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ASK THE NUTRITIONIST: How can I track my own health?

In this week's column, Nonie De Long outlines key metrics you can monitor at home to meet your health goals
blood pressure shutterstock_159748715 2016

Dear Readers, this question is from Daniel who wrote in to determine how to track his health at home. It’s a great question and very timely, as there are a number of apps and devices to help us do this now. I won’t get into the apps, as I’m not qualified to compare them, but I will share the things that are important to measure and track to better understand your own health and better communicate with your health-care professionals.

I suggest a notebook exclusively for this to help you at first. Once you know what you’re looking for you can then go hunting for apps if you prefer them. Below I’ve listed some metrics you might want to start with and why they might be of import.

Blood Pressure

The reason this is so important to track at home is that often people get anxious when they are getting measured at the doctor’s office and it artificially inflates the values for that time. When you know what it is regularly you can communicate that and be more aware of the variation and learn to better manage triggers.

Blood pressure cuffs to be used at home are automatic. You put them on the arm and they inflate with the push of a button. They will give you two values, systolic and diastolic. A healthy normal measurement for adults is considered anything under 120/80. If yours is higher, you can recheck it in 5 minutes. Make sure to follow directions on the device about how to sit and place your arm. Age, gender, weight, and health status can affect this measurement and it’s important to note that it can fluctuate a bit over time. If you note abnormalities you should speak to your physician. Knowing your typical range can help him/ her to assess what the values mean.

Oxygen Saturation (Sp02)

This is a measure of the oxygen in your red blood cells. I recommend getting a pulse oximeter to measure this if it’s something you are concerned about. It’s a small device that goes on the end of your index or finger. You’ll probably recognize it from visits to your doctor’s office. They are also often used by athletes to measure and improve their performance, so you may have seen them at the gym. Anyone who suffers from problems with their lungs or is trying to quit smoking or those interested in optimizing their health may benefit from this technology. Tracking the improvement in O2 saturation from quitting smoking may help you in your endeavour to quit.

During COVID-19 these have become more popular because they are relevant to the respiratory problems we see with complications from COVID-19. The normal range for a healthy reading is 90-100. Anything lower than should be shared with your physician.

This little device often also measures other metrics like your heart rate and respiratory rate. You can also take these manually (below).

Resting Heart Rate or Pulse

This is very easily checked by placing your fingers over your pulse and timing the count with a stop watch. You want to know how many beats per minute. You can also use a blood pressure cuff or an oximeter to determine your pulse accurately, and many smart watches also track it. A normal heart rate is considered between 60 and 100 beats per minute while resting.

Respiratory Rate

Respiratory rate refers to the rate of our breathing - usually the number of breaths taken per minute. It is the least popular vital sign to monitor and is oft overlooked in physical exams or recorded inaccurately. Yet it’s an important marker of health and can be the first sign that the body is struggling with respiration. It is thought that better monitoring this can help predict serious health events - particularly respiratory failure, which is a primary reason people are admitted to intensive care. There is an excellent series of articles on this issue in Nursing Times here.

We can easily monitor our respiratory rate at home using a Sp02 meter or our hand on our chest or abdomen with a stopwatch. Each rise and fall is a breath. A normal respiration rate is between 12 and 20 times a minute. Monitoring this can be very beneficial for those with anxiety related issues or mood imbalances. Often respiration is our first indicator that we are upset about something. Doing yoga or meditation practices can deepen respiration and have numerous health and mood benefits.

Body Temperature

Body temperature is another way to determine if we are well, as every parent knows. Monitoring body temperature usually happens when we know we are fighting a bug or infection. A spike is an early warning sign that the immune system has been marshalled to get to work.

Our age, gender, medicines, and health status impact what our normal body temperature is, and there is a healthy range. It is usually considered to be between 97-99 F today. Historically it was thought that 98.6 F was the optimal norm, but we now know there is a wider variance among people than was previously thought. Purchasing a simple digital thermometer to start to record your temperature regularly at home can help you better understand your own normal range and better know if you or a family member are fighting an infection. With kids that get frequent ear infections this can be particularly helpful.

