors aren’t going to like this list. They are going to find it way too extensive for a “healthy person.”
Which is the perfect time to bring up the difference between not being sick and thriving.
If you lack a symptom (headache, low energy, dizzy, etc) that does not mean that you are thriving. In other words, the lack of disease does not equal wellness.
So if your goal is to be thriving well into your late 90’s, you might want to consider not waiting until something goes wrong to seek help to fix it.
We want to PREVENT the onset of disease and there are SO MANY THINGS on a blood panel that can help you catch and fix things long before you have a symptom. I’m a HUGE advocate of being PROactive about your health! This is just one way you can do it.
When - and if - your doctor agrees to pull a panel like this, you need to make sure you work with someone who can interpret it for you outside of the conventional lab ranges.
Conventional lab ranges are the ones listed on the blood results. They are the ranges that the lab uses to determine if your markers are high are low. If they are, the likelihood of you having disease or developing disease in that area is high.
The problem once again comes back to the difference between lacking disease and thriving.
Just because your markers are within the lab range, does NOT mean that they are within a functional range. Functional ranges tend to be much tighter and are set to help get you reach optimal health, not just a “no disease” range.
If you need help with interpretation, reach out to me. This is one of the things I love most about what I do! Blood interpretation doesn’t typically lie, so this tool is incredibly valuable in personalizing a wellness plan for someone!
Blood sugar outside of an ideal range (ideal fasting ranges being between 80-99mg/dL) is one of the five signs of metabolic syndrome, which is a cluster of conditions that increase the risk of heart disease, stroke, and diabetes.
Roughly 90 million Americans are unknowingly living with abnormal blood glucose levels and up to 70% of them will end up being diabetic if they don’t catch it and address it immediately.
One of the biggest issues with having abnormal blood sugar (aka- being pre-diabetic) is that it comes without obvious symptoms.
The typical signs that accompany dysregulated blood sugar are energy imbalances and constant hunger. Two things that are fairly common in our culture, but not at all “normal”.
Need a coffee at 2pm to get through the afternoon? Or are you constantly thinking about food and where you’re going to get your next meal? Your blood sugar is likely out of range.
Here is how I recommend tracking/measuring it:
BEST- Continuous Blood Glucose Monitor (CGM)
Unlike a single reading from a blood glucose meter, a CGM provides real-time, dynamic information about the speed and direction (trending higher or lower) of your glucose levels. Having continuous feedback on diet, exercise, and lifestyle from a CGM can help you make more informed decisions about how to optimize your health.
Unfortunately, these CGM’s are incredibly hard to get if you are not currently diabetic. Luckily, there is a new company called Levels that is working hard to change all of that.
BETTER- Fasting Blood Glucose Readings
Nowadays, getting your hands on a blood glucose meter is EASY! Every pharmacy has them and you don’t need a prescription to buy one. To start, take your fasting blood glucose levels every morning for 7+ days in a row. If your readings are constantly between 80-99mg/dL, you’re probably headed down the right path. However, you can use this meter to help fine tune your diet and lifestyle too! Learn more about how to use this device to complete a carb tolerance test HERE.
GOOD- Annual Blood Tests
There are a few blood tests you get on an annual basis that most doctors will typically pull including: fasting blood glucose, A1c, and fasting insulin. These 3 markers are snapshots to your glucose tolerance. However, they are just a very small snapshot that will not give you an accurate picture of how you’re doing day to day. So if this is your only form of measuring your glucose levels, make sure you are keeping track of your numbers year to year and ensure they aren’t trending in the right direction!
Oh, the scale. I’m pretty happy to hear that most people don’t own them anymore. They can be helpful, but they also are very limited in what they can tell you about the health of your body.
Instead, here are a few other body based metrics to consider:
How do you measure these?
BEST- DXA scan
DXA (dual energy X-ray absorptiometry) is one of the most accurate and precise methods of evaluating body fat percentage, types of fat and lean tissue. In most metropolitan areas, there are now centers or traveling vans equipped with DXA machines. If you are close to one, these scans are typically very affordable for the information you are receiving.
BETTER- The “waist-to-hip ratio”
The waist-to-hip ratio can not scientifically evaluate body fat percentage, lean tissue or types of fat. However, this measure is a great measure of generally being overfat and is accurate for everyone. The great thing about this measurement is it can be done at home with one simple tool: a tape measure. What’s the ideal ratio? The waist, measured at the belly button, should be less than half the height. In other words, you’re striving for a measurement that is 0.49 or less. Having a measurement 0.50 or higher indicates being overfat. This measure can be easily measured over and over again, which makes it a great measure to know if your health program is working.
GOOD- Body Fat Scales
Unlike a tradition scale that just provides weight, the newer body fat scales can provide a few more metrics to help keep you trending in the right direction.
Gosh, if you haven’t read Why We Sleep by Matthew Walker yet, you need to. He does a fantastic job in his book explaining why getting restorative sleep is so critical to our health!
