India: A recent review published in the Indian Journal of Community Medicine has identified key objectively measurable biomarkers of positive health that can help implement this concept at the individual level.
The researchers revealed the development of a novel proposal to assess the positive health of individuals with five domains and nearly 50 items. They suggested that although preliminary, this communication likely addresses the key measurable biomarkers and may serve as a solid foundation for advancing the operationalization of positive health and its assessment. The framework could also highlight data gaps essential for developing policies to enhance public health.
The study conveys two key messages:
Defining Positive Health: Positive health is characterized as the ability to live a long life with minimal or no ailments.
Objective Measurement of Positive Health: Positive health can be objectively measured through a specific set of biomarkers.

According to Dr. Abhaya Indrayan, the lead author from the Department of Clinical Research at Max Healthcare, Saket, New Delhi, India, the study has identified major biomarkers for this purpose. These biomarkers are categorized into five domains: neurological, endocrinological, nutritional, immunological, and physiological. This information was shared with .
He added that, "We have identified nearly 50 biomarkers. Among these, promising biomarkers are bone density, P3 amplitude, endorphins, FEV1/FVC ratio, hand grip strength, and semen quality in men."
This exercise shows that evaluating an individual's positive health is feasible. A scale incorporating these and other relevant parameters could be developed in the future to quantitatively measure the precise level of positive health. Since the exact combination of parameters that provides protection from ailments is not yet fully understood, this framework may help identify data gaps that need further investigation.
"With this work, now there is no need to depend on psychological and social factors such as family, interactions, happiness, laughter, and sleep for assessing positive health. These factors can not be exactly measured. We emphasize that these factors are only mediators for improving the biomarkers, and those biomarkers can be directly measured to assess positive health." said Dr. Indrayan.
Positive health can be defined as the capacity to live a long life in optimal health, potentially without any activity limitations. Currently, there is no method for objectively assessing this in individuals. In this communication, Dr. Indrayan and colleagues propose a framework designed to operationalize and assess this concept effectively.
Rather than focusing on distal factors like diet and lifestyle, which are subjective and challenging to measure, we concentrate on objectively measurable biomarkers such as immunity levels, endorphins, and handgrip strength. The researchers' focus is on key parameters that may offer protection against diseases and infirmity and can be evaluated using noninvasive methods. A combination of these parameters may indicate positive health. According to them, this may be a novel way to measure positive health at the individual level.
In this communication, the researchers briefly review the literature and identify a few major biomarkers that provide a protective shield and could determine the status of positive health at the individual level. The proposed framework may spark a discussion on indicators of positive health and help define parameters for interventions aimed at enhancing overall well-being and longevity, the study stated.
Speaking on the study's limitations Dr. Indrayan commented, "Although the biomarkers have been identified based on a review of hundreds of studies, they need to be measured in a sample of individuals who should be followed up for their longevity and the incidence of ailments."
"Lifestyle and environmental factors affect changes in our body. Positive factors such as exercise, diet, family support, social interactions, and good sleep build a reserve in the body that helps in preventing ailments and living long in a healthy state," he concluded.
Reference:
Indrayan, A., Vishwakarma, G., Verma, S., Sarmukaddam, S., & Tyagi, A. (2023). Quest for Biomarkers of Positive Health: A Review. Indian Journal of Community Medicine: Official Publication of Indian Association of Preventive & Social Medicine, 48(3), 382-389. https://doi.org/10.4103/ijcm.ijcm_480_22