The HH&P Show Ep. 5: Assessing cardiometabolic risk with a Precision Health Report

Welcome to today’s episode of the Health, Happiness, and Performance Show where we discuss how to assess cardiometabolic risk using a Precision Health Report. Last week we discussed the inflammation portion of the report in a blog you can check out here.

Today we discuss the parts of the report covering insulin resistance, metabolic syndrome, & cardiovascular disease risk. We’ll cover my results and how the report uses my results to calculate my risk of Type 2 diabetes and cardiovascular disease.

The Precision Health Report uses NMR lipoprotein analysis to get a glimpse in to your insulin sensitivity. Insulin sensitivity is the common link between type 2 diabetes and cardiovascular disease so maintaining high insulin sensitivity is a must. It plays a central role in your short term and long term cardiometabolic disease risk.

Today’s show is in a bit of a different format, you’ll follow along as I go through my report as a screen recording.

Cardiometabolic risk factors

Insulin sensitivity

Insulin is a hormone secreted by your pancreas that helps manage your blood glucose. It helps lower blood glucose by causing insulin sensitive cells to pull glucose from the blood. Insulin also plays an important role in circadian signaling, growth, and liprotein metabolism.

Based on the results of my test, my insulin sensitivity is excellent!

A score below 25 is considered optimal, and my score was a 20. This means that my pancreas is working efficiently with my insulin sensitive tissues to manage my blood glucose.

Interestingly, I had slightly elevated blood glucose at 101mg/dL. During the episode I discuss a couple of reason why I think this is. Afterwards I decided to take a look at my Fitbit sleep data to see if that was a factor, and indeed it may have been:

I had a very low sleep score for me(79) and very low REM sleep(45mins). I suspect the multiple awakenings come from a certain scared 4 year old crawling into bed(Wouldn’t change it for the world!). As a result, this may have skewed my fasting glucose measurement, not sure how it would affect lipoproteins.

My A1c taken on the same day was 4.8, so this isn’t really something that concerns me. Consequently, I’ll have another fasting glucose taken in a few weeks to compare it to under better conditions.

Lipoprotein analysis

The lipoprotein analysis used for the Precision Health Report is a very comprehensive one; it’s not just your total, LDL, HDL, and VLDL cholesterol levels. You also get your ApoB, which is a measure of your atherogenic particles as well as different particle sizes.

However, the standard measures are there as well. And for the most part, mine were as they normally are, save for a slightly elevated LDL-C. Based on the numbers, my 10 year risk of cardiovascular disease is very low at 1.2%. This is about half the risk of someone in my age group. But look at the long term risk:

My lifetime risk of cardiovascular disease is pretty high at 50%. From the test, this is mostly driven by by high LDL and ApoB particles. Additionally, I have early cardiovascular disease coming from both sides of my family, so the recipe for disaster is there.

My father had his first triple bypass at my age and a couple of his brothers had early heart attacks. Luckily for me I don’t have some of their bad habits, so things are going well now. But it’s important to point out that this means I have to be vigilant to make sure I don’t confirm this high lifetime risk.

In this episode I discuss my results, what I’m doing to lower my risk, how insulin sensitivity plays a role, and the things I do to maintain tip top insulin sensitivity.


For those who want to know more, check out the Healthy Rebellion Podcast episode with Dr. Cromwell. You can check that out here.

If you’d like to look into the Precision Health Report, you can check that out here.

I also highly recommend following Robb, Dr. Cromwell, and Precision Health Reports on Twitter, the least annoying and most educational of the social media platforms. You can do that at @robbwolf @Lipoprotein and @PreciseHlthRpt

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