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5 Numbers for Optimal Health

By Drs. Michael F. Roizen, MD, & Mehmet C. Oz, MD

5 Numbers for Optimal Health

What are your 5 healthy numbers?

Ready for a fresh start? We’ve got a quick lesson in the 5 essential numbers that set you up for flourishing health, longevity, and more energy than the Energizer Bunny. All the time! You’ll be ready to birth a baby, enjoy your children—even grandchildren—if you get and keep these 5 numbers within normal range.

We’re talking about 5 measures: Your LDL cholesterol, hemoglobin A1C (blood sugar), waist size, cotinine (tobacco toxins), and blood pressure. Together, these measures make or break your risk for developing chronic disease or sustaining a major adverse health event.

Keep—or bring and keep—these 5 measures into “normal range and you reduce your risk of disease or disability by 80 to 90% (now would be a time to jubilantly shake the nearest rattle!)

5 Healthy Measures [Put this early in the article please]

Here’s normal for women (non-pregnant) and men:

1. LDL cholesterolunder 100 mg/dL
2. Hemoglobin A1Cbetween 4-5.6% of plasma glucose, and always keep your blood sugar under 110mg/dL
3. Waist sizeUnder 32.5 inches for women; under 35 inches for men
4. Cotenine (tobacco toxin)0ng/mL
5. Blood pressureUnder 115/75

Your Numbers During Pregnancy

Now, when baby’s on board expect fluctuations in these numbers (some of them, at least). It goes without saying that you need steer clear of tobacco (and hence have 0 cotinine) before, during, and after pregnancy (and always and forever).

Don’t be alarmed though if you find that over the course of your pregnancy, your LDL elevates progressively—in the 1st trimester “normal” can range from 60 to 153mg/dL, and by the 3rd trimester that can bump up to 101 to 224mg/dL.
Your Hg A1c, however, should not rise too much, except perhaps slightly in the third trimester (6% or higher, pregnant or not, is considered diabetes), and you can expect your blood pressure to drop slightly in the 1st and 2nd trimesters as progesterone relaxes your vessel walls, and then rise in the 3rd. If you already have blood pressure numbers above these, it is very important to manage that with your healthcare provider, and stay on any blood pressure medications you may have been on pre-pregnancy.

We will not lie to you: You should expect a change in waist size as baby grows, all the way through term. However, do not be lured by the idea that eating for 2 actually requires anything near eating twice as much food—for optimal nutrition for baby, and for healthy weight gain for you, you should aim to eat for about 1.1! That means you should take in, on average over the course of your pregnancy, about 10% more calories a day than you normally do, and these calories should ideally come mostly from low-fat, healthy proteins. Limit your fish those least likely to be contaminated with mercury, such as cold water fishes like salmon. As we like to say, “Ex-nay on the mercur-ay.”

In the 1st trimester, you’ll want to increase your calories by an extra 100 calories a day (equal to a tall glass of skim milk), and in the 2nd trimester to about 250 calories a day (equal to about ten walnuts plus an apple), building to an extra 300 calories a day in the 3rd trimester.

And even if you’re not yet pregnant, start a daily prenatal vitamin with DHA-omega-3 at least 3 months prior to conceiving. Just learned you’re expecting? Pop a prenatal now and continue daily until at least 6 months after birth and breastfeeding. Prenatals with DHA taken 3 months prior to and during pregnancy decrease congenital defects by 80%, childhood cancers to age 6 by 65%, and autism by 40%.


Getting to Normal
When we look at the data for the 5 normal measures (which are based on 3 major studies—one in Swedish men and two in American nurses), only 1% of Swedish men and 3-4% percent of U.S. nurses have all 5 normals—so what gives?


Achieving those measures can be challenging if you’re going at it on your own, and even more challenging if you’re juggling the sometimes hair-pulling, often sleep-depriving, and always miraculous act of raising a child.


So your task is to find a buddy—and I don’t mean a babysitter, though he or she could (and should) get in on this. You want a partner to whom you can stay accountable, and who will encourage you to stick to the practices including healthy eating, walking 10,000 steps a day, stress management, sleep that make you feel like you (and make your body feel as sweet and peaceful as a baby in a footie pajama suit).


2 Bonus Normals

Lastly, consider another two “bonus” normals that, while not measured in the studies mentioned above, have a wealth of evidence as being highly indicative of your risk for chronic disease or disability:

  • C-reactive protein (CRP) measure
  • Vaccination status


CRP can easily be measured with a blood test, and it tells you how much inflammation you have in your arteries. Keeping it in check through these healthy practices lowers your risk for heart disease, stroke, cancer, wrinkles and even weight gain (all while weight loss, if you’re overweight or obese, can reduces your inflammation).


Stay up-to-date on vaccines, and know it’s safe to get both a preservative-free flu shot in any trimester and the Tdap vaccination (tetnus, diphtheria and pertussis) toward the end of pregnancy to cocoon you and your baby from whooping cough, which can be deadly for baby. DO get vaccinated 3 months before you try to get pregnant. Vaccines prevent 20,500 infant deaths a year in the United States and other disorders such as brain dysfunction, paralysis, and even cancer in children and adults.


Lifelong Health

Lay the foundation for lifelong health in pregnancy, both for you and your child—and his or her children and grandchildren. That’s what’s so amazing about how the choices you make in your own health can long-term effects on the health of your children. Once you see those effects in person, you’ll really see why it’s so important to start this process with this end goal in mind. But there is even more good news!


If the 5 numbers aren’t normal for you now, forgive yourself and change course: You do get a 2nd chance. You can reverse health problems associated with inactivity, overeating, addictions, depression, much of your genetics, and most anything else. You can live life with high energy and happiness no matter the nature of your health concern. No matter how long you’ve had it. No matter what kind of shape you’re in right now. No matter what you’ve tried in the past.


You can have a Do-Over. You deserve a Do-Over. So reach for those 5 normals. You will feel much better, and taking time to get to normal is really showing love for those you care most about. You’ll be there to care for them rather than they having to care for you.


Michael F. Roizen, MD, is a professor of internal medicine and anesthesiology, Chief Wellness Officer, and Chair of the Wellness Institute at the Cleveland Clinic. Read more about the 5 normals in his new book, This Is YOUR Do-Over. Mehmet C. Oz, MD, is a professor and vice chairman of surgery, as well as director of the Cardiovascular Institute and Integrated Medical Center, at New York’s Presbyterian-Columbia University. His Doctor Oz show has won 5 consecutive Emmys.

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