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Job Burnout & Stress Test·
€ 132,-

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Author name: annabarzakouskaya

how to prevent job burnout

How To Prevent Job Burnout: Using The Allostatic Load Stress Calculator

How To Prevent Job Burnout: Using The Allostatic Load Stress Calculator

how to prevent job burnout

Did you know that safeguarding your well-being from job burnout can be simple using the Allostatic Load Calculator (ALI)? In today’s fast-paced work environment, chronic stress has become a pervasive issue, taking a toll on our physical and mental health. The ALI empowers individuals to assess the impact of stress on their bodies by studying the intricate interplay between inflammatory, neuroendocrine, and metabolic systems. At its core, allostatic load refers to the physiological consequences of chronic exposure to fluctuating or heightened neural or neuroendocrine responses, primarily arising from stress. To put it simply, it’s the wear and tear on our bodies due to chronic stress. Discover effective strategies on how to prevent job burnout through the assessment of allostatic load, gaining valuable insights into maintaining a healthy work-life balance and fostering resilience against the deleterious effects of chronic stress.

Before delving into how the allostatic load calculator works, it’s essential to understand the broader concept of ‘allostasis.’ Unlike ‘homeostasis,’ which strives to maintain internal stability, allostasis pertains to the process by which the body adapts to stressors by establishing new norms. Essentially, it’s the body’s response to cope with stress at the expense of its natural norms, whether it’s a looming work deadline or a sudden scare.

This article was last reviewed by Mai Saleh, Healsens, on January 22, 2023. This article was last modified on 21 January 22, 2023.

Package of lab tests to calculate your allostatic load:

  • Cortisol Blood Test
  • Dehydroepiandrosterone Sulfate (DHEA-s)
  • hs-C-reactive Protein (CRP)
  • Triglycerides (TG)
  • Thyroid Stimulating Hormone (TSH)
  • Hemoglobin A1c (HbA1c)
  • Albumin
  • Cholesterol (total)


For Whom is This Product Intended?

If you engage in a high-stress job or face prolonged personal challenges without relief, this can result in chronic allostatic load. When such a load lasts for years, we can talk about the cumulative effect of allostatic load. It would not be an exaggeration to say that those with a high allostatic load are often at a greater risk of several health challenges, including:

  • Cardiovascular diseases.
  • Impaired cognitive functions.
  • Digestive issues.
  • Sleep disturbances.
  • Mental health disorders, including depression and anxiety.

While stress is an inevitable part of life, its impact on our bodies doesn’t have to be. Just as understanding your biological age can inform lifestyle changes to reduce health risks, comprehending your allostatic load can guide interventions on how to prevent job burnout and address the associated challenges stemming from stress at home.

This holistic approach addresses not only workplace stressors but also those encountered in personal life, ensuring a comprehensive strategy for maintaining overall well-being. As we delve into the significance of the Allostatic Load Calculator, we can appreciate its proactive approach to mitigating job burnout and other chronic stress, preserving long-term well-being.

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Study Your Allostatic Load to Understand How to Prevent Job Burnout

Allostatic load cannot be directly observed because it is a latent and unobservable trait, but it’s possible to estimate it by summarizing data from a number of appropriate clinical biomarkers. The main reason is that it provides valuable information about your overall health status and can help identify areas for improvement. By undergoing an allostatic load blood test, you gain a comprehensive insight into the cumulative impact of stress on your body’s physiological systems. This not only enables early detection of potential health risks but also empowers you with the knowledge needed to proactively manage and optimize your well-being.

In the quest to prevent job burnout, home measurements are as essential as blood test results. Assessing body composition with a measuring tape at home plays a crucial role in understanding your allostatic load. Monitoring changes in your body composition offers an accessible and practical method for tracking the physical effects of stress. From cardiovascular health to cognitive function, and now body composition, the results of these assessments collectively offer a roadmap for targeted interventions, guiding you towards a healthier, more resilient lifestyle.

How to Prevent Job Burnout Unlocking Your Allostatic Load

You can find out your allostatic load by taking blood tests, as well as taking some measurements of your body parameters. For residents of the Netherlands, the test package is available via the reference link above or through the Healsens app. Since the calculation requires not only blood tests but also measurements of body parameters, installing the Healsens app and ordering tests from it can be more convenient. Additionally, when ordering tests through the app, the results will be sent automatically. However, both options are equally effective.

1 Download the Healsens App from Google Play or the App Store, depending on your device.

2 Complete the registration process in the app.

3 Go to the “Risks” page via the bottom menu of the application.

4 Tap on the test you need — ”Allostatic Load Index (ALI)

5 Tap on the “Add to Cart” button inside the test page and proceed with the ordering process.

Process of taking blood tests in:

*For Residents of Other Countries: If you wish to assess your allostatic load but are not a resident of the Netherlands, Healsens cannot facilitate blood tests for you. However, you can take the necessary tests at any other laboratory in your country and input the obtained results into the application.


If you order a blood test package through our partner labs, you need to manually enter the blood test results into the app. Because the app has no information about the person placing the order, this is necessary for the correct processing of the results. To receive the results directly in the app, install the app, choose the desired lab test package, and place the order directly from the app. When the order is placed from the app, the system recognizes your profile, and the results can be received automatically!

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simple sleep diary

Unlocking Better Sleep: The Power Of A Simple Sleep Diary

Unlocking Better Sleep: The Power Of A Simple Sleep Diary

simple sleep diary

Insomnia is a common condition characterized by significant disruptions in functions and quality of life and can lead to mental and physical health issues. The main symptoms of insomnia include difficulty falling and staying asleep, along with frequent discomfort and impairment of daytime functioning. This condition affects about 10% of the population. If you’re experiencing insomnia, it’s important to know where to seek help and how to address this problem. Additionally, a useful tool is a simple sleep diary, which can be highly effective in managing this issue.

This article is undergoing validation. The latest changes were made on November 20, 2023.

How Does Insomnia Affect Health?

In the vast majority of cases, insomnia is linked to mental or somatic illnesses. Insomnia can have a significant impact on our lives. In fact, it’s a risk factor for developing depression, anxiety disorders, substance use disorders, suicidal behavior, hypertension, and diabetes1.

When we suffer from sleepless nights, it reflects in our daytime well-being. We experience fatigue as if our energy has depleted in the morning, hindering our ability to function properly. Attention and concentration decline, disrupting our ability to focus on work, studies, or interactions. If you’re facing this issue, the Epworth Sleepiness Scale is widely used in the sleep medicine field as a subjective measure of sleepiness. This scale helps determine if you’re experiencing excessive sleepiness that requires medical attention. But wait, there’s more!

Sleepless nights sometimes lead to mood changes. We become irritable, or perhaps even sad, making communication difficult and impacting our social and family life. Professional or academic tasks start to feel overwhelming because we simply can’t focus or retain necessary information.


The Role of a Simple Sleep Diary

A simple sleep diary can be an invaluable tool in understanding sleep patterns, recording sleep disruptions, and identifying potential triggers. It aids in tracking the quantity and quality of sleep, helping healthcare providers comprehend the severity of the issue and guide effective treatment strategies.

Insomnia isn’t merely a disturbance in nightly rest; it’s a complex condition that affects mental, physical, and social aspects of life. Utilizing a simple sleep diary, along with seeking professional guidance, can be pivotal in managing and addressing the challenges posed by insomnia.

Furthermore, insomnia affects our behavior: we might become hyperactive or impulsive due to the loss of emotional control. Aggressiveness, loss of motivation, and a propensity for errors can also be outcomes of insomnia.

However, one of the key aspects of insomnia is its impact on self-perception. Lack of sleep can lead to feelings of dissatisfaction or anxiety regarding one’s own sleep, adding to the cycle of negative consequences of this condition.

Diagnosing Insomnia

According to the International Classification of Sleep Disorders (ICSD-3) for diagnosing persistent insomnia aligned with DSM-5 criteria, symptoms must be present at least 3 days per week for a minimum of 3 months2. Short-term insomnia (ICSD-3) or episodic insomnia (DSM-5) shares the same criteria as chronic insomnia but lasts less than 3 months.

Hence, it’s crucial to keep a diary, marking nights when sleep difficulties arise. This not only helps gauge the frequency of issues but also provides a more accurate depiction for diagnosis and seeking effective solutions.

Lastly, if sleep problems can be entirely explained by other conditions or disorders, they may not meet diagnostic criteria for insomnia. However, it’s essential to remember that insomnia can coexist with other mental disorders, and it’s not always the sole symptom as previously believed. Even if other disorders are the primary source, if insomnia is significant, medical practice should consider it as a separate, accompanying disorder necessitating its clinical intervention.

Current Sleep History

Analyzing the current sleep pattern plays a pivotal role in confirming the diagnosis and determining the best treatment for insomnia. This involves examining the sleep-wake schedule, sleep routines, nocturnal habits, and daytime activity. Let’s delve deeper into these aspects.

Providing the doctor with a detailed report on sleep onset, frequency of awakenings, wake-up times in the morning, and time spent out of bed is crucial. Smartwatches and trackers excel in this task, provided they are worn consistently for at least 2 weeks during sleep for data collection3. However, it’s worth noting that the accuracy of these devices is not confirmed, and your healthcare provider will likely offer more precise assessment tools for sleep duration and depth. Nevertheless, for observing trends (whether you slept more compared to previous periods), these devices can be quite suitable.

