⚙️ The score

Your daily health score is out of 100. It's the sum of weighted sub-scores. Categories with no data today fall back to your last 7-day average so a missed measurement doesn't crater the score.

🩺 Vitals

Blood pressure. ACC/AHA classification: optimal <120/80, elevated 120–129/<80, stage 1 hypertension 130–139 or 80–89, stage 2 ≥140 or ≥90. Persistently raised BP is the single biggest modifiable driver of stroke and CV mortality. Ettehad et al. (Lancet 2016) meta-analysis: every 10 mmHg drop in systolic BP yields ~20% lower coronary heart disease and ~27% lower stroke risk. Day-to-day variability of 5–10 mmHg is normal — judge trends, not single readings.

Resting heart rate. 50–70 bpm is associated with the lowest all-cause mortality (Aune et al. 2017 meta-analysis, n > 1.2M). RHR rising over weeks often signals reduced fitness, illness, or chronic stress.

SpO₂. ≥95% is normal at sea level. Persistent <92% needs clinical evaluation.

Fasting glucose. <5.6 mmol/L (100 mg/dL) normal; 5.6–6.9 pre-diabetic; ≥7.0 diabetic. Post-meal spikes >10 mmol/L correlate with vascular damage even in non-diabetics (DECODE study). CGM data shows huge individual variability in glycaemic responses to identical meals (Zeevi et al., Cell 2015).

Multiple readings per day are clinically more useful than single snapshots. The app aggregates by your chosen rule (average or highest). Both have merit: highest catches outlier excursions, average smooths daily noise.

🥗 Diet

Mediterranean pattern has the strongest cardiovascular evidence base. PREDIMED (Estruch et al. NEJM 2013, 2018, n=7,447): ~30% reduction in major CV events with EVOO or nuts vs low-fat. Lyon Diet Heart Study replicated in secondary prevention. PREDIMED-PLUS extends with weight loss + exercise.

DASH (low sodium, high potassium, fruits/veg) lowers BP by ~8/4 mmHg in 8 weeks (Sacks et al. NEJM 2001) — comparable to a single first-line antihypertensive.

Fibre. Each additional 10 g/day → ~8% lower all-cause mortality (Reynolds et al. Lancet 2019). Most adults eat <15 g; aim for 25–35 g.

Protein ≥1 g/kg body weight protects muscle mass during aging and weight loss (Bauer et al., PROT-AGE 2013).

Carnivore / Keto. Can be metabolically beneficial for some, but lipid responses are highly variable — track bloods if you stay on long-term, especially LDL. The "lean mass hyper-responder" phenotype on keto can drive LDL above 200 mg/dL.

Vegan / vegetarian with whole foods is comparably protective to Mediterranean. Watch B12, iron, zinc, omega-3 — supplement if needed.

📋 Dietary patterns

What each type means in this app — typical macro split (% of calories) plus the evidence behind it. The macros-mode "Closest dietary pattern" suggester uses these as reference points.

Vegetables, fruit, whole grains, legumes, fish, nuts, olive oil; modest dairy and red wine; little red meat or refined sugar. Strongest evidence base for cardiovascular and metabolic health (PREDIMED 2013/2018, Lyon Heart, PREDIMED-PLUS).

No meat or fish; eggs and dairy allowed. Whole-food versions show CV and longevity benefits comparable to Mediterranean (Adventist Health Studies, EPIC-Oxford). Watch B12, iron, omega-3.

No animal products at all. Lowest LDL on average; lowest CVD/T2D risk in some cohorts. Requires deliberate B12 (always supplement), plus attention to iron, zinc, EPA/DHA, vitamin D.

Carbs typically <50 g/day; body shifts to ketone production. Strong for weight loss, glucose control, epilepsy. Variable lipid response — some develop very high LDL ("lean mass hyper-responder"). Track bloods regularly if long-term.

Animal foods only — meat, fish, eggs, sometimes dairy. Limited long-term studies; anecdotally helpful for autoimmune symptoms. Concerns: zero fibre, high saturated fat, no plant polyphenols. Bloodwork is essential.

