WHAT FUNCTIONAL TESTING CAN TELL YOU ABOUT YOUR HEALTH AND RISK OF INJURY
Author: Mark Payne, Functional Medicine Practitioner at Melbourne Functional Medicine
Key takeaways:
- Functional testing reveals hidden health risks, including metabolic imbalances and inflammation, which can increase injury risk
- Testing for glucose metabolism, inflammatory markers, and oxidative stress can guide personalised strategies to improve health and reduce injury potential
- Genetic and metabolic insights from functional testing can empower you to tailor exercise, diet, and supplementation for optimal health and injury prevention
Regular exercise and an active lifestyle are key pillars of health and well-being. Combined with a nutritious diet, quality sleep, and mental balance through both activity and rest, these elements form the foundation for living a long and healthy life.
However, our bodies are not machines, they are unique living organisms, and no two are the same. So, how do you know what works best for you? What healthy strategies should you follow? And what risks should you be aware of?
In this article, we’ll discuss some of the ways functional testing can give you valuable insights into your health, including potential health risks, so you can be more informed about your choices for living long and living well.
ACTIVE PEOPLE NEED ACTIVE MUSCLES
It’s commonly accepted that as we age our muscle mass begins to decrease, as well as our muscle strength. This is often referred to as age-related sarcopenia, which was previously thought to be inevitable, with there being little that we could do about it. However, new evidence shows that maintaining metabolically active muscles is not only important for healthy ageing in both men and women, it is also achievable.
By maintaining metabolically active muscle through strength and resistance-based training, we reduce the risk of injury, as well as the risk of developing chronic and age-related illness such as obesity, cardiovascular disease, insulin resistance, and diabetes.
Underlying many of these conditions is inflammation that develops as a result of multiple factors, and is intended to repair damaged tissue. However, if this inflammation goes on for a longer period of time without resolution, it leads to the progressive breakdown of our tissues and loss of function.
CHECK GLUCOSE METABOLISM
Active muscles need energy, and the preferred form of energy for muscles is glucose, which is derived from carbohydrates. When we consume complex carbohydrates such as fruits and vegetables, our body has to work a bit harder to get the glucose, but the glucose is released more consistently, and our muscles will readily take up as much as they need.
However, if this glucose is derived from refined carbohydrates and sugars, the glucose floods our system, and our muscles can become overwhelmed by the glucose load. In response, they desensitise themselves to insulin to stem the flow of glucose. This is known as insulin resistance, which is the precursor to diabetes, and is a major contributor to weight gain and obesity.
The first step is to understand your glucose regulation. This will usually start by testing your fasting glucose and insulin levels. It is important to test both in order to assess the relationship between the amount of insulin being produced by the pancreas, and the level of glucose that remains in the blood in the fasting state. Higher range levels, even before they’re considered elevated, can be an early sign of developing insulin resistance.
In our clinic, if any of our patients show increases in fasting glucose and insulin levels, we recommend using a continuous glucose monitor (CGM). The CGM is a sensor attached to the back of your arm, which monitors your glucose continuously, 24 hours a day for 2 weeks. This test enables you to track your glucose response to diet and exercise, see where glucose spikes might be occurring, and implement effective strategies for improving glucose regulation. After collecting two weeks of data, we sit down with patients to discuss the relationship between their glucose levels, dietary choices, and physical activity, and guide them to make changes to improve their metabolic health.
Once glucose regulation improves, the muscles will begin to increase their sensitivity to insulin again. This means the muscles will start to take up more glucose, improving blood glucose levels, and ensuring the muscles have the energy they need to support an active lifestyle.
CHECK FOR INFLAMMATION
Chronic inflammation slows our muscle recovery and increases the risk of sustaining an injury. There are several tests that can tell us more about the inflammatory load on our bodies.
C-reactive protein (CRP)
CRP is what’s called an acute-phase reactant, and is produced by the liver in response to inflammation. It can be measured in the blood and is a good indicator of the presence of systemic inflammation. We can also measure CRP at very low levels through a test called highly-sensitive CRP (hsCRP). Chronic low-level inflammation underlies conditions such as cardiovascular disease and diabetes, so being able to detect it at lower levels, sooner, means we can intervene sooner to bring the inflammation under control.
Erythrocyte Sedimentation Rate (ESR)
ESR is a measure of how quickly your red blood cells settle to the bottom of the test tube. In the presence of inflammation, the red blood cells will fall faster, which is another measure of the presence of systemic inflammation.
