As I speed through middle-age, I’ve landed on a handful of health markers that let me know what kind of trajectory I’m on. In this article I’ll list what I track and why. My markers may not be your markers because my goals may be different than your goals. I call these “Dave’s KPI’s”, and I keep them on a spreadsheet on my phone. They’re all fairly low-tech, though several of them will need a piece of equipment to measure, but the overall cost of the equipment is negligible.
What I Measure
Fasting Blood Sugar (FBS)
How often: Monday-Friday
Equipment used: Keto Mojo Gk+ Blood/Ketone Meter (available here)
Why I track this: I’ve mentioned on the blog before that my dad was diagnosed with Type 2 Diabetes (T2D) when he was in his 40’s. Actually, we have quite a history of T2D in both sides of my family. I’ve seen what it can do firsthand, and I don’t want to see it happen to my family. There’s a part of me that wishes I could have a continuous glucose monitor, at least for a while, or, even better, have a way to check fasting insulin, but this is the best I can do for now without medical intervention. What I’m looking for is a trend. If you get your FBS checked once a year when you get your annual physical, and it shows up high, then it’s either too late – you’ve already got some damage – or, it could be a misfire that just happened to happen that one day. Knowing the trend keeps anything from sneaking up on you.
The reason I don’t check it on the weekend is only because I don’t want my numbers to rule my life. I want the knowledge, but I don’t want to live out of fear. Two days off allows me to take my hands off the wheel. (But I do NOT use it as an excuse to “cheat” on the weekends.)
Resting Heart Rate (RHR)
How often: Daily
Equipment used: Fitbit Charge 5
Why I track this: RHR gives you an idea of how efficient your heart is at doing its job, and how “fit” you are. Basically, every morning I take a look at what the previous days’ RHR was (since it will vary throughout the day). A “normal” RHR is somewhere between 60-100 beats per minute and tends to increase with age. Mine is somewhere around 47-48, which by most accounts is “athletic”.
Waist to Height Ratio (WHR)
How often: Weekly
Equipment used: Tape measure
Why I track this: Can we all agree that BMI as a measure of health is trash? I’ve got super-athletic, lean, muscular friends whose BMI is 30-35. BMI doesn’t work because muscle generally weighs more than fat. Also, the scale is a terrible indicator of health, generally. You can be gaining weight, but the scale doesn’t know the difference between fat and muscle. It just spits out a number. What’s more important is how lean you are judged by your visceral fat – the stuff around your organs. That stuff is deadly, and generally shows up around your waistline. A Dexa scan would be ideal, but there’s a high barrier to entry compared to a WHR. The measurement is easy: simply measure your height, in either inches or centimeters, measure your waist, then divide your height by your weight. The result should be 2 or above (basically, your waist size should be half or less than your height).
Blood Pressure (BP)
How often: Weekly
Equipment used: Kroger BP cuff
Why I track this: BP is a really good insight into cardiovascular disease. Once again, my family is riddled with high blood pressure, which in my grandfather’s case, resulted in multiple, debilitating strokes. He left his high blood pressure untreated most of his life, whereas my mother, who has suffered from high blood pressure at least since her 40’s, has been on medication for decades and has had no issues. One thing I’ve learned is that most of the time, even in doctors’ offices, your BP measurement isn’t taken correctly. I learned this when I first started, because my BP would vary wildly over the course of just a few minutes. Lately Peter Attia has had some great info on the importance of BP as a measurement, and how to measure it correctly. I highly recommend his AMA podcast “Blood pressure—how to measure, manage, and treat high blood pressure“. The method described really helped me nail down a consistent reading.
What I DON’T Measure
Weight
Well, I do take my weight from time to time, but I don’t track it, and don’t generally care. There are two circumstances where I do care:
- The most common situation is when I’m in a hypertrophy (building) phase, and I want to see if I’m being successful. If I’m doing things right, my WHR will stay the same, or fluctuate very little. Other than the thighs of my pants, or my t-shirt fitting snugly, it’s hard to tell if I’m actually gaining.
- When I’m obviously losing weight. As I write this, I’m coming off a long illness that caused me to be super nauseated at even the idea of food. My clothes were falling off, and my WHR dropped. Trying to monitor the damage, I discovered that I lost 10 lbs. in 3 weeks. Ouch.
Calories / Food
When I first began a low carb / keto lifestyle I spent quite a bit of time tracking my carbs. Turns out, they’re everywhere if you’re not looking for them. I also, for a while, did some rough math on how much protein I was taking in (hint – it’s never as much as you think). But now that I know what I’m looking for, I don’t have to track it any more.
Sleep Score
I love my Fitbit. It gives me lots of great health statistics. Sleep Score isn’t one of them. It is so inconsistent. Just because I’m in bed at 8:30 and get out of bed at 7:30, doesn’t mean I got great sleep. I could have been reading financial reports for two hours, tossed and turned, got up to pee twice, and yet Fitbit says I got an “85” sleep score. There was a time I thought it might be useful even for a baseline, but I don’t even believe that now. Fitbit (Google), y’all need to step it up on this one.
Poundages
There was a time that I lived by my training diary. The bragging rights of putting so many pounds on the bar was important to me. Now, I just want to be strong. I always want to put a little more on the bar, because if you’re not challenging your body, then you’re not making progress, and if you’re not making progress, why spend all that time in the gym?
Nowadays, I put every set, rep, and pound in my Strong App so that when I come back for the next workout, I can add a set, rep or pound. Technically, I’m tracking, but, again, progress could be in any of those three metrics: set, rep, or pound. The goal is progress.
When You Know, You Know
Over the years I’ve been tracking I’ve gotten some specific use from the data. I’ve already hinted that I’m looking for trends; is my FBS steady, or moving up? Is my BP slowly inching its way toward a dangerous level? And even if the tools I use aren’t state-of-the-art, I can still spot the trend. That’s important.
But one area that’s been of particular interest to me is that my markers are a canary in a coal mine. They will often flag to me when I’m getting sick, even before I feel it. I don’t know if it’s the stress increasing my cortisol level, or some way illness throws my metabolism off in general, but my FBS always goes up when I have some kind of viral or bacterial infection. Ditto with my RHR. And since I only recently started tracking my BP, I can say that with my latest illness, the same is true there. Slowly the numbers will start inching their way up. And, sure enough, the numbers slowly retract as my symptoms disappear. Yes, I change my supplement routine when I see the numbers moving.
I also notice differences when I’ve had even one night of poor sleep. RHR and FBS go up, which means I’m probably not gonna do well in the gym that day. It’s usually prudent to pay close attention to my body during workouts so that I don’t overdo it and end up with an injury.
So knowing your numbers can help in the short term and the long term. It may not be worth it to you, but it’s worth it to me.
Do you track any health markers? If so, what? And why? Share in the comments below.