If you Google ‘wellness testing’, you will be greeted by entries for thousands of clinics and providers, all offering you a barrage of tests to assess your general health. Many of these can be done at home at your leisure, and then sent off for analysis. If you wish, you can check for diabetes, heart health, kidney health, cholesterol, cortisol (for stress) and various types of cancer. You can check your gut microbiome. You can even have your genes analysed to tell you not only your geographical origin, but also your likelihood of developing particular conditions such as breast cancer.

Closer to home, your smartwatch will track how many calories you have used, what your heart rate is doing, and how many hours you have slept. You can also track your steps and hydration. Everywhere we look, there are measures of our ‘wellness’. But do they really give us useful information? And more importantly, do they help us to change our behaviour to improve health?

Understanding Wellness Testing and Tracking

What do we mean by wellness testing? And how is it different from wellness tracking?

• Wellness tracking uses a wearable device such as a smartwatch or continuous glucose monitor.

  This device is capable of monitoring and recording something on an ongoing basis. For example, a continuous glucose monitor will check your blood glucose continuously for a period of a few weeks. You can see in real time what is happening within your body. A smartwatch can record the number of steps that you take, your sleep, your heart rate and so on.

  Wellness trackers can also be used to track your fitness and activity (and there is more about this in our page on Using Fitness Trackers). However, on this page, we are talking specifically about tracking for the purposes of monitoring your health or wellness.

• Wellness testing requires the use of a blood, saliva, urine or faeces sample, which is sent off for analysis.

  You can take the sample at home or it may be done by a healthcare professional in a clinic or hospital. This is sent for analysis to check for various biomarkers or genes that may show that you either have, or may develop, particular conditions. It is possible to categorise wellness tests in several ways. For example:

• Some tests provide a general screen for health, and others are far more specific, checking for a particular condition.

• Some tests use genetic markers, and others use markers such as blood sugar or lipids. The difference is that you cannot change your genes, whereas you may be able to change biomarkers by changes in your lifestyle or diet.

• Some tests may be indicated because of your family history, and others may be a general check because of your age or lifestyle.

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Why Use Wellness Tracking and Testing?

Why should you consider using wellness tracking or testing?

The first, and most obvious answer is because you want to be and remain healthy.

You want to know what is going on with your body, so that you can do the right thing to keep it healthy. There is something to be said for this argument. Many of our Food, Diet and Nutrition pages emphasise the importance of remembering that we are all individuals, and have different responses to various foods.

However, when deciding whether a test or tracking system will be useful, you need to consider various issues. These include:

• Once you have the information, what are you going to do with it?

  This is the issue at the heart of any wellness testing decision: what will you do with the information?

  It is, for example, clear why elite athletes might want to wear a continuous glucose monitor. They need to understand their responses to food, so that they can ensure that their performance is not affected by eating the wrong thing at the wrong time. At that level of performance, athletes are looking for marginal gains: tiny tweaks that could give them that vital few seconds’ extra speed or endurance.

  It is also clear why diabetics might need to monitor their blood glucose. Their bodies are unable to do the job for them, and they need extra assistance to avoid becoming unwell.

  For most of us, however, there is no real need to know what our blood glucose is doing. Most of us don’t have the scientific training to understand what is happening—or be able to take any action.

  Similarly, why would you track your sleep? You know whether you slept well or badly. Obsessing over the result on your fitness tracker (which is only monitoring your movements, and therefore not very accurate anyway) is not going to improve anything.

  The same applies to genetic tests. First, do you understand what the results will mean? If you are told that you have a 40% chance of developing a particular condition, what does that mean in practice? More importantly, what are you going to do now? Are you going to change your behaviour? If not, why are you spending money on this?

  A wellness test or tracking is therefore only going to be worthwhile if:

  1. You understand what the results actually mean; and

  2. You will be able to use the results to make changes to your lifestyle or habits to improve your health.

  This is why these tests are generally not recommended for use as DIY options. They are only really helpful when done under the supervision of a healthcare professional. They can help you to interpret the results, and advise you whether to take any action, and if so, what action to take.