Furthermore, it’s essential to inform the doctor about what happens when you can’t fall asleep or when you wake up. For instance, certain post-awakening habits, like snacking or watching TV, might negatively impact sleep quality. Engaging in such activities during wakefulness might not promote improved sleep and could create irregular wakefulness rhythms. Discussing these behaviors with the doctor is important as it provides crucial information for proper evaluation.

While the sleep-wake schedule is important, it’s not sufficient for a definitive diagnosis. The doctor also requires your subjective perception of sleep quality, hence the importance of maintaining a sleep diary for more accurate information. Let’s explore the necessary information for a proper assessment of sleep quality.

Sleep Diary

We’ve discussed how collecting data on the frequency of insomnia episodes plays a crucial role in diagnosing and treating this disorder. Hence, the gold standard is maintaining a sleep diary for two weeks. A sleep diary should provide the doctor with key information, such as bedtime, lights out, sleep onset and awakenings, morning wakefulness duration, wake-up time, and overall perceived sleep quality. Occasionally, data on sedative and alcohol consumption are also important. This information aids in diagnosing insomnia and forms the basis for determining the individual nature of the problem.

A good sleep diary should encompass the following parameters:

  1. Time spent in bed.
  2. Time taken to fall asleep.
  3. Duration of sleep.
  4. Number and duration of awakenings.
  5. Final wake-up time.
  6. Perceived sleep quality.

While filling out a diary might seem laborious to some, some of these parameters can be effectively captured by smartwatches and trackers. This means that only a few additional parameters need to be added. A convenient approach could involve combining tracker data with personal observations. This way, you gather the most reliable information about sleep quality.

There are two reasons why relying solely on tracker data might be insufficient. If the aim is to provide information to the doctor, they probably won’t use raw data from smart devices for diagnosis. Firstly, it’s inconvenient. The volume of information is often presented graphically, making it unclear when insomnia episodes occurred and when they didn’t, a gap that is seldom filled in such trackers. Secondly, your doctor is likely to question the accuracy of your device’s sleep assessment. Data from limited studies suggest that some of these devices inaccurately reflect sleep structure. They tend to overestimate sleep duration in healthy sleepers and with greater error in patients with insomnia4. Hence, maintaining control over data collection is essential, verifying and correcting them when the representation becomes inaccurate. It’s beneficial to input processed and verified data into a sleep diary that would be convenient for your doctor to work with.

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How to Utilize a Simple Sleep Diary?

Let’s explore how technology can assist in assessing sleep quality, providing valuable information to healthcare providers, and tracking treatment outcomes. Firstly, it’s important to determine if sleep issues fall under the diagnosis of insomnia. As mentioned earlier, having at least 3 episodes of insomnia for a minimum of 3 months is necessary. It’s highly convenient to record these insomnia episodes in a calendar. You can use the Healsens medical card, which, among other features, not only allows you to mark the occurrence of insomnia but also categorizes it into 3 types based on the Insomnia Severity Index. This enables you to understand not only the frequency of insomnia episodes but also gather important information about its nature. This isn’t yet a sleep diary, so instead of daily data entries, simply noting the occurrence of insomnia is sufficient, which, of course, is a far less labor-intensive task and takes less than a minute of your time.

Although you’re likely aware of the importance of creating a conducive sleep environment, let’s reiterate that maintaining darkness, quietness, and coolness in the bedroom is crucial. It’s advisable not to go to bed if you don’t feel sleepy before bedtime. Additionally, waking up at the same time every morning for seven days a week and getting out of bed within 10-15 minutes after waking up is essential. Spending excessive time in bed is also crucial to avoid. Even though it might seem reasonable to catch a few extra winks, prolonged time in bed leads to a paradoxical effect – a conditioned arousal and fragmented sleep. The goal is to reduce time spent in bed.

This is where a sleep diary can come to the rescue. Search for a sleep diary, and after waking up, note how many hours you spent in bed and how much of that time you actually slept. For instance, if your diary shows that your total sleep time is 6 hours, and your time in bed is 9 hours (sleep time at 9:00 PM and waking time at 6:00 AM), then set a new sleep schedule to reduce time in bed. For example, you could set a bedtime of midnight and a waking time of 6:00 AM. If you’re using an app, you can set goals related to these sleep characteristics. This way, you’ll easily monitor how many times during that period you’ve achieved your set goal.

If all this doesn’t help and you notice that insomnia becomes chronic, it’s time to seek professional help. Show your report from the app to your specialist and discuss the measures you’ve already taken. All of this will assist your doctor in assessing the severity of insomnia and prescribing the right treatment.

Don’t forget to continue maintaining your simple sleep diary to track the effectiveness of treatment and regulate your sleep-wake cycle. This not only allows you to monitor progress but also provides crucial information for adjusting therapeutic measures in the future.

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Biologische leeftijd berekenen

Biological Age Blood Test

Biologische leeftijd berekenen

Did you know that you can determine your biological age through a simple blood test? While your chronological age is based on your date of birth, a biological age blood test measures various biomarkers to determine how well your body is aging. By taking this test, you can gain valuable insights into your overall health and identify areas where you may need to make lifestyle changes to improve your biological age.

So, why should you care about your biological age? Well, research has shown that people with a higher biological age than their chronological age are at a greater risk for age-related diseases like heart disease, Alzheimer’s, and cancer. However, the good news is that you can take steps to reduce your biological age and lower your risk of these diseases.

Package of lab tests to calculate biological age:

  • Albumine Blood Test
  • Creatinine Blood Test
  • Fasting plasma glucose (FPG, Glucose Blood Test, Fasting blood Glucose test, FBG)
  • High-sensitivity C-reactive protein (hs-CRP) Blood Test
  • White Blood Cells (WBC)
  • Mean Corpuscular Volume (MCV)
  • Lymphocyte, % (LYMP%)
  • Red Cell Distribution Width, % (RDW)
  • Alkaline Phosphatase Blood test (ALP)


For whom is this product intended?

Biological age is a measure of an individual’s health and physical condition that goes beyond their chronological age. While we all age, the rate and manner of aging can differ significantly between individuals, based on lifestyle habits, genetics, and other factors. Measuring biological age can help individuals understand how their bodies are aging and identify areas for improvement in their health habits. One tool for measuring biological age is Levine’s Phenotypic Age calculator, which uses a combination of biological markers to estimate an individual’s age at the cellular level.

So, for whom is this product? In short, anyone who is interested in their health and wants to take a proactive approach to aging. Individuals who want to optimize their health and longevity may benefit from using Levine’s Phenotypic Age calculator. This tool can be particularly useful for individuals who are at higher risk for age-related diseases, such as heart disease or cancer, or who have a family history of such conditions.

Furthermore, individuals who have experienced significant changes in their lifestyle or health status may also benefit from measuring their biological age. For example, if someone has recently quit smoking, started exercising regularly, or made significant changes to their diet, measuring their biological age can provide an objective measure of the impact of these changes on their health.

Discover Your True Biological Age with a Blood Test: Why Should You Get Tested?

But why should you purchase lab tests to calculate your biological age? The main reason is that it provides valuable information about your overall health status and can help identify areas for improvement. By knowing your biological age, you can make informed decisions about your health and lifestyle, such as increasing physical activity, improving diet, or reducing stress levels.

Moreover, measuring biological age can help you detect potential health issues early on when they are more manageable. For example, if someone’s biological age is significantly higher than their chronological age, it may indicate that they are at higher risk for age-related diseases, such as heart disease or cognitive decline. Armed with this knowledge, you can take proactive steps to reduce the risk and improve your overall health and well-being.

In conclusion, measuring biological age using Levine’s Phenotypic Age calculator can provide individuals with valuable insights into their health and aging process. By understanding your biological age, you can take a proactive approach to your health and make informed decisions about your lifestyle habits. With this information, you can optimize their health and well-being and potentially increase their lifespan.

Ordering Blood Tests in the Netherlands

If you are interested in checking your biological age, you can easily purchase a blood test kit from Healsens.

1 Download the Healsens App from Google Play or the App Store, depending on your device.

2 Complete the registration process in the app.

3 Go to the “Risks” page via the bottom menu of the application.

4 Tap on the test you need — ”Levine’s Phenotypic Biological Age

5 Tap on the “Add to Cart” button inside the test page and proceed with the ordering process.

Process of taking blood tests in:

» Discover how to check and improve your health with Healsens preventive checkup plan.


If you want to assess your biological age but are not residing in the Netherlands or have opted for a different laboratory, Healsens cannot upload your blood test results for you. Nevertheless, you have the option to undergo the required tests at any laboratory in your country and manually input the obtained results into the application. Healsens will open more opportunities for you to naturally normalize your blood test results. Furthermore, you gain full access to investigate your health risk assessment based on the provided data.

Why should you trust Healsens to calculate your biological age?

Healsens is committed to providing you with accurate and reliable results that you can trust. We partner with Medical Laboratories Dr. Stein & Collegae, a highly respected and accredited laboratory in the Netherlands, to ensure that your blood samples are processed with the utmost care and accuracy. Lab Stein has an excellent reputation within the Dutch healthcare sector. With more than 20 medical specialists (laboratory doctors), chemists, biologists, doctors-microbiology etc. and 600 employees, the laboratory is one of the three largest medical laboratories in Europe. They carry out more than 5 million tests per year.

Furthermore, we use Levine’s Phenotypic Age calculator to estimate your biological age. This algorithm has been proven with high accuracy in multiple studies and is widely accepted as a reliable method for calculating biological age.

At Healsens, we understand that not everyone is comfortable with preventive medical examinations without a referral from their general practitioner. That’s why we work with our partners to ensure that our tests are conducted with the highest standards of care and confidentiality.

