Within your control: four numbers that shape how long – and how well – you live

Chronic disease affects millions of Canadians and remains one of the greatest threats to long-term health.

The challenge isn't simply how long Canadians live, but how long they remain healthy. "Right now, there's roughly a 10-year gap between lifespan and healthspan," says Penny Wilson, VP, Growth & Go-to-Market and Head of Behavioural Insurance Canada at Manulife. "People may live into their 80s but often spend the final decade of their lives in poor health."

Many of the conditions that shorten and reduce quality of life—including heart disease, stroke, Type 2 diabetes, several cancers and some forms of dementia—share common risk factors rooted in metabolic health.

“Metabolic health is influenced by both controllable and uncontrollable factors,” says Dr. Tasha Jeyanathan, a physician with Cleveland Clinic Canada, which is the Medical Director for Group Benefits at Manulife Canada. “Genetics, age, hormonal changes and existing medical conditions aren't within our control. But a large part of metabolic health can be improved through diet, exercise, sleep and stress management.”

Many of these conditions share common metabolic risk factors, making prevention and early action increasingly important.

The scale of the challenge is significant. In Canada:

“There isn't one official definition of metabolic health,” says Dr. Jeyanathan. “But generally, being in good metabolic health refers to your body's ability to digest and absorb nutrients without developing unhealthy spikes in blood sugar, insulin, inflammation or fats circulating in the blood.”

Dr. Heather Warren, a cardiologist with the Waterloo Regional Health Network (WRHN), prefers to think about it as metabolic resilience: the body's ability to adapt to changing circumstances and maintain health through different life stages. “It's really the interaction of factors such as genetics, hormones, blood pressure, cholesterol, insulin resistance, diet and lifestyle that determines someone's overall risk,” she says.

Blood pressure, cholesterol, blood glucose, and BMI are four of the key signals of that resilience. Dr. Jeyanathan explains how each reflects a different aspect of metabolic health:

• Blood pressure: The force of blood moving through the arteries.
• Cholesterol: How the body transports and stores fat.
• Blood glucose: The sugar circulating in the bloodstream.
• BMI: A measure of body weight relative to height (see The BMI caveat: one piece of the picture for more details).

Individually, each is a data point. Together, they provide a more complete picture of future health risk.

“They're closely interconnected, but each provides different information,” says Dr. Jeyanathan. “Looking at them together gives a much more comprehensive assessment of a person's metabolic health than looking at any one marker alone.”

“Out of range” describes a value linked to higher disease risk. A single reading rarely warrants concern—blood glucose and blood pressure in particular fluctuate regularly with diet, sleep and stress. The risk lies in a number that stays elevated over months rather than days and, especially, in several drifting in a direction that increases risk.

That clustering has a name. When elevated blood pressure, blood glucose and cholesterol appear together, clinicians call it “metabolic syndrome,” which significantly increases the risk of cardiovascular disease, diabetes, dementia and several cancers.

Poor metabolic health doesn't affect a single organ or system. Over time, it can increase the risk of:

Improving metabolic health begins with measurement, but that first step is often the hardest. In Canada, adults under 50 are not typically offered routine bloodwork without a specific medical reason,¹⁶ and recent surveys suggest that nearly half have difficult or no access to a family doctor.¹⁷

Through Manulife Vitality, members can complete an annual health screening without a physician referral. ExamOne, a private clinic with mobile nurses, is able to come to members’ homes and complete a yearly health check, including measuring blood pressure and BMI on the spot and a blood draw for blood glucose and total cholesterol. By repeating the screening year after year, they can gain a clearer picture of how their health is changing over time. “By rewarding healthy behaviours like completing health screenings, we're encouraging people to learn more about their health and stay engaged in their well-being journey,” says Gillian Delanghe, AVP, Behavioural Insurance & Health Engagement at Manulife.

A number that moves can be powerful. Much as a fitness tracker turns a walk into visible progress, regular health measurements can help people stay engaged with healthy habits. It's why Delanghe gives every new member the same advice: know your numbers. “Consistency, not perfection, is what carries habits over the long run.”

The most encouraging finding across a decade of Manulife Vitality is also the simplest: diet, exercise, sleep and stress management can all make a difference, even after numbers have drifted out of range.

Among members who began the program with an out-of-range result in one of the four key markers, a substantial share who remained engaged returned to a healthy range:

Most people know they should move more, eat better and sleep well. The challenge is turning that knowledge into lasting habits.

“When Manulife Vitality was first introduced, the idea was that if people were rewarded for healthy behaviours, they would become more engaged in their health,” says Wilson. “The data shows that's exactly what's happening. People who participate in the program experience meaningful improvements.”

Delanghe puts it more simply: “Manulife Vitality helps bridge the gap between knowing what we should do and actually doing it.”

Now in its 10th year, the program supports healthier habits by rewarding everyday actions such as physical activity, health screenings and preventive care.

Because awareness is the starting point, Manulife Vitality helps members understand where they stand on key health markers. Tools such as Vitality Health Review and Vitality Age help put those results into context.

The premise is simple: healthier members benefit everyone.

“It’s positive for customers, it’s positive for insurers and it’s positive for society, because healthier people are able to enjoy their lives longer and place less strain on the health care system,” says Wilson.

Karen Cutler, VP, Head of Underwriting and Chief Underwriter, Individual Insurance, at Manulife Canada sees a parallel in another area of long-term planning. “We invest money for retirement through savings accounts and retirement plans. At Manulife, we think about physical health the same way. You're investing in your future.”

One conclusion stands out: small, sustained habits can change the trajectory of health.

Long-term health is not determined by a single test result, diagnosis or decision, but by the choices that follow—and the opportunity to make them never disappears.

“We're trying to help people maintain their independence—to keep walking their dog, travelling, playing with grandchildren and doing the things they love,” says Dr. Warren. “It's not just about adding years to life; it's about adding life to those years.”

That is the long game: not simply living longer, but creating the conditions to live well for longer.