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Are you now trying to shift to a healthier diet because your doctor told you that you had high blood sugar, prediabetic or diabetic or you had high cholesterol levels or simply trying to prevent the onset of these conditions through healthy living? If yes, then this article is for you! As part of our "Lose weight the right way: A Step-by-Step Guide" Series, this article focuses on the second important step in your weight loss or healthy living journey - the Self-Assessment Step which is divided into the ABCDE:

• Anthropometric Assessment
• Biochemical Assessment
• Clinical Assessment
• Dietary Assessment
• Ecological Assessment

This article will focus on the Biochemical Assessment. This step allows you to make an objective assessment of your current nutritional status based on your recent lab results and how they might affect your weight loss or healthy living journey. We will cover: Hemoglobin, Fasting Blood Sugar, HbA1c, Lipid Panel and Thyroid Function Tests.

Hemoglobin

According to WHO, if your hemoglobin levels are < 13.5 g/dL for Males or <12 g/dL for women, you are considered to have Anemia. Anemia is a reduction in Hemoglobin concentration in your blood which is responsible for transporting oxygen and nutrients in the body. Symptoms include: fatigue, shortness of breath, paleness and increased heart rate. The nutritional factors that may contribute to anemia are: Iron deficiency, Vitamin B12 and Folate deficiency. Adding iron rich foods such as poultry and meat or iron supplements can help support hemoglobin production. Moreover, adding Vit. B12 and Folic Acid supplements may also help address anemia related to their deficiency. Individuals with anemia may find it harder to begin exercising or may generally have low energy levels and slow metabolism. By considering this in your nutritional plan, you may be able to improve your overall health. If these nutritional interventions do not work, consult your doctor for workup on other possible causes of your anemia.

Fasting Blood Sugar & HbA1c

The Fasting Blood Sugar (FBS) is a measure of the amount of glucose still present in your blood after 8 hours of fasting. Normally, the blood sugar level should drop to a normal range of < 5.6 mmol/L or 100 mg/dL. When your fasting blood sugar is above this value, you may be considered pre-diabetic or diabetic depending on your lab results and based on your doctor’s diagnosis. The HbA1C is glycated hemoglobin which is a lab measure of your long-term blood glucose control. If you have consistently high blood glucose levels for the past 3 months, this excess glucose will start sticking to your red blood cells and can be detected through lab testing. The normal HbA1C level should be < 5.6 %. Above this, you may be considered pre-diabetic or diabetic based on your doctor’s diagnosis.

Knowing your baseline FBS or HbA1C is valuable for overweight or obese individuals who also have a family history of Type 2 Diabetes in the family. Weight reduction through a low-calorie, low-fat diet with physical activity is most beneficial for those within the pre-diabetic range because it can still be reversible at this stage. It is also beneficial for those who are already diabetic because it can improve insulin resistance and reduce the need for stronger medications or insulin therapy.

Lipid Panel

If you are recently diagnosed to have high cholesterol levels, the initial management is lifestyle change to reduce the body weight down to a healthy range through diet and exercise. Reducing the intake of alcohol, simple sugars, saturated fats and trans fats may not only improve blood cholesterol levels but also aid in weight loss.  Consult a Nutritionist-Dietitian for a personalized nutrition plan and consult your doctor for possible medical treatment.

Thyroid Function Tests

Some individuals may gain weight faster or lose weight slower due to a slow metabolism secondary to low thyroid hormone or Hypothyroidism. Symptoms of hypothyroidism include tiredness, weakness, dry skin, feeling cold, hair loss, poor concentration, constipation and weight gain with poor appetite. If you suspect that you have a thyroid problem, consult your doctor and your doctor might request for lab tests to check your Thyroid Stimulating Hormone (TSH) and Thyroxine (T4) levels.

Nutritional factors that may contribute to hypothyroidism are dietary Iodine deficiency either due to the lack of iodine in the diet or consumption of goitrogenic foods such as cabbage that hinder iodine absorption. By including iodized salt and iodine-rich foods such as fishes and seaweed in your diet, you may improve your Iodine levels and support thyroid hormone production. If these strategies do not work, consult your doctor for other underlying medical conditions and a Nutritionist-Dietitian to guide you in making your personalized nutrition plan.

The takeaway message here is that underlying medical conditions such as hypothyroidism and anemia may slow down a weight loss program due to slow metabolism and poor oxygen circulation. However, these conditions can be addressed by providing the necessary nutrients from the diet and sometimes through medical intervention. Another message is how diet and exercise can potentially reverse some medical conditions such as pre-diabetes and high cholesterol levels by attaining your healthy body weight through balanced diet and daily physical activity.

In our next article, we will discuss why your family history and current medical condition is also an important consideration and how it can affect your own nutrition plan so stay tuned!

/AET

References:

• AMBOSS (2021). Anemia. AMBOSS. Retrieved from https://next.amboss.com/us/article/6T0j72?q=anemia#Yd68dd7b08b7c74329b73e7e6d747acad
• Jameson, J. L. (2018). Harrison's principles of internal medicine. McGraw-Hill Education,.