Data
November 17, 2019

What’s included in My Nightingale results—Health Indicators

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

The health indicators included in My Nightingale results are all individual biological metrics based on groups of 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. The scoring system works exactly how you would imagine it to. That is, the higher you score, the better are your underlying metrics, which equals to better health. Here’s more on what each of these 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 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—when 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.

Inflammation

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 long-term 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 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 are associated with lowering 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 excess glucose from your bloodstream. Over time, this may develop into diabetes. It’s therefore crucial that you maintain a healthy fatty acid balance.

Diabetes resistance

Biology 101: Carbohydrates from your food break down into glucose which helps our cells produce energy. However, there is one crucial character missing from that plot—insulin. It’s a hormone produced by the pancreas that controls the energy uptake and utilisation in your body.

Impaired insulin sensitivity increases blood sugar levels in your body, which can develop into type 2 diabetes over time. Diabetes resistance is, therefore, a check to see how well-guarded your body is against developing this chronic disease.

To estimate your diabetes resistance score, we measure multiple biomarkers such as glucose, triglycerides, HDL cholesterol, GlycA and more. Medical research shows how change in level of these biomarkers are linked to a person’s long-term diabetes risk. We measure your results against this data and summarize it into a single score to show how resistant your body is currently to type 2 diabetes.

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 reflects your cardiovascular health compared to your actual age. Meaning, it simply shows how well your heart has aged based on its risk of developing cardiovascular disease in the next 10 years. We estimate your cardiovascular disease risk by measuring several biomarker results like cholesterol, GlycA, ApoB/ApoA1 ratio and such, which medical research shows are strongly linked to your heart health. To arrive at your heart age, we then simply match your risk to the general risk of developing heart disease at different ages. So, for instance, when you see that your heart age is 32 years, it basically means that you have the same heart disease risk as a healthy 32-year-old. Or, your heart is as healthy as a 32-year-old's heart.

Therefore, if your heart is younger or the same age as you, 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 simple 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.