Imagine you could know only 7 measures about your health.
No full-body MRI. No 200-page blood panel.
Just 7 measurements that, together, tell you as much information as possible about your overall health.
Which 7 would you choose?
I was recently asked this question, and I loved it because it’s both intellectually difficult and incredibly practical. It forces you to separate signal from noise—to ask what actually matters. What can you use?
So that’s exactly what we’re going to do!
By the end of this letter, you’ll have a 7-point report card on your health.
More importantly, I promise you’ll understand each metric—perhaps even better than your average doctor. I think I can deliver on that provocative promise. At least, I can promise you’ll have information your doctor doesn’t.
And, most importantly, how you can improve those markers to increase your chances of living a longer, healthier, and hopefully happier life.
1) Waist-to-Hip Ratio
Forget the scale. And while we’re at it, let’s put BMI to bed.
Neither tells you what you really want to know.
Waist-to-hip ratio does.
Why?
Because it isn’t simply a measure of how much fat you carry. It’s a measure of where you carry it. And body fat is like real estate: Location, Location, Location!
Location matters.
Fat around your hips and thighs is relatively metabolically benign—and can even have some beneficial hormonal functions. (One more reason I’m not proud of my congenital pancake ass. Hey, don’t laugh! It’s a serious condition! I sincerely fear hard chairs.)
The fat you should worry about is visceral fat: the fat packed inside your abdominal cavity around your organs.
Visceral fat secretes inflammatory molecules, promotes insulin resistance, and disrupts metabolism throughout the body.
That’s why higher visceral fat is associated with cardiovascular disease, dementia, and premature death.
As a case in point, here’s a little doodle drawn from an earlier letter showing just a few of the ways visceral fat impairs brain health—consistent with recent 2026 research published by investigators at Harvard and other institutions, showing that higher levels of visceral fat are tightly linked to faster brain shrinkage and poorer long-term cognitive function.
Or take cardiovascular disease.
In one large study of more than 27,000 participants across 52 countries, researchers compared different measures of obesity—including body mass index (BMI) and waist-to-hip ratio—to determine which best predicted heart attack risk.
BMI showed only a modest association, and that relationship largely disappeared after accounting for waist-to-hip ratio.
Waist-to-hip ratio, by contrast, exhibited a striking dose-response relationship: as waist-to-hip ratio increased, so too did the risk of heart attack.
Individuals in the highest quintile of waist-to-hip ratio had a ~75% increase compared with those in the lowest quintile, even after adjusting for age, sex, geographic region, and smoking status.
The authors concluded:
“Waist-to-hip ratio [was] closely (p<0.0001) associated with risk of myocardial infarction [heart attack] even after adjustment for other risk factors.”
But it gets even more interesting (and actionable) …
Visceral fat doesn’t just increase risk directly.
It also changes what other biomarkers mean.
Take Lp(a), one of the most feared cardiovascular risk factors.
Lp(a) is essentially an LDL-like particle with an extra protein attached—the apolipoprotein (a) tail—that makes it particularly sticky and more likely to contribute to plaque formation.
It’s also ~90% genetically determined.
Roughly one in four people has elevated Lp(a), and conventional wisdom says that if you’re one of them, there’s not much you can do. I’m in that group.
But I’m not worried because that’s not the full story.
Most of what we know about Lp(a) comes from populations that are metabolically unhealthy. And one of the hallmarks of metabolic dysfunction is—you guessed it—excess visceral fat.
So, researchers asked a simple question:
Does Lp(a) behave the same way in people with low vs. high weight-to-hip ratio?
In the rest of this letter for StayCurious Metabolism Premium members, we’ll dive into:
The science behind each of these 7 metrics
The optimal thresholds worth targeting
Practical tools that can improve each number.
No matter where you are on your health journey, I promise you’ll find something here that’s valuable.
So, if you’re looking for nuanced, evidence-based health content, I’d love to have you join the community that’s made StayCurious Metabolism the world’s fastest-growing premium Science Substack.
