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Beyond “Normal”: Optimal Levels of Medical Parameters for Assessing Positive Health

Received: 13 June 2021     Accepted: 26 June 2021     Published: 30 June 2021
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Abstract

Background: Whereas the concept of normal levels of various parameters is extensively used in medical practice, the concept of optimal levels has not received much attention. We propose that it is time to pay attention to the optimal levels so that positive health can be measured. Objective: The objective is to define optimal levels of medical parameters as that combination which prevents the occurrence of ailments or gives strength to fight these ailments if they occur. Methods: A large number of articles and other literature was reviewed in search of medical parameters and their levels that could be considered to indicate optimal levels. Result: The optimal combination of medical parameters that prevents occurrence of ailments and gives strength to fight if an ailment occurs, is conceptually beyond the ‘normal’ levels that we use in everyday clinical practice and can be considered to indicate positive health. This is illustrated with the help of several examples after dividing the concept of positive health into five domains on the pattern of quality-of-life assessment. Conclusion: A concept of positive health has been proposed and its link to the optimal level of medical parameters is described. We plead that more efforts be made to identify the positive parameters of health, and their optimal levels that measure positive health be delineated.

Published in American Journal of Internal Medicine (Volume 9, Issue 4)
DOI 10.11648/j.ajim.20210904.12
Page(s) 166-170
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2021. Published by Science Publishing Group

