Guide to Key Biomarkers for Optimal Health

Biomarkers are, by definition, biological molecules found in the blood or other body fluids or tissues. Their presence can alert us to the onset of a pathological process or, conversely, indicate that everything is going well in our body.

They are measurable biological indicators that reflect states of health, disease, or biological processes in the body. They can help in the early diagnosis of diseases, in monitoring treatments, and in predicting health risks. “Different types of biomarkers, such as ‘diagnostic’ ones, are used to detect disease. For example, troponin is used for the diagnosis of myocardial infarction” explains Dr Mariel Silva from SHA’s Well-Ageing Unit.

There are also ‘prognostic’ biomarkers, which indicate the likely course of a disease in a diagnosed patient. “An example of these are PSA levels to predict the progression of prostate cancer. There are also ‘predictive’ biomarkers that predict a patient’s response to a specific treatment. An example is HER2 in breast cancer to predict the response to a certain treatment” notes the expert.

Then there are ‘susceptibility or risk’ biomarkers which, according to the SHA specialist, “indicate the likelihood that an individual will develop a disease in the future, such as BRCA1 and BRCA2 for the risk of breast and ovarian cancer.”

Lastly, there are ‘pharmacological response’ biomarkers that evaluate how the body responds to a treatment. One example is measuring blood glucose to evaluate the effectiveness of diabetes treatments.

Dr Silva indicates that a biomarker must meet certain criteria, including specificity and sensitivity, for it to be useful. It must specifically identify a condition and do so with high precision, and its results must be consistent and replicable in different tests and environments. The accessibility and ease of measurement, as well as the clinical relevance of the biomarker, must provide relevant and useful information for clinical decision-making.

Dr Vicente Mera, head of SHA’s Well-ageing Unit, explains that biomarkers are parameters that help determine an individual’s health status. They are compared with other parameters, such as age, weight, or sex, to determine whether they are in line with the desired health goals.

“There is solid scientific evidence on the predictive ability of degenerative diseases or premature ageing in biomarkers such as telomere length, inflammation levels, genetic biomarkers related to longevity, hormone levels, oxidative stress, and epigenetics. By combining these biomarkers with more common ones, such as cholesterol, fasting glucose, and glycated haemoglobin (HbA1c), a comprehensive assessment of health and ageing is achieved, facilitating early and personalised interventions to improve quality of life and longevity” opines Dr Silva.

In the context of well-ageing promoted at SHA, it is crucial to start monitoring our biomarkers as soon as possible. “Long-term well-being and healthy ageing largely depend on detecting and addressing any imbalances or health risks early on. By evaluating biomarkers from younger ages, for instance, at 40 years old or earlier, we can identify health patterns, prevent potential diseases, and promote healthy lifestyles before problems become more serious or chronic. Moreover, this approach allows us to implement preventive interventions and lifestyle changes when they are most effective and impact long-term health most” concludes Dr Silva.

Here are the most important biomarkers we should consider:

Weight

This is the most important of all biomarkers. “It is excellent for predicting health status, disease progression, and lifespan. But weight alone is not enough; it must be related to height. Weighing 100 kilos and being 1.60 metres tall is not the same as weighing 100 kilos and being 1.90 metres tall. That’s why a formula to measure body mass index (BMI) provides a more reliable figure,” says Dr Mera.

It is calculated by dividing weight by the square of height. “A person with a BMI of less than 25 will have the average life expectancy of the population; a BMI between 20 and 25 could lose between 10% and 15% of their longevity; but with a BMI between 30 and 35, nearly half of their life expectancy is lost,” explains the SHA expert.

Abdominal Circumference

Biomarkers are compatible with each other, and not all areas where fat accumulates pose the same risk. Measuring abdominal circumference, which indicates accumulated abdominal fat, can signal the risk of developing certain diseases. “Abdominal fat blocks the function of hormones like oestrogen and cortisol: this means that not only is there an increase in adiposity, but also a lower quality of life and a greater risk of disease. It’s not just a cosmetic issue to accumulate fat in the abdomen,” says Dr Mera.

“The systematic practice of fasting and calorie restriction (stopping eating when we are at 80% of our capacity) would be two very useful strategies to maintain a good state of the two previous markers. Moreover, longevity genes would be activated” explains the expert.

Fasting Glucose

Having high fasting glucose levels poses a high risk of developing diseases, and accelerated ageing, and suggests a shorter lifespan compared to those with normal fasting glucose levels.

Glycated Haemoglobin (HBA1C)

According to Dr Mera, this is one of the most useful biomarkers because it measures the average behaviour of glucose over a period of two to three months.

Fats – HDL (good cholesterol), LDL (bad cholesterol), lipoprotein (a), and homocysteine

These four markers measure the state of lipids in the body and indicate cardiovascular risk, with cardiovascular diseases being the leading cause of death. They are important for measuring longevity. Lipoprotein is heavily influenced by genetics and is difficult to modify as it indicates a family’s vascular risk.

C-reactive Protein (CRP)

“It should be as low as possible, but several events can transiently elevate this biomarker, including infection or stress. This protein is a good longevity marker, but its measurement often yields false positives.”

Fibrinogen

“It is a marker of inflammation. If it is very high, the individual’s inflammatory state worsens” says Dr Mera.

Additionally, other more complex biomarkers are measured in specialised laboratories, offered to all SHA patients, and which very precisely indicate life expectancy:

Telomere Length

Telomeres are repetitive DNA sequences at the ends of chromosomes that protect them from wear. “The longer the telomeres, the greater the longevity,” assures Mera. “A third of telomere length depends on genetics. Many studies show that stress and poor emotion management consume telomeres. Therefore, any relaxation technique or systematic practice of an exercise like yoga can be beneficial. Very high insulin, obesity, poor diet, or poor-quality sleep shorten telomeres, but some things can be done, such as regular moderate physical exercise” explains the doctor. Astragalus, a Chinese plant, has been shown to lengthen telomere length.

DNA Methylation

This indicator measures the phenomena that affect DNA and methylate—or mark—it for better or worse. Highly methylated DNA indicates shorter longevity. Methylation should be reduced as much as possible with moderate physical exercise and diet, but also with natural products such as acetylcysteine, which improves methylation.

NAD

It is a great biomarker that must be balanced to keep mitochondria in good condition and thus prevent ageing. Products to improve mitochondrial condition, in addition to NAD, are available. Glycolic acid is also a good activator, in controlled doses.

Glutathione

It is genetically determined. Many people produce poor glutathione due to bad genetics. It is very common for people not to produce enough glutathione; in such cases, they lack the tool that reduces cellular oxidation. SHA offers various treatments and therapies that help provide glutathione, which allows for cellular balance and halts the ageing process of mitochondria.

What You Need to Know:

• Biomarkers must be measured regularly because the interesting aspect is the trend, not the measurement on a specific day.
• Some biomarkers are compatible with each other. For example, weight and abdominal circumference should be measured together.
• C-reactive protein and fibrinogen (a protein involved in blood clot formation) are inflammation markers. They indicate a shorter lifespan in years and poorer quality of life.
• Biomarkers are measured with blood tests indicated by a professional.
• The information from biomarkers should be analysed by an expert to personalise treatments as much as possible to balance these biomarkers.
• In the pursuit of healthy ageing, the sooner biomarkers start being measured, the better.