Written by Sabine Hoadley, Bsc (Hons), Lead Exercise Scientist
Can someone live in good health but not optimal health?
The answer is yes. Optimal health is about supporting your lifestyle with the highest quality of health and wellbeing habits that are possible. It’s not just about living to 100, but it’s about having a complete physical and emotional state of wellbeing. The good news is that lifestyle management can support health optimisation and there are changes you can make now to transition from ‘good’ to ‘optimal’ health.
Why is optimal health better than good health?
In 1948, the World Health Organisation (WHO) defined health as:
“A state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.” (1)
Good health is therefore a state of emotional and physical wellbeing. Dependent on who you ask, you may get definitions such as:
- A state free of disease
- A state of happiness
- A pain-free state
- Being able to run a marathon
- Being able to walk to the shops
Good health can be subjective, and it can mean different things to different people. You may be free of disease but may be overweight. You may feel physically functional but emotionally unhappy.
So, how do we define optimal health?
Optimal health and wellness is a state of health that is the best it can be for an individual. This typically refers to the highest level of health and wellbeing that an individual can gain. Whether the purpose of this is for peak performance optimal health, or to achieve optimal health whilst you lose weight, there should be a goal for everyone.
Let’s have a look into two case studies. We will investigate a few health metrics (a measurable marker of health) and what they mean for someone’s health profile.
Person 1
Age: 50
BMI: 21.5
Muscle mass: Below ideal range
Visceral fat: 14
Low-density-lipoprotein: 3.5 mmol/l
ApoB: Elevated
Vitamin D: 60 nmol/l
Person 2
Age: 50
BMI: 21.5
Muscle mass: In the ideal range
Visceral fat: 4
Low-density-lipoprotein: 1.15 mmol/l
ApoB: In ideal range
Vitamin D: 90 nmol/l
Technically the health metrics here indicate that both cases would be classed as having ‘good health’, but can you guess who has more ‘optimal health?’
Some distinct differences in the profiles here mean that person 2 has much more optimal health than person 1.
Let’s explore this in more detail…
Health metrics and body composition
A body mass index of 21.5, as shown in case studies 1 and 2 indicates that their weight is ‘in range’. However, taking this a step further and looking into the breakdown of body composition, we can see that there are some fundamental differences between these two people.
Even though person 1 has a ‘healthy’ BMI, they have a low muscle mass and a high visceral fat.
Muscle mass is often overlooked and is plays an essential role in the prevention of many common chronic diseases, managing blood glucose levels, maintaining healthy bone strength, and managing weight (2).
High visceral fat can increase the risk of type 2 diabetes, cardiovascular disease, and metabolic disease (3). The lower the visceral fat, the more optimal it is for health.
With both health metrics, it is important to look beyond BMI to determine the most optimal body composition for excellent health.
Blood Test Results
When you have a blood test, the results you get back might indicate that the results are ‘normal’ or ‘healthy’. However taking this a step further, it is important to understand that just because blood test results are in the normal range, this may not be the most optimal level for your overall health.
The reference/ normal range for many blood tests is defined as where 95% of the population of ‘apparently’ healthy individuals would fall (4)
Some blood tests have ‘optimal’ ranges, which are evidence-based, scientific recommendations indicating a range that will promote better health than the reference range provided in blood test results.
Looking at the example here, person 1 has vitamin D levels of 60nmol/l and person 2 has vitamin D levels of 90nmol/l.
Whilst guidelines state that vitamin D levels above 50 nmol/L are ‘adequate’, research shows that it is much healthier to have vitamin D levels between 75 and 99 nmol/l(5).
Poor Vitamin D levels are associated with several chronic and infectious diseases.
Once again, this demonstrates that it’s always worth looking further than blood test recommendations for optimal health. Each of these health metrics can be influenced by lifestyle management, so it is important to understand how you can make changes to optimise your health.
Case Study: Cardiovascular disease (CVD)
Now let’s investigate the example of CVD and optimal health.
When looking into the risk of CVD disease, a healthcare professional may look a few things:
- Blood pressure
- Cholesterol levels
- Family history of CVD
Most people can expect to get a blood lipid test that includes total cholesterol, high-density lipoprotein “good” cholesterol (HDL-C) and low-density lipoprotein “bad” cholesterol (LDL-C).
Yet there is another test missing from most of these check up’s that is considered a new simple and accurate risk factor that is considered the ideal measurement to assess the clinical risk of CVD.
That is known as an apolipoprotein (apoB) test. In most people, more than 90% of all apoB is found in LDL molecules, which is considered the “bad” cholesterol (6).
The problem is that some people can have results that indicate that their LDL cholesterol is in the normal or low range (indicating good health), yet at the same time have high levels of apoB.
High levels of apoB can lead to an increased risk of inflammation, plaque growth and possible cardiac complications such as a heart attack.
Therefore, it is important to look beyond generic testing to look at one’s risk of CVD.
At Uniquely Health, our comprehensive blood test includes an apoB test, which can be used as part of the bigger picture of whether someone is at risk of CVD.
There is much more to cardiovascular disease than people once thought.
Uniquely Health lifestyle management
At Uniquely Health, we can help you take a deeper dive into your health through our comprehensive blood testing and health assessments to understand your health profile.
Our team are equipped to give you the most up-to-date, evidenced-based recommendations around your health to support your health goals.
Nutrition, exercise, and lifestyle are key players in whether you simply have ‘good health’ or ‘optimal health’.
It’s worth considering what you would prefer.
Key Conclusions
1. Evidence-based recommendations around ‘what defines optimal health’ are often a better way to adopt a healthier lifestyle than some of the existing guidelines.
2. It is important to look further into body composition than just BMI – health metrics such as muscle mass and visceral fat play a crucial role in optimal health.
3. ApoB is a cardiovascular measure that can be used to determine someone’s risk of CVD, improving the ability for someone to live with more optimal health.
If you would like to take your health to the next level, book a complimentary call with our team to discuss how we can help you.
- Callahan, D., 1973. The WHO definition of ‘ health’. Hastings Center Studies, pp.77-87
- Wolfe, R.R., 2006. The underappreciated role of muscle in health and disease. The American journal of clinical nutrition, 84(3), pp.475-482
- Després, J.P., 2001. Health consequences of visceral obesity. Annals of medicine, 33(8), pp.534-541
- Boyd, J.C., 2010. Defining laboratory reference values and decision limits: populations, intervals, and interpretations. Asian journal of andrology, 12(1), p.83
- Sempos, C.T., Durazo-Arvizu, R.A., Dawson-Hughes, B., Yetley, E.A., Looker, A.C., Schleicher, R.L., Cao, G., Burt, V., Kramer, H., Bailey, R.L. and Dwyer, J.T., 2013. Is there a reverse J-shaped association between 25-hydroxyvitamin D and all-cause mortality? Results from the US nationally representative NHANES. The Journal of Clinical Endocrinology & Metabolism, 98(7), pp.3001-3009
- Sniderman, A.D., Thanassoulis, G., Glavinovic, T., Navar, A.M., Pencina, M., Catapano, A. and Ference, B.A., 2019. Apolipoprotein B particles and cardiovascular disease: a narrative review. JAMA cardiology, 4(12), pp.1287-1295