It’s good to know that in holistic communities it is not recommended to decrease a low grade temperature. Herbalists actually induce a spike in temperature to help the body’s innate defense mechanisms kill viruses at the earliest sign of infection. We now know that a fever is the body’s initial reaction to an invader and stopping that natural process can lower our natural immunity. When it’s dangerously high (high grade fever of 103 F or more) or very uncomfortable, natural baths and common medications can be used as per physician recommendations.

Activity

Watches and phones can monitor our steps with fitness apps or we can learn to document the time and frequency of exercise to better track it. Knowing how much we walk or move can be helpful. When we sit for prolonged periods, as we are prone to do at the computer or television or at work, we actually lose muscle mass and bone density and alter our metabolic rate! Setting a timer to get up and move around every hour or setting an app to monitor our steps can be helpful to figure out where we can improve. Low grade activity is as beneficial for health as what we consider more intense, cardiovascular activity. Our bodies are made to move around all day every day and we experience great improvements in health when we do this more. Walking is a great way to get started and wearable trackers can help us understand how many steps we’ve taken or how great a distance we’ve covered.

For optimal health I recommend a baseline of at least 8000 steps per day and better yet, 10,000. Anyone who is able to move can achieve this if they break it down. Of all the data health tracking we can do, this is the one I think everyone needs to start with. It helps us know if we are moving enough to sustain health or if we need to kick it up a notch. And competing with ourselves to take it to the next level once we meet a goal is a great way to increase our activity.

Blood Glucose

This is a measure of the sugar in your blood at any given time. It’s particularly relevant for anyone who is diagnosed as diabetic, but I would suggest it’s also helpful to know for those who carry excess weight and those with health problems they can’t figure out, like regular anxiety or migraines. Knowing your blood sugar can help you figure out if what you’re eating and the impact on blood sugar is a factor. It can also help you understand why weight loss may be going slow, as high blood sugar provokes insulin, which inhibits fat burning. Our bodies simply can’t burn stored fat when insulin is present.

Normal values range, as your blood sugar goes up and down during the day. But normal fasting blood glucose is considered to be 3.9 - 5.5 mmol/L.

Your doctor will screen your blood sugar for abnormalities during your annual check in, but if this test is done at one time with no provocation of sugar it may not catch an overreaction to sugar, which is also an indicator for diabetes. The most accurate blood sugar test is one that’s done throughout the day and measures fasting and reactive blood sugar, but this isn’t always done. So collecting this information at home could be helpful for your healthcare provider in assessing your health, particularly if diabetes runs in your family or you are in a risk group (overweight) or have been told you are prediabetic.

Glucometers can be purchased online and are fairly straightforward to use. They use tiny lancets to collect blood, so there are best practices around disposal of the lancets and safe handling of the equipment. Please be aware of this if you have pets or small children before you consider getting one. There are also new devices that strap on the arm and continually monitor blood glucose, if you are diabetic and find constant testing to be a pain. These are cost prohibitive for many, but can greatly ease the task of tracking blood glucose when your health depends on it.

Ketones

This may only apply to a select audience, but I think it’s noteworthy because so many people are doing a keto diet now. Ketones are the type of energy that is used on a ketogenic diet and thus people like to measure them to know definitively they are in ketosis, typically when starting the diet. It’s a clear marker that helps people know they are getting it right, which helps them in their efforts.

I’m not that person and I confess it wasn’t until this year that I started tracking my own ketones at all, and only for the sake of understanding the metrics better. Why? I’m a person who believes that how we feel and perform and how much excess weight we carry and how we sleep and think and move is more accurate than any test in speaking to us about our health. So I have learned to listen to my body. I mean really listen. I am at a point where I can tell when I have ingested something that contains ingredients I am sensitive to. And I can tell when my liver has cleared those. Our bodies give us a great deal of information if we only learn to listen to them. But many people are all about the data, so learning how to track ketones has been on my to do list this year.

