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7 Health Markers You Don’t Track But Should

By Charlie Seltzer, MD / September 25, 2017

Taking care of your body is not always a simple thing, but there are certain health markers that can indicate whether or not your health is where it should be. While a good, balanced diet and exercise certainly helps you stay fit and healthy, so many things are at work in your body simultaneously, it is always a good idea to keep your eye on these important markers that can alert you to some health problems early enough to address them.

Health Marker #1: Blood Pressure

High blood pressure is not only a risk for heart disease and stoke by itself, but it commonly exists with other serious health issues. In general, the lower your blood pressure, the better. Since this test is so easily performed and noninvasive, it makes sense for everyone to monitor their blood pressures. There are automatic machines in most pharmacies and home cuffs are inexpensive. If you see a top number over 120 or a bottom number over 80, make an appointment to see your doctor.

Health Marker #2: Ratio of Triglycerides to HDL & LDL Particle Size

High triglycerides, which you can think of as fat floating through the blood stream, are a risk factor for heart disease and stroke. HDL, commonly known as the good cholesterol, protects against those same conditions. Thus, the higher your ratio, the worse your health probably is. In other words, elevated triglycerides and low HDL are a bad combination. You should aim to make your ratio as low as possible. Ideally, your triglycerides would be less than your HDL.

On a traditional cholesterol test, the LDL, or what’s commonly known as “bad cholesterol” is given as one number. The problem is that half the people who have heart attacks have LDL within the “normal range.” This is so because there is more than one kind of LDL particle. Small, dense LDL particles are clearly associated with an elevated risk of heart disease. Larger, “fluffier” LFDL particles are not correlated with heart disease. Thus, a person could have a “normal” LDL number but if most of the particles are small and dense a heart attack could be right around the corner. Similarly, a person could have “high” LDL and if all the particles are big and airy he or she will not be at elevated risk. Unfortunately, tests for particle size are not always offered at primary care offices, or even at specialists’. Ask your doctor for an “NMR” or “VAP” panel, or seek a physician who orders them as part of his practice.

Health Marker #3: Fasting Insulin Level

Many physicians look at your fasting blood sugar as a way to gauge risk for diabetes. The problem is that our bodies are very good at regulating blood sugar, and by the time the sugar starts to rise on a blood test a person is usually well down the road to diabetes, heart disease and stroke. A person’s pancreas can be pump out loads of insulin to lower blood sugar, and not addressing this can lull the patient (and his physician) into a false sense of security. Looking for an elevated fasting insulin level can clue you into problems before they show up on more common tests.

Health Marker #4: Heart Rate

Heart rate, which is determined by the number of times your heart beats each minute, is an important measure of your health. How hard your heart has to work during various activities tells you a lot about your overall physical condition.[#. Heart Rate . Heart-Rate. 2009]. Unreasonably low heart rates (bradycardia) or high heart rates (tachycardia) can be a sign of trouble and should be evaluated by a physician.

Health Marker #5: Body Fat Percentage

Although physicians are still using the BMI as a means to gauge health, I believe it is of little clinical use (See: BMI Chart For Men & Women). Body fat percentage as well as waist circumference gives a much better idea of health risk, as it takes into account muscle mass and frame. If you decide to get your body fat done, do not use one of those hand held machines, which are notoriously inaccurate. Better options include ultrasound testing (which is what I use in my office) which is accurate and inexpensive, DEXA scanning (which costs around $100-$150 and is not covered by insurance for body composition), hydrostatic weighing (very accurate but requires the individual to get in a big water tank), or good old-fashion skin calipers, which are very accurate when done by a skilled person (See: 5 Ways to Measure Body Fat Percentage).

Health Marker #6: Urine Microalbumin Level1

Many fitness enthusiasts use protein, amino acid, and creatine supplementation, and for good reason. And while there is no evidence that high protein diets or creatine harm healthy kidneys, we do know that they can hasten damage to unhealthy kidneys. Therefore, it makes sense for everybody to have their urine tested for microalbumin. Albumin is a protein in the blood that should not be present in significant amounts in the urine. Microalbumin level is a test that picks up this protein before it can be seen on a regular urinalysis.” Although it is unlikely most otherwise healthy people will have protein in their urine, because the test is cheap, easy to perform and can provide life-saving information, I order it on every patient and client I see.

Health Marker #7: C-Reactive Protein

C-Reactive Protein (CRP) is a blood protein that rises in relation to inflammation. Good research has shown that inflammation, as measured by CRP, is associated with diabetes, heart disease and high blood pressure. This test is useful because inflammation often causes no obvious symptoms but can predispose to serious health risks.

