The five new vital signs

by | Apr 9, 2021 | Functional Medicine, Heart Health, Muscles & Tendons | 0 comments


When you go for your annual physical there are a number of routine “vital signs” that your doctor checks: your height, weight, heart rhythm, blood pressure, and a few more. But there are other tests which are equal or better predictors of the future arc of your health that never find their way into the annual physical routine. With a small investment, you can even test yourself and add them to your permanent medical record.

1. Lung power

The amount of air your lungs can process is an important predictor of health. In fact, men in their 50’s and 60’s with abnormally low lung capacity had double the mortality rate over an 11 year period compared to those whose lungs were within the normal range.

The most useful measure of lung function is called FEV1. This stands for “Forced Expiratory Volume – 1,” the volume of air you can force out of your lungs in the first one second of a strong exhale.

The best way to measure FEV1 is with a spirometer. Pulmonary doctors have high-tech ones, but there are inexpensive versions for home use. You can purchase your own spirometer, measure your lung function as a baseline, and then continue to check it each year to note any changes. If your lung volume declines sharply from one year to the next, check with your doctor. And take action to improve it – I can share with you some exercises designed to strengthen lung capacity.

The Blowing Out a Candle Test

You don’t even need a spirometer to measure lung strength. There’s a low-tech way: the Blowing Out a Candle Test. To perform this test you need a candle and a yard stick. And some matches.

Place the yardstick on a horizontal surface (like your dining table or kitchen counter) and use it to place the candle one foot away from you. Light the candle, then see if you can blow it out with a quick, sharp breath. Don’t cheat by bending in toward the candle; keep it honest.

If that’s easy to do, try the candle at two feet…..three feet……etc. Eventually you’ll discover your maximum candle-blowing-out-distance. Write it down. Next year, when it’s time for your (self-administered) “annual physical,” try the test again and see if your lungs have improved, stayed about the same, or gotten worse.

2. Walking (or running) speed

Walking speed is an accurate predictor of longevity for those over 65. The most standardized test of walking speed is the ten meter walking test. It’s easy to set up a ten meter distance and time yourself walking it.

If your level of fitness makes it easy for you to speed through ten meters, you can challenge yourself with a running test. One way to test yourself is to see how long it takes to run a mile. Alternatively, see how far you can run in 5 minutes.

Keep a chart to record your results. If you’re concerned that this aspect of your health is in decline, you can give yourself a boost by using the high intensity interval training (HIIT) method.

3. Heart rate variability

Many people are surprised to learn that the heart isn’t designed to beat with metronomic regularity. Actually, heart rate should be adaptive. This is most obvious when you exercise; your heart should speed up. But your heart rate should respond to more subtle cues too: when you digest food, experience emotional shifts, or even just breathe in or out. The interval between one heart beat and the next should vary constantly. This is called Heart Rate Variability, or HRV.

Heart rate variability is a useful measure of how well your nervous system can regulate your body. I can measure your heart rate variability in my office, or you can easily measure it yourself. You’ll need a strap that wraps around your chest to pick up your heart beat. And you’ll need to download an app to your phone that connects to the strap and calculates your heart rate variability. I use Elite HRV.

Low heart rate variability is a bad thing. It means your heart can’t adapt to circumstances. Low heart rate variability has been linked to a higher risk of cardiac events and mortality in general.

4. Grip strength

Strengthening your muscles is a key way to live longer. Muscle power lowers your chance of falling as you age. And by avoiding falls you’re avoiding a major health risk.  Perhaps even more importantly, muscles also improve your metabolism, helping to control body weight and reducing your risk of type 2 diabetes.

The strength of your hand muscles correlates well with your overall strength, so testing the strength of your grip is an easy way to test the general health of your muscles. You can test your grip strength with a hand grip dynamometer.

5. Body fat percentage

Measuring your body weight only takes you part way in understanding the state of your health. But measuring your percentage of body fat (along with its opposite, percent of lean body tissue, mainly muscle) tells you much more.

You can purchase a scale that measures your percentage of body fat as it also measures your weight.

Your permanent medical record

Start keeping track of your own vital signs. Test each of these five, either on your own or with my help, write down the results, and save them as part of your permanent medical record. Then pull out your chart next year and retest to see where you’ve gained or lost ground.

If you’re concerned about your score on any of these measures, I’ll be helping you out in an upcoming article. I’ll be suggesting self-care methods to address each of these five vital health measures. Or, in the  meantime, call or e-mail to schedule an appointment so we can craft some specific steps you can take to improve your health over the next year.

Dr. Lavine has been an innovator in the use of movement and touch to promote health since 1981. He practices in New York City and Princeton, NJ.


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