I must seem a little obsessed with longevity!
It is not that I wish to live forever, but rather I want to live a good quality of life for as long as possible, and measures of longevity translate into health span as well as life span.
So, I am always on the lookout for data that might aid this process.
So what are the six blood tests that have predictive qualities when it comes to avoiding the more common causes of chronic ill health and shortened lifespan?
Well, we of course include a number of tests that help measure risk of things like diabetes and heart disease in our standard well-person checks.
ApoB is a protein carried by all atherogenic (artery furring) particles, including LDL, which we routinely test and VLDL, IDL and Lp(a) which we do not. Although non-HDL, which we can test, gives an estimate of some of these markers, ApoB is the more accurate test and is not included in a routine lipid profile.1 Longevity clinicians aim for much tighter control of lipids than is routinely recommended by cardiologists. (£90)
Lipoprotein (a) is a LDL like particle and your level is governed by your genes inherited by your parents.2 It increases the risk of clots and of furring of the arteries and is independent of LDL/ApoB.3 It is not easy to lower but does signify the need to keep LDL/ApoB at ultralow levels. Drugs may be coming that can lower Lp (a)4 (£70).
Fasting insulin can be measured in addition to the usual HbA1c or glucose when assessing risk of future diabetes and metabolic syndrome ( a triad of obesity, high blood pressure, diabetes that increases risk of heart disease) Fasting insulin can give an early warning of metabolic syndrome or diabetes even where glucose markers are normal.5 This can allow measures to be taken to reduce this risk. (£110 and must be fasting)
HsCRP is different from CRP which is often routinely measured to look for inflammation. HsCRP is a marker for silent inflammation, wearing tissues and arteries. It detects low levels associated with long term heart disease and stroke risk.6 (£70)
Homocysteine is an amino acid made and removed by your body with the use of vitamin B12 and folic acid. High levels are associated with increased heart and stroke risk and with decline in mental function.7 This test is difficult to perform as it must be done at the London laboratory. If you have adequate B12 and folic acid levels, you are unlikely to have raised levels. (£120)
Gamma GT is a liver enzyme we routinely test for in a liver function test. It is a marker for excess alcohol intake and liver disease, but it can also be seen as a marker for oxidative stress, the cellular wear and so is associated with a greater heart disease and all-cause mortality risk.8 It can also rise with alcohol intake, certain drugs, weight gain, and a fatty liver, so results need to be taken in context.(£36)
What is the kettlebell routine that has been shown to improve the markers associated with aging?
Aerobic fitness and grip strength predict early death even better than most blood tests.9 A large study of people sent for cardiac testing found that those with the lowest level of fitness had five times the risk of death that the fittest of the group tested.10 Low grip strength, a measure of general strength is similarly associated with a much higher risk of death.11
The kettle bell routine performed in short, hard intervals, reduced CRP, improved grip strength, increased the number of sit to standing from a chair in 30 seconds, lowered resting heart rate (a good thing) and improved a measured walking distance in a set time.12
Your Kettlebell Routine
A five minute warm up of hip hinges, glute bridges and light goblet squats, if the terms are unfamiliar a quick Google will show you how to do them.
A 12 minute circuit, three rounds of the following with 90 seconds between rounds;
A two hand kettlebell swing 12-15 reps
A Goblet squat 10-12 reps
Romanian or sumo deadlift 10-12 reps
Bent over rows 10 reps each side
This can be followed by an optional 3 minute cardio finisher, 2 hand kettlebell swings for 30 seconds followed by 30 seconds of rest, repeated three times.
Then a 3 minute cool down.
Start with light kettle bells and ensure your form is good, compare yourself to the expert in the video.
It is daunting at first but the rewards are enormous. If you are uncertain if you are fit enough to start, you can always book a check up with us first
Stay fit
Dr Allan Fox
All prices quoted correct at the time of publishing, for up to date prices please see our Fees Page.
