Sanna Lindqvist
56 · Stockholm · Day 30 · Complete Assessment & Design
Private and confidential. Prepared for Sanna alone.
Executive Summary
Sanna, you came to us tired in a way that felt new to you. You were waking at ten to three, losing the afternoon to a fog that lifts by evening, carrying weight around your middle that arrived with the menopause, and missing a desire that has gone quiet. A year ago a ski fall in Zermatt took your ACL, and with it the training that had always held everything together.
Thirty days later, we know why. Your body has completed its hormonal transition, and almost everything you described traces back to that shift and to the quiet year that followed the injury. These are connected patterns, and connected patterns respond to a connected plan.
The most important finding is your heart. Your coronary calcium score is 46. That is early plaque in the arteries that feed your heart, more than we see in four out of five women your age. Your heart feels completely well today, and it would likely have felt that way for many years. Oestrogen protected your arteries for five decades. That protection has now gone, your ApoB is high at 1.31 g/L, and your father had a stent at 61. This is the thread we work on first, with a preventive cardiologist alongside us.
It is also very workable. Your inherited heart risk, Lp(a), is low. Plaque at this stage responds to exactly what we can change together: ApoB, blood sugar, inflammation, fitness and sleep.
The reassurance is substantial. Your full body MRI, mammography, stool screening and skin check are all clear. Your thyroid and kidneys are excellent. Your morning cognition is in the top tier for your age, your grip and upper body strength are strong, and your friendships and sense of purpose are deep.
Five Vital Threads run through your data
The 3am Signal.
Night sweats, an early morning rise in glucose and cortisol, and evening wine converge in one hour of the night. Your low energy and low libido begin here.
Ten Years Early.
Early plaque, found while there is time to change its course.
The Shift to the Middle.
Visceral fat, liver fat and rising insulin, built by the transition and a year of stillness.
The Afternoon Fog.
A glucose crash after lunch, short sleep and low vitamin D slow your thinking by mid afternoon. With your family history, protecting your brain is part of every decision we make.
The Comeback.
Your knee, your legs, your bones and your fitness, rebuilt for the mountains.
Your system is already responding. In four weeks your 3am wakes fell from five nights a week to two. Your HRV rose from 24 to 31 ms, your afternoon glucose crash has softened, and your daily feeling score climbed from 5.8 to 7.1.
Where the year goes. Weekly refinement of your protocols. Biomarker panels every quarter. Four Recovery & Longevity retreats. Clear milestones: your first long hike in the spring, your return to the slopes next winter, and by September 2027 an ApoB under 0.8 g/L, a stable calcium score, and a body ready to ski and hike into your nineties.
Your Numbers at Day 30
Your Vital Threads Index stands at 61, with a clear path to 75 over the next twelve months.
The Vital Threads Index brings every source in this report into one number: your biomarkers, imaging, wearables, physical and cognitive assessments, and what you tell us each day. It moves when your system moves, and we track it with you weekly.
| Index | Day 30 | Month 12 target |
|---|---|---|
| Vital Threads Index | 61 | 75 |
| Physical | 58 | 74 |
| Cognitive | 68 | 78 |
| Recovery | 54 | 72 |
61
75
58
74
68
78
54
72
Biological range: 55 to 58. Built from your biomarkers, your epigenetic assessment, your physical performance and thirty days of wearable data, this places your body close to your calendar age of 56. The range matters less than its direction, and every thread in this report pulls it younger. Our aim for month 12 is a range that sits below your age.
The 8 Domains at a glance
| Domain | Grade | In one line |
|---|---|---|
| Metabolic Health | Deficit+ | ApoB, insulin, visceral and liver fat: the centre of your year |
| Sleep | Deficit+ | 6h18 a night, broken between 02:45 and 03:45 |
| Stress Regulation | Solid− | Morning cortisol at the top of range, HRV rising from a low base |
| VO2 Max | Solid− | 27.5 ml/kg/min, a year of stillness to recover |
| Nutrition and Supplements | Solid− | A good Nordic kitchen, protein and vitamin D to lift |
| Muscle Mass and Strength | Solid | Strong grip and upper body, a right leg and bones to rebuild |
| Social Connection & Purpose | Strong− | Deep friendships and meaningful work |
| Cognitive Health | Strong− | Top tier in the morning, slower by mid afternoon |
Deficit+
ApoB, insulin, visceral and liver fat: the centre of your year
Deficit+
6h18 a night, broken between 02:45 and 03:45
Solid−
Morning cortisol at the top of range, HRV rising from a low base
Solid−
27.5 ml/kg/min, a year of stillness to recover
Solid−
A good Nordic kitchen, protein and vitamin D to lift
Solid
Strong grip and upper body, a right leg and bones to rebuild
Strong−
Deep friendships and meaningful work
Strong−
Top tier in the morning, slower by mid afternoon
Grades: Deficit sits below the threshold needed for long term health and performance. Solid meets it. Strong exceeds it. Peak is among the highest for your age and gender.
