By Dr. Ali Aldibbiat — MD, PhD, FRCP (London & Edinburgh), FACE. Consultant Endocrinologist, Newcastle Vitality Clinic, Jumeirah, Dubai.
Most executive health packages measure what is cheap and traditional rather than what is predictive. You receive a folder of results, most of them normal, and no plan. A year later you do it again.
This article sets out which tests genuinely change what happens next, which are noise, and how often each is worth repeating.
The cardiovascular tier
Atherosclerotic cardiovascular disease remains the leading cause of death worldwide, it begins decades before it presents, and it is the area where measurement most reliably changes outcomes.
ApoB — the most under-ordered test in preventive medicine.
Every atherogenic lipoprotein particle carries exactly one apolipoprotein B molecule. Measuring ApoB therefore counts the particles capable of entering the arterial wall, rather than estimating the cholesterol carried inside them.
This matters because the two can disagree. A person with small, dense LDL particles can have a reassuring LDL cholesterol and a high particle count — the pattern typical of insulin resistance, metabolic syndrome and type 2 diabetes, which is exactly the pattern most common in this region. Their LDL-C says they are fine. Their ApoB says they are not. The ApoB is the one that reflects risk.
Lp(a) — measure it once, in everyone.
Lipoprotein(a) is genetically determined, largely unaffected by diet or exercise, and an independent causal risk factor for cardiovascular disease and aortic stenosis. Roughly one in five people has an elevated level and does not know it.
Because it is genetically set, it needs to be measured once in a lifetime. That single test identifies people whose risk is substantially higher than any conventional calculator suggests, and who therefore warrant more aggressive management of everything else that is modifiable. Targeted therapies are in late-stage development. It is inexpensive, and it is still not routinely ordered — which makes it one of the highest-value tests on this page.
hs-CRP, as a marker of inflammatory risk, useful in refining risk in intermediate-risk individuals.
Blood pressure, measured properly. A single reading taken after you have hurried in from the car park is not a blood pressure. Home monitoring over a week, or ambulatory monitoring, is what should inform decisions.
Coronary artery calcium score. For an asymptomatic middle-aged adult, this is arguably the most useful single investigation available. It shows whether atherosclerotic plaque is actually present, rather than estimating the probability. A score of zero is strongly reassuring; a raised score reclassifies risk upward and changes management immediately. See cardiovascular screening at NVC (/cardiovascular-screening-genetic-diet-plans-and-anti-aging-care-in-dubai-all-under-one-roof/).
The metabolic tier
Metabolic dysfunction underlies most age-related disease, and it is detectable many years before a diagnosis of diabetes.
HbA1c gives average glucose over about three months — necessary, but it rises late.
Fasting insulin, with HOMA-IR. This is the test that finds the problem early. Insulin resistance develops years to decades before glucose rises, because the pancreas compensates by producing more insulin and holds glucose in the normal range while doing so. Measuring only glucose means waiting until compensation fails. Fasting insulin shows the compensation happening — which is precisely when intervention works best.
Triglyceride to HDL ratio, a simple and useful surrogate for insulin resistance available from a standard lipid panel.
Liver function and assessment for metabolic dysfunction-associated steatotic liver disease (MASLD). Fatty liver is extremely common in the UAE and largely undiagnosed. ALT is a starting point but is insensitive; a fibrosis score such as FIB-4, and ultrasound or transient elastography where indicated, characterise it properly. This matters because MASLD is both a cardiovascular risk marker and a potential cause of cirrhosis in its own right.
Waist circumference, which costs nothing and predicts more than BMI.
The hormonal and nutritional tier
Thyroid function. Common, treatable, and productive of symptoms attributed to everything else.
Vitamin D. Deficiency is widespread in the UAE despite year-round sunshine — sun avoidance in the hot months, indoor working and living, and clothing coverage all contribute, and systematic reviews of UAE populations report high prevalence. Vitamin D status affects bone and muscle function directly.
Ferritin and full blood count. Iron deficiency is a very common and very treatable cause of fatigue, particularly in menstruating women, and ferritin can be low while haemoglobin remains normal.
B12, particularly in vegetarians, in people on metformin, and in those on long-term acid suppression.
Sex hormones, where clinically indicated. In men, testosterone with SHBG and calculated free testosterone, tested correctly — see how testosterone should be tested (/low-testosterone-symptoms-testing-dubai/). In women, menopausal status assessed clinically rather than by panel — see perimenopause symptoms in your 40s (/perimenopause-symptoms-40s-dubai/). Note the word indicated: broad hormone panels in people without relevant symptoms generate confusion, not insight.
