Are you as healthy as you think? Take our step-by-step health check

Weight may not be the best way to tell how healthy (or otherwise) you are. Dietitian Clarice Hebblethwaite has a guide on how to measure your true health.

You are probably familiar with some indicators of health, such as weight, body mass index (BMI), cholesterol and blood pressure levels. But there are other ways to help us know we are on the road to optimal health and well-being. To know how healthy we are, we need to look at a combination of factors — things we can see on the outside as well as less visible things that can be checked. A personal ‘WOF’ (Warrant Of Fitness), if you will.

Let’s look at some of the things we can measure, both inside and out. And take our quick quiz at the end to see how you shape up.

Your personal WOF checklist

Your body can tell you a lot about your state of health. The state of your nails, skin, eyes and hair provides great feedback on your well-being, indicating signs of vitamin and mineral deficiencies and can sometimes even reflect poor organ health. Do you pass a personal WOF? Keep an eye on the following outward signs.

Eyes

Ideally the whites of your eyes are, well, white — not yellow or bloodshot — and while the odd floater or twitch is not unusual, get your eyes checked if it’s more than that. Any obvious inflammation in or around the eye needs to be checked by your GP. And don’t wait for symptoms before getting an eye check as there are many conditions your optometrist can check for that may have no immediate symptoms.

Skin

Cracks at the corner of the mouth can reflect low iron or low vitamin B2, and excessive bruising can be a sign of low vitamin C or other nutrients which affect blood clotting. And keep an eye out for any changes in moles — be sure to get these checked by your doctor.

Hair

Is your hair dry or brittle? This can be a sign of a less than adequate diet, in particular, low intakes of essential fats or iron may result in lacklustre hair. Of course, other possible causes may be harsh hair treatments, excessive washing and drying or even excess sun exposure. Increased hair loss can be one of the symptoms of poor thyroid function and needs to be checked by your GP.

Nails

Healthy nails are strong and slightly pink. Pale or concave nails may indicate a lack of iron and a yellow thickening can show a fungal infection. If nails change in colour, shape or texture or there’s inflammation around the nails, it may be time to see the doctor.

Hydration

Staying hydrated helps us think straight, feel energised and keep our organs working properly. Pay attention to possible signs of dehydration: dry mouth, thirst, headaches and dark urine. Ideally, urine is the colour of champagne, not apple juice.

Hearing and vision

Changes in our sight and hearing can happen gradually over time, so we may not notice them. If others notice your hearing or vision weakening, check this with your health practitioner.

Digestion

Ideally, our bowels move daily and easily with little troublesome wind and no bloating, nausea or reflux. If you’re suffering from nausea, constipation, diarrhoea, reflux, bloating or wind, it could indicate your bowel, liver and/ or gall bladder may not be functioning at their best. See your doctor to rule out anything serious if you have any of these symptoms (See our feature Getting to know your gut for more information.)

Things you can measure at home or at the gym

Here are some useful measurements you can take — by yourself or with the help of  a trainer or nurse — that will help towards building an overall picture of your health.

Weight and body mass index

Both being too light or too heavy can increase our chances of ill health. Our BMI is a measure of our weight in relation to height. You may be aware that the healthy range is a BMI between 20 and 25, but recent studies show that as we age being a bit heavier and maintaining weight can be better for our health. Those aged 70 and over are best to have a BMI of between 20 and 30. Weight loss can result in loss of vital muscle mass and bone density, both of which are important for health.

Check your BMI with our on-line calculator.

Body fat

BMI and weight can’t identify how much of your body is muscle, fat, bone or water. Bioelectrical Impedance Analysis (BIA) is one way to measure these.

By standing on scales with electrodes, BIA can calculate an estimate of your total body water, then fat-free body mass and body fat. The most accurate BIA devices are known as tetrapolar and have at least four electrodes. Ideal levels of body fat are 18 to 24 per cent for men and 18 to 30 per cent for women.

Abdominal fat

Some BIA scales measure this but there are also two simple measures you can do at home to give you an idea of whether you have too much fat in your abdomen.

1. Waist size: This is a measurement of the widest part of your waist where your belly button is. A healthy waist measurement for men is no greater than 94cm and for women, no more than 80cm.
2. Waist-to-hip ratio: The waist is smaller than hips for optimal health. Measure your waist and hips (the widest part) then divide the waist measure by the hips measure. We’re aiming for less than 0.8.

Flexibility

Can you move in all the ways you want to? Can you twist your torso and look behind you? A gym will have a range of flexibility tests but a popular measure is sitting down with your legs stretched out in front of you with the feet flat against the wall. Depending on how close your fingers get to the wall gives a measure of your flexibility. If your palms touch the wall, that’s considered excellent. If your fingers touch, that’s good. If you’re unable to touch the wall at all, your flexibility could be improved.

Resting heart rate

The best time to measure your resting heart rate is first thing in the morning before you get out of bed. Use your index and middle finger. Find the pulse on the inside of your wrist and put your fingers on the thumb side. Count the beats for one minute. Generally, 60-80 beats per minute is considered normal but the lower end is better. Your risk of cardiovascular disease and death from other diseases decreases as the rate decreases.