What We Learned Together
Over twelve hours together this month, the clearest thing you told us is that you are the person who holds everything up, and that you want a system that holds you up in return.
These are the insights from our one on ones: your three hour epigenetic interview, the physical assessment, and the conversations in between. Each one shapes your plan as much as any lab value.
How you work
Your mornings are your best hours. You wake naturally at 05:45, think clearly until lunch, and do your most important work before noon. After lunch, which you often eat at your desk in ten minutes, the day gets harder. You described 15:00 to 17:00 as "walking through wet sand." Fifty five hour weeks, a board cycle every quarter, and regular travel to Oslo and Helsinki are part of the life you have chosen, and your plan is built to fit inside it.
How you close the day
Since your divorce nine years ago, two glasses of wine have become the way you mark the end of the day in a quiet apartment. You named this yourself, with clarity and calm. Your wearable data shows the cost: on wine nights your HRV falls 19% and your 3am wake arrives almost every time. Together we have built a new evening ritual you actually look forward to, and you already moved wine to Friday and Saturday in week two.
The mountains
You lit up talking about the Kungsleden, the long day in Chamonix, and skiing Åre with your children when they were small. The Zermatt fall last October took more than a ligament. It took the part of your identity that was always the strong one on the mountain. Since the reconstruction you stopped training regularly, and you told us you have been waiting to feel ready. Your goal is to ski and hike into your nineties, and that goal anchors every decision in this report.
Your knee
In the physical assessment your right knee showed more capacity than confidence. It held a controlled single leg squat to 60 degrees, yet you guarded every landing and shifted load to your left side. That pattern is common after ACL surgery, it is very trainable, and it explains why your right leg now carries 7% less muscle than your left.
Your mother
Your mother died of breast cancer at 51. You are now five years past the age she reached, and you described a quiet relief and a quiet fear sitting side by side. You have carried a strong hesitation about hormone therapy because of her. We heard that fully. Your plan gives you the facts, a gynaecologist who knows this history, and genetic counselling, so that the decision is yours and well informed.
Your grandparents
Both of your father's parents developed Alzheimer's in their eighties. When the afternoon fog arrives, you told us, a part of you wonders. Your cognitive results answer much of that worry: your processing speed and working memory are excellent. Protecting them for the next forty years is part of the plan, through sleep, blood sugar, training, hearing and connection. Whether to test for APOE is a conversation we will have when you choose to.
Energy and desire
You raised this yourself, with real candour. Desire has gone quiet, and you would like it back, for yourself and for whatever comes next. Your hormone panel shows why: low testosterone with a high SHBG leaves very little of it free to act. Sleep, strength training, and the conversation with your gynaecologist all touch this directly.
What you are proud of
Your friendships of thirty years, your Thursday book club, your children, now 26 and 23, and a career built on your own judgment. You have a deep well of purpose and people. That is a real asset to your health, and we will draw on it.
Your Baseline Results
Across 21 clinical tests and three Eirloom assessments, your screening is clear, and one finding, early coronary plaque, sets the direction of your year.
All biomarkers were drawn fasting on 8 September. Imaging and clinical tests followed over weeks two and three.
Heart
Your heart findings are the most important page of this report, and the most workable.
| Test | Your result | Where we want it | What it means for you |
|---|---|---|---|
| Coronary calcium score | 46 (left anterior descending artery) | 0 | Early calcified plaque. Higher than about four in five women your age. |
| ApoB | 1.31 g/L | Under 0.8 g/L | The particles that build plaque. Yours are high, and this is the number we move first. |
| LDL cholesterol | 4.4 mmol/L | Under 2.6 mmol/L | Tracks with ApoB. Rose sharply after menopause. |
| hsCRP | 2.3 mg/L | Under 1.0 mg/L | Low grade inflammation, which accelerates plaque. Linked to visceral fat and short sleep. |
| Lp(a) | 14 nmol/L | Under 75 nmol/L | Your inherited risk is low. Excellent news. |
| HDL cholesterol | 1.7 mmol/L | Over 1.2 mmol/L | Strong. |
| Triglycerides | 1.4 mmol/L | Under 1.0 mmol/L | Mildly raised, responds quickly to evening alcohol and carbohydrate changes. |
| Blood pressure (clinic) | 131/84 mmHg | Under 120/80 mmHg | Upper end. We will track it at home weekly. |
46 (left anterior descending artery)
0
Early calcified plaque. Higher than about four in five women your age.
1.31 g/L
Under 0.8 g/L
The particles that build plaque. Yours are high, and this is the number we move first.
4.4 mmol/L
Under 2.6 mmol/L
Tracks with ApoB. Rose sharply after menopause.
