Hello friends! In Part 1 of this year's "State of my Health" address I talked about reference ranges, and updates to last year's metrics and criteria. Also new this year, I created a Health Report Card tool that calculates a "grade point average" regarding your cardio-metabolic health! It's a free, shareable, calculator on Google Sheets. Feel free to distribute as you'd like!
What's my GPA this year? 2.64 or C+.
Somehow less than spectacular, right?!
First, let me encourage you again to hop over to that spreadsheet and look at how the variables are calculated. There are no handouts or participation trophies, getting an "A", or a corresponding 4.0, is actually quite impressive as it's set to a standard of thriving. In contrast, most mainstream health recommendations are meant to keep you "surviving", so basically not failing – congratulations on your D-.
Second, there are some hairball / outlier metrics that I will discuss below. Namely:
- Vitamin D
- Cholesterol (HDL / Triglycerides)
- C-Reactive Protein (CRP)
Due to seasonal and some medical issues, these were greatly deviated not only from what I expected to see, but previous results as well. At any rate, I'll get to that below, for now let's take it from the top!
- Weight: 170 lbs
- Waist-Height Ratio (visceral fat; goal < 0.5): 0.44 (Grade: A)
- Percent Body Fat (subcutaneous fat; goal < 10%): 6.5% (Grade: A)
All As here, no surprises here!
Notes: PBF was calculated with JP3, and I take the average of three measurements each on all three sites (chest, abdomen, thigh); to further err conservatively I round these averages up.
Cardiovascular / Respiratory Metrics:
- Blood Pressure (MAP, Goal: 93): 104.87 (Grade: B)
- Resting Heart Rate (RHR, Goal: 60): 62.6 (Grade: A)
- Cardiovascular Load (CVL, Goal < 5640): 6,564
- Breathing Rate (BR, Goal: 12): 13.5 (Grade: B)
- Heart Rate Variability (HRV, Goal > 60): 42.8
As expected, RHR earned an A and BP (which then corresponded to CVL) earned a B. I'm pretty satisfied with this result. Another strength of the "Report Card" I built is that you can't hide behind or (over)compensate with a single metric. 110% earns you the same "A" as 90%. In my case, a typically good heart rate won't necessarily save me from sub-par blood pressure.
Notes: HRV, BR, and RHR were calculated via 90-day average from FitBit data. MAP was computed from blood pressure readings over the past 30-days due to changes in how Cronometer logs the information.
Notes: You'll note that HRV didn't make it to the Report Card. This is because average values are highly dependent on an individual reference range, which for the time being, seemed like it would be more effort than it's worth to incorporate into the Report Card.
Lipids, Sugar, and Insulin:
- Triglyceride : HDL Ratio (cardiovascular risk, Goal: 1:1): 3.3 (Grade: D)
- HbA1c (90 day average blood glucose, Goal < 5.7): 5.4 (Grade: A)
- Fasting Insulin (insulin resistance, Goal: 3): 3.4 (Grade: B)
A1c was a little higher than I was expecting, but still sufficiently below the "pre-diabetic" threshold of 5.7%. This is where fasting insulin comes in. Technically I scored a B, but you can see that 3.4 is much closer to that A-grade (< 3) than it is to C-grade (5).
Cholesterol... was out of whack here. Remember when I said I set the report card standards high? Mainstream medical reference ranges would tell you that 3:1 Triglyceride to HDL ratio is good, and that my HDL of 53 is good, but my Triglycerides are a little high. Contrarily, I would much rather see a ration of 1:1, with both values nearing 100!
So, what happened? Well, at the time I got my labs drawn this year I had a double dose of salmonella – from my dog's food, totally my fault for not clean up as well as I should have. After a quick breeze through PubMed I found that triglycerides do increase in rats with salmonella. Though I didn't find anything specific to HDL and salmonella, it is, again as expected, that HDL is affected by infectious disease (like sepsis).
Notes: If you're wondering how the Report Card grades get scored, metrics like Insulin and A1c give clear benchmark intervals for very good > acceptable > bad > very bad. Others (RHR, MAP) allow for more granular integers to be uses and are computed as a percentage of excellence (a true 100% or A+). Thus, excellence becomes the standard to compare yourself against, not "passing."
Vitamin D and Inflammation:
- Vitamin D (Goal: 30 - 80, optimal around 50 - 60): 28.9 (Grade: F)
- C-Reactive Protein (inflammation, Goal < 1): 45.0 (Grade: F)
Did I really "fail" these categories? Well, yes and no. Regarding Vitamin D, seasonality matters greatly (e.g. winter vs. summer). Specifically, I wanted to see a "worst case scenario" in the late winter. While some sources declare values < 20 - 25 as deficient, I set the bar much higher than simply "not deficient."
So, really, I'm satisfied by almost hitting 30 ng/ml in winter without tanning beds or supplements. This will be a much different story when I test again in September-ish (along with cholesterol (above) and CRP (below)).
CRP is a measure of inflammation, and as with cholesterol markers, there's some "normal" physiology we've got to take into context regarding the the infection I had at the time of testing. Firstly, CRP measurements definitely do go up in the case of infection. Second, there is evidence of this specific to salmonella. Third, infections (type and severity dependent of course) can make CRP levels 1,000x higher, so my 45 value may theoretically have been a 0.045 under "normal" circumstances. The difference between failing by a lot and an easy A+.
As I mentioned above, I'll be re-testing Vitamin D in the fall and have decided to just present CRP and cholesterol as they are when will re-test them again in the fall as well – while I'm getting blood drawn anyway.
So, you'll have to wait 6-months or so for Part 3, but it will be rife with training journals and hopefully some much better inflammation / immune / hormone labs!
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