Why is bio-impedance screening important!?

The key to longevity is not so much living long, as it is living well.

The chronic degenerative diseases of ageing are now known to be partly due to genetic inheritance, but mostly due to lifestyle


Exciting new evidence has demonstrated that the body’s decline is not due to the passing of years but rather to the combined effects of inactivity, poor nutrition and illness.

Generally most of us would consider health simply the absence of discomfort and a functioning we are familiar with. Actually true health is a state where the functioning of the body is the best it can be. Similar to feeling fantastic. (Homoeostasis is a balanced state of the  functioning of the body which is naturally maintained by the body’s internal processes. At any point in time the body is working to maintain that balance. For instance the body needs to be at a certain temperature and there is a cold breeze; as a response our hairs stand up we get goose bumps and our blood vessels contract to conserve body heat.)

What we are saying here is that the balanced working of the body requires that the building-up and repair processes of the body need to be equal or exceed the processes which cause harm. For instance when we eat the action of food passing through the digestive system wears the lining of the digestive system (catabolic influence). So therefore the body needs to be able to repair that constantly. In another example if we experience prolonged periods of stress (a catabolic influence) and we do not have proper rest and adequate nutrients to support the body it will eventually start to run down.

Many factors influence a person’s state of health. Some have positive influences and other negative ones. We want you to consider which of these factors can be adjusted to favourably influence your wellbeing. Your state of health is in direct proportion to the body’s ability to match repair to ware.

Each of us has our own unique needs. This can be seen in all areas of our lives and it is the same with our diet. But generally we can say that people living in the western countries do not eat sufficient protein in their diets. This is promoted by the whole range of cereal products available for easy eating. From corn flakes to pasta we find our diet is deficient in the essential building blocks for building and repair of our bodies, protein.

Why is exercise important; well, if you don’t use it you loose it, the saying goes, and it is the same with our muscles, bones and aerobic capacity. (See Biomarkers)

Research conducted by Evens and Rosenburg from the Human Nutrition Research Centre at Tuffs University lead to the identification of ten key biomarkers which can be used to chart the progression or regression of sarcopenia, (the disease of ageing).

Biomarkers are the key physiological factors which are associated with the prolongation of youth and vitality

These studies demonstrated that by adopting a particular pattern of activity and eating, it was possible for virtually anyone to slow down the ageing process and maintain functional capacity and vitality for the longest period of time.

Clients are monitored at their visit and at each subsequent visit. This allows us to see firstly where they are in relation to cellular health and secondly it show how effective their treatment program is.

Biomarkers of ageing

Biomarker #1            Body Cell Mass (especially muscle mass)

 Typically, lean body cell mass declines with age. From young adulthood to middle age, the average person losses 3 kg of lean body mass per decade. This rate of loss accelerates after age 45.

Lean muscle is a very important functional tissue. The following functions of muscle demonstrate why it is vital for optimum function.

  1. Glucose Disposal

Our ability to control our blood glucose level is dependent on muscle mass, because 80% of circulating glucose is typically stored m muscle as glycogen. With low muscle mass blood glucose clearance is delayed, resulting in dysglycaemia and an exaggerated insulin response. (see Biomarker 7.)

  1. Organ Reserve

Muscle is a major body reservoir of body glutamine. This glutamine store is called upon to repair and fuel many other tissues. The immune system is dependent on adequate glutamine reserves for optimal function. The integrity of the gastrointestinal mucosa (the lining of the digestive system) relies heavily on glutamine availability. Low muscle mass, therefore, leads to a reduction in organ reserve and limited function under stressful circumstances.

  1. Metabolic Rate

Muscle is the key determinant of metabolic rate. A higher metabolic rate will typically result m more kilojoules consumed per day and greater control over body fat mass. To achieve long term weight control muscle mass must be adequate. A progressive reduction in basal metabolic rate is a recognised characteristic of the ageing process and diminishing muscle mass may be largely responsible.

  1. Mobility

The ability to exercise, to maintain basic physical activity and to avoid frequent falls is an important consideration in the ageing process. Adequate muscle mass and function are required for normal daily activities and to maintain balance and required strength.

The two primary factors which influence this that we can readily engage and improve are:

i)Our level of physical activity

  1. ii) Our nutrition.


What we do not use, we lose. Muscles used properly and stimulated regularly strengthen and do not atrophy. This is true for people of all ages.


To maintain and maximise muscle function and health we must also have a supportive nutrition plan. One which favours anabolic hormone, balance.

Biomarker #2            Strength/Musculoskeletal Fitness

Building muscle tissue and regaining and/or maintaining strength obviously go hand in hand. The muscles which attach to and move your skeleton are referred to as your skeletal muscles. Your skeletal muscles receive direction from the motor nerves, which run from your central nervous system via the spinal cord and its branches, which exit from your spinal column. Sets of motor nerves and the muscle fibres that they supply are known as “motor units”.

As we age we typically lose motor units, approximately twenty percent over the 40 years between age 30 and 70.

There are two primary kinds of muscle fibres: the red slow twitch and the white fast twitch fibres.

  • The red slow twitch fibres are focused on low force, endurance

related activities (e.g. posture and walking).

  • The white fast twitch fibres are for shorter, high intensity

activities (e.g. lifting heavy objects and sprinting).

Studies show that we lose fast twitch fibres more rapidly with age and that we typically lose approximately thirty percent of our muscle cells between age 20 and 70.