CHECK OXIDATIVE LOAD
Whilst inflammation is an important factor to assess, in many cases oxidative stress from free radicals precedes the development of inflammation. Thereafter, inflammation increases oxidative load, thus feeding into the cycle of inflammation. Being able to test a person’s antioxidant status or oxidative load is a useful way to determine if oxidative stress is a driver for inflammation increasing the risk of injury.
It is also worth keeping in mind that exercise is a primary contributor to increased oxidative load, in particular extended cardio, or endurance-type exercise. This doesn’t mean we should avoid exercise; rather, it highlights the need to focus on a diet rich in antioxidants and consider targeted supplementation to manage rising oxidative load.
We check our oxidative load through organic acids testing. Organic acids testing is carried out on urine and measures the levels of end-metabolic chemicals excreted in urine, including those associated with oxidative stress and antioxidant metabolism.
Metabolites such as para-hydroxyphenyl lactate is a measure of oxidative stress, with higher levels indicating a need for more antioxidants. 8-hydroxy-deoxy-guanosine is another measure of oxidative stress that has been associated with an increased risk for cardiovascular disease. Both of these markers indicate the need for higher antioxidant intake with things such as vitamin C, our body’s major extracellular (outside the cells) antioxidant.
Our intracellular (inside the cells) antioxidants are just as important, and glutathione is considered to be the major intracellular antioxidant. However, glutathione is more than just an antioxidant, it is also a critical component of our body’s methylation processes. By measuring pyroglutamic acid in an organic acids test, we can indirectly assess a person’s glutathione levels to inform the need for targeted supplementation with either glutathione or its precursor N-acetyl-cysteine (NAC).
Of course, it shouldn’t all be about supplementation, it should all start with consuming a healthy diet, rich in anti-inflammatory and antioxidant foods, and ensuring we’re getting enough of the all-important macros; protein, fats, and carbohydrates.
However, this is where our genetics come into play. We don’t all metabolise and use nutrients from food in the most efficient way. For some people, vitamin D metabolism will be impaired, for others, they will need more omega-3 fats or protein, and yet others may have genetic variants that impede the function of glutathione, vitamin C, or any one of the many micronutrients the body’s need to function optimally. And the only way to know this? Test your DNA.
DISCOVER YOUR DNA PROFILE
DNA tests are relatively inexpensive, and the great news is that you only ever need to test it once, because your DNA, the genetic hand you were dealt from your parents, will never change. But that doesn’t mean you can’t do something about your genes, as your genes are not your destiny. We all have good genes we want to capitalise on, and we all have bad genes that we want to control. The trick is knowing how you can turn on the good ones, and keep the bad ones turned off, or at least offset any risk those genes might present.
A good DNA profile will give you a comprehensive nutrigenomics profile that tells you how your body deals with the macro and micronutrients. This information will guide you towards how to eat for your genotype, increasing your consumption of foods that you need more of, and reducing those foods that might be problematic for you. From this information, you can also select targeted supplements to make up the difference where it is likely that you’ll fall short of optimal levels.
Your DNA profile can also give us insights into the composition of your muscles and the type of exercise you can focus on, as well as your risk factors for injury.
- Genes related to the ACTN3 gene tell us whether your muscles are producing more of the ACTN3 protein related to Type II muscle fibres that are associated with power-lifting and explosive contractions such as sprinting. This gene is also associated with an improved response to exercise that builds muscle mass, known as muscle hypertrophy. The ACTN3 gene can also indicate your relative risk of sustaining ankle and hamstring injuries
- Other genes such as SOD2 are associated with higher levels of the powerful antioxidant superoxide dismutase, which is associated with a reduction in inflammation associated with high-intensity exercise
- COL1A1 gene codes for collagen production. Variants in this gene can increase the risk of shoulder and knee injuries, suggesting the need for increased intake of collagen peptides along with important cofactors such as vitamin C, zinc, vitamin B6, and copper
Diet, exercise, quality sleep, and a healthy mind are undeniably the foundation for living a long and healthy life, but in this day and age, with access to advanced functional testing, we no longer have to leave it up to guesswork, or a one-size-fits-all approach to health. Personalised care, informed by appropriate testing, can help you identify your strengths, weaknesses, and risks, and with this knowledge, you can be empowered to take charge of your health, avoid chronic disease, reduce your risk of injury, and ultimately live long and well.
At Melbourne Functional Medicine, we provide personalised healthcare solutions for Australians committed to optimising their health, including enhancing exercise performance. With functional testing, we can help you identify potential risks and create a tailored plan to prevent injury and improve your results. Visit optimise.mfm.au to discover how to take your performance to the next level.
