Objectively Measurable Biomarkers for Positive Health

Author Bio: Dr. Abhaya Indrayan is a Biostatistics Consultant at Max Healthcare in New Delhi, after retiring as professor and head of the Department of Biostatistics and Medical Informatics from the Delhi University College of Medical Sciences. He has authored 6 books and has been a consultant to the WHO, the World Bank, and UNAIDS for several projects.

Many people undergo a preventive health checkup after a certain age, mostly for monitoring physiological and biochemical parameters against their normal range. When the level of any parameter is outside its normal range, the person is advised to seek medical help because such a level is considered to indicate some kind of deficiency or disease. The primary purpose of such a checkup is to find whether an aberration in health is in the offing or has set in so that corrective steps can be undertaken. Despite the name ‘preventive health checkup’, no cognizance is generally taken whether the levels are healthy enough to prevent disease, protect health, or maintain health. We know that the primary focus of medical science is on therapeutics – detecting an ailment and advising corrective measures, and very little attention is paid to identifying the parameters and their levels that provide protection. This distinction is important and can be explained as follows.

Some people live long and remain healthy most of their life while others easily get sick and die young. Whereas factors such as genes, social interaction, stress, sleep, diet, exercise, and laughter are studied in this context, these factors are highly subjective and defy exact measurement. All of these are mediators and help in improving various biomarkers in the body that protect health. Can we identify measurable medical biomarkers that serve as a shield and protect our body from falling sick? Or identify those that enable the body to quickly get back to its healthy level if an ailment, an injury, or psychosocial stress occurs?

Let us define positive health as the ability to live long without ailments. The parameters that indicate positive health are mostly known although not enough attention is paid. Positive health is not just normal levels of the parameters but are the levels that are assets for protecting and maintaining health. For immunity levels, perhaps the most important determinants are the levels of IgG and IgM. For neurological parameters, examples of major parameters that can be used to assess positive health are P3 amplitude and gamma-aminobutyric acid (GABA). Adequate levels of hormones such as serotonin, oxytocin, insulin, and endorphins may have predominant role in determining positive health. Vitamins and minerals are well-known nutritional parameters that protect from diseases. Musculoskeletal parameters such as body mass index, bone mineral density, skeletal mass index, and handgrip strength can also be amongst the indicators of positive health. Similarly, parameters for circulatory system (hemoglobin, heart rate, and platelet count), respiratory system (spirometry and oxygen saturation), reproductive system (semen quality in men, follicle-stimulating hormone), and urinary system (glomerular filtration rate, blood urea nitrogen to creatinine ratio) can be targeted for achieving positive health. These examples illustrate the biomarkers that can be used to objectively assess positive health.

Orientation of medical science to such an approach of assessing positive health by objectively measurable biomarkers is currently missing. There is a potential to initiate a discussion on its indicators, to characterize the parameters for intervention, identify the data gaps, and help develop a new strategy for achieving better health. For details, see https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10353687/