2.3 mg/L
Under 1.0 mg/L
Low grade inflammation, which accelerates plaque. Linked to visceral fat and short sleep.
14 nmol/L
Under 75 nmol/L
Your inherited risk is low. Excellent news.
1.7 mmol/L
Over 1.2 mmol/L
Strong.
1.4 mmol/L
Under 1.0 mmol/L
Mildly raised, responds quickly to evening alcohol and carbohydrate changes.
131/84 mmHg
Under 120/80 mmHg
Upper end. We will track it at home weekly.
A calcium score of 46 tells us plaque has begun to form, while your ApoB and inflammation tell us what is feeding it. Your low Lp(a) tells us the cause is largely within reach. Lower ApoB, lower inflammation, better insulin sensitivity and higher fitness together slow plaque growth and stabilise what is there. You will meet a preventive cardiologist in month two to decide together whether medication belongs alongside the work we do every week.
Cancer screening
Every screen is clear.
| Test | Your result | What it means for you |
|---|---|---|
| Full body MRI, head to pelvis | Clear | Clear of any sign of cancer. Mild liver fat seen (see Metabolism). One small simple kidney cyst, benign and common at your age. |
| Mammography with ultrasound | Clear | Dense breast tissue (category C). With your mother's history, you will have yearly imaging with ultrasound. |
| Home stool test (FIT) | Clear | Colon screening is up to date. |
| Dermatologist mole check | Clear | 54 moles mapped. One on your upper back photographed for comparison in twelve months. |
Clear
Clear of any sign of cancer. Mild liver fat seen (see Metabolism). One small simple kidney cyst, benign and common at your age.
Clear
Dense breast tissue (category C). With your mother's history, you will have yearly imaging with ultrasound.
Clear
Colon screening is up to date.
Clear
54 moles mapped. One on your upper back photographed for comparison in twelve months.
Metabolism and liver
Your metabolism is the engine behind three of your five threads, and it is shifting in a direction we can turn.
| Test | Your result | Where we want it | What it means for you |
|---|---|---|---|
| HbA1c | 41 mmol/mol | Under 38 mmol/mol | One point below the prediabetes range. |
| Fasting glucose | 5.8 mmol/L | Under 5.4 mmol/L | Raised. Partly driven by early morning cortisol. |
| Fasting insulin | 13 mIU/L | Under 7 mIU/L | Your body is working harder to manage glucose. Insulin resistance is building. |
| Liver fat (MRI) | About 9% | Under 5% | Mild fatty liver. Fully reversible with the changes in your plan. |
| ALT | 0.68 µkat/L | Under 0.5 µkat/L | Upper range, consistent with liver fat. |
| Thyroid (TSH, free T4) | 2.1 mIU/L, 15 pmol/L | Within range | Excellent. Your thyroid is ruled out as a cause of low energy. |
| Blood count | Within range | Within range | Healthy. |
| Continuous glucose, two 14 day sensors | Mean 6.0 mmol/L, 86% in range | Over 95% in range | Clear patterns after lunch and in the early hours. See Thirty Days of Data. |
41 mmol/mol
Under 38 mmol/mol
One point below the prediabetes range.
5.8 mmol/L
Under 5.4 mmol/L
Raised. Partly driven by early morning cortisol.
13 mIU/L
Under 7 mIU/L
Your body is working harder to manage glucose. Insulin resistance is building.
About 9%
Under 5%
Mild fatty liver. Fully reversible with the changes in your plan.
0.68 µkat/L
Under 0.5 µkat/L
Upper range, consistent with liver fat.
2.1 mIU/L, 15 pmol/L
Within range
Excellent. Your thyroid is ruled out as a cause of low energy.
Within range
Within range
Healthy.
Mean 6.0 mmol/L, 86% in range
Over 95% in range
Clear patterns after lunch and in the early hours. See Thirty Days of Data.
Hormones and bone
Your hormones confirm a completed transition, and your bones are asking for the same strength work your knee needs.
| Test | Your result | What it means for you |
|---|---|---|
| FSH | 78 IU/L | Postmenopausal. |
| Oestradiol | Under 40 pmol/L | Postmenopausal. The protection it gave your arteries, bones and sleep has gone. |
| Progesterone | Under 0.5 nmol/L | Postmenopausal. |
| Testosterone | 0.4 nmol/L | Low end of range. |
| SHBG | 72 nmol/L | High. Combined with low testosterone, very little is free to act on energy, muscle and desire. |
| DHEA S | 1.9 µmol/L | Low end for your age. |
| Morning cortisol | 560 nmol/L | At the top of range. Your stress system runs hot in the early morning. |
| DEXA bone density | Spine T score −1.6, hip −1.2 | Osteopenia at the spine. Very responsive to heavy strength training and impact. |
| DEXA body composition | Body fat 36%, visceral fat 1,120 g | Visceral fat above the 1,000 g line linked to heart and metabolic risk. |
| DEXA lean mass | ALMI 5.9 kg/m², right leg 7% below left | Close to the lower threshold, with a clear asymmetry from the injury. |
78 IU/L
Postmenopausal.