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Source: ©️2019 Healsens B.V. All right reserve

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blood tests netherlands

Ordering Blood Tests In The Netherlands

Ordering Blood Tests In The Netherlands

blood tests netherlands

With pleasure, we announce that starting from version 1.5 and above of our Healsens application, residents of the Netherlands can now request blood tests without a referral from a general practitioner. This functionality enables you to obtain the essential tests you need, eliminating the need for a doctor’s visit. Simplify your healthcare journey with our blood test service in the Netherlands.

To get started, simply log in to the Healsens application and follow the instructions to place your order. Our comprehensive set of laboratory tests, including blood tests, are available to residents of Amsterdam, Utrecht, Arnhem, and other cities across the Netherlands. You can choose our Healsens Checkup Plan, which assesses the health of your vital organs, inflammation markers, heart disease risk, fat metabolism, diabetes risk, anemia risk, and potential deficiencies in vitamin D3 and B12. Alternatively, you can use our DNAm PhenoAge calculator, developed at Yale University, to assess the condition of your liver and kidneys, immunity, inflammation, and metabolism.


How to Order Blood Tests in the Netherlands?

To order blood tests online in the Netherlands, you’ll need to download the Healsens mobile app and create an account by registering within the app.


Once logged in, you’ll have the option to choose from a variety of lab test packages, including the comprehensive Healsens screening plan, which assesses the most common age-related conditions. Additionally, lab tests from your Healsens plan are readily accessible, along with their respective prices. The application’s algorithm intelligently selects the relevant lab tests based on your chosen plan. If you prefer a custom examination plan, the algorithm will also assist in identifying and pricing the necessary tests from the available options. It’s not uncommon to find that after completing all the tests and obtaining results within the normal range, the application may not suggest ordering any additional tests. This is how the algorithm operates, guiding you to take only those tests from the list “Tests to be passed” or fall outside the healthy range. You can always view the complete list of available analyses in your profile. In the risk calculators section, you’ll also find the option to request a package of analyses for risk assessment. This is where you can conveniently order a package of analyses for DNAm PhenoAge or AIP calculator, among others.

After selecting your desired test package, you’ll need to provide some basic information such as your name, address, and contact details. You’ll also need to pay for the tests using a credit or debit card. Once your order is confirmed, you’ll receive a confirmation email with instructions on how to prepare for your test, such as any necessary fasting requirements.


You’ll then receive a tailor-made test kit from one of Healsens’ partners by post at your home address. The test tubes will be provided with a barcode linked to your research, and they will be specially prepared with liquid for shipping. It is important to check all your data to ensure it is correct.


In the confirmation email, you’ll be able to choose a nearby blood test center where you can have a blood sample taken. You’ll need to book an appointment and bring your referral letter, test kit, and ID to the center. The blood will be taken by professionals, and you should have all the tubes in your test kit filled.


Once you’ve had your blood sample taken, you’ll need to send the test kit back to the lab using the pre-paid packaging provided. Simply post the collection material with the lab form as a letter, not registered or with a track & trace code. Medical mail is very well organized by postal services in the Netherlands, and you can be assured that your samples will be delivered safely to the laboratory.

You’ll receive the results of your lab tests by email within a few days up to a maximum of 10 working days. No one else will receive your results unless you give written permission. You’ll be called first for results that require immediate medical follow-up.

You can use your lab test results to improve your health by getting advice on nutrition, supplements, and lifestyle changes. Healsens works together with various health coaches, specialists, and therapists who provide complementary care. The Healsens app provides access to personalized health plans, coaching, and support to help you achieve your health goals.

Why should you trust Healsens?

Healsens is committed to providing you with accurate and reliable results that you can trust. We collaborate with Medical Laboratories Dr. Stein & College, a highly respected and accredited laboratory in the Netherlands, to ensure that your blood samples are processed with the utmost care and precision. Lab Stein has an excellent reputation within Dutch healthcare. With over 20 medical specialists (laboratory physicians), chemists, biologists, doctors in microbiology, and 600 employees, the laboratory is one of the three largest medical laboratories in Europe. They conduct more than 5 million tests annually.

Availability: Our laboratory test package is cost-effective and utilizes affordable laboratory tests, making it accessible and user-friendly.

At Healsens, we understand that not everyone feels comfortable with preventive medical examinations without a referral from their general practitioner. That’s why we work with our partners to ensure that our tests are conducted to the highest standards of care and confidentiality.

Unlock your health insights with our smart data analysis – the Free Health Tracker app, your reliable medical record!

Drastically reduce the time to detect chronic diseases & inspire healthy habits

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Important Blood Tests to Get

Important Blood Tests To Get

Important Blood Tests To Get

Important Blood Tests to Get

Preventive medicine is rapidly advancing towards a more personalized approach. This shift is driven by international medical organizations that prioritize disease prevention and develop clinical recommendations that account for various risk factors. Despite this, many medical centers still offer a standard list of tests to all patients, disregarding individual risk factors and updated recommendations. This approach can lead to delayed diagnosis of many diseases. It is crucial to understand which important blood tests to get based on individual needs and risk factors to avoid missing a potential illness. Additionally, understanding which tests to get can also help avoid unnecessary tests, false diagnoses, and treatments that can lead to excess mortality.

This article was last reviewed by Svetlana Baloban, Healsens, on January 24, 2022. This article was last modified on 3 March 2023.

Screening examinations

Let’s delve into the concepts of diagnostic and screening tests. If you visit a doctor with specific complaints and they prescribe a list of tests, those are diagnostic tests. However, if the doctor also recommends tests unrelated to your complaints, those are screening tests. While diagnostics are relatively straightforward, screenings can be more complicated.

If you’re experiencing symptoms, diagnostic tests can help identify the underlying cause. These tests are tailored to your specific needs and symptoms. On the other hand, screening tests are typically used to detect a particular disease or condition before symptoms develop. These tests are often recommended based on age, sex, family history, or other risk factors, even in the absence of symptoms.


However, screening tests are not always necessary or appropriate for everyone. Some tests may carry risks or lead to unnecessary interventions and treatments. That’s why health screening can be complex. Many articles on screening present a staggering array of medical data, and many reputable organizations offer their own (often differing) recommendations on screening. But where do these differences come from?

One reason for differing screening recommendations is the varying levels of evidence supporting them. Some tests may have a strong evidence base, while others may not. Additionally, different organizations may prioritize different outcomes, such as mortality reduction or cost-effectiveness. For example, a screening test that is highly effective at reducing mortality may also be expensive or carry risks, leading some organizations to recommend against it.

Diseases that are good candidates for screening are those that are widely prevalent and cause significant morbidity and mortality. For example, in the United States, good examples are heart disease and lung cancer. On the other hand, trypanosomiasis may be a good target for screening in Tanzania, but not in the United States. Thus, screenings depend not only on gender and age, but also on the place of permanent residence. But that’s not all.

The Factors for Assessing the Need for Screening

There are several factors that contribute to identifying which blood tests are important to get and will provide benefits. For example, it makes no sense to screen for diseases that have no asymptomatic period. Additionally, even if there is an asymptomatic period, it is necessary to consider whether treatment started before symptoms appear will reduce morbidity or mortality. The effectiveness of treatment should also be considered as a factor in the need for screening. Why screen for a disease that cannot be cured?

When it comes to screening for diseases, the next important factor to consider is selecting the appropriate screening test. Medical researchers aim to find tests with high sensitivity and specificity, but no test is perfect. For instance, the screening approach for diabetes has changed multiple times. Prostate cancer screening using PSA1 is known for having a high rate of false positives, which can lead to additional testing. Conversely, normal levels of biomarkers may be present in someone undergoing cancer treatment that produces those biomarkers2. Thus, it’s crucial to ensure that you have been recommended the best screening test available before getting important blood tests to get. However, this is just one of the many factors that need to be taken into consideration before deciding on a screening test.

The next factor that should be considered is the family history of diseases. Studying the hereditary risk factors allows for not missing potentially dangerous diseases, which are usually not screened for in a wide range of people because they are rare. For example, there are multiple methods for testing mutations in genes such as BRCA1 and BRCA2. The most accessible and affordable method is PCR testing, but it’s also the least accurate, diagnosing only 5% of all mutation cases. Therefore, if you have a family history of breast or ovarian cancer, it’s recommended to use more advanced screening methods like NGS. It’s crucial to take all of these factors into account when determining which important blood tests to get to ensure early detection and prevention of potentially life-threatening illnesses.

Interesting Fact

Do you know that there are several methods for testing mutations in the BRCA1 and BRCA2 genes? The most accessible and inexpensive one is PCR testing for mutations in the BRCA1 and BRCA2 genes. And as you might guess, it is the least accurate. Only 5% of all cases of mutations will be diagnosed by this testing method. Therefore, if you have a family history of breast or ovarian cancer, the NGS method is used as a screening method.

What Important Blood Tests to Get?

Fortunately, medical organizations such as the US Preventive Services Task Force, the American Society of Clinical Oncology (ASCO), the Centers for Disease Control and Prevention, and others, develop and publish their guidelines on screening and prevention of diseases, including important blood tests to get. Typically, these guidelines take into account risk factors, assess the benefits and harms of screening, and recommend the most optimal screening tests. In addition, they are constantly updated, allowing for the latest research on disease prevention to be utilized.

