What’s included in My Nightingale results—Biomarkers

To give you a deep dive into your metabolic health, the My Nightingale blood test and app includes numerous biomarkers.

Along with the Nightingale Health Index and various health indicators, the My Nightingale blood test results also show numerous individual biomarker measures. So, what are these biomarkers? They are scientifically established health makers from your blood that acts as a foundation for measuring health. If you’ve ever played Jenga, think of biological markers (or biomarkers) as the blocks that build the tower of your health. They can be anything—fats, sugars, hormones, amino acids and other molecules in your body—which gives an indication about your wellbeing. In theory, they are individual health markers with their own individual place and functions in your body. Yet, they are interlinked and together create a healthy and balanced system. Here’s a closer look at what these biomarker measures are and why the My Nightingale blood test helps you track them:

Total cholesterol

Total cholesterol is the aggregate cholesterol concentration in your bloodstream measured to check your heart health. Although most of us think of cholesterol as “something bad”, the fact is, it’s just a type of fatty substance. It’s produced in your liver, or comes from food, and is needed to build healthy cells. Your body only needs a specific amount of cholesterol and excess of it blocks your blood vessels, which obviously is not good for your heart. However, it’s good to remember that the total cholesterol count does not tell the full story. For instance, your total cholesterol may be a bit high due to a high “good” HDL-cholesterol level and that’s OK. However, if the “bad” LDL-cholesterol levels are high, you may need to pay attention.


LDL-cholesterol, or low-density lipoprotein cholesterol, is often referred to as the "bad” cholesterol. It’s not bad per se, as it has an important function. LDL, the lipoprotein in LDL-cholesterol, carries essential cholesterol needed in your cells via the blood. However, if there are more LDL-cholesterol in your bloodstream than required, it starts to clog your arteries and increase your risk of having a heart problem. Measuring LDL-cholesterol is, therefore, a standard test to ensure that your heart stays healthy.


HDL-cholesterol, or high-density lipoprotein cholesterol, is also called the "good” cholesterol. That’s because while excess "bad cholesterols" (LDL-cholesterol) clog your arteries, HDL, the lipoprotein in HDL-cholesterol, carries cholesterol to the liver where it is broken down. So, HDL helps in removing unnecessary cholesterol from your body, thereby reducing your risk of getting heart disease.


You might not have heard about them, but triglycerides are the most common type of fat in your body. They come from fats in your food like butter, oils and the “extra calories” that you eat. Your body stores triglycerides in fat cells and burns them when you need energy. Like cholesterol, they are also circulated in your body via the blood. And since they tag along with the “bad cholesterols” (LDL- cholesterol and VLDL-cholesterol), an excess of them is not good for your heart health.


VLDL-cholesterol, or very low-density cholesterol, is the “bad” cholesterol’s (LDL-cholesterol) partner in crime. The only difference is that, while LDL mostly carries cholesterol to your cells, VLDL mostly carries triglycerides. Just like LDL-cholesterol, excess VLDL-cholesterol isn’t good for your heart health as it can block your blood vessels.


ApoB, or apolipoprotein B, you guessed it right...is a protein. Think of it as a glue that holds particles inside “bad” cholesterol molecules (LDL- and VLDL-cholesterol) together and helps them move in your blood. ApoB is basically the total number of “bad” glue particles that you have in the bloodstream. Since “bad” cholesterols are attached to these “bad” glues, ApoB is bad for your heart health.


HDL-cholesterol, the “good” cholesterol in your blood, needs a protein called apolipoprotein A1 or ApoA1 to circulate in your blood. Since ApoA1 supports the movement of “good” cholesterol that is good for your heart health, ApoA1 is also good for you.

ApoB/ApoA1 ratio

As the name suggests, ApoB/ApoA1 balance is a ratio of ApoB to ApoA1 in your blood. Here, “Apo” stands for apolipoproteins and ApoB and ApoA1 are the two types. As mentioned above, they help cholesterol particles to circulate in your blood. The difference is that while ApoB carries the “bad” cholesterols (LDL- and VLDL-cholesterol), ApoA1 carries the “good” HDL-cholesterol. And since having “good” cholesterol is better for your heart health than the “bad” cholesterols, a lower ApoB/ApoA1 ratio is better for you.