Under 40 pmol/L
Postmenopausal. The protection it gave your arteries, bones and sleep has gone.
Under 0.5 nmol/L
Postmenopausal.
0.4 nmol/L
Low end of range.
72 nmol/L
High. Combined with low testosterone, very little is free to act on energy, muscle and desire.
1.9 µmol/L
Low end for your age.
560 nmol/L
At the top of range. Your stress system runs hot in the early morning.
Spine T score −1.6, hip −1.2
Osteopenia at the spine. Very responsive to heavy strength training and impact.
Body fat 36%, visceral fat 1,120 g
Visceral fat above the 1,000 g line linked to heart and metabolic risk.
ALMI 5.9 kg/m², right leg 7% below left
Close to the lower threshold, with a clear asymmetry from the injury.
Gut and microbiome
Your gut is healthy, with room to grow its diversity.
| Test | Your result | What it means for you |
|---|---|---|
| GI Effects stool analysis | Lower diversity, low butyrate producers | Fewer of the bacteria that feed your gut lining and calm inflammation. Fibre and fermented foods rebuild them. |
| Calprotectin | 28 µg/g | A calm, healthy gut lining. |
| Digestive markers | Within range | Healthy digestion. |
| H. pylori and coeliac antibodies | Clear | Both clear. |
Lower diversity, low butyrate producers
Fewer of the bacteria that feed your gut lining and calm inflammation. Fibre and fermented foods rebuild them.
28 µg/g
A calm, healthy gut lining.
Within range
Healthy digestion.
Clear
Both clear.
Kidneys
| Test | Your result | What it means for you |
|---|---|---|
| Cystatin C | 0.88 mg/L, eGFR 86 | Excellent kidney function. |
0.88 mg/L, eGFR 86
Excellent kidney function.
Nutrition
| Test | Your result | Where we want it | What it means for you |
|---|---|---|---|
| Vitamin D | 46 nmol/L | 75 to 125 nmol/L | Low, typical of a Stockholm autumn. Linked to mood, bone and immunity. |
| Vitamin B12 | 410 pmol/L | Over 300 pmol/L | Healthy. |
| Ferritin | 58 µg/L | 50 to 150 µg/L | Healthy iron stores. |
46 nmol/L
75 to 125 nmol/L
Low, typical of a Stockholm autumn. Linked to mood, bone and immunity.
410 pmol/L
Over 300 pmol/L
Healthy.
58 µg/L
50 to 150 µg/L
Healthy iron stores.
Eirloom assessments
| Assessment | Your result | What it means for you |
|---|---|---|
| Epigenetic assessment | Three hour interview with Rob | The patterns, history and goals in What We Learned Together. |
| Physical assessment | Grip 29 kg (Strong), 11 full push ups (Strong), dead hang 38 s (Strong), 30 second sit to stand 14 (Solid), single leg balance left 30 s, right 14 s (Deficit) | A strong upper body and a right leg waiting to catch up. |
| VO2 max test | 27.5 ml/kg/min | Solid for your age. We expect 31 or more within a year. |
| Cognitive assessment, taken at 09:30 and 15:30 | Processing speed and working memory Strong. Reaction time 14% slower at 15:30. | An excellent brain, with an afternoon dip we can trace and fix. |
Three hour interview with Rob
The patterns, history and goals in What We Learned Together.
Grip 29 kg (Strong), 11 full push ups (Strong), dead hang 38 s (Strong), 30 second sit to stand 14 (Solid), single leg balance left 30 s, right 14 s (Deficit)
A strong upper body and a right leg waiting to catch up.
27.5 ml/kg/min
Solid for your age. We expect 31 or more within a year.
Processing speed and working memory Strong. Reaction time 14% slower at 15:30.
An excellent brain, with an afternoon dip we can trace and fix.
The Path Forward
The next eleven months run in four phases, starting with your heart and your nights, building to the slopes in February and ending on the Kungsleden in August.
Your protocols refine every week as your data comes in. Your biomarkers are retested every quarter. Rob works alongside you throughout, with weekly bodywork at home and four Recovery & Longevity retreats planned around the mountains.