Thus, you can compile a list of tests that are specifically needed for you. This same list can be obtained using platforms such as Healsens. Typically, such a list of screening tests includes:

  • Cancer screenings
  • Screenings for the most common age-related diseases
  • Laboratory tests for general health maintenance

And this is actually a great idea to accumulate all recommendations because the medical field often undergoes changes and updates. Collecting information about which tests to take in one place, as well as monitoring them carefully and linking to sources, can help doctors keep up with the latest developments and improve the quality of their work. In turn, patients can obtain more reliable information about screenings and health recommendations.

Overall, the Healsens checkup plan appears to be a comprehensive and personalized approach to preventive health maintenance, utilizing the latest medical guidelines and research to provide individuals with the most appropriate screening tests for their individual needs.

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hdl-cholesterol waarde

How To Increase Good Cholesterol

hdl-cholesterol waarde

Dietary strategies to lower levels of bad LDL cholesterol can negatively affect HDL cholesterol, which is quite common, unfortunately. However, it’s important to know how to increase good cholesterol to maintain a healthy heart. Therefore, there are a number of clinical strategies for treating atherosclerosis and boosting HDL cholesterol levels. Let’s take a look at some of these strategies and also explore what foods can help with increasing good cholesterol.

This article was last reviewed by Svetlana Baloban, Healsens, on January 24, 2020. This article was last modified on 5 April 2022.

How does HDL cholesterol affect cardiovascular disease?

We have written more than once about the importance of a healthy lipid profile, if, in the future, you do not want to experience atherosclerosis, coronary heart disease, and stroke. But why did we decide to write specifically about good HDL cholesterol? Let’s start with numbers.

In prospective epidemiological studies, each 1 mg/dL increase in HDL is associated with a 2–3% reduction in risk of coronary heart disease1. This ratio is not affected by the level of bad LDL cholesterol and triglycerides due to the ability of good HDL cholesterol to reverse cholesterol transport. Let’s see what it means.

So, reverse cholesterol transport (RCT) is a pathway through which cholesterol is transported from the artery walls to the liver so it can be excreted from the body. It is through this process that the body reduces the amount of plaque buildup in vessel walls and reverses atherosclerosis. Not surprisingly, data from the Framingham Heart Study showed that people with the highest HDL levels have the lowest risk of developing heart disease2.


HDL Normal Range

In Adult Treatment Panel III (ATP III) guidelines, the HDL cut-off for healthy individuals has been increased to at least 40 mg/dl in men and to 50 mg/dl in women3. In general, the following HDL normal range was announced:

<40 mg/dL

≥60 mg/dL

Low HDL cholesterol

High HDL cholesterol

There are several factors that lead to low HDL cholesterol, namely:

  • Overweight and obesity
  • Elevated triglycerides
  • Lack of physical activity
  • Smoking
  • Very high carbohydrate intake (>60% of total energy intake)
  • Type 2 diabetes
  • Certain medicines (beta-blockers, anabolic steroids, progestogens)
  • Genetic factors.

In our previous articles, we talked about ways to reduce bad cholesterol. Now it’s time to talk about how to increase good HDL cholesterol. Let’s start with the analysis of drug treatment.

How to increase good HDL cholesterol?

Medication to increase HDL

Nicotinic Acid or Niacin

The most widely used drug to increase HDL levels is nicotinic acid or niacin. Niacin is thought to reduce the risk of cardiovascular disease by lowering LDL cholesterol and increasing good HDL cholesterol. Therefore, niacin is often recommended for patients with low HDL cholesterol levels. One study reports that niacin can increase HDL levels by 25-35% at the highest doses4. And if we talk about the situation of atherogenic dyslipidemia, then studies show a strong trend towards a decrease in the risk of coronary artery disease. It should be remembered that atherogenic dyslipidemia is characterized by low levels of high-density lipoprotein (HDL), high levels of triglycerides, and a high number of low-density lipoprotein (LDL) particles.

Despite the apparent ability of niacin to increase HDL levels and lower LDL, not everything is so rosy. Studies have also shown that niacin can cause serious adverse events. Thus, among participants who received niacin/laropiprant tablets, there was a 55% increase in diabetes control disorders that were considered serious.


Another drug that affects reverse cholesterol transport is ezetimibe. In a recent study, ezetimibe was shown to enhance macrophage reverse cholesterol transport in hamsters. However, as with niacin, ezetimibe as a primary agent has not been shown to improve patient outcomes.

The ezetimibe and simvastatin ENHANCE study was designed to show that ezetimibe can reduce the growth of fatty plaques in the arteries5. Patients with genetically high cholesterol were given only statins or ezetimibe plus simvastatin. The doctors then measured their LDL cholesterol levels and examined their arteries to measure plaque growth.

As a result, LDL cholesterol decreased more with combination therapy, it did not improve the condition of the arteries. In fact, after 2 years of therapy, intima-media thickness increased more in the ezetimibe/simvastatin group. However, it is worth noting that patients with high cholesterol due to genetics may not represent the entire population.

One way or another, but further studies of these drugs are currently being conducted. The results will help doctors conclude whether these drugs are an effective strategy for treating atherosclerosis. In any case, for people with high risk for CVD, who have excess weight, diabetes, metabolic syndrome, or a family history of CVD, it is worth discussing medical options with a cardiologist.

Diet Plan to Increase HDL

One of the most intriguing areas of research within treating atherosclerosis and heart disease is dietary intervention, including how to increase good cholesterol. Most doctors agree that diet is one of the most effective ways to prevent atherosclerosis, and that making dietary changes can help improve HDL cholesterol levels. This is true in reverse as well. Thus, additional research confirms that a Western diet high in meat, butter and dairy products plays a large role in the high rate of death from cardiovascular diseases.

The most common dietary intervention is the consumption of fish. This is primarily because fish is correlated with an improved omega-3/omega-6 ratio and cardiovascular health. For example, a summary of dietary data showed that saturated fatty acid intake increased good HDL cholesterol without increasing bad LDL cholesterol6.

Other researchers have taken this idea further and even attempted to reverse cardiovascular disease through dietary interventions.

The effect of plant-based nutrition on HDL cholesterol

Vegetables and a vegan diet play a big role in normalizing your lipid profile and prevent atherosclerosis. The American Heart Association have released specific diet guidelines to prevent cardiovascular disease:

  • Eat a variety of fruit and vegetable servings every day. Dark green, deep orange, or yellow fruits and vegetables are especially nutritious. Examples include spinach, carrots, peaches, and berries.
  • Eat a variety of grain products every day.
  • Include whole-grain foods that have lots of fiber and nutrients. Examples of whole grains include oats, whole wheat bread, and brown rice.
  • Eat fish at least 2 times each week. Oily fish, which contain omega-3 fatty acids, are best for your heart. These fish include tuna, salmon, mackerel, lake trout, herring, and sardines.

In addition, studies show that a plant-based diet can help with regression of stenoses. So, in the study, 22 patients with severe coronary heart disease were observed for five years. However, we must also take into account that there is no control group in this study. All participants were volunteers interested in following a plant-based diet.

Another study published in the Atherosclerosis Journal found that green leafy vegetables help restore healthy endothelium.

Another benefit of plant-based diets on our health is their effect on the gut microbiome. The microflora has been found to enhance health by improving digestion, absorption, vitamin synthesis, and reducing gas production. The foods we eat form our own microflora. A recent article in the New England Journal of Medicine shows that choline in eggs, poultry, dairy, and fish produces the same toxic TMAO as carnitine in red meat7. This further explains plant-based protection from heart disease.

So, which dietary changes have the most impact on HDL cholesterol levels? To find this, we turn to research.

Fun Fact

The Norwegian experience between 1938 and 1948 showed a strong relationship between cardiovascular mortality and changes in fat intake in the form of butter, milk, cheese and eggs. Between 1940 and 1945 Germany occupied Norway and the German occupying forces confiscated their livestock. So they restricted the Norwegians in their diet and they switched to a plant-based diet. Also during this period, Norwegians consumed 20% fewer calories than during the period of concern. Sugar consumption also decreased, while fish consumption increased by 200%. All this has led to a sharp drop in mortality from strokes and heart attacks. However, once World War II ended and Norwegians started eating animal products again, their death rate from cardiovascular disease increased.

Almonds and nuts

The effects of almonds are well documented in systematic reviews and meta-analyses of clinical trials. A 100g serving of almonds contains about 50g of healthy fats, most of which (40g) are MUFAs and PUFAs, as well as 4g of saturated fats. Almonds are also a rich source of several minerals as well as vitamins such as calcium, copper, iron, magnesium, phosphorus, potassium, zinc, manganese, thiamine, riboflavin, niacin, and vitamin E.

A clinical study conducted in people with initially low levels of good HDL cholesterol found that a low dose of almonds (10 g/day) can increase HDL cholesterol levels. At the same time, patients were offered to eat only 10 g of almonds every day. The almonds were pre-soaked overnight and peeled off in the morning before eating. Lipid profile measurements were checked at 6 and 12 weeks. As a result, HDL cholesterol was higher by 12-16% of the original8.

Several other studies have demonstrated that almonds not only support good HDL cholesterol levels, but also lower bad cholesterol, which is known as a risk factor for coronary heart disease (CHD)9.

The same conclusion was reached in New Zealand when studying the effect of almonds and hazelnuts in various forms (chopped, chopped and whole) on HDL levels. The result showed a statistically significant decrease in LDL levels along with an increase in HDL levels10. Of all the presented forms, the consumption of whole nuts showed the highest result.

But as for walnuts, they have not shown any effect on levels of good cholesterol11. At the same time, walnuts lowered total cholesterol and LDL cholesterol12.

