Normal vs Optimal: Biomarkers, Longevity, and the Lifestyle That Bridges the Gap

Do you want to live longer and stay healthier?

I think a lot of us do.

But for that, we need to be doing things that reduce our risk of chronic diseases.

Risk reduction is a scale not an on-and-off switch — it’s degree-dependent.

I’m going to explain to you something precious.

Normal vs Optimal

We’ve all had a blood test and the results were in the normal reference range.

However, what’s in the normal reference range isn’t necessarily optimal.

Let me explain…

The “normal” reference range reflects where 95% of the normal population falls into.

The optimal range reflects what’s linked to the lowest risk of mortality and chronic diseases.

These two aren’t always mutually inclusive.

Being in the “normal” reference range is sometimes already linked to a higher risk of death compared to the optimal range.

Here are a few examples:

• Triglycerides are fat molecules in the blood. High triglycerides are causally linked to diabetes and metabolic syndrome. The normal range for triglycerides is below 150 mg/dL. However, it’s been found that higher triglycerides even below the 150 mg/dL level, which is considered normal, are associated with an increased risk of cardiovascular disease. Triglyceride levels above 50 mg/dL are linked to a greater risk of CVD linearly until above 200 mg/dL. So, the reference range is 150 mg/dL but anything above 50 mg/dL is already linked to a significantly higher risk of heart disease.

• Inflammation is mostly measured by hsCRP. Normal CRP levels are 0.1–3.0 mg/L. A hs-CRP value of <1.0 mg/L is considered low risk for heart disease, 1.0–3.0 mg/L moderate risk, and >3.0 mg/L high risk. A 2020 dose-response meta-analysis found that, compared to low CRP (<1 mg/L), high CRP (>3 mg/L) increased the relative risk of all-cause mortality by 75%, CVD mortality by 102%, and cancer mortality by 32%. However, a CRP of 1–3 mg/dL was already linked to a 30% higher risk for all-cause mortality and 43% higher risk for CVD mortality.

• VO2 max is also a good example. An average person’s VO2 max might be 30–45 for males and 25–35 for females. However, the lowest all-cause mortality is seen with a VO2 max above 50.

• Resting heart rate is the final example. The average person’s resting heart rate is between 60–100 and in a 2016 meta-analysis of 1.2 million people, every 10-beat increase beyond 45 beats per minute was linked to a 9% higher relative risk of all-cause mortality and 8% higher relative risk of cardiovascular disease mortality. So, a resting heart rate of 60–100 would entail a 12–45% higher risk of mortality.

I think you are starting to get the point…

You can find very similar phenomena across virtually all biomarkers — there’s the normal reference range and then there’s the optimal that’s linked to the lowest risk of heart disease and all-cause mortality.

Not everyone is going to be in the optimal range.

That’s because most people aren’t in excellent health.

They’re not following the lifestyle and dietary habits that would put them into the optimal range for the lowest mortality risk.

That’s why most people die prematurely from some sort of chronic diseases.

Centenarians and Genetics

Centenarians fit into this paradigm already — their biomarkers are not only in the reference range but also in the optimal zone.

Now, that’s mostly because of genes that enable them to have optimal biomarkers even with a suboptimal lifestyle (think the grandpa who smoked every day but still lived to 100).

But for every smoker that made it to the age of 100, there are hundreds of thousands if not millions of other smokers who died in their 60s or 70s.

As a regular person without parents or grandparents who lived over the age of 100, you would have to be more meticulous with your lifestyle and biomarkers.

That’s what I want you to take away from this — “normal” isn’t optimal.

Fundamental Blood Markers to Test Yearly

Regardless of that, testing your blood markers at least once a year is one of the most informative things you can do for your health.

If you don’t test, you don’t know if something is bad, normal, or optimal in the first place!