Meat, fish, eggs, vegetables, fruit, nuts, seeds; excludes grains, legumes, dairy, refined sugar. Modest CV benefit in trials, similar to Mediterranean over 6–12 months.

Typical Western/UK diet: bread, pasta, rice, some vegetables, mixed protein, moderate processed food. Not bad, not great. Most people sit here by default.

Heavily processed: fried items, sugary drinks, refined carbs, low fibre. Strongly linked to weight gain, CVD, T2D, and (in cohort studies like NutriNet-Santé) cancer risk. The score penalises this pattern.

Full 24-hour fast. Triggers ketosis, autophagy markers, and improvements in insulin sensitivity. Sustainable for some as alternate-day or 24h-once-weekly; not usually appropriate daily.

☕ Coffee & caffeine

One of the most-studied dietary exposures. Poole et al. (BMJ 2017) umbrella review of 218 meta-analyses: 3–4 cups/day is associated with the largest reduction in all-cause mortality (~17%), CVD, type 2 diabetes, Parkinson's, Alzheimer's, several cancers, and liver disease.

Mechanisms: chlorogenic acids (polyphenols), modest insulin sensitisation, mild thermogenesis, plus caffeine.

Caveats:

• Acute BP rise: 5–10 mmHg, 1–3 hours post-cup. Diminishes with regular use.
• Sleep impact: caffeine ≤6h before bed reduces total sleep time by ~1 hour (Drake et al. JCSM 2013). Half-life ~5h average, 2–12h based on CYP1A2 genetics.
• Filter coffee preferred for cholesterol — espresso/French press contain cafestol/kahweol that raise LDL.
• >6 cups/day shows no extra benefit and may impair sleep, anxiety, BP load.

Score: 1–3 cups/day = small bonus, 0 or 4–5 = neutral, 6+ = small penalty.

🧠 Mental health

Chronic psychological stress sits alongside smoking, lipids, and diabetes as a top-tier modifiable cardiovascular risk factor — INTERHEART (Yusuf et al. Lancet 2004, n=29,972 across 52 countries) ranked it among the top 9 predictors of first MI.

Mechanism. Sustained cortisol → BP up, glucose up, visceral fat up, sleep down, immune down. Stress directly correlates with HRV, BP variability, and HbA1c trajectory.

Meditation / MBSR. 8-week mindfulness-based stress reduction lowers systolic BP by ~4–5 mmHg (Hughes et al. 2013 meta-analysis), comparable to a low-dose antihypertensive. Improves sleep and HRV.

Social connection matters as much as exercise — Holt-Lunstad et al. (2010, 2015) found social isolation as strong a mortality risk factor as smoking 15 cigarettes/day.

This app captures mood (1–5), stress (1–5), and a meditation flag. Reports correlate these with BP, glucose, and sleep so the connection shows up in your own data.

🏃 Exercise

Steps. Paluch et al. Lancet Public Health 2022 meta-analysis (n=47k): mortality reduction plateaus around 7,500 steps/day for adults ≥60 and 10,000 for younger. Below 4,000 steps, mortality risk rises sharply.

Cardiorespiratory fitness (VO₂max) is among the strongest mortality predictors. Mandsager et al. JAMA Network Open 2018 (n=122k): elite vs low fitness was a 5× mortality difference — larger than smoking or diabetes.

Resistance training independently lowers all-cause mortality (~10–17% reduction, Stamatakis et al. 2017). Sarcopenia after 50 accelerates frailty; muscle is protective.

WHO target: ≥150 min moderate or ≥75 min vigorous activity per week, plus 2 days resistance training.

😴 Sleep

Sleep is upstream of almost everything else. Spiegel et al. (Lancet 1999) showed sleep restriction to 4h for 6 nights dropped glucose tolerance by ~40% — a single bad week induced pre-diabetic physiology in healthy young men. Cappuccio et al. (Sleep 2010) meta-analysis: <6h sleep → 12% increased mortality.

One bad night raises next-day BP, hunger hormones (ghrelin↑, leptin↓), and inflammation. Sleep quality (architecture, awakenings) matters as much as duration.

This app accepts a 0–100 score from any tracker (Oura, Whoop, Apple Health, Garmin, Fitbit, Sleep Cycle) and normalizes it.