Keywords

Beyond Normal, Normal Levels, Optimal Levels, Positive Health

References
[1] World Health Organization. Constitution of the World Health Organization–basic documents. 2006. Available at: https://www.who.int/governance/eb/who_constitution_en.pdf - last accessed 25 April 2021.
[2] Misselbrook D. W is for wellbeing and the WHO definition of health. Brit J Gen Practice. 2014; 64[628]:582. https://pubmed.ncbi.nlm.nih.gov/25348979/
[3] Catita M, Águas A, Morgado P. Normality in medicine: a critical review. Philos Ethics Humanit Med. 2020; 15[1]:3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7161186/
[4] Indrayan A, Sarmukaddam S. Medical Biostatistics [First Edition]. Marcel & Dekker, 2001; 164.
[5] Seligman MEP. Positive health. Applied Psychology: An International Review 2008; 57: 3-18. https://iaap-journals.onlinelibrary.wiley.com/doi/10.1111/j.1464-0597.2008.00351.x
[6] Positive Health: Researching strengths that contribute to good health and protect against illness. Available at: https://positivehealthresearch.org/ - last accessed 25 April 2021.
[7] Harden KP, Klump KL. Introduction to the special issue on gene-hormone interplay. Behav Genet. 2015; 45[3]:263–7. Epub 2015. https://pubmed.ncbi.nlm.nih.gov/25903987/
[8] Harvard Medical School. Exercising to relax. Harvard Health Publishing, 2020. Available at: https://www.health.harvard.edu/staying-healthy/exercising-to-relax - last accessed 25 April 2021.
[9] Childs CE, Calder PC, Miles EA. Diet and immune function. Nutrients. 2019; 11 [8]: 1933. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6723551/
[10] Schwimmer H, Stauss HM, Abboud F, Nishino S, Mignot E, Zeitzer JM. Effects of sleep on the cardiovascular and thermoregulatory systems: A possible role for hypocretins. J Appl Physiol [1985]. 2010; 109 [4]: 1053–63. Epub 2010. PMID: 20705949. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5243202/
[11] Thompson AE. The Immune System. JAMA. 2015; 313 [16]: 1686. https://jamanetwork.com/journals/jama/fullarticle/2279715
[12] National Research Council [US] Committee on Diet and Health. Diet and Health: Implications for reducing chronic disease risk. Washington [DC]: National Academies Press [US]; 1989. Available at: https://pubmed.ncbi.nlm.nih.gov/25032333/ - last accessed 25 April 2021.
[13] Greenlee H. Natural products for cancer prevention. Semin Oncol Nurs. 2012; 28 [1]: 29–44. https://pubmed.ncbi.nlm.nih.gov/22281308/
[14] Rall LC, Meydani SN. Vitamin B6 and immune competence. Nutr Rev. 1993; 51 [8]: 217–25. https://pubmed.ncbi.nlm.nih.gov/8302491/
[15] Laird E, Ward M, McSorley E, Strain JJ, Wallace J. Vitamin D and bone health: Potential mechanisms. Nutrients. 2010; 2 [7]: 693–24. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3257679/
[16] Chambial S, Dwivedi S, Shukla KK, John PJ, Sharma P. Vitamin C in disease prevention and cure: an overview. Indian J Clin Biochem. 2013; 28 [4]: 314–28. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3783921/pdf/12291_2013_Article_375.pdf
[17] Rizvi S, Raza ST, Ahmed F, Ahmad A, Abbas S, Mahdi F. The role of vitamin E in human health and some diseases. Sultan Qaboos Univ Med J. 2014; 14 [2]: e157–65. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3997530/
[18] Chandra S, Chandra RK. Nutrition, immune response, and outcome. Prog Food Nutr Sci. 1986; 10 [1–2]: 1–65. https://pubmed.ncbi.nlm.nih.gov/3097756/
[19] Prasad, A.S. Zinc in human health: Effect of zinc on immune cells. Mol Med 2008; 14:353–7. https://doi.org/10.2119/2008-00033
[20] Wang Y, Li X, Ge T, et al. Probiotics for prevention and treatment of respiratory tract infections in children: A systematic review and meta-analysis of randomized controlled trials. Medicine [Baltimore]. 2016; 95 [31]: e4509. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4979858/pdf/medi-95-e4509.pdf
[21] CDC. The role of potassium and sodium in your diet. Centers for Disease Control and Prevention. Available at: https://www.cdc.gov/salt/potassium.htm - last accessed 25 April 2021.
