Normal results, changing trends: Why your health data needs a longer view

Your health screening results are out, and they seem reassuring: blood sugar is within range while cholesterol and inflammatory markers are acceptable. Nothing looks immediately concerning.

But while these results offer a snapshot of where your health stands today, do they tell you how it might be changing over time? Doctors from Novi Health say they often see patients whose annual check-up results appear “normal” when viewed in isolation, but reveal a gradual shift when tracked over years.

Dr Sue-Anne Toh, Novi Health’s chief executive officer and co-founder, says: “Normal is a single point in time. It doesn’t tell you whether you’re standing still, improving, or slowly drifting towards disease that has not shown symptoms.”

Put three or four years of results side by side, and the picture can look quite different, she adds.

For example, fasting glucose or inflammatory markers may creep upwards year after year.

While none of the changes may trigger concern, taken together, they form a clearer picture of where the person’s health may be heading towards, says Dr Toh, who is also a senior consultant in the field of endocrinology. This is where tracking and interpreting those health trends can be important.

Dr Kyle Tan, preventive medicine consultant and co-founder of Novi Health, says: “A screening tells you where you are today. But understanding your trajectory requires looking at how your markers are changing over time, and what those changes are pointing toward, in light of your circumstances and health status.”

Why a normal result does not always mean optimal

While results from a health screening that fall within acceptable range can be reassuring, the doctors point out that does not necessarily mean the person’s health is optimal.

Take HbA1c, a measure of average blood sugar levels over the past two to three months. Two people can have the same readings yet be on different health trajectories, says Dr Toh.

“One person’s number has been flat for five years. The other has climbed steadily and, if that continues, could cross into the diabetes range within the next few years. Read alongside their other markers and habits, the two people are at very different levels of risk,” she explains.

This longer-term perspective is where the concept of healthspan comes in. Rather than focusing only on whether the person has a disease or health screening results are within the reference range, healthspan considers whether they are ageing in a way that protects what matters to them, says Dr Toh.

Looking at the bigger picture

So what does tracking health over time look like? Doctors do this by taking a longer view, looking at patterns that reveal how different aspects of health are changing, and then using the information to identify areas that the person needs to work on.

“In practice, this means we’re not just comparing you to a population average - we’re comparing you to yourself, over time and holistically factoring in your unique risk profile and personal goals,” says Dr Toh.

That also means looking beyond blood tests, which mainly show whether a disease is present or not. “A blood test can tell you whether a disease is there. It usually can’t tell you how well you’re ageing,” says Dr Tan.

Instead, he says, doctors look at a wider set of measures. These may include body composition, such as the amount of muscle in the body and the visceral fat around the organs, and functional measures such as VO2 max, which measures how well the body uses oxygen during exercise, and grip strength. Simple, validated measures like these can be more meaningful than expensive panels or commercial over-testing with unvalidated diagnostics, he adds.

Blood markers such as HbA1c and insulin resistance still matter, but they are read alongside lifestyle factors such as sleep, activity and stress, rather than as standalone numbers.

“Any of these on its own is a snapshot. Tracked together over time, they show where your health is heading, even in people who look and feel perfectly well today,” explains Dr Tan.

An example is the “skinny fat” phenomenon, which Dr Tan and his colleagues have observed in professionals as young as their late twenties, particularly among Asian populations. “They may have a normal weight and appear physically healthy, but their biomarkers tell a different story. These are warning signs that are only visible if you know where to look,” he says.

Small changes matter

When unfavourable changes are identified early, there may be opportunities to influence the factors driving them.

While the idea of longevity brings to mind high-tech treatments or elaborate wellness routines, Dr Tan says the basics remain some of the most important things. Think consistent physical activity, strength training, adequate protein intake, high-quality sleep and sustainable nutrition habits.

“The science of longevity is often less about finding a secret and more about consistently executing proven habits,” says Dr Tan. “The basics are the hardest things to do. It is far harder to eat well and move enough every day than to occasionally plunge into an ice bath. What makes the difference is tailoring those basics to the person, based on their own data, so it maximises benefit, and becomes a plan they can actually sustain.”

According to Dr Toh, meaningful improvements can be seen within months when individuals commit to evidence-based data-driven lifestyle changes. These may include reductions in visceral fat, improvements in HbA1c and insulin resistance, lower blood pressure and improved functional strength and endurance.

Core lifestyle pillars of prioritising regular aerobic and resistance exercise, a plant-forward balanced diet, restorative sleep, and social connection have consistently shown to yield health gains, says Dr Toh.

However, knowing what to do and doing it consistently can be challenging. Continuous personalised support can help people turn these insights into lasting habits. A physician-led, coaching-supported approach allows changes to be introduced, monitored and adjusted over time as the person’s health and goals evolve.

The conversation matters more than ever in Singapore, where chronic diseases continue to affect a significant proportion of the population. According to the National Population Health Survey (NPHS) 2024 Report, Singapore’s obesity rate increased significantly to 12.7 per cent in 2023 to 2024, compared to 10.5 per cent in 2019 to 2020. Diabetes and hypertension rates stood at around 9.1 per cent and 33.8 per cent respectively in 2023 to 2024.

At the recent HSBC Longevity Forum on July 25, Dr Toh joined panel discussions around longevity and healthy ageing, reflecting a growing interest in how people can stay healthier for longer. A good starting point would be to know which changes can make a difference to the number of years a person spends in good health.

Dr Tan notes that prevention can be difficult because the payoff might not be obvious immediately. But the opportunity to influence the direction of health is often the greatest before the problem shows up.

“The best time to understand your trajectory is before it becomes impossible to change,” he says.

Explore Novi Health’s Longevity Signature programme to better understand your health trajectory and explore ways to support your healthspan.