9.5 Reviewing Basic Health Markers
Key Takeaways
- The content outline names specific markers a CCFT should be able to review: HDL, triglycerides, HbA1c, body fat percentage, lean body mass, blood pressure, and bone density.
- Reviewing a marker means understanding what it measures and how training and nutrition tend to move it — not diagnosing, interpreting a result clinically, or recommending medication changes.
- These markers are the measurable content of the sickness-wellness-fitness continuum, which is why they belong in a trainer credential.
- Blood pressure and body composition are the two markers a coach may reasonably measure directly; blood markers and bone density come from the athlete's clinician.
- Any abnormal or concerning value goes to a physician, and the coach's role is to encourage the referral and to program appropriately in the meantime.
Why a Trainer Reviews Health Markers at All
The content outline asks the CCFT to "review basic health markers (e.g., high-density lipoprotein, triglycerides, hemoglobin A1C, body fat percentage, lean-body mass, blood pressure, and bone density)." That list is not arbitrary — it is the measurable content of the sickness-wellness-fitness continuum. CrossFit's claim that fitness is measurable health only means something if the measurements are named, and these are they.
The verb is also deliberate. Review, not interpret, diagnose, or treat.
What Each Marker Measures
| Marker | What it measures | Typical direction with training and improved nutrition |
|---|---|---|
| HDL cholesterol | High-density lipoprotein, which transports cholesterol away from tissues to the liver | Tends to rise with regular exercise; higher is generally favourable |
| Triglycerides | Circulating fat, strongly responsive to diet | Tend to fall with reduced refined carbohydrate and added sugar, and with exercise |
| HbA1c | Average blood glucose over roughly the previous three months | Tends to fall with improved diet quality, reduced added sugar, and increased activity |
| Body fat percentage | Proportion of body mass that is fat | Tends to fall with an appropriate energy deficit and maintained protein and training |
| Lean body mass | Total mass that is not fat, including muscle, bone, organs, and water | Tends to rise or hold with resistance training and adequate protein |
| Blood pressure | Force of blood against arterial walls, systolic over diastolic | Tends to fall with regular aerobic and resistance training and weight management |
| Bone mineral density | Mineral content of bone, an indicator of skeletal strength | Tends to improve or be preserved with axial loading and impact; important in masters and post-menopausal athletes |
Marker Clusters
Several of these move together and tell a common story. Rising triglycerides, falling HDL, rising HbA1c, and rising waist circumference form a recognisable pattern that clinicians investigate as metabolic dysfunction. A coach should recognise that they cluster — and should recognise that recognising a cluster is not the same as diagnosing a syndrome. The correct action is to encourage the athlete to see their physician.
What a Coach Can and Cannot Measure
Reasonably measured in a gym:
- Blood pressure, with a validated cuff and correct technique — seated, back supported, arm at heart height, no caffeine or exercise in the preceding 30 minutes, after five minutes of rest.
- Body composition estimates — skinfolds, bioelectrical impedance, or circumference measures. Every method has meaningful error, and the honest framing to an athlete is that the trend matters and the absolute number does not.
- Resting heart rate, waist circumference, and body weight.
Not measured or interpreted by a coach:
- Blood lipids, HbA1c, and any other blood marker. These come from the athlete's clinician, and the athlete may choose to share them.
- Bone mineral density, which requires a DXA scan ordered clinically.
Reviewing Without Diagnosing
When an athlete shares results, a CCFT can do four legitimate things:
- Confirm what the marker measures. "HbA1c is an average of your blood sugar over about three months."
- Explain how training and nutrition generally relate to it. "Reducing added sugar and training consistently tends to move that number down over months."
- Set training and nutrition process goals consistent with the direction the athlete and their clinician want.
- Encourage and support the clinical relationship, including re-testing on the clinician's schedule.
What a CCFT must not do:
- Tell an athlete whether a value is normal, abnormal, or dangerous.
- Suggest a diagnosis, or dismiss one.
- Recommend starting, stopping, or changing a dose of any medication — including telling an athlete their blood pressure medication is no longer needed because their readings have improved.
- Recommend supplements to treat a marker.
- Order or push for tests.
If a reading you take in the gym is markedly abnormal — a resting blood pressure well into hypertensive range, for example — the correct action is to tell the athlete the number without interpreting it, recommend they see their physician promptly, modify training in the meantime (reducing maximal breath-holding and very heavy loading), and document what you observed and advised.
Using Markers as Motivation
Health markers are among the most motivating data a coach can point at, because they connect training to the thing many athletes actually care about. Used well:
- Frame markers as a direction of travel on the continuum, not a pass/fail.
- Celebrate marker improvements as loudly as performance improvements. An athlete whose HbA1c fell out of the pre-diabetic range has achieved more than a personal-record deadlift.
- Set the review interval with the clinician's schedule, typically 6 to 12 months, and do not encourage frequent re-testing.
- Never use markers to shame. An athlete who shares blood work and is criticised for it will not share anything again.
An athlete shares blood work showing an HbA1c of 6.1 percent and asks whether they are pre-diabetic. What is the appropriate CCFT response?
Which of the named health markers can a CCFT reasonably measure directly in the gym?
An athlete's blood pressure has improved substantially over six months of training and they ask whether they can stop taking their prescribed antihypertensive medication. What should the CCFT say?