16 November 2019
16 November 2019

What’s included in My Nightingale results—Biomarkers

To give you a deep dive into your metabolic health, the My Nightingale app includes 16 different biomarkers.

Along with the Nightingale Health Index and six health indicators, the results also show 16 individual biomarker measures. So, what are these biomarkers? They are universally accepted 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—proteins, 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, if you pull one block out, you risk unbalancing the whole system. Here’s a closer look at what these measures are and why we track them:

Total cholesterol

Total cholesterol is the cholesterol concentration in your bloodstream measured to check your heart’s health. Although most of us think of cholesterol as something bad, the fact is, it’s just fat from your liver (or food) that are 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.


LDL-C, 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-C, carries essential cholesterol needed in your cells via the blood. However, if there are more LDL-C in your bloodstream than required, it starts to clog your arteries and increase your risk of having a heart problem. Measuring LDL-C is, therefore, a standard test to ensure that you have a healthy heart.


HDL-C, or high-density lipoprotein cholesterol, is also called the good cholesterol. That’s because while excess bad cholesterols (LDL-C) clog your arteries, HDL, the lipoprotein in HDL-C, 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 fatty 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-C and VLDL-C), an excess of them is not good for your heart’s health.


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


ApoB, or apolipoprotein B, you guessed it 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’s 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’s 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, Apostands 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 thebad cholesterols (LDL- and VLDL-cholesterol), ApoA1 carries the good HDL-cholesterol. And since having good cholesterol is better for your heart’s 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 whatever you eat and drink. However, for it to be used as energy, glucose needs to be transported to your tissues and a hormone called insulin makes that happen. So, when your insulin levels are low or the hormone isn’t functioning properly, your blood glucose levels rise. This is not good and can eventually develop into diabetes. Very high levels of glucose also cause inflammation and damage your blood vessels over time. Meaning, it is bad for your heart’s 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 often during intermittent fasting. 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 special protein circulating in your bloodstream. Basic blood tests can 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, an 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.


Omega-3% tells you how much of your total fatty acid count is omega-3, which is a good polyunsaturated fat in your blood. Omega-3 improves blood flow, lowers inflammation and is therefore good for your heart’s health. Your body can’t naturally produce all types of omega-3, like alpha-linolenic acid. So, you need to include things like oily fish and vegetable oils in your diet.


Omega-6% tells you how much of your total fatty acid count is omega-6, which is a good polyunsaturated fat in your blood. It helps build healthy cells, reduces diabetes risk, lowersbad cholesterol and good for heart’s health. Like omega-3, our body produces some omega-6, but not all; like linoleic acid—the essential one. You need to get the missing omega-6 from food like walnuts and vegetable oils.


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 MUFA, consuming too much saturated fat (such as from butter, cheese and red meat) may cause MUFA levels in your blood to go up, which is bad. A high level of MUFA is also often a sign of obesity 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’s health.


SFA% tells you how much of your total fatty acid count is saturated fatty acids (SFA). SFAs, such as butter, cheese and red meat, are often considered bad fats that you should keep an eye on. So, you don’t need SFA-rich food like pizzas, fries, processed meat and sweets, except for when eating for taste. Scientific studies have shown that eating too much of SFA-rich food can 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) and maintain a lower SFA%.


Branched-chain amino acids are made up of three of the nine essential amino acids: leucine, isoleucine and valine, which make up around 35% of your body’s muscle protein. They are essential for your normal body functions plus help you recover from strenuous workouts. But, unfortunately, your body can’t produce BCAAs. So, you must include them in your diet. While eating BCAA-rich food is good, science says high levels of BCAAs in your blood increases the risk of diabetes, especially for those who are overweight. Therefore, a lower level of BCAAs is better. However, extremely low values are not healthy either.

Read more on how you can improve these biomarkers →

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