Blood glucose is the amount of glucose in your bloodstream. As you might already know, glucose is needed to produce energy in your body and comes from what you eat and drink. For it to be used as energy, glucose needs to be transported to your tissues and a hormone called insulin makes that happen. However, when your tissues don’t respond to insulin properly, your blood glucose levels rise. This isn’t good for your body and can eventually develop into diabetes. Very high levels of glucose may also cause inflammation and damage your blood vessels over time. Meaning, it is bad for your heart health.


Fun fact: unlike your body, your brain can’t use proteins or fats as an energy source. It uses the smallest carbohydrate unit, glucose as the main energy form. Ketosis is a state in which, when your body is low on glucose, it burns stored fat to produce ketones that act as an alternative energy source for the brain. Ketosis is reflected by a raised level of beta-hydroxybutyrate, the main ketone bodies circulating in your blood. Ketosis may occur when you’re following a very low-carb ketogenic diet and during fasting over several days. If you are healthy, ketosis is neither good nor bad. It’s just the body's normal way to adapt to an abnormal situation.


If you haven’t heard about glycoprotein acetylation, or GlycA before, that’s because no standard medical test measures this biomarker. Basic blood tests only measure C-reactive protein, which indicates acute inflammation caused by serious illnesses. By then, a person is already sick. However, a more advanced blood analysis (like the one done by Nightingale) can measure GlycA, a new indicator of low-grade inflammation, that predicts future risk of diabetes, heart, kidney and liver problems. GlycA is, therefore, an important health marker to track for future-proofing your health.


PUFA% tells you how much of your total fatty acid count is polyunsaturated fatty acids (PUFA). PUFAs include omega-3 and omega-6, which are considered the “good” fats. They’re essential for building healthy cells, have anti-inflammatory properties and lower "bad" cholesterol levels and triglycerides. Meaning, they are good for your health. So, a higher PUFA% is better for your heart health.


Omega-3% tells you how much of your total fatty acid count is omega-3, which are good polyunsaturated fats. They lower triglyceride levels, prevent blood clots, ease inflammation and are therefore good for your health. However, our body cannot produce all the essential omega-3s. So, you need to include omega-rich food in your diet. For instance, oily fish (salmon), canola oil, flaxseeds, chia seeds and walnuts are a rich source.


Omega-6% tells you how much of your total fatty acid count is omega-6, which are good polyunsaturated fats in your blood. They help build healthy cells, improve insulin sensitivity, lower “bad” cholesterol and are good for your heart health. Like omega-3, our body can’t produce all omega- 6. So, don’t forget to include things like walnuts, pumpkin seeds, almonds and vegetable oils (like sunflower and olive oil) in your diet.


MUFA% tells you how much of your total fatty acid count is monounsaturated fatty acids (MUFA). They are “good” fats as part of your diet. However, because how your body handles fats, consuming too many saturated fats (such as from butter, cheese and red meat) causes MUFA% in your blood to go up, which is bad. A high MUFA% is also often a sign of overweight and insulin resistance, a condition in which your cells have a difficulty to take up glucose from your bloodstream. This may develop into diabetes and is not good for your heart health.


SFA% tells you how much of your total fatty acid count is saturated fatty acids (SFA). SFAs in food, such as butter, cheese and red meat, are often considered “bad” fats that you should keep an eye on. Scientific studies have shown that eating too much of SFA-rich food could increase both type 2 diabetes and heart disease risk. Instead, you should replace them with MUFA and PUFA (such as in olive oil and fish) to maintain a lower SFA%.


Branched-chain amino acids are made up of three of the nine essential amino acids: leucine, isoleucine and valine, which are vital for building your body’s muscle protein. They are essential for your normal body functions plus help you recover from strenuous workouts. Your body can’t produce BCAAs, therefore, you should include them in your diet, but in moderation. High levels of BCAAs in your blood may indicate an increased risk of diabetes, especially in those who are overweight. Therefore, a lower level of BCAAs is usually better.