But ketone monitoring is not as straightforward as it seems. Clients can get upset because they are doing everything right and urine strips don’t say they’re deep in ketosis. This is because a body that’s keto adapted can use the ketones very efficiently so less are excreted. It can be tricky to determine your levels accurately.

There are three different test methods, each with their pros and cons, and for this discussion I am going to defer to Mark Sisson - because really he’s the man when it comes to all things Keto and Primal. He knows far more than I do on keto tracking and has an excellent article on it, which readers can find here.

Anyone who is looking to manage their T2 Diabetes naturally may want to learn more about ketone monitoring and a ketogenic diet, as this can help drastically stabilize blood sugar and reduce the need for medications. Readers can go to dietdoctor.com for more info if this is something they are seeking.

Sleep

Monitoring sleep can be done now with apps on phones and watches, both wearable an non wearable, but you can also kick it old school and just make note of the time you went to bed, the time you got up, if you remember any wakefulness or dreaming, and if you feel refreshed in the morning. Maybe it’s just because I’ve listened to too many true crime stories, but any device collecting data on when I am asleep and when I am awake gives me the heebie jeebies. If a phone on the bedside table can track my sleep what else does it monitor in the bedroom? That’s a big pass for me. If you are also concerned about this, you may be interested to know that airplane mode disables data collection and takes you off the grid for a period of time.

How much energy we have in the morning is often a very accurate indicator for how deeply and sufficiently we slept during the night. Many clients I see know they are burning the candle at both ends and are sleep deprived - especially parents of young children - but tracking this can help bring awareness to just how sleep deprived we are.

Many people may not know that sleep impacts our bodies in incredible ways. When we sleep, our bodies repair themselves on a molecular level. Think of it as a sort of molecular housekeeping and self repair mode. This is why I advocate the use of melatonin before sleep. It is a super redox antioxidant that gets into the mitochondria to do the housekeeping, on top of helping to regulate sleep cycles. It is one supplement I don’t think people yet understand the full benefit of.

Sleep is so essential that every year when clocks go ahead and we lose an hour there is a noteworthy spike in driving accidents and heart attacks! And we know sleep changes not only the way we handle stress and perform at physical and mental tasks, but also our relationships and our relationship with food. It’s very difficult to lose weight when we are sleep deprived for a variety of reasons. And it’s very difficult to be happy when we are walking zombies. I hypothesis that this is part of the reason Mediterranean countries are known to have better health. It isn’t just the diet - it’s the sleep and the sun and the pace of life, too!

The bottom line is tracking your sleep can be a start to understanding just how deprived you are and taking your health to the next level by correcting that.

Basal Body Temperature

This is a lesser known measurement that clinicians do not often use now, but women in particular may find very helpful. Low thyroid function and thyroid imbalances are epidemic among women now, as are adrenal and fertility issues, and this is considered by some practitioners to be the most accurate metric of hormonal health.

Basal body temperature is the temperature of your body at rest and is usually the lowest your body temperature will go through the day. It’s taken at rest when we wake in the morning before moving or getting up. It’s taken with a very sensitive thermometer and written down over a period of days at a specific time in the hormonal cycle. For more information on how to track it, readers can go here.

The thyroid gland is the primary regulator of body temperature, so even slight changes in temperature give us information about the thyroid gland function. Now we know that all hormones do a synergistic dance and impact on temperature collectively, but some clinicians believe thyroid is the master regulator and resting body temperature is the best way to monitor for irregularities in our thyroid gland. BBT can also help monitor our adrenal function and fertility hormones.

For more information on BBT tracking for fertility, go here.

For thyroid monitoring purposes, you can find detailed information at holistic-hypothyroid-solutions.com.

I hope this is helpful, Daniel. As always, if readers have health questions, they can send me an email at [email protected]. In the upcoming months I’m running several free webinars on mental helath. You can find them on my events page. Tune in next week when we’re going to talk about a diet that’s shown promise for dementia.

Namaste!

Nonie Nutritionista



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