Olive oil

Olive oil is high in monounsaturated fatty acids as well as vitamins, minerals and polyphenols. The health effects of olive oil, including as part of the Mediterranean diet, have been the subject of much research. Antioxidant and anti-inflammatory properties and improvement in endothelial dysfunction and lipid profile have been reported. Most studies have shown that extra virgin olive oil increased HDL cholesterol levels by almost 50%. In the studies, participants received a daily dose of 25 ml of olive oil. The beneficial effect of olive oil was more pronounced in subjects with established metabolic syndrome or other chronic conditions/diseases13.


Avocados are a nutrient-rich source of MUFAs and antioxidants. Several studies have shown that 0.5 – 1 avocado per day improved blood lipid profile[efn_note]Hass Avocado Composition and Potential Health Effects[/efn_note]. Some studies have seen decreases in LDL cholesterol and triglycerides and increases in HDL cholesterol. Other studies have observed only a decrease in triglyceride levels. However, all of these trials were conducted among a small number of people. Let’s hope that larger and longer-term tests will be carried out in the near future.

In addition, there are studies that show avocados also contain a wide range of other nutrients and phytochemicals that may have vascular health benefits beyond cholesterol. In particular, the potassium and lutein in avocados may help normalize blood pressure and help control oxidative/inflammatory stress14. Eating avocados with salads or salsa increases the bioavailability of carotenoids many times over, which can increase potential health benefits. Considering all these factors, adding avocados to your diet seems to make a lot of sense.

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Eggs are a source of cholesterol and choline and may affect plasma lipid concentrations. For healthy individuals, consumption of up to 3 eggs per day results in an overall positive effect on biomarkers associated with cardiovascular disease risk151617. So, in humans, HDL cholesterol increased, while a decrease in the ratio of cholesterol and high-density lipoprotein was observed. But what about people with an unhealthy lipid profile?

In the next study, 28 overweight men aged 40–70 were recruited to assess their cholesterol during an egg diet. Eighteen patients were classified as having metabolic syndrome (MetS). All men followed a carbohydrate-restricted diet during the experiment. All participants were randomly assigned to consume 3 eggs per day (640 mg/day of extra cholesterol from food) or no eggs group (SUB). The SUB group received an 0 egg (0 dietary cholesterol). As a result, in the egg group, HDL cholesterol increased from 1.23 +/- 0.39 to 1.47 +/- 0.38 mmol/l18.

Aerobic exercise

While diet is the most important lifestyle factor in promotingreverse cholesterol transport, there is mixed evidence that regular aerobic exercise improves cholesterol efflux. At the same time, recent studies have demonstrated that in order to get a positive effect, it is necessary to exceed the threshold of exercise dose19. Overall, exercise represents a potential therapeutic approach to improve HDL function and learn how to increase good cholesterol. Preliminary evidence suggests that exercise improves the antioxidant and anti-inflammatory properties of HDL, which can help reduce the risk of atherosclerosis and heart disease.

» Discover everything about what your cholesterol results mean.

HDL Health Harmony with Healsens

Unlock the potential of your health journey by seamlessly integrating your HDL blood test results into the Healsens app. This personalized platform not only facilitates a clearer understanding of your current status but also empowers you to naturally enhance and monitor your HDL levels over time. “HDL Health Harmony with Healsens” invites you to embark on a wellness expedition, where informed choices and personalized plans lead to sustained improvements.

If you are interested in checking your HDL level, you can easily purchase a blood test kit from Healsens.

1 Download the Healsens App from Google Play or the App Store, depending on your device.

2 Complete the registration process in the app.

3 Go to the “Profile” page via the bottom menu of the application.

4 Tap on the test you need — ”List of Available Tests

5 Find the Cholesterol Pack & Tap on the “Add to Cart” button. Proceed with the ordering process.

» Discover how to check and improve your health with Healsens preventive checkup plan.


If you want to assess your HDL level but are not residing in the Netherlands or have opted for a different laboratory, Healsens cannot upload your blood test results for you. Nevertheless, you have the option to undergo the required tests at any laboratory in your country and manually input the obtained results into the application. Healsens will open more opportunities for you to naturally normalize your blood test results. Furthermore, you gain full access to investigate your health risk assessment based on the provided data.

Unlock your health insights with our smart data analysis – the Free Health Tracker app, your reliable medical record!

Drastically reduce the time to detect chronic diseases & inspire healthy habits


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How To Increase Good Cholesterol Read More »

mammogram screening guidelines


In one of our previous articles, we wrote that mammography (MMG) is a screening diagnostic method for breast cancer. Today, we would like to expand on this topic and have invited a specialized specialist to share information about MMG and the current mammogram screening guidelines being used.

This article was written by Y. Timovskaya, Ph.D., doctor oncologist of the highest category, Member of ESMO with the help of A Galishyna, head of the diagnostic department of the Specialized Breast Center, a doctor of radiation diagnostics, member of ESR, EUSOBI. This article was last modified on 10 August 2021.

It has been proven that regular examinations increase the rate of early detection of breast cancer.

👉 But are all examination methods (examination, mammography, ultrasound) equally effective for the early detection of breast cancer?
👉 And how often should they be applied: annually, every six months, or are there other options?

Today we will deal with these issues.

Early Diagnosis of Breast Cancer

For early detection of breast cancer, especially preclinical forms, the effectiveness of mammography (MMG) and magnetic resonance imaging (MRI) of the mammary glands with contrast enhancement has been proven. Ultrasound examination of the mammary glands is a useful addition to them. When choosing a diagnostic method, there is no universal approach that would suit everyone.

The results of breast cancer treatment directly depend on the stage at which the treatment of this disease is started. The smaller the stage, the shorter, cheaper, and more effective the treatment. Therefore, the whole world is fighting to identify the early, if possible, preclinical stages of breast cancer (we wrote about what clinical breast cancer is in a separate article).


At the same time, it is necessary to take into account the patient’s age, complaints, anamnesis, clinical examination data, and the results of previous medical tests.

Ultrasound Breast Screening and Mammogram: definition

✔ Mammography (MMG) is an X-ray method for breast examination, which is the gold standard for diagnosing breast cancer. It perfectly detects microcalcifications, one of the early signs of breast cancer. The most important thing when using MMG is the fact that even standard views allow you to visually assess the full volume of an organ.

✔ Ultrasound – ultrasound examination of breast tissue, an additional diagnostic method. Suitable for patients with increased density of breast tissue (women under 35-40 years old). Therefore, it may be more appropriate for patients under 35-40 years of age to have an ultrasound scan rather than mammography (MMG). It is also the best method for fragmentary assessment of breast tissue. It is also used for the differential diagnosis of some formations. These, for example, include formations with a clear outline, identified on mammography.

Each of these methods has advantages and disadvantages. There are no absolute contraindications to their implementation.

How to Choose Diagnostic Methods

As we wrote above, each clinical case requires an individual approach in the selection and examination sequence.

So, for example, if a patient has complaints, her examination is diagnostic in nature. In this case, the doctor’s task is to choose the most appropriate diagnostic method. The aim will be to find out the reason for the complaints, the nature of the process, and the extent to which it has spread.

It’s worth saying that a multimodal approach is often used. In such cases, a combination of several methods is used (MMG + ultrasound, MMG + MRI, using interventional techniques). It is also important to note that doctors sometimes need to apply special techniques within the same research method. For example, in the case of MMG, these are spot view, magnification view(s), Cleopatra’s view, etc1.

But in any case, the doctor is responsible to choose the appropriate diagnostic methods and techniques. Therefore, it is very important to contact specialists who can use the entire arsenal of diagnostic methods.

Is it possible to avoid examinations if there are no complaints from the breast?

The American Society of Breast Surgeons says that all women over the age of 25 must have a formal breast cancer risk assessment. You can do it yourself, or go through the risk assessment according to the NCCN guidelines in Healsens (below there will be links to download the app). After such an assessment is made, categories of patients without complaints should undergo screening. If a woman is not at risk, then such examinations can be started from the age of 40+. But we’ll talk more about mammogram screening guidelines below. If the risk of breast cancer is above average, then annual screening mammograms should be started at an earlier age, and in addition to mammography, additional examinations may be required.

Mammogram vs Ultrasound

It is worth pointing out what the limitations are for each diagnostic method. Thus, it will become more obvious what is decisive when choosing a diagnostic method. So, for ultrasound, the following limits are distinguished:

  • the predominance of adipose tissue in the structure of the mammary gland in patients over 40 years of age with symptoms of fibrous-fatty involution of the breast tissue (age-related changes);
  • the presence of large skin lesions. For example, with skin diseases and inflammatory processes.

Since ultrasound assesses the gland tissue fragmentarily, section by section, for patients with large breast sizes, this method is also not very suitable. This is due to the fact that there is a high risk of missing small formations.

Mammography is not recommended without direct indications (suspected cancer) during pregnancy and lactation. In addition, in young patients, the diagnostic value of MMG decreases. This is due to the fact that young women have a higher density of breast tissue. And finally, we add that MMG is also ineffective in the presence of inflammatory diseases of the mammary glands.

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Mammogram screening guidelines

At the moment, medical guidelines aim for an individualized approach, taking into account personal risks. Generally, the higher the risk of breast cancer, the earlier and more often screenings are recommended. So, for example, the American Cancer Society divides women into risk groups.

For Women at Increased Risk of Breast Cancer

✔ It’s recommended annual MMG from age 30 for women at increased risk of breast cancer2. This group includes patients with mutations in the BRCA1 or BRCA2 genes. And also if it is known that mutations in these genes have been identified in first-line relatives.