Eleven months from your heart to the Kungsleden
Foundation
1 Oct 2026 to 30 Nov 2026
Build
1 Dec 2026 to 28 Feb 2027
Expand
1 Mar 2027 to 31 May 2027
Consolidate
1 Jun 2027 to 30 Sep 2027
Refined every week from your data
1 Oct 2026 to 30 Sep 2027
Cardiologist
20 Oct 2026
Gynaecologist, genetics
17 Nov 2026
Return to sport test
19 Jan 2027
Quarterly panel
8 Dec 2026
Quarterly panel
9 Mar 2027
Quarterly panel
8 Jun 2027
Full reassessment
14 Sep 2027
Mallorca
12 Nov 2026
Åre, back on skis
18 Feb 2027
Dolomites
20 May 2027
Kungsleden
19 Aug 2027
Your week
| Rhythm | What it holds |
|---|---|
| Every day | Polar Loop and Withings sync to your portal. A two minute check in: energy, sleep, mood, night sweats. Ten minute walks after lunch and dinner. |
| Every week | Sessions with Rob. Your protocols refined from the week's data. Bodywork at home. Three strength sessions, two to three steady cardio sessions. |
| Every month | A review of your Vital Threads Index and each thread's direction. |
| Every quarter | A full biomarker panel, a repeat of the 14 day glucose sensor, and a written update to this report. |
Polar Loop and Withings sync to your portal. A two minute check in: energy, sleep, mood, night sweats. Ten minute walks after lunch and dinner.
Sessions with Rob. Your protocols refined from the week's data. Bodywork at home. Three strength sessions, two to three steady cardio sessions.
A review of your Vital Threads Index and each thread's direction.
A full biomarker panel, a repeat of the 14 day glucose sensor, and a written update to this report.
Phase one · October to November · Foundation
Focus: your heart, your nights, your knee.
Heart.
Fibre to 35 g a day, oily fish three times a week, saturated fat reduced, and psyllium with your two largest meals. Preventive cardiologist in October to review ApoB and decide together on medication.
Nights.
A cool bedroom at 17°C, a cooling mattress and bedding, a fixed wake time of 06:00, wine on Friday and Saturday only, and a new evening ritual built with Rob. Gynaecologist in November, who knows your mother's history, to lay out every option for night sweats, sleep and desire.
Knee and strength.
A physiotherapist leads your knee programme from week five, with Rob building the rest of your strength around it. Three sessions a week, with the right leg trained first and longest.
Fuel.
Protein to 100 g a day, starting at breakfast. Lunch away from your desk, protein and vegetables first. Vitamin D3, omega 3 and creatine from The Eirloom Selection.
Genetic counselling
for BRCA in November, given your mother's history.
Retreat one, Mallorca, November.
Coastal hiking, sleep reset, and four days of eating the way your plan describes.
Phase two · December to February · Build
Focus: strength, fitness, the return to snow.
First quarterly panel, December.
ApoB, HbA1c, insulin, hsCRP and vitamin D. Your plan adjusts to what moved.
Heavier strength work
and, once your knee is cleared, impact training for your bones.
One interval session a week
added to your steady cardio, to lift VO2 max.
Return to sport testing, January.
Strength, hop and balance tests with your physiotherapist decide when you ski.
Retreat two, Åre, February.
Your first runs since Zermatt, with a ski instructor, short days and full recovery.
Phase three · March to May · Expand
Focus: distance, metabolism, your brain.
Second quarterly panel, March.
By now we expect ApoB and insulin well on their way to target.
Hiking volume builds:
weekend hikes in Tyresö and Skärgårdsleden, rising to 20 km days.
Your afternoon
protected by the lunch, light and movement pattern we will have refined over six months.
Retreat three, the Dolomites, May.
Your first multi day hike.
Phase four · June to September · Consolidate
Focus: making it yours for the long run.
Third quarterly panel, June.
Retreat four, Abisko and the Kungsleden, August.
The trail you told us about, walked again.
Your full reassessment, September 2027.
Biomarkers, DEXA, VO2 max, cognitive assessment, liver imaging and 14 days of glucose, brought together in your second Vital Threads Report.
Where we aim to be in September 2027
| Marker | Today | Target |
|---|---|---|
| Vital Threads Index | 61 | 75 |
| ApoB | 1.31 g/L | Under 0.8 g/L |
| HbA1c | 41 mmol/mol | Under 38 mmol/mol |
| Visceral fat | 1,120 g | Under 850 g |
| Liver fat | About 9% | Under 5% |
| VO2 max | 27.5 ml/kg/min | 31 or more |
| Right leg lean mass | 7% below left | Within 3% |
| Sleep | 6h18, wakes most nights | 7h or more, one wake a week or fewer |
| HRV | 27 ms | 35 ms or more |
| Spine bone density | T score −1.6 | Stable or improving |
| Mountains | Last skied October 2025 | Skiing Åre, hiking the Kungsleden |
61
75
1.31 g/L
Under 0.8 g/L
41 mmol/mol
Under 38 mmol/mol
1,120 g
Under 850 g
About 9%
Under 5%
27.5 ml/kg/min
31 or more
7% below left
Within 3%
6h18, wakes most nights
7h or more, one wake a week or fewer
27 ms
35 ms or more
T score −1.6
Stable or improving
Last skied October 2025
Skiing Åre, hiking the Kungsleden
In Your Words
You checked in on every one of your first 30 days, and what you told us lines up with your data almost exactly.