- Sniderman AD, et al. “ApoB, LDL-C, and non-HDL-C as markers of cardiovascular risk.” Journal of Clinical Lipidology, 2025. A systematic review of 15 discordance studies (593,354 participants) found ApoB outperformed LDL-C in 9 of 9 comparisons. https://www.lipidjournal.com/article/S1933-2874(25)00315-0/abstract – See also Marston NA, et al. “Physiological Bases for the Superiority of Apolipoprotein B…” JAHA, 2022. https://www.ahajournals.org/doi/10.1161/JAHA.122.025858 [↩]
- Twin studies show Lp(a) is one of the most strongly genetically determined traits in human biology, with heritability estimates of 90–98% – far higher than for LDL cholesterol, which is much more diet- and lifestyle-responsive. Boomsma DI, et al. “Lipoprotein(a): relation to other risk factors and genetic heritability. Results from a Dutch parent-twin study.” Atherosclerosis, 1993 (heritability 93% in females, 98% in males). https://www.sciencedirect.com/science/article/abs/pii/002191509390047X – See also Austin MA, et al. “Lipoprotein(a) in women twins: heritability and relationship to apolipoprotein(a) phenotypes.” American Journal of Human Genetics, 1992. https://pubmed.ncbi.nlm.nih.gov/1415225/ [↩]
- Willeit P, et al. “Independence of Lipoprotein(a) and Low-Density Lipoprotein Cholesterol–Mediated Cardiovascular Risk: A Participant-Level Meta-Analysis.” Circulation, 2024 -based on 27,658 participants across six statin trials. https://pmc.ncbi.nlm.nih.gov/articles/PMC11771346/ [↩]
- As of mid-2026, several Lp(a)-lowering drugs are in Phase 3 outcomes trials, with reductions in Lp(a) of up to 95%. None is yet approved for clinical use. Tweneboah C, et al. “Lowering of Lipoprotein(a) with Olpasiran.” Cardiovascular & Hematological Disorders – Drug Targets, 2026. https://pubmed.ncbi.nlm.nih.gov/41879443/ – See also the registered Phase 3 outcomes trial for pelacarsen: ClinicalTrials.gov, “Lp(a) HORIZON,” NCT04023552, https://clinicaltrials.gov/study/NCT04023552, and for olpasiran: ClinicalTrials.gov, “OCEAN(a)-Outcomes,” NCT05581303, https://clinicaltrials.gov/study/NCT05581303 [↩]
- “Hyperinsulinemia: an early biomarker of metabolic dysfunction,” PMC. https://pmc.ncbi.nlm.nih.gov/articles/PMC10186728/ [↩]
- Ridker PM. “C-Reactive Protein and the Prediction of Cardiovascular Events Among Those at Intermediate Risk.” Journal of the American College of Cardiology, 2007. HsCRP is an established independent predictor of myocardial infarction and stroke, including in people with normal LDL. https://www.sciencedirect.com/science/article/pii/S0735109707011187 [↩]
- Homocysteine, Vitamin B12 and Folate Level: Possible Risk Factors in the Progression of Chronic Heart and Kidney Disorders. PMC, 2023. https://pmc.ncbi.nlm.nih.gov/articles/PMC10494275/ -Note: evidence for the cognitive-decline link specifically is somewhat more mixed across prospective studies than the cardiovascular link. [↩]
- Mason JE, et al. “Gamma-Glutamyl Transferase: A Novel Cardiovascular Risk Biomarker.” Preventive Cardiology, 2010. GGT was associated with an 18% per-quartile increase in cardiovascular event risk and a 26% per-quartile increase in all-cause mortality, independent of its role as a liver/alcohol marker. https://pubmed.ncbi.nlm.nih.gov/20021625/ [↩]
- Leong DP, et al. “Prognostic value of grip strength: findings from the Prospective Urban Rural Epidemiology (PURE) study.” The Lancet, 2015 (155,722 participants, 21 countries) – grip strength was a stronger predictor of all-cause and cardiovascular mortality than systolic blood pressure. https://www.sciencedirect.com/science/article/abs/pii/S0140673614620006 [↩]
- Mandsager K, et al. “Association of Cardiorespiratory Fitness With Long-term Mortality Among Adults Undergoing Exercise Treadmill Testing.” JAMA Network Open, 2018. In this cohort of 122,007 patients, those in the lowest fitness group had roughly 5 times the mortality risk of the fittest group (HR 5.04). https://pmc.ncbi.nlm.nih.gov/articles/PMC6324439/ [↩]
- See Leong et al., The Lancet, 2015, cited above. [↩]
- American Physiological Society, “Kettlebell Training May Help Maintain Muscle Strength in Older Adults,” November 21, 2024. https://www.physiology.org/detail/news/2024/11/21/kettlebell-training-may-help-maintain-muscle-strength-in-older-adults [↩]



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