[22] Bhattacharya PT, Misra SR, Hussain M. Nutritional aspects of essential trace elements in oral health and disease: An extensive review. Scientifica [Cairo]. 2016; 2016:5464373. https://pubmed.ncbi.nlm.nih.gov/27433374/
[23] Schwartz ET, Holtorf K. Hormones in wellness and disease prevention: common practices, current state of the evidence, and questions for the future. Prim Care. 2008; 35 [4]: 669–705. https://pubmed.ncbi.nlm.nih.gov/18928825/
[24] Yawoot N, Govitrapong P, Tocharus C, Tocharus J. Ischemic stroke, obesity, and the anti-inflammatory role of melatonin. Biofactors. 2021; 47 [1]: 41–58. Epub 2020 Nov 2. https://pubmed.ncbi.nlm.nih.gov/33135223/
[25] Brown GM. Light, melatonin and the sleep-wake cycle. J Psychiatry Neurosci. 1994; 19 [5]: 345-53. https://pubmed.ncbi.nlm.nih.gov/7803368/
[26] Renfrew MJ, Lang S, Woolridge M. Oxytocin for promoting successful lactation. Cochrane Database Syst Rev. 2000; [2]:CD000156. https://pubmed.ncbi.nlm.nih.gov/10796158/
[27] Kumar R, Thompson JR. The regulation of parathyroid hormone secretion and synthesis. J Am Soc Nephrol. 2011; 22 [2]: 216–24. Epub 2010 Dec 16. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5546216/
[28] Nassar GN, Leslie SW. Physiology, Testosterone. [Updated 2021]. In: StatPearls. Treasure Island [FL]: StatPearls Publishing, 2021. Available at: https://www.ncbi.nlm.nih.gov/books/NBK526128/ - last accessed 25 April 2021.
[29] Dfarhud D, Malmir M, Khanahmadi M. Happiness & health: The biological factors- systematic review article. Iran J Public Health. 2014; 43 [11]: 1468–77. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4449495/
[30] Berger M, Gray JA, Roth BL. The expanded biology of serotonin. Annu Rev Med. 2009; 60: 355–66. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5864293/
[31] Sprouse-Blum AS, Smith G, Sugai D, Parsa FD. Understanding endorphins and their importance in pain management. Hawaii Med J. 2010; 69 [3]: 70–1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3104618/
[32] Shinya H. The Enzyme Factor. Millichap Books, 2010.
[33] Haug A, Høstmark AT, Harstad OM. Bovine milk in human nutrition--a review. Lipids Health Dis. 2007; 6:25. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2039733/
[34] Ciccocioppo F, Lanuti P, Centonze D, Miscia S, Marchisio M. The link among neurological diseases: Extracellular vesicles as a possible brain injury footprint. Neurosignals. 2019; 27 [1]: 25–39. https://www.neuro-signals.com/Articles/000116/
[35] NICHD. What does the nervous system do? Eunice Kennedy Shriver National Institute of Child Health and Human Development. 2018. Available at: https://www.nichd.nih.gov/health/topics/neuro/conditioninfo/functions - last accessed 25 April 2021
[36] Olsson B, Lautner R, Andreasson U, et al. CSF and blood biomarkers for the diagnosis of Alzheimer's disease: A systematic review and meta-analysis. Lancet Neurol. 2016; 15 [7]: 673–84. Epub 2016 Apr 8. https://pubmed.ncbi.nlm.nih.gov/27068280/
[37] Korfias S, Stranjalis G, Papadimitriou A, et al. Serum S-100B protein as a biochemical marker of brain injury: a review of current concepts. Curr Med Chem. 2006; 13 [30]: 3719–31. PMID: 17168733. https://pubmed.ncbi.nlm.nih.gov/17168733/
[38] Polich J, Kok A. Cognitive and biological determinants of P300: an integrative review. Biol Psychol. 1995 Oct; 41 (2): 103-46. doi: 10.1016/0301-0511(95)05130-9. https://pubmed.ncbi.nlm.nih.gov/8534788/
[39] Boulware DR, Hullsiek KH, Puronen CE, et al.; INSIGHT Study Group. Higher levels of CRP, D-dimer, IL-6, and hyaluronic acid before initiation of antiretroviral therapy [ART] are associated with increased risk of AIDS or death. J Infect Dis. 2011; 203 [11]: 1637–46. https://pubmed.ncbi.nlm.nih.gov/21592994/
[40] Rosano C, Marsland AL, Gianaros PJ. Maintaining brain health by monitoring inflammatory processes: a mechanism to promote successful aging. Aging Dis. 2012; 3 [1]: 16–33. Epub 2011 Sep 30. https://pubmed.ncbi.nlm.nih.gov/22500269/
[41] Indrayan A. Aleatory and epistemic uncertainties can completely derail medical research results. J Postgrad Med. 2020; 66 [2]: 94–8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7239410/
Cite This Article
  • APA Style

