The time to intervene is not when test results show you have already developed high cholesterol, diabetes or are overweight, but when you are nearing a danger zone. Photo / Nguyen Hiep, Unsplash
Vicky Saynor knows how important it is to keep an eye on your health. Three years ago, she finished treatment for breast cancer, and ever since has had regular blood tests.
"I keep a print-out of my results so I can see any patterns and have a good understanding of what they mean. I could see my pre-diabetic markers were going up with every single test," the 46-year-old says.
"If you've had chemotherapy, you can become diabetic. Plus, I was putting on weight, not exercising well as I was menopausal, and my waist measurement was 43 inches."
In December, her last blood glucose test showed she was pre-diabetic and one point away from a possible Type 2 diabetes diagnosis. Vicky, who runs luxury holiday accommodation bethnalandbec.com, decided to make lifestyle changes.
"I read Michael Mosley's book on reversing Type 2 diabetes, did his 800-calorie blood sugar diet and wore a monitor.
"When I started in May, my blood sugar at 7am was 9.7, while the normal range is between 4.5 and 5.8. Since then, I've gone from 86.4kg to 77kg and my waist is 38 inches. Now my blood sugars are down to 5.9 at 7am. I fully anticipate my next blood test will show I have reversed my pre-diabetic status."
This week, a campaign called Know Your Numbers!, will encourage Britons to monitor their blood pressure regularly at home. But it is also important to get blood sugar and cholesterol levels checked and understand what the results mean.
Dr Lucy Prince, an NHS GP in Newcastle, says: "Patients are realising that their health is their responsibility and doctors will support them wherever we can."
The time to intervene is not when test results show you have already developed high cholesterol, diabetes or are overweight, but when you are nearing a danger zone, as Saynor was. So, what are the tests you need to take and what do the numbers really mean?
Normal blood pressure is between 90/60 and 120/80
High blood pressure or hypertension tends not to have noticeable symptoms, but if left untreated increases risk of serious health problems, such as heart attacks and strokes.
Dr Samar Mahmood, GP and clinical lecturer, explains: "Blood pressure measures the force of the blood being pushed against the walls of the arteries. The first number is the systolic pressure and the second, diastolic pressure." Systolic measures the force when your heart beats, and diastolic when it rests.
Those numbers – particularly systolic pressure – can increase as we age and arteries stiffen. GP checks at least every five years are crucial – one in nine people has high blood pressure without knowing it – but regular home testing is also increasingly recommended, as is being tested at the local pharmacy.
GP Dr Sarah Levy says: "Increasingly we advise patients to buy their own blood pressure machines. They're an excellent way of monitoring."
How to tackle it
Dr Levy says: "If someone has high blood pressure, I'd work out their body mass index, ask about their alcohol intake and if they're eating a lot of processed foods. Tackling blood pressure means addressing other risk factors, like cholesterol, alcohol, diet and [lack of] exercise."
Figure it out
Patients under the age of 80 should have an average BP of below 135/85, or below 140/90 in a medical setting, as "white coat hypertension" can make BP go up. Low blood pressure is considered to be 90/60 or lower.
Aim for less than 42
Higher blood sugar levels "may be suggestive of diabetes, which causes long-term damage to the blood vessels, kidneys, eyes and nerves", says Dr Prince.
"There are two ways to monitor," says Dr Prince. "The first is a blood glucose test, which gives a snapshot of your current blood sugar level and can vary hour on hour." The second is the more accurate Hba1C blood test, which Dr Mahmood says, "calculates an average of your blood glucose over the last three months".
If you have symptoms including excessive thirst, fatigue or blurred vision, or family history of diabetes, book a blood test with a GP. Home-testing kits are not recommended unless you're diabetic, and people with established diabetes will have a regular GP check.
How to tackle it
The NHS advises a healthy diet, eating at regular mealtimes and 2.5 hours of weekly exercise.
