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Writer's pictureMatt Crowe

Get Off The Train Early!

Your health is like a train track. The statistics show overwhelmingly that the end destination (at some point) is likely cancer, heart disease, dementia, diabetes or other metabolic disease if you don’t take very good care of yourself or get very very lucky.

But there are stops along that track that show signs of future illness and disease. Signs that medicine knows are likely ‘initial indicators’ leading to ‘bigger problems’ later on.


The key is to get off the train as early as possible… Or better still never get on the train.


The way to do this is to understand that your metabolic health is the gateway to many diseases that you really want to avoid for as long as possible. Maintain good metabolic health and you dramatically limit your risk of all disease… at any age!


You are considered metabolically unhealthy if you have any one of the following:

  • High BP > 130/85

  • High triglycerides >1.7mmol/L

  • Low HDL <1.0mmol/L men & <1.3 mmol/L women

  • Central adiposity/waist circumference - above 100cm men & above 88cm women

  • High fasting blood glucose >6.1mmol/L

If you have 3 or more you have metabolic syndrome and your risk factors for getting diseases early and/or them killing you early is multiplied.


So after 10 years of dedicated longevity study and 30 years of ‘boots on the ground’ experience I believe the key to extending healthspan (how long you live in good health) and by extension lifespan (how long you live) is acting early before ‘something little becomes something big, to ‘stick your thumb in the dam wall leak’ or ‘to cut the head off the snake’ before it strikes!


To do this we need to know how well you are ageing biologically!

To know we have to test… regularly! Not only metabolic health markers but also physical capability & composition markers.


So I designed an Optimal Health Panel to act as your ‘gauge’ to how well you are doing in the game of life!

I have limited these tests as much as I can. If you want to live as healthy as possible for as long as possible… stay in the optimal range of all these tests!


The Optimal Health Panel

  • VO2max - Your level of peak aerobic fitness (how fast & long you can run, cycle, swim etc) is THE BIGGEST mover of lowering risk of death (and healthspan) that we can influence. Bigger than not smoking, good diet, even good sleep!

  • Goal - It goes down with age but the minimum levels for a 40 year old are 35ml/kg/min for women & 40ml/kg/min for men.


  • KB Farmers Carry - grip strength + systemic strength & stability! Muscle strength & mass is your life capability indicator! Maybe more important than aerobic fitness!

  • Goal - Men - Carry 33-50% body weight KB in each arm for 1min & Women - 25-33%.


  • One Leg Balance - no balance means more falls! Falls in old age kill!

  • Goal - 30sec each leg (bonus if eyes shut!)


  • Turkish get up - Burpee - Step Up - Squat - Bar Hang - Continue to perform these 5 exercises proficiently and you will live without limitations!

  • Goal - complete 5 of each with good stability & control. Bar Hang - 90sec


  • Dexa - lean muscle mass, visceral (organ) Fat & Bone density - maintaining lean muscle mass and bone density is critical to healthy ageing but keeping your visceral fat low (organ fat around waistline associated with being skinny fat) may save your life (stop you getting cancer, heart disease, dementia, diabetes) more than any other measurement! Even more than obvious obesity.

  • Goal - the ‘green zone’ or good level charts come with the test.


  • Abdominal Girth measurement - obesity is the new smoking when it comes to cancer and early death!

  • Goal - Men - under 100cm & Women - under 88cm


  • Blood Pressure - a key measure in every single pathway that leads to early death! Getting it down is a priority!

  • Goal - Under 120/80.


  • Cholesterol + ApoB + Apo(a) - yes there is some correlation between atherosclerosis and very high LDLC and triglyceride numbers but THE REAL drivers of heart disease are APoB & Lp(a). The medical system has just not caught up with the science! Insist on these two extra tests!

  • Goal - ApoB under 1.0 but ideally 0.6. Lp(a) under 70.


  • Fasting Insulin - Insulin resistance is one of the BIG 2 factors linked to 9 out of 10 top diseases known to man! Your blood sugar can be high for 10 years because your insulin has been keeping it down! Your body will almost certainly stop listening to the insulin signal. Next step Type 2 diabetes! It is bewildering that insulin is not a mandatory test for everyone instead of just fasting blood glucose.

  • Goal - under 5.0mmol/L but ideally 2.0


  • Hba1c - your 3 month measure of average blood sugar. You must track it and keep it optimal.

  • Goal - under 5.1mmol/L


  • Biochemistry - Liver & Kidneys - There are many factors in your biochemistry panel but knowing the health of your detoxification organs (liver & kidneys) is often the earliest indicator of impending illness & disease!

  • Goal - All markers important but very important is ALT - Men under 30 & Women under 20


  • CRP & Homocysteine - every disease we know of has chronic inflammation as a precursor! Keep inflammation low and blood sugar low and you have gone a long way to “cutting the head off the snake!’

  • Pass - CRP - under 1.0 & Homocysteine at 6-8.


  • Uric Acid - this is way more than a gout test! It is a very good indicator of your metabolic health (BP, insulin, kidneys) that is very under-rated!

  • Pass - under 5.5

Tests to consider every 2-5 years

  • Heart Angiogram or cleerly heart scan

  • Full body MRI

  • Cognitive analysis

  • Galleri cancer liquid biopsy

  • Colonoscopy - every 3-5 years

  • ApoE - E2, E3 or E4 - alzheimers risk (genetic test - once only)

Every Year:

  • Dexa Scan - visceral fat, lean body mass and bone density

  • Cardio EKG - executive medical

  • Physical screening - strength, flexibility, functionality, aerobic capacity



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