By the numbers

We live our lives by the numbers.  By “lives,” I am referring here to our health and wellness (and anti-aging) lives.  By “we,” I mean probably you – and most definitely me.

My quantified life:  5-mile runs, 7-minute work-outs, 20 seconds work/ 10 seconds rest Tabata, 10,000 steps a day, 20 reps, 25 lb. kettlebells, 350-calorie breakfast, 20 g of protein a meal, 1200 mgs of calcium a day.  What’s the number on the scale this week?  What’s my VO2 max, BMR, BMI, hip-to-waist ratio, fat-to-lean ratio? (And I’m not nearly as serious about all this as those FitBit, everything-I-do-is-synched-to-every-device-I-own people.  You know who you are.)

Numbers are meaningful — if they have meaning, and if we understand what they mean, and if we realize their limitations and flaws.

For example: Cholesterol.

For years now we’ve been hearing about how high cholesterol is a major risk factor for cardiovascular disease (which puts a person on the fast track to poor health and a shortened lifespan).  First we were told that any number above 220 total cholesterol was bad.  Then the magic number was lowered to 200.  Then we began to hear that this total cholesterol number, whatever it was, was really not that important.  It was the ratio of “bad” cholesterol (LDL) – which builds up on the walls of arteries to form plaque — to “good” cholesterol (HDL) – which helps remove “bad” cholesterol from the body that was important.  This gave us another set of numbers to focus on: According to the American Heart Association, the goal is to keep cholesterol ratio 5-to-1 or lower. An optimum ratio is 3.5-to-1.

Now medical researchers are becoming increasingly convinced that “good” and “bad” cholesterol numbers, and their ratios, are less meaningful than was previously thought.  It turns out that it is the size of the lipoproteins, both the “good” and the “bad” ones, that may be what play the significant role in heart disease, diabetes and longevity.  Yay! Another number!  Apparently, small particles are better at digging into the walls of blood vessels and creating the conditions for plaque to form.  Larger, “fluffier” particles don’t do this.  It is not often that large and fluffy are good things in the world of health, so let’s take a moment to enjoy that bit of medical news.

As regular readers of this blog know, I never pass up an opportunity to tout the benefits of exercise, so let me pass along this good news from researchers at Duke University Medical Center:  Exercise makes small dense LDL particles (the most harmful kind) “larger and fluffier”… which translates into lowered risk.

The blood test you get as a part of your annual exam (aka the “lipid panel” your doctor orders), measures total cholesterol and gives you those now less-than-meaningful numbers for LDL and HDL (plus the now less-than-meaningful ratio).  It does not count small particles versus large particles within the LDL and HDL. For those numbers, you need to ask your health provider to order either a VAP or an NMR test.  It may be, next week or next year or ten years from now, we discover that these numbers are less than meaningful, and another metric reveals itself to be the magic measurement of heart and artery health.

I expect that will happen.  I also expect that an active, engaged life and a diet rich in whole foods will remain the keys to enhancing vitality and health.