Things a health professional can measure

Blood pressure

High blood pressure, also called hypertension, is often called the ‘silent killer’ because many people don’t know they have it. When your blood pressure goes up it means that your heart must work harder and damage can occur in blood vessels. An ideal blood pressure is around 130/80 or less but this is an upper limit for people with diabetes or heart disease. People who exercise regularly tend to have lower blood pressures than those who don’t exercise.

Blood lipids

It’s a good idea to have regular blood tests for cholesterol, triglycerides and the ratios between total cholesterol and HDL (good) cholesterol. Your doctor will order these.

Optimal measures are:

• Total cholesterol <4mmol/L
• LDL cholesterol <2mmol/L
• HDL cholesterol >1mmol/L
• Total/HDL ratio <4mmol/L
• Triglycerides <1.7mmol/L

There is a direct relationship between elevated cholesterol levels and the risk of developing cardiovascular disease. Your GP will take into account these and other factors to assess your risk.

Blood glucose

The HbA1c test provides an indication of blood glucose control. This is important to test for pre-diabetes or diabetes.

What your HbA1c levels mean:

• > 50 mmol/mol indicates probable diabetes (but does not confirm a diagnosis by itself)
• 41-49 mmol/mol suggests pre-diabetes/insulin resistance
• < 40 mmol/mol is normal

Other blood tests

• Liver function tests: To show your major organ of detoxification is working well.
• Homocysteine: Elevated homocysteine can be linked with a higher risk of heart disease. If this is high, it can be due to being low in vitamins B6, folic acid and B12.
• Thyroid function: Important for our metabolism, generating heat, helping our bowels move and keeping our body at a healthy weight.
• Vitamin D: Helps calcium get into bones so maintains strong bones and reduces risk of osteoporosis.
• Iron, vitamin B12 and folic acid: All important for carrying oxygen to your tissues so vital for energy.
• Progesterone: Vital hormone for women to have optimal health and to conceive. Lower levels can be a feature of PCOS.
• C-reactive protein (CRP) is elevated if there is inflammation in the body, including that related to heart disease.

What does a healthy body look like?

A healthy body is not necessarily that of the models we see in magazines. Healthy bodies can come in all shapes and sizes. In fact, it can be healthier to be heavier and have more muscle mass than to appear thin but have low muscle mass and high body fat. The term ‘skinny fat’ describes someone who looks slim on the outside, but who has too much dangerous fat inside, ie. visceral fat, which sits around the vital organs. As visceral fat increases, so does our risk of insulin resistance, diabetes, gallstones, heart disease and cancer. One way to check whether you may have too much visceral fat — even if you appear normal — is to check your waist-to-hip ratio (see above).

To reduce visceral fat, exercise is key. Aim for at least 30 minutes per day of moderate-intensity activity, and include strength training (weight-bearing exercise) as well. Spot exercising, such as doing sit-ups, can work abdominal muscles but it won’t get rid of visceral fat. Diet is important, too, so keep an eye on portion sizes and keep the ideal plate in mind.

Muscle mass – the key to staying young?

The more muscle mass we have, the higher our metabolic rate and the more energy we burn, even when we’re not moving. But as we age, we tend to gradually lose muscle and gain fat — even if we don’t gain weight. If we are physically inactive, we can lose as much as five per cent of our muscle mass every decade after age 30. Maintaining our muscle mass is an important part of staying strong and energetic as we age, helps maintain a healthy weight, and may also help prevent conditions such as osteoporosis. Strength training is the most important thing we can do to regain and maintain muscle mass. Research has shown that using weights, resistance bands or your own body weight in a programme of progressive strength training can increase muscle mass and reduce body fat. So if you don’t already include this type of exercise in your routine, now’s the time to start.

How healthy are you?

Think about how healthy you’re looking and feeling and score yourself 1, 2 or 3 in each category.

Eyes, hair, nails

1. Looking good!
2. Better diet and lifestyle would probably help
3. Might get my GP to take a look

Hearing and vision

1. No problems so far
2. Someone did question my hearing/vision recently
3. What was that? Time to get checked!

Digestion

1. Passing wind is quite normal and healthy
2. One or more of these is normal for me: excess wind/bloating/constipation/diarrhoea… maybe time to find out what’s causing it

Is it time to get my bloods checked?

1. Not yet
2. Yes

Note: All women aged over 55 and men over 45 should have blood tests at least once every 10 years. For people of Maori, Pacific or Indo-Asian ethnicity, this is 10 years earlier.

BMI, waist size, waist-to-hip ratio, flexibility, resting heart rate

1. Looks healthy
2. More exercise and attention to portion sizes on my plate would help
3. Time to review my diet and get moving!

Results

Congrats if you scored all 1s, but if you didn’t, think about whether there are some simple changes you can make to nudge yourself in the right direction, or whether it’s time to get a full check-up for professional advice on how to improve your health.