Under­stand­ing blood test num­bers

 

Screening tests are an important indicator of not only current disease, but also your future risk of developing certain chronic diseases. — Filepic

Many of us might go for screen­ing tests, espe­cially when we hit middle age, but do we really know what the res­ults sig­nify?

TURNING 40 is often when many people begin paying closer attention to their health.

Energy levels, exercise recovery time and metabolism may start to change, and many Malaysians undergo their first comprehensive health screening.

However, interpreting a multi-page laboratory report can be confusing.

The first thing to understand is that a laboratory “normal range” does not always mean optimal health.

These ranges are based on population averages and are designed mainly to detect disease.

Preventive health focuses on identifying risks early and understanding the overall pattern of results.

HEART DISEASE RISK

One of the most important sections is the lipid profile, which measures LDL (low density lipoprotein) cholesterol, HDL (high density lipoprotein) cholesterol and triglycerides.

LDL cholesterol plays a major role in the development of atherosclerosis and cardiovascular (heart) disease.

The ideal LDL level depends on an individual’s overall risk profile.

People with diabetes, kidney disease, a strong family history of early heart disease, or existing cardiovascular disease often require lower LDL levels.

HDL cholesterol is best considered a risk marker rather than a treatment target, while triglycerides should ideally remain below 1.7 mmol/l.

Raised triglycerides combined with low HDL cholesterol may indicate insulin resistance and increased metabolic risk.

Beyond standard cholesterol testing, additional markers can provide further insight.

Lipoprotein(a), or Lp(a), is an inherited cholesterol particle that independently increases the risk of heart attack, stroke and aortic valve disease.

Elevated Lp(a) is common, affecting approximately 20-30% of the population when defined as levels above 50mg/dl (about 125 nmol/l).

As Lp(a) is largely determined by genetics and remains stable throughout life, measuring it once in adulthood can help identify hidden cardiovascular risk.

Apolipoprotein B (Apob) reflects the number of cholesterol particles that can contribute to plaque formation and may provide additional risk information, especially in individuals with diabetes, obesity, metabolic syndrome or elevated triglycerides.

DIAGNOSING DIABETES

Another useful metabolic marker is HOMA-IR (Homeostatic Model Assessment of Insulin Resistance), which is calculated using fasting glucose and fasting insulin levels.

It may identify insulin resistance before blood sugar becomes abnormal, allowing earlier lifestyle intervention in selected individuals at higher metabolic risk.

Hba1c reflects average blood glucose over the previous two to three months, and is an important screening test for diabetes.

In Malaysia, diabetes affects almost one in five adults.

An Hba1c below 5.7% is considered normal, 5.7-6.4% suggests prediabetes, and 6.5% or above is consistent with diabetes when appropriately confirmed.

Identifying prediabetes provides an opportunity to reduce future risk through exercise, weight management and dietary changes.

LIVER AND BLOOD

Your liver enzymes, particularly ALT (alanine transaminase) and AST (aspartate aminotransferase), provide clues about liver health.

Mild abnormalities may be associated with metabolic dysfunction-associated steatotic liver disease (MASLD), previously known as non-alcoholic fatty liver disease.

These results should be interpreted alongside body weight, waist circumference, alcohol intake, medications and other risk factors.

The Full Blood Count (FBC) evaluates red blood cells, white blood cells and platelets.

Low haemoglobin may indicate anaemia, while abnormal white cell or platelet counts may require further evaluation depending on any other signs or symptoms the person may have.

OPTIMINSING HEALTH

The most important lesson from health screening is that individual numbers rarely tell the whole story.

Doctors look for patterns – a combination of raised blood pressure, increased waist circumference, abnormal cholesterol and rising blood sugar may indicate metabolic syndrome and increased future cardiovascular risk.

Your annual health screening should not be viewed as a passor-fail test.

It is a roadmap that helps identify risks early and guides better decisions.

The goal is not simply to be within the laboratory reference range, but to optimise your health so that you can remain active and well for years to come.

Dr Kishen Sivakumar is a general practitioner (GP). For more information, email starhealth@thestar.com.my. The information provided is for educational and communication purposes only, and should not be considered as medical advice. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this article. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.

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Strength­en­ing your core

Your core muscles are essen­tial to sup­port your spine, but many people often for­get to exer­cise them.

     https://www.pressreader.com/malaysia/the-star-malaysia/20251207/282492895014630

By Dr SITARAMARAO NAGESWERARAV

7 Dec 2025

YOUR core is like Wifi – when it’s weak, everything dis­con­nects.

1 Dead bug with heel slide: 1. Lie on your back with both your knees bent at 90° in the air. exhale fully to engage the core, then bring one foot down to touch the floor. — Pho­tos: dr Sit­ara­marao nageswer­arav

A hun­dred sit-ups a day won’t give you a strong core.

That’s because the core isn’t just your abs (abdom­inal muscles) – it’s the net­work of deep muscles around your stom­ach, back and hips that keeps your body bal­anced, sup­por­ted and stable.

Your core is your body’s cent­ral sta­bil­iser, even your spine depends on it for sup­port.

Decreased move­ment or over­do­ing a move­ment, coupled with weight gain and poor nutri­tion, weak­ens the spine and con­nect­ive tis­sues, caus­ing the lat­ter to wear down.