• How accurate is the test or tracking system?

  This is generally the first ‘frequently asked question’ on the website of any company selling wellness tests—because it is absolutely crucial.

  The answer, of course, is ‘it depends’ on the test, and what it measures, how carefully you take the sample, whether it could be contaminated in the taking or in the lab, and what question you have actually asked.

  Most tests have a tolerance level, which describes the changes of getting a false positive (a positive result when you are in fact negative) or a false negative (a negative result when you are in fact positive).

  This is an important value, because it shows the chances of your result being wrong. However, it doesn’t take into account your competence in taking the sample.

  Most companies will not market tests that have a high false positive value, because the outcomes can be devastating. For example, if you are having a test for the gene for a life-threatening condition, you want to be certain the result is going to be fairly accurate, because it will turn your life upside-down: you may decide not to have children, or not to bother saving into a pension if you get a positive result.

  This means that you can be reasonably confident about the results of a test for a condition controlled by a single gene, such as cystic fibrosis.

  However, most tests are about a predisposition, rather than a definitive answer. The problem here is that there are simply too many genes involved, and we know too little about how they interact with each other and with the environment, to be able to provide any definitive answers. You cannot, for example, predict which diets will help you lose weight by looking at your genes.

  This means that you are unlikely to get any useful information about lifestyle issues from this kind of testing.

  Similarly, some tracking systems are fairly inaccurate. Wrist-mounted heart rate monitors, for example, are notoriously so compared with a chest strap. The conditions may also affect accuracy: wet skin can change heart rate readings.

  You can therefore never be completely confident in the result. The real question is whether the test or tracking will give you useful information.

  Is the company reliable?

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  One further question to ask when considering tests is the reliability of the company.

  A reporter from NBC News, Maggie Fox, tested four genetic testing kits for an article. She reported that two of the companies lost her results. Even when she identified herself as a reporter, both companies stopped accepting her calls, and she received no refund until after the story was published.

  You want to be confident in the company that you choose. It’s worth looking at reviews, and searching for any negative publicity—but also checking the labs used, and the general reputation.

  It is also worth checking the quality of any recommendations in the results, especially about the use of supplements or other ‘wellness products’. If the company makes money from selling these, including via affiliate links, it has incentives to recommend additional products.

  Use a tool like consensus.app to check whether there is any scientific evidence behind the recommendations.

  You can read more in our page on Supplements.

• What does it cost?

  Wellness testing and tracking is not cheap.

  23+me’s Health and Ancestry service, for example, costs £179. It provides information about your genetic background, including your geographical origin, plus information about whether you have a predisposition to particular conditions or carry particular genes. Is doing a test just a bit of fun? Go ahead. If you are depending on the results to inform important decisions such as whether to have children, go and see your doctor, and get proper, informed advice.

  Other testing services offer a bewildering array of tests, costing anything from $50 upwards. Tracking services are similar. ZOE has an initial fee of around £300 for a test of your gut microbiome, then an ongoing membership fee for tailored advice.

  You could spend a fortune just being tested—and you might get nothing useful.

  The bottom line is that if you have genuine concerns about your health, you should talk to your doctor, and get advice about whether any tests are necessary.

  You should then consider having those tests done through the healthcare system, in high-quality laboratories. Tests like 23+me should really only be considered ‘a bit of fun’.

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A Final Thought

If we are honest, we all know the elements of a healthy lifestyle. We know that it is important to eat plenty of fresh fruit and vegetables, choose whole grains over more processed versions, and avoid ultra-processed food. We also know that exercise is important for heart and general health, and that being outside is good for both our mental and physical health.

None of us needs a wellness test or a tracker to tell us any of that—or whether we are really doing enough of any of those things. A wellness test will not provide a ‘magic bullet’ that means that you don’t have to eat well or exercise.

If you have a specific health concern, it may be worth having a test for that issue—but only if advised to do so by your doctor, who can also advise on whether any further action is needed. Otherwise, it may be best to steer clear of wellness testing, and save your money.

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