In addition, other mammogram screening guidelines distinguish the medium-risk group of women who have been treated for ovarian cancer3 or bowel cancer before age 354. Similarly, this risk zone includes women who have close relatives who have had breast cancer and ovarian cancer.

Some sources suggest starting screening MMG for women from this group no later than 10 years before the age at which breast cancer was detected in 1st or 2nd line relatives5. These are sisters, mothers, aunts, grandmothers (both on the mother’s side and on the father’s side). But screening should be started not earlier than 25 years old.

As you can see, everything is very individual.

For example, if the patient’s mother had breast cancer at the age of 36 when her daughter needs to undergo annual examinations, starting at the age of 26. The choice of the method for these annual examinations should be made by the physician, depending on the findings of the clinical examination.

For Women with Low Risk of Breast Cancer

For women with an uncomplicated medical history, it is recommended to carry out screening MMG from 40 years according to the scheme6:

  • once every 2 years from 40 to 50 years old and after 70 years old,
  • once a year at the age of 50-70 years old.

Therefore, all women over 40 should be offered MMG, with possible additional research. In all other cases, the approach to the diagnostic method should be completely individualized.

And in conclusion, adherence to the indicated intervals allows for the most effective detection of breast cancer in the early, often preclinical stages. The main problem remains the low awareness of general practitioners and patients about the problem of breast cancer, as well as the need to perform screening MMGs.

What you need to tell the doctor to determine the research method

Before taking the examination, it is recommended to inform the doctor about the following problems, if any:

  1. A history of oncological diseases (such as breast cancer, ovarian cancer and colon cancer) in the patient or relatives.
  2. Previous breast surgery and past trephine biopsies.
  3. The presence of chronic diseases (especially endocrinological and gynecological) and the constant intake of drugs, especially contraceptives and hormone replacement therapy drugs.
  4. Menstruation (age of onset of menstruation, duration of menopause, regularity of the menstrual cycle), number of pregnancies and childbirth, duration and nature of lactation.
  5. The presence of complaints from the mammary glands (cyclical changes before the onset of menstruation and their severity, pain outside the menstrual cycle, discharge from the nipples, induration).
  6. Results from previous breast studies.

After analyzing the patient’s survey data, the doctor will choose the best diagnostic method. The decisive factors here are the age and timing of previous studies. Because compliance with them allows you to correctly assess dynamic changes.

👉 And finally, the information received on time is the most important!

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what is metabolic syndrome


Metabolic syndrome is an unhealthy metabolism that leads to fatal diseases such as heart attacks, diabetes, and cancer. Moreover, this condition affects more than a fifth of the US population and about a quarter of the European population. Even though its prevalence in South-east Asia is lower, it is still rapidly moving towards the rates of the western world even there. It should be understood that metabolic syndrome is a problem for not only overweight people. So, in 40 out of 70 percent of people with normal weight, doctors diagnose metabolic disorders. This is at least related to an increase in waist circumference or visceral obesity. So what is metabolic syndrome? How do you know if you are at risk? How can lifestyle help prevent this condition and what is the treatment aimed at?

This article was last reviewed by Svetlana Baloban, Healsens, on January 24, 2020. This article was last modified on 4 September 2021.

What is Metabolic Syndrome?

Essentially, metabolic syndrome is the simultaneous presence of several conditions, such as obesity, hyperlipidemia (abnormal levels of cholesterol and / or lipoproteins), diabetes and / or hypertension. This combination was first described back in the late 1960s. Nowadays, medical organizations say that even a few of the risk factors are sufficient. Let’s take a look at which conditions are referred to as metabolic syndrome and which of the factors are more influential.

Metabolic Syndrome Criteria

The NCEP ATP III1 panel identified 3 of 5 risks of the next metabolic syndrome criteria:

  1. increased waist circumference. In this case, the following values are named:
  • ≥40 inches [≥102 cm] for men;
  • ≥35 inches [≥88 cm] for women.

At the same time, the International Diabetes Federation names narrower ranges2:

  • ≥37 inches [≥94 cm] for men;
  • ≥30 inches [≥80cm] for women.


These are recommendations for the European race. For Chinese, Japanese and South Asians, a waist circumference of ≥90 cm for men is at risk. Note that weight is not taken into account, just the waist circumference. This is no accident. In the next chapter, we will review in detail why so much attention is paid to waist circumference.

Other risk factors include the following indicators:

2) elevated triglycerides (≥150 mg/dl); 

3) low HDL cholesterol (<40 mg/dl in men, <50 mg/dl in women); 

4) hypertension (≥130/≥85 mmHg); and 

5) impaired fasting glucose (≥110 mg/dl). The American Heart Association reports a level of risk fasting glucose levels at ≥100 mg / dL.

At the same time, the pathophysiology of this syndrome remains a subject of continuing controversy. However, despite the lack of knowledge, researchers have identified visceral obesity and insulin resistance as the most important causative factors. Central obesity or visceral obesity is readily assessed at waist circumference and is independently associated with each of the other components of metabolic syndrome. The second significant factor in the development of this disease is an increase in glucose levels (hyperglycemia). However, even a small increase, both on an empty stomach and after a meal, increases the risk of cardiovascular disease and mortality.

In addition, a prospective Quebec study has found that even with no increase in blood sugar, elevated insulin levels (i.e., insulin resistance) are associated with a risk of coronary heart disease. In addition, insulin resistance also contributes to the development of hypertension due to the loss of the vasodilator effect of insulin and vasoconstriction3.

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What causes metabolic syndrome?

The pathogenic mechanisms of MetS are complex and yet to be fully elucidated. However, the wide variation in geographic distribution of MetS emphasizes that the consumption of excess calories and lack of physical activity are the major contributors to the development of the disease. Moreover, visceral obesity is the key trigger for most pathways involved in metabolic syndrome.

It is worth saying here that visceral fat may not be visible to the naked eye, but it is the fat that envelops the heart, liver and other organs, representing a real threat. By itself, visceral fat behaves very differently from subcutaneous fat. For example, visceral fat deposits contribute to insulin resistance4. This is due to the fact that the visceral process of lipolysis leads to an increased supply of free fatty acids (FFAs) to the liver. This, in turn, increases synthesis of triglycerides and production of apolipoprotein B, the carrier of “bad cholesterol”. Ultimately, the “bad” particles become smaller, denser and much more numerous and easily penetrate the vascular endothelium, where they cause irreparable damage.

Very high levels of “bad” LDL cholesterol and low levels of “good” cholesterol are indirect effects of insulin resistance. If you add to this an increase in triglycerides (atherogenic dyslipidemia), then even at a normal weight, you will get central obesity with the same high risk of death as obesity5.

Thus, as you can see, visceral fat, elevated insulin levels, and an unhealthy lipid profile (unhealthy cholesterol levels) are linked to each other. And all this leads to problems with cardiovascular diseases, diabetes, hypertension. It is not a surprise why in Healsens, in addition to monitoring weight, we recommend monitoring waist circumference.

Metabolic Syndrome treatment


As previously described, MetS results from increased caloric intake out of proportion to metabolic requirements. That is why lifestyle changes are imperative to manage the main risk factors. The first step in reducing risk factors is maintaining ideal body weight. Accordingly, if BMI is increased, then weight loss is an important preventive and therapeutic strategy.

However, weight loss doesn’t have to be a goal by itself. As we wrote above, people whose weight within the normal range may have visceral obesity, which can be measured by checking the circumference of the waist. In this case disease prevention will imply reducing visceral fat without losing weight. The good news is that numerous studies show that it suffice to add physical activity to help the problem. In fact, physical exercise can reduce visceral adipose tissue by 6.1%. Moreover, exercise itself is effective in maintaining muscle mass and facilitating mobility.

As for exercise, if there is nAs for exercise, if there is no personal trainer to consult, 30-60 minutes of moderate-intensity exercise per week will bring good results. These activities include jogging, brisk walking, cycling, or swimming. Medium intensity refers to exercise where your heart rate rises up to 80% of your maximum heart rate. We wrote separately how to calculate your maximum heart rate. Such conscious efforts to make lifestyle changes will be highly beneficial in reducing the risk and treating metabolic syndrome.

Finally, research also shows that judicious use of bariatric surgery has benefits for treating obesity and MetS. This is due to the fact that weight loss helps improve all components of exercise. In turn, exercise increases your calorie intake, promotes weight loss, and reduces your overall risk of cardiovascular disease.

Clinical Note

Bariatric surgery is a branch of surgery that deals with the treatment of obesity. Depending on the surgery, people often lose 30% to 50% of their excess weight within 6 months.


The second important step in the prevention and treatment of MetS is diet modification. For example, avoiding or significantly reducing the intake of saturated fat, trans fat, cholesterol, sodium and simple sugars helps with dyslipidemia, hyperglycemia and hypertension. We talked about this in detail when we looked at ways to lower cholesterol. In addition, we just note that diets with high or very low fat content exacerbate the problem, since 25-35% of our daily calories should come to us in the form of fat. By the way, a meta-analysis of studies showed that only with a diet, visceral adipose tissue decreases by 1.1%. Note that exercise reduced this rate by 6.1%.

So, central obesity is a serious risk factor, and the central factor is the increased sugar content in foods. In addition to home-made sugar, 66% of packaged foods and beverages contain added sugar. This triggers the release of insulin, which causes circulating lipids to be deposited as fat. And the increase in fat, in turn, causes insulin resistance. As these deposits become excessive, fat begins to be deposited in internal organs, appearing in the liver, omentum, skeletal muscles and peripheral organs. Therefore, limiting or avoiding foods containing added sugars is the mainstay of metabolic syndrome prevention.