What you told us at the start
“I'm fine. I'm just tired in a way that feels new.”
“I wake at ten to three, hot, and my brain starts the workday.”
“By three in the afternoon I'm reading the same email twice.”
“My clothes fit differently and I eat exactly the same.”
“I've always been the strong one on the mountain. I'd like to be her again.”
“I want to ski and hike into my nineties. Properly. With my grandchildren, if I'm lucky enough to have them.”
Where you placed yourself on day one
| You rated | Out of 10 |
|---|---|
| Energy | 4 |
| Sleep quality | 3 |
| Afternoon focus | 4 |
| Desire | 3 |
| Confidence in your body | 5 |
| Sense of purpose | 9 |
| Closeness to people you love | 8 |
Energy
Sleep quality
Afternoon focus
Desire
Confidence in your body
Sense of purpose
Closeness to people you love
How you felt, day by day
How you feel each day has risen week on week
Your lowest days followed broken nights. Your best days came in the final week, after four consecutive nights of unbroken sleep.
What your check ins showed
| Week | Night sweats | 3am wakes | Wine nights | Afternoon energy |
|---|---|---|---|---|
| Week one | 5 nights | 5 | 4 | 4.2 |
| Week two | 4 nights | 4 | 2 | 4.9 |
| Week three | 3 nights | 3 | 2 | 5.6 |
| Week four | 2 nights | 2 | 2 | 6.4 |
5 nights
5
4
4.2
4 nights
4
2
4.9
3 nights
3
2
5.6
2 nights
2
2
6.4
From your journal
“Woke at 02:50 again. Second glass last night. I can see the pattern now. Time to change it.”
“Walked after lunch instead of the second coffee. Made it to five o'clock with a clear head. First time in months.”
“Single leg squats with the physio. The right leg shakes, but it holds. I cried a little in the car. Good tears.”
“Slept through. Woke at 06:00 and thought it was a mistake.”
What your words and your data say together
Your 3am wakes in your journal match your Polar data on 13 of 14 nights. Every night you logged two glasses of wine, your HRV the next morning was lower. Your best afternoons followed a walk after lunch, and your continuous glucose sensor shows why. Your instinct about your own body is accurate, and it is one of the most useful tools we have.
Your Vital Threads
Five threads connect everything we measured, and the second, your heart, sets the priority for the year.
A Vital Thread is a pattern that runs across several sources at once: a biomarker, a night of wearable data, a sentence in your journal, a moment in a session with Rob. Each thread is specific to you. Each is graded by the strength of the research behind the plan we attach to it, and each has the numbers that will tell us it is moving.
The 3am Signal
Your nights, your energy and your desire share one root: the hour between 02:45 and 03:45.
With oestrogen gone, your body's temperature control has become sensitive, and night sweats wake you. At the same hour your glucose rises by 1.1 mmol/L on average and your cortisol climbs toward its morning peak, the top of range at 560 nmol/L. On nights with wine, the wake arrives earlier and lasts longer. The result is 6h18 of broken sleep, which leaves you with low energy the next day and, with low free testosterone, very little desire.
Hormone panel, morning cortisol, continuous glucose, Polar Loop sleep and HRV, your journal, your interview.
Cool the bedroom and the bed, fix your wake time, move wine to weekends, close the day with a ritual you enjoy, and train strength three times a week. Your gynaecologist will lay out every option for night sweats and desire, with your mother's history at the centre of the conversation.
High for sleep timing, temperature and alcohol. High for strength training and sleep quality.
3am wakes fall to one a week, sleep reaches seven hours, and your HRV passes 35 ms.
Ten Years Early
Plaque has started in your arteries, and we found it a decade before it would have made itself known.
Your calcium score of 46 shows early plaque. Your ApoB of 1.31 g/L is what feeds it, and it rose when oestrogen fell. Your hsCRP of 2.3 mg/L shows the inflammation that speeds it up, driven largely by visceral fat and short sleep. Your father's stent at 61 adds weight. Your low Lp(a) changes the story: your risk comes mostly from what we can change.
Coronary calcium score, ApoB, LDL, hsCRP, Lp(a), DEXA visceral fat, hormone panel, your father's history.
Lower ApoB through fibre, fish, less saturated fat and psyllium, and decide with a preventive cardiologist whether medication belongs alongside. Lower inflammation by reducing visceral fat and lengthening sleep. Raise your fitness, the single strongest protection your heart has.
High. ApoB lowering slows plaque growth in large trials.
ApoB is under 0.8 g/L, hsCRP under 1.0 mg/L, and your calcium score holds steady at its next check in 2029.
The Shift to the Middle
The weight you noticed arrived in the most active place it could: around your organs and in your liver.
