Know your numbers — and your risks

No two people are alike — none of us have the same genes, lifestyle habits or experiences. These days, it’s all about personalization with treatments and prevention strategies tailored to individuals. Unfortunately, some of the science — like expensive genetic tests — is financially out reach for many people.

However, genes are just a part of our personal medical puzzle.

“Most people think that if you know your genes, that will tell you what to do,” says Dr. Mark Liponis, author and corporate Medical Director at Canyon Ranch. “But genes don’t reveal everything. The genes don’t reflect where we live, what we’ve done, how we behave.”

We don’t need expensive tests to personalize our health care, Dr. Liponis says, in his talk at ideaCity 2012. From knowing more about our family history to a few inexpensive at-home tests, we can learn more about our risks for chronic illnesses.

Know yourself

Your doctor has likely asked you if you have a family history of this or that condition, but there are a few additional factors Dr. Liponis notes we should take into account:

Your birth weight. Believe it or not, how we start life can influence our health throughout our life. If you don’t know your birth weight, it’s time to find out. Babies who fall within the 6.5 to 9.5 pound range at birth are considered a “normal” weight. Go above or below and you could be facing an increased risk for diabetes or cardiovascular disease later in life.

Why does size matter? If you were a small baby, Dr. Liponis points out that you came into the world “primed for stress”. That stress can predispose you to some health risks later on.

Your birth order. If you were the second born or beyond, you have a lower risk of developing asthma, allergies, autoimmune disease or eczema than a first born or only child — especially if you had older brothers. All those germs your older siblings brought into the house helped train your immune at an early age and you’re likely to be more resistant to problems in adulthood.

Whether you had pets growing up. Big brothers aren’t the only ones bringing in the bugs. People who grew up with pets — especially dogs — are also less likely to develop asthma, allergies and autoimmune disorders than people who didn’t.

Reproductive history. Doctors know hormones play a role in breast cancer, and how much you ovulate makes a difference. Women who started menstruating early (before age 12) or reached menopause later (after age 55) have an increased risk of developing breast cancer. Women who had children before age 30, had multiple children and breast fed have a lower risk than women who have never been pregnant. 

(For more information on the risk factors for breast cancer, visit Public Health Agency of Canada and the Canadian Cancer Society.)

Another thing to know: how fast you grew. The faster you grew as a child — if you reached your peak height before age 14, for example — the greater the risk for breast cancer.

Test yourself

Your doctor runs routine tests and screens, but there are a few assessments you can do at home – and with little expense.

Measure your neck. Get out the measuring tape — neck circumference is a known risk factor for sleep apnea. Experts warn a thick neck could crowd the airway and lead to trouble when the neck and throat muscles naturally relax during sleep. Neck circumference is also an indication of being overweight or obese — another important risk factor.

At what point should we be wary? Dr. Liponis says that a circumference over 40 cm could increase risk.

Look inside your mouth. Grab a mirror and say “ahhh.” If you can see your uvula — that dangly bit in the back of your throat — that means there’s plenty of room back there and your airway is less likely to become obstructed when you sleep.

Another check for sleep apnea: stick out your tongue. If you see scalloped edges, they are indentations caused by your teeth. Larger tongues (or smaller jaws) that crowd the teeth can also crowd the airway.

Stand naked in front of the mirror. When you get over the shock, there are two things you should look for. The first is the size and number of moles on your body (especially your back). If you see any suspicious moles — they’re asymmetrical and larger than the eraser on a pencil, for example — have them checked out by a doctor. (For more information, see Recognizing the trouble spots.)

The second thing you should look at is your alignment. Something as seemingly harmless as an over-pronated ankle can put strain on your body that impacts the knees, hip and back. You and your doctor can take steps to correct alignment issues now — and possibly avoid a joint replacement in the future.

Calculate your waist to hip ratio. Regardless of our weight, where we carry it is crucial for gauging our risk for cardiovascular disease and diabetes. People who gain weight around their mid-section are at a higher risk for these conditions than people who gain weight around their hips and thighs.

Not sure how to do it? Try this Waist to Hip Ratio Calculator.  According to Dr. Liponis, a result over .8 for women or .9 for men warns of a risk for diabetes and cardiovascular disease. The waist to hip ratio indicates something the scale alone does not: how resistant our bodies are to insulin, an important hormone that controls blood sugar and regulates other bodily functions.

However, people who are pear shaped don’t get off easy either, notes Dr. Liponis. They have a higher risk of developing cancer during their lifetime than their apple-shaped cohorts.

Test your blood sugar. Blood sugar levels can detect diabetes or pre-diabetes long before symptoms appear. If you’re looking for more information than your annual blood test gives you, you can try a blood sugar home test kit. You’ll want to try it three times during the day: In the morning, the results should be under 100 mg/dL. After a meal, they should be less than 200 mg/dL, and two hours after that meal, it should be back down to 140 mg/dL.  

What if your numbers are higher? It could be a sign of pre-diabetes or diabetes.

Take your blood pressure. True, our doctor or nurse usually does this for us — but you can learn even more if you have access to a blood pressure test machine (at home or at your pharmacy). We often have our blood pressure taken at rest, and it should be at or below 120/80 (at rest). We know high numbers mean high blood pressure and a higher risk of heart attack and stroke

However, most people don’t look for high blood pressure during exercise — which can also be risky to our health. After a few minutes of activity, these numbers should be lower than 210/110 for men during exercise and 190/100 for women.

Take your pulse. Your pulse can also warn of trouble ahead — and let you know if you need more exercise now. At rest, your pulse should be between 60-90 beats per minute, says Dr. Liponis. With exercise, your maximum heart rate should be no higher than 220 minus your age. (If you’re age 50, that upper limit would be 220 – 50 = 170.) 

Two minutes after you stop exercising, your pulse should drop by 20 per cent. If it doesn’t, it could be a sign you need more aerobic exercise. 

Look at a grid. An Amsler Grid, that is. As we age, our risk for macular degeneration, glaucoma and other eye diseases increases too. When you look at this test grid, you should see sharp, straight lines all the way across. If any lines are wavy or you’re missing the corners, it’s time to see an eye doctor. (You can view and download the test grid at All About Vision.)

Test your urine. If you’re keeping up with your recommended colorectal screening measures, you’re already familiar with the fecal occult blood test kit. But did you know you can also test for blood in your urine with a home test kit? Blood in the urine can be a sign of infection or disease involving the kidneys or urinary tract. It can also signal chronic diseases like diabetes, or be a side effect of certain medications.

While experts continually warn us not to diagnose ourselves at home, knowing some of these crucial facts about our health can help us be more empowered patients. The goal isn’t to scare ourselves — it’s to have an understanding of what risks we could face so we can start doing something about them now. Maybe it’s as simple as more exercise and a better diet, or orthopaedic insoles for our shoes.

For more information on knowing your risks — and what you can do about it — watch Dr. Liponis’s recent ideacity talk here:

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