This even­tu­ally leads to chronic lower back pain, disc her­ni­ation and poor pos­ture.

The four lay­ers of the core con­sist of:

> Deep core sta­bil­isers - the 

inner “cor­set” muscles > Super­fi­cial core movers - the vis­ible abs

> Lat­eral and pos­terior core - the core-to-hip con­nect­ors > Func­tional net­work - sup­port­ing sta­bil­isers for every­day move­ment.

A strong core:

> Keeps your pos­ture upright

and con­fid­ent

> Pro­tects your back from injury,

and

> Improves bal­ance and every­day move­ment.

When the core is weak, the spine loses its nat­ural brace.

Spinal seg­ments start to shear and com­press, lead­ing to chronic lower back pain, disc her­ni­ation and poor pos­ture.

Your pos­ture is a mir­ror of your health, so pay atten­tion to it!

Other effects include:

> A roun­ded upper back (kyphosis)

> Pel­vic tilt or exag­ger­ated lumbar curve

> Core inhib­i­tion and glu­teal amne­sia (yes, your butt can “for­get” how to work).

The longer you sit, the more your core muscles dis­en­gage, caus­ing your brain to “for­get” about them.

From the age of 35 onwards, muscle mass begins to decline.

The deep sta­bil­isers, such as the trans­versus abdominis, are often the first to weaken because they’re rarely activ­ated in daily life.

Even reg­u­lar gym-goers tend to train what they can see (e.g. arms, chest and legs), rather than what they can feel (e.g. the deep core).

However, you don’t need fancy machines to train your core. Try this instead:

> Tighten your abdom­inal wall (like bra­cing for a gentle punch) while walk­ing, climb­ing stairs or car­ry­ing gro­cer­ies.

> Sit tall, walk upright and stretch for five minutes every half-an-hour of sit­ting. Small adjust­ments in breath­ing and pos­ture make a big dif­fer­ence.

Two other power­ful core exer­cises you can do at home are:

> Dead bug with heel slide (deep core repat­tern­ing)

This exer­cise tar­gets the trans­verse abdominis, pel­vic sta­bil­isers and deep spinal flex­ors.

It retrains coordin­a­tion between the dia­phragm, core and your pel­vic floor – all cru­cial for pos­ture and spine sup­port. > Half-kneel­ing pal­lof press (rota­tional sta­bil­ity for real life)

This exer­cise tar­gets the obliques, mul­ti­fidus, glu­teus medius and trans­versus abdominis.

It builds anti-rota­tion strength – the body’s defence against twist­ing stress dur­ing daily activ­it­ies.

As uncon­ven­tional as these moves may seem, they’re backed by solid research and proven to improve func­tional strength and pos­ture.

The core doesn’t age – we do. Train it now or pre­pare to make friend­ship brace­lets with your chiro­practor later.

Dr Sit­ara­marao Nageswer­arav is a gen­eral prac­ti­tioner (GP) and cer­ti­fied fit­ness trainer. This is the first of a three-part series, which will be pub­lished fort­nightly. For more inform­a­tion, email star­health@the­star.com.my.

The inform­a­tion provided is for edu­ca­tional and com­mu­nic­a­tion pur­poses only, and should not be con­sidered as med­ical advice. The Star does not give any war­ranty on accur­acy, com­plete­ness, func­tion­al­ity, use­ful­ness or other assur­ances as to the con­tent appear­ing in this art­icle. The Star dis­claims all respons­ib­il­ity for any losses, dam­age to prop­erty or per­sonal injury suffered dir­ectly or indir­ectly from reli­ance on such inform­a­tion.

7 Great Core Strengthening Exercises - Ask Doctor Jo  

896,950 views 22 Mar 2018

Core strengthening exercises are great for improving your core strength. They can help prevent injury, increase core stability, and improve balance. I start with some beginner core exercises & then progresses to harder ones. More core exercises:    • Swiss Ball Core & Back Strengthening Exerc...   Progress through these core strength exercises at your own pace. If this is your first time doing core exercises, you may not be ready for the last ones yet. It's better to do the easy ones first and then see how you feel the next day. The first exercise is a pelvic tilt. This is great to get the core moving, and strengthening the whole pelvic area. The second core exercise is going into a bridge. This not only works your core, but it also works your glutes and hamstrings. If two legs are easy, you can do them with one leg at a time. The third exercise is with a Swiss or therapy ball. A prayer plank on the ball is a great way to activate your core. You can do this modified or a full plank. Next you will do a trunk rotation lying down with your feet on the ball. This is great for your oblique muscles. You can also do the trunk rotation seated on the ball. Using a weight will give you an extra workout, but you don’t have to use one. Now for some harder ones for core strengthening. This one is in tall kneeling, and you will lean back slightly. You can have someone hold onto your feet, or you can place them under something for support. When you are ready, you can do them without any support. This works your core, glutes, hamstrings, and quads. Finally you will do a standing march with elbow tap. You can do this on the same side or opposite sides. Try not do bend your back forward, and use your core to lift your knees. Related Videos: Back Pain Core & Back Strengthening Exercises:    • Back Pain Core & Back Strengthening Exerci...   Exercise Ball Core and Back Strengthening Exercises (Moderate):    • Exercise Ball Core and Back Strengthening ...  

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