17 November 2019
17 November 2019

What’s included in My Nightingale results—Health Indicators

My Nightingale app shows you measures from six health indicators connected to different aspects of health. 

The health indicators included in My Nightingale results are all individual biological metrics based on groups of health biomarkers. Each of these focus on a specific aspect of health and help you track how your lifestyle affects those areas of wellbeing.

To make the metrics easy to read, we have converted them into scores that max at 100. Heart age, which compares your cardiovascular health to your chronological age, is the only exception to that rule. The scoring system works exactly how you would imagine it to. That is, the higher you score the closer you are to the optimal range of the underlying metric, a.k.a, good health. Here’s more on what each of these six indicators represents and how they work:

Cholesterol balance

Cholesterol balance is a measure of good versus bad cholesterol in your blood.  You may have heard that cholesterol is bad for your heart’s health. But cholesterol is just a type of fat that’s, in fact, needed to build healthy cells. It’s produced in your liver and carried to your tissues by two lipoproteins—LDL and HDL. While the low-density lipoprotein (LDL) carries cholesterol from the liver to tissues, the high-density lipoprotein (HDL) carries it back to the liver from where it’s excreted. Things get complicated when this balance is disturbed. That is, when you have excess LDL cholesterol, it clogs the blood vessels, increases the risk of heart disease and therefore is considered bad. HDL, on the other hand,  is considered good as it helps in reducing your cholesterol count.

To check your cholesterol balance, we measure the two apolipoproteins—ApoA1 and ApoB. Apolipoproteins are proteins that hold particles inside LDL and HDL together. While ApoA1 holds the good HDL, ApoB holds the bad LDL particles. So, looking at the ApoB to ApoA1 ratio gives an accurate measure of the good versus bad cholesterol in your blood.

Blood sugar

Blood sugar is simply the level of glucose (sugar) in your bloodstream. To maintain the energy levels and have stable blood sugar, our body uses two hormones—insulin and glucagon. So, after a meal when your sugar levels go up, insulin helps cells absorb the glucose. On the other hand, when your sugar levels drop, glucagon instructs the liver to release glucose into the bloodstream. However, if this system is disturbed—insulin levels are too low or the body isn’t responding well to insulin—the blood sugar level rises. This could lead to diabetes, harm your blood vessels and develop into heart disease. Measuring your blood sugar levels is therefore crucial for your wellbeing.


Ever noticed how sometimes your tissues around injuries and infections swell up? That’s acute inflammation, our body’s way to fight damage and heal. However, there is another kind of inflammation that doesn’t belong in a healthy body—chronic low-grade inflammation. Low-grade inflammation is often related to excess fat mass, especially in the abdominal region. Recent scientific studies have found that this kind of inflammation plays a central role in the development of chronic diseases like diabetes and heart illnesses. So, it’s again an important health indicator to track for longterm health.

Fatty acid balance

Fatty acid balance is a measure of good versus bad fats in your blood. You probably already know that some fats are essential for us, for example, as a source of energy or for building cells. So, to check that you have a healthy fatty acids balance, we measured your polyunsaturated fatty acid (PUFA) to Monounsaturated fatty acids (MUFA) ratio. PUFAs are often called good fats as they reduce the risk of diabetes and heart disease. MUFAs are a bit complex as they are good when part of the diet, but bad in your blood. That’s because high MUFA level is often a sign of being overweight and insulin resistance, a condition in which your cells have trouble utilising glucose from your bloodstream and produce energy. Over time, this may develop into diabetes. It’s therefore crucial that you maintain a healthy fatty acid balance.

Insulin sensitivity

Insulin sensitivity is a measure to check how your body is responding to insulin, a hormone that regulates the energy utilisation. We measure your insulin sensitivity based on many health markers from your blood (such as glucose, triglycerides, HDL cholesterol, GlycA and more) and then summarise the information to a single score. Your cells’ sensitivity to insulin gets affected due to an inactive lifestyle with too little physical activity or if one is overweight. Over time, impaired insulin sensitivity increases blood sugar levels and can develop into diabetes. It is, therefore, an important indicator to track for longterm health.

Type 2 diabetes risk: To further explore how well your body is responding to insulin, the indicator also shows your estimated risk of developing type 2 diabetes in the next 10 years.

Heart age

Heart age is a reflection of your cardiovascular health vis-à-vis your actual age. To calculate your heart age, we take into account several health markers such as cholesterol, GlycA, ApoB/ApoA1 ratio and more. Based on these, we estimate your heart disease risk for the next 10 years. Then, we compared your heart’s status with other people of the same age and gender who have a healthy heart — non-smokers who have normal weight, healthy cholesterol and blood pressure levels—to arrive at your heart’s physiological age. So, if your heart is younger or the same age as your chronological age, it means you are taking excellent care of it. If it’s higher than your age, don’t worry. You can always improve by making lifestyle changes.

Cardiovascular disease risk: To further understand your heart’s health, the indicator also shows your estimated risk of developing cardiovascular disease in the next 10 years as well.

Read more on how you can improve health indicator scores →

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