7 health metrics high performers track

You can measure your resting heart rate, your sleep score, your daily steps. The numbers that actually predict where you'll be in twenty years lie deeper — in your blood and in your organs. Something no wearable can measure.

High performers in sport, business and medicine increasingly treat their health metrics like financial data: they want the leading indicators, not the lagging ones. A high resting heart rate or blood sugar are lagging indicators. Raised visceral fat, a rising ApoB, or elevated fasting insulin, on the other hand, can signal cardiovascular and metabolic risk years before symptoms appear.

According to the STADA Health Report 2023, almost 9 in 10 Europeans do not receive adequate preventive care. That means the vast majority of people have no overview of the values that matter most.

Here are the seven health metrics worth knowing, and why each one gives you information a standard check-up probably doesn't.

1. Visceral fat

Not all body fat is equal. Subcutaneous fat, the kind you can pinch, is less harmful than visceral fat. Visceral fat, which wraps around the liver, pancreas and intestines, is metabolically more active and releases inflammatory compounds directly into the bloodstream.

A study in The Lancet Diabetes & Endocrinology showed that visceral fat is a stronger predictor of cardiometabolic disease than BMI or waist circumference alone. You can have a normal BMI and still carry dangerous amounts of visceral fat. The only way to quantify it accurately is imaging, specifically MRI-based body composition analysis.

2. ApoB (Apolipoprotein B)

Most people know their total cholesterol. Fewer know their ApoB, which cardiologists increasingly regard as a leading blood marker for cardiovascular risk. Every atherogenic lipoprotein particle — the kind that builds plaque in your arteries — carries exactly one ApoB molecule. A high ApoB means more of these particles are circulating, regardless of what your LDL says.

The European Society of Cardiology now recognises ApoB as a primary target in lipid management. A standard check-up typically measures total cholesterol and LDL. ApoB goes further, and is included in Ahead's advanced blood test of more than 80 biomarkers.

3. HbA1c (glycated haemoglobin)

Fasting glucose shows you what your blood sugar is doing right now. HbA1c shows you what it has been doing over the past two to three months. It reflects the percentage of haemoglobin in your red blood cells that has been coated with sugar, and is the standard marker for diagnosing and monitoring type 2 diabetes.

The problem: many people with rising HbA1c are never tested, because they have no symptoms. Insulin resistance can develop quietly over a decade before blood sugar crosses the diagnostic threshold. Across Europe, a substantial share of people living with diabetes remain undiagnosed.

4. hsCRP (high-sensitivity C-reactive protein)

Chronic low-grade inflammation is linked to heart disease, cancer, neurodegeneration and metabolic syndrome. hsCRP measures C-reactive protein at very low concentrations and detects systemic inflammation that a standard CRP test may miss.

For cardiovascular risk stratification, hsCRP is well established. The Physicians' Health Study showed that men with the highest hsCRP levels had roughly a threefold increased risk of heart attack compared with those with the lowest levels, even after adjusting for cholesterol.

A single raised value doesn't mean you're ill. But a persistently elevated hsCRP, especially combined with other metabolic markers, signals that something deserves attention.

5. Organ integrity

The liver, kidneys, pancreas, spleen and thyroid can develop structural changes, cysts, nodules or early tumours long before symptoms appear. A blood test can detect functional limitations in some of these organs through markers such as ALT (liver), creatinine (kidneys) or TSH (thyroid). But blood values often stay normal until significant damage has already occurred.

This is where imaging closes the gap. A head-to-knee MRI provides a structural view of all major organs in a single session and picks up findings that blood tests cannot see. Put simply: blood tests check the software, imaging checks the hardware. Together they give a far more complete picture.

6. Arterial health

Heart disease remains a leading cause of death across Europe. In many cases, the first consequence of coronary heart disease is a heart attack. An exercise ECG or calcium scoring can help detect coronary heart disease. Calcium scoring and an exercise ECG serve different, complementary roles: a calcium score measures plaque deposits to assess long-term risk, while an exercise ECG assesses the heart's current blood supply. Calcium scoring by CT measures the amount of calcified plaque in your coronary arteries and produces an Agatston score — one of the strongest predictors of future cardiac events. A score of zero is very reassuring. A score above zero, even a moderate one, changes the conversation about prevention.