The tier that is mostly noise
Saying what not to buy is as useful as saying what to buy.
IgG food intolerance panels. IgG antibodies to foods indicate exposure, not intolerance. Major allergy and immunology societies advise against these tests for diagnosing food intolerance. They routinely produce long lists of “reactive” foods and drive unnecessary dietary restriction.
Heavy metal and “toxin” screens in asymptomatic people. Meaningful where there is a genuine exposure history or clinical suspicion; otherwise a source of anxiety and unnecessary chelation offers.
Routine salivary hormone panels. Not validated for clinical decision-making.
Whole-body MRI screening in asymptomatic adults. This deserves particular care, because it is heavily marketed in Dubai and it sounds unambiguously sensible. The problem is incidental findings — small abnormalities of no clinical significance found in a high proportion of healthy people. Each generates further imaging, sometimes biopsy, invariably anxiety, and occasionally complications from investigating something that would never have caused harm. This is overdiagnosis, and it is a real harm rather than a theoretical one. There are specific high-risk groups for whom whole-body imaging is appropriate. Most people paying for it are not in them.
Genetic testing is a different matter and should not be lumped in. Certain findings genuinely change management — familial hypercholesterolaemia, hereditary cancer syndromes with a suggestive family history, pharmacogenomic variants affecting drug metabolism. The distinction is between testing that changes what you do and testing that merely produces a document.
How often, and what changes management
| Test | Healthy adult under 40 | 40–60 | Over 60, or existing risk |
|---|---|---|---|
| ApoB, lipid profile | Every 3–5 years | Every 1–2 years | Annually |
| Lp(a) | Once in a lifetime | Once in a lifetime | Once in a lifetime |
| HbA1c, fasting insulin | Every 3 years | Annually | Annually |
| Blood pressure | Every 2 years | Annually or home monitoring | Home monitoring |
| Liver function, FIB-4 | Every 3 years | Every 1–2 years | Annually |
| Thyroid, vitamin D, ferritin, B12 | If symptomatic | Every 1–2 years | Annually |
| Coronary artery calcium | Not routinely | Once, if risk is intermediate | As advised |
Adjust for family history, ethnicity and existing conditions. South Asian and Arab populations warrant earlier and more frequent metabolic and cardiovascular assessment, because risk develops at lower BMI thresholds and at younger ages.
A result is not a plan
The value of testing lies entirely in what happens afterwards.
A high ApoB should lead to a discussion about targets and, where appropriate, treatment — not to a note saying “discuss with your doctor.” A fasting insulin indicating early insulin resistance should produce a specific plan for resistance training, protein intake, sleep and, where indicated, medication. An elevated Lp(a) should change how aggressively everything else is managed.
If your health check produces a folder rather than a plan, you have bought data, not care.
Frequently asked questions
What blood tests should I do every year? For most adults over 40: lipid profile with ApoB, HbA1c and fasting insulin, liver and kidney function, full blood count, thyroid function, vitamin D and ferritin — with blood pressure measured properly. Lp(a) is measured once, ever.
Is ApoB better than an LDL cholesterol test? ApoB counts atherogenic particles directly and is a better predictor of cardiovascular risk than LDL-C, particularly in people with insulin resistance, diabetes or metabolic syndrome, in whom LDL-C can be falsely reassuring.
Should I get my Lp(a) checked? Yes — once. It is genetically determined and does not change meaningfully over your life, and an elevated level substantially changes how aggressively other risk factors should be managed.
Are full body health checks worth it? The blood-based components can be, if the right tests are chosen and someone acts on the results. Whole-body imaging in asymptomatic people frequently produces incidental findings that lead to further investigation, anxiety and occasional harm without improving outcomes.
What is a good HbA1c if I don’t have diabetes? Below 5.7% (39 mmol/mol) is considered normal, and 5.7–6.4% indicates prediabetes. Within the normal range, a rising trend over successive years is meaningful even before any threshold is crossed — which is why fasting insulin adds so much.
Turn results into a plan. A comprehensive metabolic and cardiovascular assessment identifies risk early, and produces a specific plan rather than a folder. Book an assessment with Dr. Ali Aldibbiat, Consultant Endocrinologist, at Newcastle Vitality Clinic, Jumeirah.