What about medications? There is currently no single medicine therapy for metabolic syndrome. Accordingly, pharmaceutical therapy is aimed at treating its individual components. For example, your doctor may prescribe medications to treat dyslipidemia (unhealthy cholesterol levels) if tests results indicate this problem. If hypertension has been diagnosed, appropriate medications will be prescribed to control blood pressure. In addition, your doctor may prescribe antiplatelet medications to reduce your prothrombotic risk. The same principle will be used to reduce the risk of diabetes. So, medical intervention is aimed at stopping or treating certain components of metabolic syndrome.

Supplements or Nutraceuticals for Metabolic Syndrome

Before talking about additives, we should note that they are not recommended as replacement for pharmacotherapies. This is because the benefits of these nutraceuticals are still being researched. However, since they have shown some benefits, they can be used to supplement or reduce the risk of developing MetS.


The active ingredient in this spice has anti-inflammatory and antioxidative properties. Curcumin has been shown to suppress inflammation by a reduction in the expression of pro-inflammatory cytokines. Thus, studies of the effect of curcumin on the components of metabolic syndrome in humans have shown positive effects. For example, a significant improvement in fasting glucose, triglycerides, “good” HDL cholesterol. In addition, a decrease in diastolic blood pressure was observed. However, curcumin did not have any significant effect on waist circumference and systolic blood pressure levels6.


Garlic is known for its medicinal value due to its antioxidant and antithrombotic properties. Reinhart and colleagues, in a meta-analysis of 29 randomized placebo-controlled trials, showed that the garlic intake lowers total cholesterol and triglyceride levels7. Another study demonstrated the effects of aged garlic extract in people with metabolic syndrome8. In the study, patients took 1.2 grams of garlic supplements per day for 24 weeks. The anti-inflammatory effect of garlic is due to organosulfur compounds in their derivatives. These compounds have antioxidant effects that help fight inflammation. As a result, garlic is proven en to be a promising natural treatment for metabolic syndrome.


Resveratrol is a natural polyphenol found in edible plants. Clinical studies in patients with insulin resistance and non-alcoholic fatty liver disease have shown promising results. In fact, the use of resveratrol has been shown to improve insulin sensitivity, glucose tolerance, and overall weight and body mass index. In the study, patients took 2 150mg resveratrol capsules twice a day for three months9.


Cinnamon extracts have antithrombotic, insulin-sensitizing, lipid-lowering, anti-inflammatory, and antioxidant properties that are beneficial in MetS. In a randomized placebo-controlled trial, Ziegenfuss and colleagues demonstrated that the use of an aqueous extract of cinnamon was associated with improvement in fasting blood glucose, blood pressure, and body composition in people with MetS10.


Berberine is used in China for its antimicrobial properties and is known to have antidiabetic properties. Studies in humans with MetS have reported a reduction in waist circumference, triglyceride levels, and systolic blood pressure, especially in women11.

Furthermore, nutraceuticals such as omega fatty acids, quercetin, bergamot essential oil, neem extracts, and sulforaphane (extracted from Brassica vegetables such as broccoli) may be helpful in managing MetS. We will keep an eye on new research in this area. In the meantime, let’s summarize all of the above.

First, metabolic syndrome is a global epidemic. It is a chronic disease that is a risk factor for atherosclerotic and non-atherosclerotic CVD. Secondly, existing treatments target different components of metabolic syndrome. In addition, the choice of therapy is quite limited, as there are only a few drugs that have a convincing effect on long-term results. Third, the chronic nature of the components of the metabolic syndrome requires long-term and often indefinite use of various medicines. All this suggests that early diagnosis and preventive treatment of the disease aimed at changing the way of life play an important role.

Unlock your health insights with our smart data analysis – the Free Health Tracker app, your reliable medical record!

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Source: ©️2019 Healsens B.V. All right reserve


Biologische leeftijd berekenen


Aging is an inevitable process, but there are differences in susceptibility to age-related diseases and the risk of death among people of the same chronological age. This means that different people have differences in the rates of biological aging. To better understand the differences between biological and chronological age, it is necessary to measure biological aging. For this purpose, various calculators of biological age have been developed, which allow us to assess the impact of lifestyle on the aging process. One such biomarker is DNAm PhenoAge, a biological age biomarker developed at Yale University. DNAm PhenoAge significantly outperforms previous measurements in predicting various aging outcomes, including all-cause mortality, cancer, health span, physical functioning, and Alzheimer’s disease1.

This article was last reviewed by Svetlana Baloban, Healsens, on March 4, 2023. This article was last modified on 28 February 2023.

What is Biological Age by DNAm PhenoAge?

DNAm PhenoAge is an aging biomarker developed at Yale University that measures a person’s biological age. It is based on data from NHANES III and includes 9 biomarkers, such as the number of red and white blood cells, as well as a person’s chronological age. It is capable of predicting risks of various aging outcomes in tissues and cells and provides insight into important pathways of aging2. The DNAm PhenoAge biomarker has been validated in NHANES IV as a strong predictor of morbidity and mortality risk, and has been tested for accuracy in calculations on several patient cohorts taking into account age-related outcomes.

So, the biological age according to DNAm PhenoAge is a fairly accurate predictor of healthspan and lifespan at the epigenetic level. This means that biological age according to DNAm PhenoAge can be used as an indicator of a person’s health status before any pathologies appear. For most people, this can be a good indicator of the real state of their health before they encounter any diagnoses.


How to determine your biological age?

To calculate biological age using DNAm PhenoAge, several simple blood tests need to be taken, including:

Biological Age Blood TestUnits
Albumin Liverg/L
Creatinine ↓Kidneyumol/L
Glucose, serum ↓Metabolicmmol/L
C-reactive protein ↓Inflammationmg/dL
Lymphocyte percent Immune%
Mean cell volume (MCV) ↓ImmunefL
Red cell distribution width (RDW) ↓Immune%
Alkaline phosphatase ↓LiverU/L
White blood cell count (WBC) ↓Immune1000 cells/uL
Table 1. Phenotypic aging measures

In general, the DNAm PhenoAge biomarker can be determined through inexpensive blood tests, making it accessible to most people. After receiving the test results, online calculators can be used to calculate one’s biological age based on DNAm PhenoAge. This is convenient not only for a one-time calculation but also for monitoring the dynamics of biological age over time.

Below you can see the biomarkers of our user who, over the course of several years, was able to reduce their biological age by 21 years compared to his chronological age with the help of changes in their diet and physical activity.

AlbuminCreatinineGlucosehs C-react ProteinLymphs (Lympocyte, % not absolute)MCV (Mean Cell Volume)RDW (Red Cell Dist Width) or Red Blood Cell Distribution Width (RDW-SD)?Alkaline PhosphataseWBC (White Blood Cells)Age
g/Lumol/Lmmol/LLn(mg/L)%fL%U/L10^3 cells/uLyears
Table 2. Lab test results of a 49-year-old man whose biological age is 21 years less than his chronological age.

How to use biological age calculator?

The calculated biological age by Levine’s DNAm PhenoAge is compared to the current chronological age. If the result is lower than your passport age, it is not only good news but also an indicator that your lifestyle positively affects your health. But what if the situation is the opposite? The most important thing is not to get upset! Now you know that you should pay attention to your health, and it makes sense to review your lifestyle. Thanks to the fact that there are several biomarkers, you can see what exactly to focus on. In addition, by making changes to your lifestyle, you can evaluate each individual indicator in addition to your biological age.

To understand whether the dynamics are positive for each indicator, let’s return to Table 1. Each biomarker contains arrows ↓ or ↑. These arrows indicate a positive trend. For example, the downward arrow “↓” next to the glucose level indicates that lower levels of glucose indicate a younger biological age.

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Is it possible to reverse biological aging?

New research shows that we can actually reverse biological aging through diet and lifestyle. In 2021, it was published the results of a pilot randomized clinical trial that demonstrated the ability to reverse biological age and was confirmed by objective outcomes3.

This is a very interesting observation, and there are several factors that can influence biological aging. Our lifestyle, comprising factors such as diet, physical activity, and stress, is considered a crucial element that affects biological age. In an effort to reverse the biological age in humans, researchers utilized a combination of diet, physical activity, and stress resilience techniques. The study monitored a group of individuals who were enrolled in a health program featuring a balanced low-calorie diet, daily 30-minute exercise at 60-80 percent intensity of maximum perceived exertion, and breathing exercises twice a day.

Additionally, the study also focused on the quality of sleep, and it was discovered that insomnia was linked to an increase in DNAmAge clocks. Another study also found a connection between poor sleep quality/less sleep hours and accelerated aging in a small sample of 12 college female students4.

In the end, those who adhered to the recommended health program showed a reduction in age by 9 years, indicating that by maintaining a balanced diet, regular physical activity, and effective stress management, we can improve our overall health and potentially slow down the aging process.

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Соотношение кортизол/ДГЭА-С


A complex interaction between cortisol and dehydroepiandrosterone-sulphate (DHEA-S) is crucial in the stress system balance. In particular, significantly higher or lower cortisol/DHEA(S) ratios have been associated with depression1 and aggression2. In general, DHEA-S levels affect various body systems, as well as prevent aging (Chahal and Drake 2007). That is why the Cortisol DHEA ratio is a very informational indicator, which, along with other indicators calculated in Healsens, provides important information about human health. Thus, using the ratio of cortisol / DHEA-S, you can assess body responses to exercise or evaluate mental health. Another benefit is that you can check your cortisol and DHEA-S levels at home.