Dr Prince says if you are in the Type 2 pre-diabetic range between 42 and 47 – as Vicky was – it's "a crucial time to make lifestyle changes". This is not diabetes, but if left unmanaged may lead to diabetes over time.
Prince adds: "It's potentially fully reversible back into normal range without the need for any medication. If you are overweight, this is an excellent area to focus on. Even losing five per cent of your weight can reduce the risk of developing Type 2 diabetes. If you need support with this, a primary care navigator at your GPs can direct you to NHS weight management services.
"Research shows that a Mediterranean diet, whole grains and lean proteins are protective. Try to avoid being sedentary. This doesn't mean you need to join a gym or run a marathon. Even small changes, such as introducing a standing desk instead of sitting, can have a positive impact."
Figure it out
A normal Hba1C test is below 42; 42-47 indicates "non-diabetic hyperglycaemia" (NDHG) or pre-diabetes; over 48 may be diagnostic of diabetes.
Aim for total cholesterol 5 or below
"Cholesterol is a fat chemical made by cells, mostly in the liver. It can be found in some foods as well," says Dr Prince. "Low-density lipoprotein (LDL) is commonly referred to as 'bad cholesterol' and high-density lipoprotein (HDL) as 'good cholesterol'. LDL clogs up arteries and causes cardiovascular disease including heart attack and stroke."
Dr Mahmood says: "If you have a strong family history of high cholesterol or cardiovascular disease, drink a lot of alcohol, have an unhealthy diet, or believe you are very overweight, get a cholesterol blood test."
Testing at least every five years is important because you may have no symptoms.
Simple home tests are available, however, your GP will usually combine cholesterol test results with other risk factors such as blood pressure, age and weight to produce a risk score. A 10 per cent score means a one in 10 chance of having a stroke or heart attack in the next 10 years.
That indicates it's time to take action, and adopt a healthy lifestyle. If the figure is higher, your GP may advise it's time to start taking statins.
How to tackle it
Dr Levy advises: "We should avoid the opposite of the Mediterranean diet: saturated fat, red meat, excess alcohol.
Dr Mahmood adds: "The things that lower your cholesterol are a Mediterranean diet, exercise and keeping your alcohol intake down. Things that boost HDL include eating fish, doing exercise, not smoking. There are foods which can actually decrease LDL, these include olive oil, nuts, flax seed oil, avocado."
Figure it out
Total cholesterol should be lower than 5.0; LDL cholesterol should be lower than 3.0; HDL cholesterol should be as high as possible, ideally 1.4; a total cholesterol to HDL ratio of above 6 is high-risk.
Aim for a BMI of 18.5-24.9 and a waist/height ratio of 0.4-0.49
"Being overweight or obese also puts us at a higher risk of developing diseases," says Dr Mahmood. A large waist measurement can indicate a higher amount of visceral fat – that's fat stored in the abdominal cavity – which can increase the risk of Type 2 diabetes, heart disease, breast cancer, colorectal cancer and Alzheimer's.
It's easy to keep an eye on at home with the NHS BMI Tracker app. However, there are limitations to its effectiveness. "BMI is a useful indicator but not perfect. People who are quite muscular can have a high BMI," Dr Levy advises, "Or you could be reassured by having a normal BMI but actually have all your fat deposited around your centre."
Take a measurement every few months or invest in body composition scales which give BMI, a more accurate visceral fat reading and muscle mass readings.
How to tackle it
Take action with lifestyle changes when you hit a 24 or 24.5 BMI. Dr Prince says: "That's the time for proactive health, rather than reactive when the problem happens. Risk factors for health problems start when BMI tips into being overweight."
Figure it out
Your body mass index or BMI is your weight in kilograms divided by your height in metres squared. Less than 18.5 is underweight, a healthy range is 18.5-24.9, 25-29.9 is overweight and over 30 is obese. Current guidelines suggest waist size should be less than half your height, while a worrying waist size in women would be 31.5 inches, and 37 inches in men.
Plus, Amisfield owner and chef celebrate global award in Italy.