    Abhaya Indrayan, Gayatri Vishwakarma, Sanjeev Sarmukaddam, Saumya Verma. (2021). Beyond “Normal”: Optimal Levels of Medical Parameters for Assessing Positive Health. American Journal of Internal Medicine, 9(4), 166-170. https://doi.org/10.11648/j.ajim.20210904.12

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    ACS Style

    Abhaya Indrayan; Gayatri Vishwakarma; Sanjeev Sarmukaddam; Saumya Verma. Beyond “Normal”: Optimal Levels of Medical Parameters for Assessing Positive Health. Am. J. Intern. Med. 2021, 9(4), 166-170. doi: 10.11648/j.ajim.20210904.12

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    AMA Style

    Abhaya Indrayan, Gayatri Vishwakarma, Sanjeev Sarmukaddam, Saumya Verma. Beyond “Normal”: Optimal Levels of Medical Parameters for Assessing Positive Health. Am J Intern Med. 2021;9(4):166-170. doi: 10.11648/j.ajim.20210904.12

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  • @article{10.11648/j.ajim.20210904.12,
      author = {Abhaya Indrayan and Gayatri Vishwakarma and Sanjeev Sarmukaddam and Saumya Verma},
      title = {Beyond “Normal”: Optimal Levels of Medical Parameters for Assessing Positive Health},
      journal = {American Journal of Internal Medicine},
      volume = {9},
      number = {4},
      pages = {166-170},
      doi = {10.11648/j.ajim.20210904.12},
      url = {https://doi.org/10.11648/j.ajim.20210904.12},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajim.20210904.12},
      abstract = {Background: Whereas the concept of normal levels of various parameters is extensively used in medical practice, the concept of optimal levels has not received much attention. We propose that it is time to pay attention to the optimal levels so that positive health can be measured. Objective: The objective is to define optimal levels of medical parameters as that combination which prevents the occurrence of ailments or gives strength to fight these ailments if they occur. Methods: A large number of articles and other literature was reviewed in search of medical parameters and their levels that could be considered to indicate optimal levels. Result: The optimal combination of medical parameters that prevents occurrence of ailments and gives strength to fight if an ailment occurs, is conceptually beyond the ‘normal’ levels that we use in everyday clinical practice and can be considered to indicate positive health. This is illustrated with the help of several examples after dividing the concept of positive health into five domains on the pattern of quality-of-life assessment. Conclusion: A concept of positive health has been proposed and its link to the optimal level of medical parameters is described. We plead that more efforts be made to identify the positive parameters of health, and their optimal levels that measure positive health be delineated.},
     year = {2021}
    }
    

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  • TY  - JOUR
    T1  - Beyond “Normal”: Optimal Levels of Medical Parameters for Assessing Positive Health
    AU  - Abhaya Indrayan
    AU  - Gayatri Vishwakarma
    AU  - Sanjeev Sarmukaddam
    AU  - Saumya Verma
    Y1  - 2021/06/30
    PY  - 2021
    N1  - https://doi.org/10.11648/j.ajim.20210904.12
    DO  - 10.11648/j.ajim.20210904.12
    T2  - American Journal of Internal Medicine
    JF  - American Journal of Internal Medicine
    JO  - American Journal of Internal Medicine
    SP  - 166
    EP  - 170
    PB  - Science Publishing Group
    SN  - 2330-4324
    UR  - https://doi.org/10.11648/j.ajim.20210904.12
    AB  - Background: Whereas the concept of normal levels of various parameters is extensively used in medical practice, the concept of optimal levels has not received much attention. We propose that it is time to pay attention to the optimal levels so that positive health can be measured. Objective: The objective is to define optimal levels of medical parameters as that combination which prevents the occurrence of ailments or gives strength to fight these ailments if they occur. Methods: A large number of articles and other literature was reviewed in search of medical parameters and their levels that could be considered to indicate optimal levels. Result: The optimal combination of medical parameters that prevents occurrence of ailments and gives strength to fight if an ailment occurs, is conceptually beyond the ‘normal’ levels that we use in everyday clinical practice and can be considered to indicate positive health. This is illustrated with the help of several examples after dividing the concept of positive health into five domains on the pattern of quality-of-life assessment. Conclusion: A concept of positive health has been proposed and its link to the optimal level of medical parameters is described. We plead that more efforts be made to identify the positive parameters of health, and their optimal levels that measure positive health be delineated.
    VL  - 9
    IS  - 4
    ER  - 

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Author Information
  • Department of Clinical Research, Max Healthcare, New Delhi, India

  • Department of Biostatistics, Indian Spinal Injuries Centre, New Delhi, India

  • Department of Biostatistics, BJ Medical College, Pune, India

  • Department of Clinical Research, Max Healthcare, New Delhi, India

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