HEALTH 14th March 2018

Annual health checks:
Why a rethink is required


Annual health checks are a risk assessment tool used to guide decisions about your health. Yet studies indicate no real benefit is derived from them. In some cases, they may even cause more harm than good, due to their limited scope and nature.

It’s time for a rethink.

Current State:

For most of us, an annual physical looks something like this:

  • A weigh in
  • BMI (Body Mass Index) check
  • Cholesterol testing
  • Blood pressure check

Here is why that approach falls short:

Let’s start with the BMI test. This compares your weight in relation to your height but neglects muscle weight from the equation. Because muscle weighs more than fat, BMI misleads those who lack lean muscle into thinking they are healthy when in reality, they may face a higher risk of cancer, heart disease and type two diabetes.

Cholesterol testing, which remains a staple of your annual health check, is now (arguably) irrelevant. There is sizeable evidence demonstrating that cholesterol alone does not lead to heart disease, yet most physicians routinely prescribe their patients a statin to control it, despite inherent risks to the liver.

The current state suffers from both quality and quantity issues. To screen for cholesterol, blood pressure and BMI is only half of the picture. Supplementary tests are required, to make more informed decisions.

Future State:

A future state health check should include the following markers:

  • Body fat percentage

By replacing the BMI, with a body fat percentage test, a doctor can evaluate your risk for the most common metabolic disorders (cancer, heart disease and diabetes). The test takes less than two minutes and involves a tool designed to measure fat under your arms, around your waist, and on your thigh.

  • Inflammation check

Inflammation at the cellular level is actually why you get sick (see here for my post on inflammation). An inflamed body is susceptible to weight gain, diabetes, heart disease, cancer, and other chronic conditions. By testing you for inflammation through a blood test called C-reactive protein (CRP), a doctor can assess the results in conjunction with say, your cholesterol reading, in a more meaningful way.

A CRP result of <1 mg/l denotes low levels of inflammation, a result of 1-3 mg/l denotes average inflammation, and anything above 3 puts you at a higher risk of illness.

  • Vitamin D levels

The jury is beyond reasonable doubt when it comes to vitamin D and your health: deficiency in vitamin D is linked to:

  • Osteoporosis and Osteopenia
  • 17 varieties of Cancer (including breast, prostate and colon)
  • Heart disease
  • High blood pressure
  • Obesity
  • Metabolic Syndrome and Diabetes
  • Autoimmune diseases
  • Multiple sclerosis

As of now, it is an optional test which doctors order, but absolutely should be incorporated into the standard health check.

  • A1C test for Pre-Diabetes

Traditional methods of testing for diabetes rely on your fasting blood glucose levels at a single point in time. They are therefore not indicative of your average rate over the last few months. The A1C test measures your average rate over a period of three months, making it a more accurate way to screen for pre-diabetes. Due to rising rates of diabetes across the world, the need for A1C to be incorporated into the standard health check couldn’t be more necessary.

The tests outlined here are readily available but we need to urge our physicians to incorporate them into standard practice. Next time you’re up for your annual health check, ask about body fat, CRP and A1C testing; they could save your life.

As always, pushing for health.