Introduction
Britain faces growing pressure on its health system, driven by rising rates of chronic disease and an ageing population. While GP consultations typically focus on symptoms, many early warning signs of poor health develop silently, often years before diagnosis.
To better understand what routine testing can miss, Emerald analysed results from more than 25,000 comprehensive biomarker tests spanning nutritional status, metabolic health, inflammation, and cardiovascular risk. Our analysis examined how early biological signals emerge and progress, offering insight into the transition from optimal health to early dysfunction.
Crucially, the dataset reflects a largely health-conscious population and includes longitudinal testing, allowing patterns to be tracked over time rather than viewed as one-off snapshots. This approach provides context that single tests often lack and highlights where even proactive individuals remain exposed to hidden risk.
The findings show that while Emerald users outperform national averages across several indicators, early warning signs of future disease remain widespread, particularly around cholesterol, inflammation, and metabolic health.
The Key UK Biomarker Statistics
1 in 6 UK adults is vitamin D deficient
8% of women have iron-deficiency anaemia, rising to 23% during pregnancy
53% of adults have raised cholesterol
Over 64% of UK adults are overweight or living with obesity
32% of UK adults have high blood pressure
These markers point to persistent nutritional gaps, elevated cardiometabolic risk, obesity and a population increasingly vulnerable to preventable chronic disease.
The Broader Context
Beyond individual biomarkers, national data consistently show declining population health.
Life expectancy in the UK is 79.1 years for males and 83.0 years for females, with improvements slowing over the past decade.
Healthy life expectancy is just over 61 years for both men and women, meaning many people spend nearly two decades living in poor health.
Long-term conditions account for the majority of NHS spending, placing sustained pressure on health services.
Millions of adults are living with undiagnosed or early-stage metabolic disease.
Health inequalities remain stark, with people in the most deprived areas living significantly fewer years in good health than those in the least deprived areas.
1 in 5 people report experiencing a common mental health problem (like anxiety and depression) in any given week in England.
Physical inactivity remains common, particularly in more deprived communities, despite two-thirds of adults meeting activity guidelines.
Less than 20% of adults meet the recommended fruit and vegetable intake, with lower rates in deprived areas.
One in five UK adults is estimated to be living with diabetes or pre-diabetes, up to ⅓ without a formal diagnosis.
More than 3.6 million people in England have been identified with non-diabetic hyperglycaemia (pre-diabetes), with numbers rising year on year.
Cardiovascular disease remains one of the UK’s leading causes of death, despite being largely preventable.
Over half of adults have raised cholesterol, a key risk factor for heart disease and stroke.
Alcohol-related hospital admissions continue to rise, with liver disease often diagnosed late after years of silent damage.
This backdrop highlights the importance of earlier detection and prevention, rather than reactive treatment.
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How Emerald Users Compare to the National Picture
1. Nutrition: Better, but deficiencies persist
Vitamin D deficiency
Emerald: 14.3% (1 in 7)
UK average: 16.7% (1 in 6)
Emerald users show slightly lower deficiency rates. This reflects higher awareness and supplementation. However, deficiency still remains common.
Iron deficiency in women
Emerald: 10%
UK average: 8%
Rates are comparable, suggesting that even health-aware women remain at risk.
Vitamin B12 deficiency
Emerald: 0.9%
UK average: ~6% (adults under 60)
Significantly lower rates among Emerald users point to better dietary intake and monitoring, and to higher use of over-the-counter supplementation.
Folate deficiency
Emerald: 7.8% (1 in 13)
UK average: 13% (ages 19–64)
Lower than national averages, but still affecting a meaningful proportion of individuals and a key risk in women looking to conceive.
2. Cardiometabolic risk: Harder to escape
Raised cholesterol
Emerald: 50.9% (1 in 2)
UK average: 53%
Rates are nearly identical. Even among proactive individuals, elevated cholesterol remains common and often requires substantial lifestyle changes or medical intervention.
Overweight or obesity
Emerald: 40.1%
UK average: 64%
A 24-percentage-point gap suggests that those who actively monitor their health maintain a healthier weight.
Pre-diabetes (HbA1c)
Emerald: 2.6% (1 in 38)
UK average: ~12%
Lower prevalence is likely linked to the age profile and baseline metabolic health, and, implicitly, to healthier dietary habits.
3. Inflammation: The silent red flag
Elevated hs-CRP (high-sensitivity C-reactive protein)
Emerald: 32.3% (1 in 3)
There is no comprehensive national screening benchmark for low-grade inflammation. This is a significant blind spot in routine testing, despite strong links between chronic inflammation and long-term cardiovascular risk.
The Surprising Findings: Biomarkers People Don’t Think to Test
Emerald’s data highlights several clinically relevant markers that rarely trigger routine GP testing.
High-sensitivity CRP: Elevated inflammation in asymptomatic individuals, which predisposes them to elevated cardiovascular risk.
Fasting insulin: Early insulin resistance years before diabetes diagnosis.
Raised HbA1c and undiagnosed diabetes in lean individuals: Challenging assumptions that weight alone predicts metabolic health.
Suboptimal thyroid markers: Present without classic symptoms.
Raised liver enzymes in individuals reporting higher alcohol intake: Suggesting early liver strain.
These markers may sit outside standard screening pathways, but they provide valuable insight into future health risk.
Why Do Biomakers Matter?
GP reference ranges are designed to identify established disease. That means many biomarkers that indicate emerging risk can still fall within “normal” limits, even as underlying health issues begin to develop.
Preventive testing, which incorporates the full picture, offers an opportunity to intervene earlier, when changes in diet, activity, sleep, and alcohol intake can have the greatest impact. Yet, true prevention requires moving beyond the blood test alone. At Emerald, our GP-led assessment integrates biomarker data with a comprehensive analysis of the four pillars of healthy living: diet, exercise, sleep, and lifestyle.
By combining laboratory results with a detailed questionnaire and wearable-based data, we provide our clinicians with the full context of a patient's life. This allows us to move beyond the "snapshot" and utilise longitudinal monitoring to track subtle deviations in a personal baseline. When we see a shift in inflammation or glucose, we don't just see a number; we see how it correlates with a patient's sleep quality or activity levels.
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A Shift from Snapshots to Longitudinal Oversight
True prevention relies on tracking a "moving picture" of health, using biomarkers, wearables, and lifestyle data to understand an individual's unique baseline over time.
Clinically Supervised Data Access: Data alone can cause anxiety; data plus clinical expertise creates a plan. We need to empower individuals with access to their own biological data, provided it is delivered within a professional, GP-led framework.
Redefining "Normal" through Early Detection: We need to look beyond standard reference ranges that only flag established disease. By identifying shifts in inflammation and metabolic markers years in advance, we can intervene while lifestyle changes are still most effective.
Integrating the Four Pillars of Prevention: Health does not happen in a lab. Real change requires a "full picture" approach that connects clinical biomarkers directly to the four pillars: diet, exercise, sleep, and lifestyle.
Reducing Pressure through Proactive Care: Shifting the UK’s healthcare culture from reactive treatment to data-led prevention is the only sustainable way to reduce the long-term burden on the NHS and improve healthy life expectancy.
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