Here are some of the most fundamental blood markers to measure every year:

• Lipid panel (total cholesterol, LDL-c, HDL-c, triglycerides, ApoB, ApoA)
• Complete blood count (white blood cells, red blood cells, hematocrit, hemoglobin, platelets)
• Glucose markers (HbA1c, fasting insulin, glucose)
• Liver markers (ALT, AST, GGT)
• Kidney markers (eGFR, cystatin C, BUN, creatinine, albumin)
• Sex hormones (testosterone, free T, E2, SHBG)
• Thyroid markers (T3, T4, TSH)
• Vitamin D3
• Inflammation (hsCRP, homocysteine)
• IGF-1
• Iron panel (ferritin, serum iron, TIBC, transferrin saturation)
• Electrolytes (sodium, potassium, calcium, phosphorus, magnesium, bicarbonate, chloride)
• Lp(a) if you haven’t tested it ever

This is not a comprehensive list of what I would measure, but all the fundamentals are covered.

It might not be cheap, but it’s worth it. You should at least test your biggest family history risk factors i.e. blood sugar, lipids, kidneys, etc.

What Does Being Healthy Mean?

The absence of disease is important, but it’s not the same as being in the top 1% health.

This definition is closer to reality: a state of physical, mental, and social well-being, not merely the absence of disease.

So when I talk about “top 1% health,” I’m talking about all of this:

• Minimal disease risk (based on optimal labs, blood pressure, and other biomarkers)
• Physical fitness (VO2 max, strength, body composition, resilience)
• Mental health and stress resilience
• Good social health (relationships, not feeling loneliness)
• Epigenetics (how your lifestyle turns genes on/off over time)

And the key point: Health is quantifiable. You can measure it, and you can know roughly where you sit on the curve.

The Bell Curve: Why “Normal” Isn’t the Goal

Most people sit in the big middle of the bell curve: average health.

• Not overtly sick yet
• Not optimized either

However, average “normal” labs often aren’t enough.

Example: CRP (inflammation): people with CRP < 0.2 mg/L (roughly top 1%) have significantly lower heart-disease risk over the next 10–15 years than people with “normal” CRP around 1 mg/L.

So average often means “no obvious disease today,” while top 1% means “maximum risk reduction over decades.”

That’s a very different target.

Goldilocks vs “Lower Is Better”

Many biomarkers follow a Goldilocks curve:

• Too low = bad
• Too high = bad
• There’s an optimal “just enough” range

Examples: fasting glucose, HbA1c, white blood cells, vitamin D, IGF-1, muscle mass, body fat, sleep duration, and even cortisol. Too much is bad, too low is also bad.

Others are almost always “lower is better”: CRP, triglycerides, fasting insulin, homocysteine, etc. As long as they’re not pathologically low, lower is better.

Top 1% health means:

• Most of your Goldilocks markers are in the optimal band
• Most of your “lower is better” markers are at the low end of normal

You don’t have to be perfect on all of them — nobody is — but the more you stack in the right direction, the more you pull yourself into better future health.

How to Move Up: Progressive Overload for Your Health

Aging by default is regressive overload: do nothing, and almost all markers slowly get worse.

The same way progressive overload builds muscle, it also builds health:

• Start where you are
• Add challenge gradually
• Stay consistent for years, not weeks

This is what it looks like at a high level:

• Exercise:
  • At least 2–3x/week resistance training
  • At least 2–3x/week cardio (mix of Zone 2 + harder work)
• Body composition:
  • Men: roughly 10–15% body fat
  • Women: roughly 20–30%
  • Low visceral fat, reasonable waist circumference
• Sleep:
  • 7–8 hours, consistent timing, good quality
• Diet:
  • 80% whole foods
  • Adequate protein (1.2–1.6 g/kg)
  • High fiber (30–40 g+)
  • Minimal ultra-processed junk and excessive alcohol
• Mental/social:
  • Basic stress management
  • Regular meaningful social connection

You don’t have to live like a monk, but you do have to stop living like the statistical “average.”

Otherwise, you’ll get the average results.

If You Want Help Targeting the Top 1%

Most of you reading this are not at the bottom of the curve. You’re already:

• Exercising
• Trying to eat well
• Maybe tracking sleep or labs

But you might still be plateaued, overwhelmed by conflicting advice, or feeling that aging is slowly catching up.

You can figure this out alone if you’re willing to spend years reading papers, testing, and adjusting.

Or you can have someone who’s already done that work design and run the plan with you.

In any case, I can help guide you in the right direction.