The menopause moves fat from hips to belly. A year away from training lowered the muscle that would normally absorb your glucose. Together they have built 1,120 g of visceral fat, about 9% liver fat, a fasting insulin of 13 and an HbA1c one point from the prediabetes range. Your Withings readings, set against your weight before the injury, confirm what you described: 5 kg gained in a year, nearly all of it fat.
DEXA, MRI liver fat, fasting insulin, HbA1c, continuous glucose, Withings body composition, your interview.
Rebuild muscle, which is where glucose goes. Walk after meals. Protein first at every meal. Wine on weekends. Fibre and fermented foods to rebuild your gut.
High for strength training, walking after meals and alcohol reduction.
Visceral fat is under 850 g, liver fat under 5%, insulin under 7, and HbA1c under 38.
The Afternoon Fog
Your mind is excellent until about 15:00, and the cause is on your lunch plate and in last night's sleep.
Your desk lunch sends your glucose to 9.1 mmol/L by 13:15 and down to 4.4 by 15:30. That drop matches your reaction time slowing by 14% and the hours you call wet sand. Broken sleep and low vitamin D make it heavier. With Alzheimer's on your father's side, we treat your brain's long term health as a priority in its own right. The same habits that clear the fog protect your brain for decades: deep sleep, steady glucose, strength and fitness, and close connection.
Cognitive assessment at 09:30 and 15:30, continuous glucose, Polar Loop sleep, vitamin D, your journal, your family history.
Lunch away from your desk, protein and vegetables first, a ten minute walk after, vitamin D3 through the winter, and your sleep work from Thread 1. Rob will discuss APOE testing with you when you choose.
High for exercise and sleep in brain health. Medium for glucose stability and afternoon cognition.
Your 15:30 reaction time matches your morning, afternoon energy in your check ins reaches 7, and your glucose dip disappears.
The Comeback
You are rebuilding for the mountains, and your upper body has already done half the work.
Your grip, push ups and dead hang are all Strong. Your right leg carries 7% less muscle than your left, balances for 14 seconds against 30, and guards every landing. Your VO2 max of 27.5 has room to climb back after a year of rest. Your spine bone density sits in the osteopenia range, which the same heavy strength and impact work will address. Every part of this is trainable, and you have the discipline for it.
Physical assessment, DEXA lean mass and bone density, VO2 max test, Polar Loop activity, your interview, the Zermatt injury and reconstruction.
A physiotherapist led knee programme inside three strength sessions a week, steady cardio building to intervals, impact work for bone once your knee is cleared, return to sport testing in January, and four retreats planned around hiking and skiing.
High for progressive strength training after ACL reconstruction, for VO2 max training at any age, and for impact training in bone density.
Your legs are within 3% of each other, you balance 30 seconds on each, your VO2 max passes 31, and you ski Åre in February.
The 8 Domains in Depth
We looked closely at all eight Domains, and your data puts Metabolic Health and Sleep at the front of the year, with Social Connection & Purpose and Cognitive Health as your greatest strengths.
Metabolic Health
Deficit+ApoB 1.31 g/L, coronary calcium 46, fasting insulin 13, HbA1c 41, visceral fat 1,120 g, liver fat about 9%, hsCRP 2.3.
Low Lp(a), strong HDL at 1.7, excellent kidney and thyroid function, and a kitchen you already enjoy cooking in.
ApoB down, insulin sensitivity up, visceral and liver fat reduced. This Domain carries Threads 2 and 3 and receives the most attention in phase one.
Sleep
Deficit+6h18 average, 41 minutes awake each night, a wake between 02:45 and 03:45 on most nights in week one, Polar sleep score averaging 64.
You fall asleep within 12 minutes, your deep sleep holds up well in the first half of the night, and your wake time is naturally early and steady.
An uninterrupted second half of the night through temperature, timing and alcohol, and a gynaecologist's input on night sweats.
Stress Regulation
Solid−Morning cortisol at 560 nmol/L, HRV averaging 27 ms, 55 hour weeks, evenings used to come down.
You know your own patterns, and your HRV rose by 7 ms in four weeks once your evenings changed.
A firm end to the working day, a new evening ritual, weekly bodywork at home, and recovery days written into your training.
VO2 Max
Solid−27.5 ml/kg/min, after a year away from regular training.
A lifetime of hiking, running and skiing. A heart and lungs that have been fit before rebuild fitness faster.
Two to three steady sessions a week on the bike and cross trainer while your knee strengthens, then one interval session a week from December. Target: 31 or more.
Nutrition and Supplements
Solid−Protein around 65 g a day, fibre around 18 g, a ten minute desk lunch, wine on three to four evenings, vitamin D at 46 nmol/L.
You cook from scratch most evenings, eat fish weekly, and rarely eat processed food.
Protein to 100 g, fibre to 35 g, lunch away from your desk, wine on weekends, and a focused set from The Eirloom Selection: vitamin D3, omega 3, creatine and psyllium.