These are specifics that you should be aware of if you want to take a gauge of your health. However, if you feel something is not normal, whether or not you monitor these health markers yourself, it is always safest to see a doctor to make sure nothing more serious is going on.

Show 1 References

  1. The microalbumin to creatinine ratio is a simple urine test that provides reliable results. The gold standard test is a 24 hour urine collection, but this is inconvenient and unnecessary for people with a low probability of kidney disease.


  • Marc Perry, CSCS, CPT says:

    This is a really interesting article, I've never come across some of these health markers you recommend. I need to get my physical done soon, so I'll be sure to bring this article in with me. Thanks for putting these together.

    • Charlie Seltzer, MD says:

      Of course, Marc. And your doctor doesn't want to order any of the lab tests, let me know and I will.

  • Milagros says:

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  • Jason Buberel says:

    Just a note - DEXA scans cost less than $100 dollars at several locations here in the SF/Bay Area. Definitely nowhere near the $1000 you mentioned above.

    • Marc Perry, CSCS, CPT says:

      @Jason - made the change to the article, made it $100-$150. Appreciate the correction.

    • Charlie Seltzer, MD says:

      Nice. Way to go SF!

  • Stephen says:

    Dr. Seltzer:

    Thank you for a very helpful article. You have touched upon a favorite subject of mine: body composition. You suggest measuring it but you do not supply any guidelines! We know the bodybuilders have their own super lean agenda which is not appropriate for average people who only want to live a healthy and long life. So what is optimal percent body fat percentage for health and longevity?

      • Charlie Seltzer, MD says:

        Whoops. Didn't see your comment before I wrote mine. Day late and a dollar short.

      • Stephen says:

        Dear Marc,

        You've done a great job of assembling information on the important question of ideal percent body fat for health and longevity. I've reviewed your references to better cement the concepts into my head. But I could not find a reference to the industry standard study by Jackson & Pollack that you refer to. This study is crucial to assessing the charts you've included in your article. Please send a reference to the Jackson & Pollack study.



        • Marc Perry, CSCS, CPT says:

          @Stephen - And here are the original sources of Jackson & Pollock's research:

          Jackson, A. S., & Pollock, M. L. (1978). Generalized equations for predicting body density of men. British Journal of Nutrition, 40, 497-504.

          Jackson, A. S., Pollock, M. L., & Ward, A. (1980). Generalized equations for predicting body density of women. Medicine and Science in Sports and Exercise, 12, 175-182.

        • Marc Perry, CSCS, CPT says:

          @Stephen - Thanks for reading that article. I'll get you the original Jackson & Pollock studies soon. If you check out pubmed, you will see there are many studies that compare Jackson Pollock. For example, one found that Jackson Pollock was not the best framework for predicting body fat mass of obese people => https://www.ncbi.nlm.nih.gov/pubmed/20582331 - but I think a skin fold analysis is not useful for obese people and a study wasn't necessary to figure this out.

          It seems like what you are getting at is the validity of body fat measurement. There is no perfect way to measure body fat. I wrote about the challenges of body fat measurement in my article 5 ways to measure body fat percentage:

          "All these methods (underwater weighing, DEXA, calipers etc.) rely on algorithms to convert a measured parameter into an estimate of body fat percentage, so none of them are perfect. Algorithms have variation based on how the underlying assumptions and formulas apply to different populations"

          The chart I included in the ideal body fat article was created by Accumeasure, which created "ideal" vs. "average" ranges. These are completely subjective and I chose them because they are in line with what other organizations recommend like ACE. I wouldn't get hung up on how Jackson & Pollock created their algorithms. You can certainly find others if you like as there are many. Again, they are just an algorithm, they are not perfect. Consider a BodPod, DEXA, or underwater weighting for most accurate measurement.

  • Michael says:

    Excellent and useful article as always for Builtlean.

    But DEXA scans are available for much less $1000. You can get one in Toronto for about $100. I'd be interested in your views on how accurate they are in tracking body composition changes over time.

    • Marc Perry, CSCS, CPT says:

      @michael - and to more specifically answer your question, I'm somewhat wary of tracking results over time with dexa because it's fairly expensive and impractical, but it seems like it may be the best option in terms of accuracy. Then skin fold and simply using a body weight scale.

    • Marc Perry, CSCS, CPT says:

      @Michael - I think you're right. In NYC they range around $100-$150. May need to update that line.

      • Charlie Seltzer, MD says:

        You guys are right. The two hospitals I used as my reference price are apparently the most expensive places in the country to get DEXA scans. I stand corrected. I apologize.