Health Screening 101 (Part 3 of 3)

A health-care specialist dresses up as a heart.
Spc. Jesse Venable, a health-care specialist at the SHAPE Health Care Facility, dresses as a heart and hands out heart-shaped stress balls to attendees at the Healthy Heart Day event Feb. 25, 2016. (Sgt. Dani White/U.S. Army photo)

This is the third article of the three-part series of Health Screening 101. The first two articles in the series of Health Screening 101 are the following:

Health Screening 101 – Part 1: Introduction to Blood Tests/Insulin Resistance/Cholesterol Education

Health Screening 101 – Part 2: Courses of Action to Follow: Diet, Exercise, Medications Recommended

In this article, we will discuss the changes in his health screening test after four months of following a low-carb/Paleo diet, an exercise program and a statin drug.

As you recall in part one of this series, we received a question concerning recent blood tests from a non-​​smoking officer. See below for four-month scores, most recent scores and follow-on actions to take over the rest of the year.

(Red = danger, yellow = borderline, green = good)

  Blood Test (Nov 2012)    Blood Test Four Months Later
red light Body Mass Index
(BMI) Must be <25
(waist 41”)
  BMI 31.5 — lost 22 pounds – still high
(Waist 39 but under 40!)
yellow light
red light Blood Pressure
Must be <120/​80
148 /​​ 84   103/​74 green light
red light HDL (good chol)
Must be >60
31   35  — needs to be over 40 — 60 red light
yellow light LDL (bad chol)
Must be <100
117   61 green light
red light Triglycerides
Must be <150
362   119 green light
red light LDL – P (Lipoproteins)
Must be <1050
2231   1026 – best if below 1000 green light
red light Insulin resistance Ratio  (Trig /​ HDL)
Must be < 3.5
11.7   3.4 green light

* Ranges of acceptable numbers for the above tests on Health Screening 101 – part 1

By changing five of the seven red lights to green lights, you have reduced your risk of heart attack, coronary artery disease, stroke and Type 2 diabetes significantly. Before this health screening cycle, you were insulin resistant and had metabolic syndrome, which is defined by the National Institutes of Health as being present if you have three or more of the following symptoms: high blood pressure, a waist more than 40 inches, low HDLs, high triglycerides or high fasting blood sugar levels.

E. James Greenwald of Specialty Health in Reno, Nevada, was asked to cite the biggest contributor to a patient's success -- diet, exercise or meds -- and how to improve the good cholesterol (HDL).

“I think it is the combination of exercise, diet and the meds," Greenwald said. "All of them are equally important."

Here is why:

Diet: The nutritional program is especially good at dropping the triglyceride levels. He loses two inches around the middle during the process, and that is nice to see. He is burning the visceral fat that is most metabolically active and, in severe cases, can act like an extra endocrine organ, secreting all sorts of inflammatory bad stuff. Insulin resistant cases can continue to improve over the long haul.

Exercise:  With an insulin resistant patient, the exercise program especially improves the insulin sensitivity of the muscles. HDLs take time, and we like to see a gradual rise over time that may reflect the continued exercise program as much as anything.  HDL is not a target of therapy and is an area of great interest in the lipid world as we speak. It is looking like HDL-P, the particle number, again could be very important. (Jim Otvos, Liposcience)

Medications: The statin is the best medicine I know of to drop lipoproteins (particle number -- LDL-​​P).

Due to diet and exercise over the four-month period, the patient has become much more of a “ fat burner,” and that is reflected in the triglyceride drop (a fat). If it's dropping in the blood sample, it also is dropping in the liver and reversing the underlying insulin resistance.   243 points is a big drop in triglycerides.

"I’m happy to see the red/yellow lights turn green, but I really don’t care about the standard cholesterol numbers anymore if I know that I have an IR patient," Greenwald said. "The total focus becomes the particle number in a case like this, LDL-P getting under 1,000. That’s nice to see, so keep him on the program.  It is very important to maintain contact with a patient like this and follow the numbers appropriately."

How about some tips to help with this new way of eating?

"We do not have self-control," Robb Wolf of the Paleo Solution said. "Plan ahead. Don’t have tempting foods in the house. Remove the bread, rice, pasta, cookies, crackers, puddings, ice cream, waffles, juice, sodas, cereals, oatmeal, artificial sweeteners, yogurt, soy sauce, teriyaki sauce, canned soups, apple sauce, noodles … all refined, packaged foods.

Sleep and stress: Black out your room. No, really, black out your room. No LED lights from alarm clocks, fire alarms, TV’s, etc. Do not watch TV or check email for at least one hour before bed. Go to bed early and get at least eight to nine hours of sleep. You should wake up without an alarm, feeling refreshed. This will help you in so many areas of your life. It is our natural recovery and stress-reducing tool.

Losing 22 pounds in four months demonstrates effort on the officer’s part. It largely comes down to the individual and how much extra weight you are carrying and your personal effort.  All the best foods, exercise programs and medications will not help anyone if the person does not follow the plan and do their part. So good job and congrats.

"While we are on this 'weight topic,' please just throw your scale away," Wolf said. "Do not rely on it as a significant marker of whether this process is working or not. The fact is that you may not lose a ton of weight on this plan. Why? Because you are increasing muscle mass and losing fat. Increasing your muscle mass is good for controlling your blood sugar, helping your body to naturally regulate appetite and [it] has anti-​​aging properties. Muscles make you look good naked. So, don’t focus on scale weight.

Keep doing what you are doing. There is a saying in the health and fitness world: "Give health and fitness a month and it will change how you look and feel. Give it a year, and it will change your life.”

If you have several of these symptoms, take a good look at your daily schedule and find out what is out of balance. This game of stress is a delicate balance of hormonal responses from the speed-up and slow-down sides of our autonomic nervous system. Even though they are automatic responses to life that are difficult to control, we can control how we deal with stress with some serious thought and action.

Stew Smith is a former Navy SEAL and fitness author certified as a Strength and Conditioning Specialist (CSCS) with the National Strength and Conditioning Association. Visit his Fitness eBook store if you’re looking to start a workout program to create a healthy lifestyle. Send your fitness questions to

Want to Learn More About Military Life?

Whether you're thinking of joining the military, looking for fitness and basic training tips, or keeping up with military life and benefits, has you covered. Subscribe to to have military news, updates and resources delivered directly to your inbox.

Story Continues