Many standard check-ups include neither an exercise ECG nor calcium scoring. Coronary heart disease is therefore often diagnosed only at a late stage, or even at the point of a heart attack.

7. Body composition (muscle-to-fat ratio)

Weight alone tells you almost nothing about your health. A 90-kilo person can have 25% or 12% body fat. The difference in disease risk is enormous.

MRI-based body composition analysis quantifies lean muscle mass, fat mass and the distribution of both across your body. It can also measure intramuscular fat, a marker of muscle quality that is relevant to metabolic health and physical resilience, especially as you age.

Many people who exercise regularly assume they are fit. Ahead's MRI-based body composition analysis can confirm that assumption or reveal surprising imbalances — such as high visceral fat in someone who trains regularly but eats poorly.

Why you should look at these 7 metrics together

No single value in isolation is enough. Normal cholesterol and LDL don't rule out cardiovascular risk if your ApoB is elevated. Normal HbA1c doesn't rule out type 2 diabetes risk if your insulin resistance is high. Unremarkable blood values don't mean your organs are structurally fine. Low visceral fat doesn't protect against coronary plaque.

This is why Dr Anna Erat, founding medical advisor at Ahead Health, argues for triangulation:

"A single value can mislead. Someone can have a normal HbA1c and still be metabolically at risk if their ApoB is elevated and their inflammatory markers are up. The real picture emerges when you read these markers together."

The reactive model of healthcare waits until one of these values causes a problem, then investigates. The proactive model measures all of them as a baseline, so you know where you stand before something goes wrong.

How Ahead Health can measure all seven

Ahead's Advanced package covers all seven metrics in a single appointment. It combines a head-to-knee MRI — including body composition analysis — with an advanced blood test of more than 80 biomarkers, including ApoB, HbA1c, insulin resistance, hsCRP, a lipid panel, liver and kidney markers and more. For a broader baseline that includes brain analysis, hip and knee screening, and vitamin and hormone blood tests, Ahead Pro extends the assessment. (Local NL pricing to be inserted.)

The head-to-knee MRI examines all major organs and the musculoskeletal system. The blood test captures the metabolic, inflammatory and cardiovascular markers. Body composition analysis adds the quantification of visceral fat and the muscle-to-fat ratio. Together, these tests produce a dataset most people never see until something has already gone wrong.

A calcium-score CT can be added for a direct assessment of the coronary arteries.

Ahead's services are designed to complement your GP, not replace them. Your results come with a physician-reviewed health report and, where needed, a consultation to interpret the findings and plan next steps.

Bottom line

The gap between what wearables measure and what determines long-term health is large. Heart rate variability, step count and sleep stages are useful, but they don't tell you whether your arteries are calcifying, your liver is developing a nodule, or your visceral fat is quietly rising.

The seven metrics above are measurable, actionable and available today.

Sources

1. STADA Health Report 2023. "Almost 9 in 10 Europeans do not receive adequate preventive healthcare."
2. Neeland IJ et al. "Visceral and ectopic fat, atherosclerosis, and cardiometabolic disease." The Lancet Diabetes & Endocrinology , 2019.
3. ESC/EAS Guidelines for the management of dyslipidaemias. European Society of Cardiology, 2019.
4. Ridker PM et al. "Inflammation, aspirin, and the risk of cardiovascular disease in apparently healthy men." NEJM , 1997.

Frequently asked questions

How often should I repeat a comprehensive blood test?

For most healthy adults, an annual test provides a useful trend. Your doctor may recommend a shorter interval if specific markers need monitoring.

Can I book just a blood test without an MRI?

Yes, we offer standalone blood tests that can be booked independently of an MRI.

What is the difference between your blood test and a standard GP blood test?

A standard GP blood test usually covers a basic panel: blood count, cholesterol, blood sugar and sometimes liver and kidney values. It typically includes 10–15 markers and is ordered reactively when there is an existing complaint. The Ahead advanced blood test is a preventive screening panel of 80+ biomarkers, designed to detect early warning signs before symptoms appear. The key differences are broader scope (cardiovascular risk markers such as ApoB and hs-CRP, metabolic health such as HbA1c, HOMA-IR and insulin, a full thyroid panel and more), a proactive rather than diagnostic approach, detailed reporting in an interactive online report, and physician review of every result.