Muscle Mass and Strength
SolidGrip 29 kg, 11 full push ups and a 38 second dead hang, all Strong. Lean mass index 5.9 kg/m², a right leg 7% below the left, right leg balance of 14 seconds, spine T score −1.6.
An upper body most women your age would envy, and the discipline of someone who has trained most of her life.
Three strength sessions a week, the right leg first, heavier loads month by month, and impact work for your bones once your knee is cleared.
Social Connection & Purpose
Strong−Friendships of thirty years, a weekly book club, close adult children, meaningful work you rate 9 out of 10 for purpose. Evenings are often spent alone.
This is one of your greatest assets, and it protects your heart and brain directly.
Shared movement, a hiking partner for weekends, and retreats you can share with the people you choose.
Cognitive Health
Strong−Processing speed and working memory Strong at 09:30, reaction time 14% slower at 15:30.
A sharp, fast mind and a career of complex decisions that keeps it trained.
Steady afternoon glucose, deeper sleep, vitamin D, fitness and strength, the strongest protections for your brain over the next forty years, and an APOE conversation when you are ready.
Thirty Days of Data
Thirty nights of Polar Loop data, thirty mornings on the Withings scale and four weeks of continuous glucose show a body that answers quickly to what you change.
Sleep
Your nights lengthened as 3am wakes fell
Week one 5h56, week four 6h39.
You fall asleep easily and your deep sleep is strong in the first half of the night. The second half is where your nights break, and those breaks cluster in one hour. As the breaks became rarer, your nights grew by 43 minutes.
Heart rate variability
Your HRV is climbing, and dips after every wine night
HRV is the clearest daily window into how well your body is recovering. Yours started low and is climbing steadily. Wine is the single largest daily influence we can see in your data, which is why moving it to weekends came first.
Glucose
Your afternoon glucose crash has softened
Three moments shape your glucose day. The night rise near 03:00 matches your wakes. The climb after a quick desk lunch, followed by a fall to 4.4 mmol/L at 15:30, matches your afternoon fog. Your dinner peak is highest on pasta and wine evenings, reaching 10.2 mmol/L on the highest night. Walking after meals and eating protein first have already flattened all three.
Body composition
Your Withings scale shows the first, gentle shift: weight down while muscle holds.
| Withings | Week one | Week four |
|---|---|---|
| Weight | 72.4 kg | 71.6 kg |
| Body fat | 36.4% | 35.8% |
| Muscle mass | 43.1 kg | 43.3 kg |
72.4 kg
71.6 kg
36.4%
35.8%
43.1 kg
43.3 kg
Day to day, the scale moves up to 1 kg with hydration. We read the weekly average.
Activity and heart rate
Your daily steps rose from 5,900 in week one to 7,800 in week four, almost entirely from your walks after meals. Your resting heart rate fell from 63 to 60 beats per minute over the same weeks, an early sign that your fitness and recovery are both responding.
Early Movement
In four weeks, with four changes to your evenings, your lunches, your walks and your bedroom, eleven of your markers have already moved in the right direction.
| Marker | Week one | Week four | Change |
|---|---|---|---|
| 3am wakes | 5 nights | 2 nights | 3 fewer |
| Time asleep | 5h56 | 6h39 | +43 min |
| HRV | 24 ms | 31 ms | +7 ms |
| Resting heart rate | 63 bpm | 60 bpm | 3 beats lower |
| Night sweats | 5 nights | 2 nights | 3 fewer |
| Glucose peak after lunch | 9.1 mmol/L | 7.6 mmol/L | 1.5 lower |
| Afternoon glucose low | 4.4 mmol/L | 5.1 mmol/L | Steadier |
| Daily steps | 5,900 | 7,800 | +1,900 |
| Afternoon energy | 4.2 | 6.4 | +2.2 |
| Daily feeling score | 5.8 | 7.1 | +1.3 |
| Weight | 72.4 kg | 71.6 kg | 0.8 kg lower |
5 nights
2 nights
3 fewer
5h56
6h39
+43 min
24 ms
31 ms
+7 ms
63 bpm
60 bpm
3 beats lower
5 nights
2 nights
3 fewer
9.1 mmol/L
7.6 mmol/L
1.5 lower
4.4 mmol/L
5.1 mmol/L
Steadier
5,900
7,800
+1,900
4.2
6.4
+2.2
5.8
7.1
+1.3
72.4 kg
71.6 kg
0.8 kg lower
What made the difference. Wine moved to Friday and Saturday from week two. A ten minute walk after lunch and dinner from day ten. Your bedroom cooled to 17°C with lighter bedding from week two. Lunch away from your desk, protein first, from week three.
What it tells us. Your system responds quickly and clearly. Sleep and HRV answer within days, glucose within a week. The slower markers, ApoB, visceral fat, liver fat and bone, respond over months, and your first quarterly panel in December is where we will see them begin to turn.