This article was last reviewed by Svetlana Baloban, Healsens, on January 24, 2020. This article was last modified on 4 March 2021.

How Cortisol and DHEA Sulfate Affect the Body

Let’s start by looking at how cortisol and DHEA-S affect overall health. Dehydroepiandrosterone (DHEA) and cortisol are produced in the adrenal glands and are both derived from pregnenolone. So, DHEA and DHEA-S production reaches its peak at the age of 20–30 and then declines progressively with age. When it comes to cortisol levels, while some studies show that cortisol increases with age3, others do not support this observation4. However, everyone agrees that the reduction in DHEA-S entails disruption of various physiological systems.

Stress Level

As mentioned above, DHEA and DHEA-S play a protective role during acute stress as an antagonist to the action of the stress hormone cortisol56. In turn, cortisol also helps to effectively manage stress. Let’s see how this happens.

About 15 minutes after a stressful situation, cortisol levels rise and remain elevated for several hours. This marks the onset of stage 1. During this stage, there are elevations in cortisol with no corresponding changes in DHEA. Subsequently, glucose is mobilized, non-essential organ systems are suppressed, and inflammation is reduced. All of these physiological responses collectively enable the body to effectively cope with stress.

However, in cases of chronic stress, this adaptive reaction can take a catastrophic turn: cortisol loses its ability to function normally. This transition ushers in stage 2. In this latter stage, the persistence of stress leads to a sustained peak in cortisol levels, matched by a corresponding elevation of DHEA.


It becomes increasingly challenging to maintain appropriate blood sugar levels, to allow for adequate rest, to achieve high-quality sleep, and to achieve a harmonious balance among other hormones. This signals the arrival of stage 3, wherein stress persists and becomes chronic. During this stage, cortisol levels decrease, while DHEA remains elevated. In the absence of timely intervention, prolonged adrenal hyperstimulation can result in adrenal exhaustion. This condition is eventually manifested by a decline in both cortisol and DHEA, a phase often denoted as adrenal exhaustion or stage 4. Ultimately, this process may culminate in adrenal failure.

Thus, the optimal ratio between salivary cortisol and DHEA is approximately 5:1 to 6:1, serving as an indicator of a normal state of adaptation to stress7.

When the body’s ability to maintain its normal stress adaptation is compromised, a process known as stress maladjustment can ensue. This phenomenon is now recognized as a chronic stress response, often identified by terms like pregnenolone steal, cortisol escape, or an elevated cortisol to DHEA ratio. The longer one remains in a state of chronic stress, the more pervasive its negative impact becomes on various aspects of physical well-being.

As a result, individuals grappling with depression or heightened anxiety levels (measured at 0.24 ± 0.03 in the healthy group compared to 0.41 ± 0.12 in the group of individuals with severe anxiety)8, along with those dealing with post-traumatic stress disorder, exhibit disruptions in the cortisol to DHEA ratio9. Nevertheless, it’s worth noting that certain studies have demonstrated the potential of DHEA treatment to mitigate the adverse health effects associated with stress.

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Musculoskeletal disorders

We have already mentioned that cortisol dysfunction entails disorders of the musculoskeletal system10. Thus, the higher the cortisol / DHEA-S ratio, the more serious the risk of this problem.

Moreover, multiple regression analysis showed that the independent risk factor for sarcopenia was a serum cortisol/DHEA-S ratio ≥ 0.211. Sarcopenia is a type of muscle loss that occurs with aging and/or immobility.

Immunity and Cortisol DHEA Ratio

In addition, an increase in the cortisol / DHEA-S ratio with age (Phillips et al. 2007) is associated with immune dysfunction and the risk of infection in the elderly due to the fact that DHEA-S enhances immunity. However, cortisol has an inverse immunosuppressive effect (Buford and Willoughby 2005). It is also worth adding that DHEA-S is known for its antioxidant properties12.

Metabolic Syndrome

Various studies have shown that both cortisol and DHEAS are related to metabolic syndrome13, and type 2 diabetes14. While high cortisol concentrations are associated with an increased risk of metabolic syndrome, high DHEA-S levels appear to be protective. By far, the strongest associations were observed for the cortisol / DHEA-S ratio. According to observations, the higher the coefficient, the greater the risk of metabolic syndrome. This ratio is also strongly associated with four of the five components of metabolic syndrome.

Alzheimer’s Disease

The cortisol / DHEA-S ratio may also be crucial in Alzheimer’s disease. For example, some studies have found a link between the cortisol / DHEA-C ratio and a decrease in hippocampal volume15. It is worth saying that a decrease in the volume of the hippocampus is one of the early diagnostic signs of Alzheimer’s disease.

This finding has been confirmed by other studies, observing the relationship between cortisol / DHEA-S and hippocampal atrophy (HA)1617. For example, such a direct relationship was observed in patients with Cushing’s syndrome18. Moreover, HC volume partially recovered following treatment-induced cortisol decrease. However, not all studies support this association within normal cortisol levels in healthy people19.

To sum up, the ratio of cortisol / DHEA sulfate can reflect:

  • psychological health (high level of anxiety, depression, etc.).
  • more favorable hormonal profile which implies higher levels of DHEA sulfate and a lower cortisol / DHEA-S ratio.
  • increased risk of sarcopenia.
  • increased risk of metabolic syndrome and type 2 diabetes.
  • mortality in general, which is strongly associated with the cortisol / DHEA-S ratio

This article was last reviewed by Svetlana Baloban, Healsens, on January 24, 2020. This article was last modified on 4 March 2021.

Assessing Exercises

DHEA (Aldred et al. 2009; Cumming et al. 1986) and DHEA-S (Tremblay et al. 2004) have been shown to increase in response to active exercise. Measuring the ratio of cortisol to DHEA-S can help determine the intensity of physical activity. A higher level of cortisol and/or a lower level of DHEA-S may indicate significant physical stress. This can be valuable information for assessing whether the workout is sufficiently intense or if a lighter approach is needed to prevent overtraining. However, resistance training showed a stronger increase compared to endurance training (Tremblay et al. 2004). It’s also worth noting that trained and untrained people can cause different hormonal responses to exercise. So, untrained people experienced more significant increases in DHEA and cortisol levels2021. Such result was observed in both young people and people over 60 years old22.

How to define intensity of exercise?

For this purpose, the researchers used heart rate (HR) indicators. So the exercise was stopped as soon as the participants had reached 75% of their maximum HR. You can also determine maximum HR by the Tanaka formula:

208 − (age × 0.7)

So, for a 65-year-old person, the maximum heart rate will be 162 beats per minute. Consequently, 75% of this figure will be 121 bpm. Healthwise, muximum loads are not advisable. Therefore, it is recommended to use between 50% and 80% of the maximum.

Research has shown that 16 weeks of regular exercise decreased cortisol/ DHEA ratio by nearly 30%. In addition, athletes with the highest performance levels and the greatest amount of training had the lowest ratio. So,

Healthy Cortisol/DHEA-S Ratio

1 : 5 – 1 : 6

1:6 corresponds to 0.167 & 1:5 corresponds to 0.2

Adrenal/DHEA Restoration

High Adrenal/DHEA-S Ratio

Taking this into account, DHEA supplementation may be considered. Research confirms that it has a significant effect on the concentration of cortisol. For example, even a single morning dose of 200 mg DHEA can lower cortisol concentrations23. Moreover, in women, such a decrease was more pronounced.

An earlier study in healthy people came to the same result24. By the way, researchers also found that taking DHEA (300 mg) did not improve memory. However, supplementation is rational only in cases of decreased DHEA-S levels. In addition, it is important to monitor the sex steroid hormones as well as DHEA-S, because both deficiency and excess of DHEA can lead to negative symptoms.

In addition to DHEA supplements, your doctor may recommend pregnenolone25 and seriphos (phosphatidylserine)26. Seriphos was developed to aid in lowering cortisol. Besides, it contains key nutrients for stress resiliency. As for about pregnenolone, it is a steroid hormone. It plays a key role in the production of other steroid hormones, such as progesterone, DHEA, and estrogen.

Research also shows that fish oil supplements2728 and an Asian herbal medicine called ashwagandha both help to reduce cortisol levels29.

Calculated Cortisol/DHEA-S Ratio in Healsens App

Clinical Note

Improving adrenal function (augmenting DHEA and pregnenolone) can significantly enhance thyroid function, thereby reducing the amount of thyroid medication necessary. If this possibility is taken into account, it is suggested that any patient on thyroid should be closely monitored and lower dosages of pregnenolone and DHEA should be initially considered.

Low Adrenal/DHEA-S Ratio

So, as discussed in previous chapters, exercise has a positive effect on DHEA and cortisol levels. Besides, your doctor may recommend taking licorice extract. This is because licorice helps the adrenal glands prevent the breakdown of cortisol. In some cases, cortisol supplementation may be required.

Either with increased and decreased cortisol / DHEA-S ratio, an adrenal support program is recommended. So, try to balance your intake of protein, healthy fats, and carbohydrates. It will also be very beneficial to increase your vegetable intake to get the required amount of vitamins and minerals. To this end, foods high in vitamin C, B-5, B-6 and magnesium will assist in maintaining adrenal health.

Unlock your health insights with our smart data analysis – the Free Health Tracker app, your reliable medical record!

Drastically reduce the time to detect chronic diseases & inspire healthy habits


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Source: ©️2019 Healsens B.V. All right reserve


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