⏱️ Fasting

14–16h time-restricted eating windows improve insulin sensitivity, lipid markers, and produce modest weight loss in most randomised trials (Wilkinson et al. Cell Metab 2020). Mechanism: improved metabolic flexibility, reduced postprandial insulin exposure.

Longer fasts (24h+) trigger autophagy in animal models — clearer in mice than humans. Daily long fasts can be counterproductive in lean, active people or those with poor sleep (cortisol elevation cancels benefit).

The score caps at 16h — diminishing returns and risk of hormesis flipping into chronic stress beyond that.

⚖️ Body composition

Day-to-day weight swings are mostly water and glycogen — a single high-carb meal can shift +1–2 kg without any fat change. The score uses 7-day rolling averages.

Visceral fat (deep abdominal type) is the strongest body-composition CV/metabolic predictor. Waist:hip >0.9 (men) or >0.85 (women) flags it.

Muscle mass is protective with age — sarcopenia after 50 doubles fall and frailty risk. Resistance training + protein ≥1 g/kg defends against it (Cruz-Jentoft et al. 2010).

Body water %. Normal range ~50–65%, varies by sex and body fat. Sudden drops can indicate dehydration; sudden rises water retention or sodium load.

💊 Medications & supplements

Tracked, but not part of the daily score by default. Skipping a dose won't dock your number — instead, the Reports tab correlates each medication and supplement with your actual vitals (BP, glucose, weight, etc.) so you can see how taking or skipping it affects what it's meant to affect.

Medications and supplements are tracked separately. Both group by timing slot (Morning, Midday, Evening, Night, PRN). Tap a slot to log everything in it at once, or expand to tick individual items if one was missed.

🧪 Blood markers

Blood markers complement the daily score — slow-moving but they capture what daily metrics can't:

• LDL-C: causal in atherosclerosis (Ference et al. Eur Heart J 2017). Lower is better; no real "floor" in healthy adults.
• HbA1c: 3-month glucose average. 5.7–6.4% (39–47 mmol/mol) pre-diabetic; ≥6.5% diabetic.
• HDL-C: higher generally protective but the relationship is non-linear at extremes.
• Triglycerides: track carb sensitivity. <1.7 mmol/L target.
• Vitamin D (25-OH): optimal 75–125 nmol/L; majority of populations deficient in winter.
• TSH: 0.4–4.0 mIU/L. High = hypothyroidism (fatigue, weight gain, cold intolerance).
• CRP (high-sensitivity): <1 low CV risk; >3 high. Tracks systemic inflammation.
• Ferritin: storage iron. Low = deficiency. >300 may flag metabolic dysfunction or hereditary haemochromatosis.
• eGFR: kidney function. Drops <60 = chronic kidney disease.
• ALT / AST: liver enzymes. Elevated suggests fatty liver or alcohol load.

🔗 How metrics interact

Single metrics tell only part of the story. The Reports tab surfaces these well-evidenced combinations:

• High carbs + sedentary → glucose excursions ~2× larger than either alone. A walk after a carb-heavy meal blunts this dramatically.
• Poor sleep + high stress → cortisol-driven BP and glucose spikes the next day.
• Skipped antihypertensive + high sodium → BP risk multiplies.
• Mediterranean diet + regular exercise → strongest combined CV protection in trials (PREDIMED-PLUS).
• Exercise + good sleep → compounded insulin-sensitivity gains.
• Fasting + poor sleep → cortisol up, recovery down, often cancels fasting benefit.
• Skipped statin + saturated-fat-heavy day → noticeable LDL impact within weeks.
• Alcohol + poor sleep → mutually reinforcing; alcohol fragments sleep architecture even at low doses.
• Low fibre + low water → glycaemic spikes worsen, plus GI issues.

After ~14 days of data, the Reports tab will start showing which of these combinations actually move your score the most.

📊 Reading the effect bars

For each habit, intervention, diet type, and medication, Reports shows your average score on days that factor was present vs absent. The bigger the gap, the more it matters for you. Values with fewer than 3 occurrences are hidden — too noisy to trust.