So I’ll assume you already know all those details and jump to my favorite ways of tracking.
For this, there is only one way I recommend tracking your sleep and that is with a wearable device like an Oura ring, a Whoop strap or a FitBit.
All 3 companies are continually doing research to provide better data through their devices and additionally give better recommendations to their users on how to improve sleep. In the end, the data means nothing if you aren’t doing anything with it, right!?
I personally wear the Oura ring and love it! But I have many clients who use the Whoop strap and have a similar affection towards it.
Whatever device you choose to use, you need to make sure you want to wear it. If wearing a watch to bed sounds terrible to you, the FitBit and Whoop strap may not be the best options for you.
Stress is something that many of us experience more than we would like, but have found a way to cope with it.
Unfortunately, that coping mechanism may be hurting your health.
To better understand how your body is responding to stress, I highly recommend tracking your HRV. HRV stands for heart rate variability.
Many of the above mentioned trackers, like Oura and Whoop, track this data automatically for you. However, there are also apps you can purchase on your smartphone to use to take your HRV.
Simply put, HRV is a measure of the variation in time between each heartbeat. This variation is controlled by a primitive part of the nervous system called the autonomic nervous system (ANS).
The ANS controls out heart rate, blood pressure, digestion and breathing, but it also controls the hormones that help us fight or flee.
The more stress we have in our lives, the less variation we will have in our HRV (resulting in a lower score). The healthier our autonomic nervous is and the better response we are having to daily stressors, the higher our HRV will be.
Since this is a non-invasive way to measure your ANS, I highly recommend this as a trackable measure...especially for athletes who tend to think that their training is stress relieving.
Depending on who you ask, there are a couple of key components to staying fit and active as you age. I can only assume that if you want to live a long life, you want to live it disease free.
You want to be able to carry your own luggage through the airport. Walk from the furthest parking spot in the lot to the entrance of the grocery store. And certainly to do your own grocery shopping (which includes loading and unloading them into your car).
For that, there are a few areas of physical fitness that you might want to consider measuring and monitoring as you age:
FLEXIBILITY- you know...to bend over and pick up a pencil.
You can certainly create a list of movements that you can test monthly for free. I personally have found a love for the GoWOD in which they provide a daily protocol, tailor-made for you that can be done in 8, 15 or 22 minutes. No excuses!
STRENGTH- you know...to be able to pick up your old dog and lift her into the car without throwing out your back.
If you have the proper flexibility and strength, you should be capable of exerting force on the muscles you need in the direction they are supposed to go without dissipating that force to areas that don’t need it (like your back or your knees).
When you lack strength, especially in the little stabilizing muscles, that is exactly how injuries occur.
For strength training, I highly recommend you work with a professional to have an assessment done of your specific goals and body. A custom plan can be put together for you that doesn’t have to be complicated or require fancy gym equipment.
Once you have a few movement routines to complete weekly, keep a log and track your progress. There’s nothing more rewarding than seeing (and feeling) your ability to lift more weight as you age!
AEROBIC FITNESS- aka “easy cardio.”
Majority of your cardio fitness should be done at this level. The general rule of thumb is 80% aerobic and 20% anaerobic.
The best way to monitor your aerobic fitness at home is with a heart rate monitor and a clock. You can test your fitness by doing your fastest 40 minute treadmill/track, elliptical or bike test WITHOUT allowing your heart rate to go above 180-age (maximum aerobic function or MAF heart rate).
As you continue to train your aerobic system, your aerobic fitness should increase and you will see your pace increase with a lower heart rate. Of course, working with a coach who understands endurance training is helpful if improving your aerobic fitness is needed.
ANAEROBIC FITNESS- aka “HIIT training.”
This is the high heart rate, don’t want to talk to anyone right now, type of training. This type of training should only make up about 20% of your endurance training.
Monitoring this type of training is similar to aerobic training. You don’t need more than a heart rate monitor and a clock.
The difference is you are trying to get close to your max heart rate (220-age) for just a few seconds multiple times during a workout. The measure of anaerobic fitness comes when you can recover faster between these bouts of sprints (aka your heart rate drops back down to an aerobic level faster).
So, do you still feel tracking weight is the best way to gauge your health?
Monitoring metrics that actually have an effect on your long term health are now more accessible and more affordable that it doesn’t make sense not to use them. There are many other markers besides the ones I mentioned here that you can use from both a lab and at home that can help keep your health on track. But this is where I recommend you start!
Information is knowledge. However, understanding what to do with the data can feel overwhelming at times, so be sure to surround yourself with a team of health care professionals who can help you interpret and use that data to be driving far away from disease and into a state of optimal health.
If you want to explore these metrics, I’m here for you! Just click HERE to schedule a free discovery call where we can discuss your goals and how I can best help you reach them.
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Tiana Rockwell is a certified nutritional therapist, avid endurance athlete and dark chocolate lover. She believes that by eating REAL food, we can balance our body and reach optimal health and wellness!