This gradual muscle loss appears to be the catalyst for a number of other age related changes in our bodies.

These include:

  • A decreased blood sugar tolerance
  • A declining metabolism
  • An increase in body fat
  • A reduced aerobic capacity
  • A loss of bone mineral density

The remarkably good news is that human studies have proven that with the right exercise program, those in their 60th, 70th, 80th and even 90th decade of life can expect improvements in strength and muscle cell size similar to those of young people doing the same amount of exercise!

Skeletal muscles can be considered the engine of your body and your skeleton the chassis. The more efficient your engine, the farther you will go. Which leads us to our next biomarker.

Biomarker #3 `           Phase Angle/Expected Phase Angle

The phase angle is a measure of the amount of muscle mass and the function of cellular membranes and is a mathematical relationship between the resistance and reactance readings.

Phase angle is related to the integrity of the Phospholipid membrane. The membrane of each cell is made of two rows of fat molecules. Research has shown that the consumption of Omega 3 fatty acids such as those found in Salmon, Tuna and Sardines is beneficial. All cellular functions are dependent on the membrane of the cell.

The phase angle is one of the best indicators of cellular health and function available. It is computed from the resistance and reactance values, and is an indicator of the amount of electrical charge the cell membrane can hold. This is dependent on the total cell membrane mass (including the mass of the active tissue mass) and the efficiency of protein and electrolyte channel functions. The larger the phase angle, the better the cellular membrane integrity and, therefore, cell function.


The change the cell can hold is also dependent on the intracellular volume, so the phase angle is also an indicator of tissue cell volume. When patients are dehydrated, the extracellular volume (extracellular water) becomes depressed and a falsely elevated phase angle may be read.

The greater the phase angle, the better cellular health the patient has. This is one of the most important readings to gauge the integrity of your cellular membranes. Females (and small framed individuals) have reduced phase angle readings (generally lower by half to one point), which is due to the lower amount of active tissue (muscle).

This number will generally decline as you age. However, it can be reversed. Strength training, quality protein and essential fatty acids are considered important for improving the phase angle.

Expected Phase Angle

The phase angle will increase with an increase in muscle mass and cell function. By allowing for the muscle mass, the % expected phase angle gives the practitioner information on the cellular function and general energy levels. The % expected phase angle is often low in individuals with chronic fatigue. A normal range is from 75?85%. If low, there is a need to detoxify and support mitochondrial function.

Biomarker #4            Body Fat Percentage

Unlike the first 3 biomarkers which typically decline with age, our body fat usually increases with age, even if our weight does not.

Here again, human studies have demonstrated unfavourable changes in body composition with advancing age. The sedentary man or women at 65 has approximately twice the body fat they had as young people!


Proportion of lean-body mass versus fat in young and older women

These two magnetic resonance images make a dramatic point about the loss of lean-body mass and the accumulation of fat as we age. Both show a cross-sectional view of a women’s thigh. The left photo is of a 20 year-old athlete and the right of a 64 year-old sedentary women. The younger women has a body mass index (BMI) of 22.6, and the older women a BMI of 30.7.

A body fat mass above ideal has numerous ageing effects that strongly disrupt metabolic control and contribute to most of the common conditions seen in modem clinical practice.

These include:

  1. Insulin Resistance

A high body fat mass invariably results in high circulating serum free fatty acids. These fatty acids have a well?recognised effect to inhibit insulin signalling resulting in insulin resistance. The resulting elevations in insulin and (later) blood glucose, are potent age promoting factors causing increased blood pressure, tri-gylcerides and inflammatory response. (see Biomarker 7.)

Insulin resistance leading to hyperinsulinaemia also reduces fat release from adipose stores, thereby further promoting obesity. The insulin resistant state also disrupts hormonal/neurotransmitter control causing gonadal dysfunction and neurological difficulties.

  1. Inflammation

Obese individuals are now recognised to be producing elevated levels of inflammatory cytokines resulting in high levels of inflammatory markers including C?reactive protein. This proinflammatory state of obesity is due to elevated production of inflammatory chemicals like TNF?a and interleukin?6. These create immune dysfunction and heighten any inflammatory response.

  1. Hormone Imbalance

Fat tissue is a producer of weak oestrogen (oestrone).  Oestrone can block more potent oestrogens like oestradiol, thereby inhibiting normal cyclical oestrogen surges resulting in oestrogen/progesterone ratio imbalance with subsequent menstrual disturbance and infertility.

  1. Cardiovascular Disease

The insulin resistant state promotes arteriosclerosis and cardiovascular disease, whilst obesity may do this directly by increasing inflammation and directly increasing circulating lipids.

It is important to note that where your body fat is stored may be as important to your health and how much of it you have.

Biomarker #5             Fluid Index

The fluid index is simply the % extracellular water, divided by the % intracellular water. This result will give you a quick reference number for the ratios between the intra/extracellular water. What causes the fluid index to rise is oedematous conditions, and a high body fat %. The lower the number, the better the patient’s composition health. Women, due to their naturally high levels of body fat, would be expected to have a higher fluid index.

To improve fluid index, the extra and intracellular water levels must thus be considered independently.

Intracellular Water

Intracellular water (ICW) is the potassium?rich fluid volume found within the cell. Intracellular water is a sensitive indicator of cellular function. An increase in ICW is associated with anabolic metabolism (cellular health) whilst a loss of ICW is associated with catabolism.

Maintenance of intracellular water is dependent on cellular membrane integrity, mitochondrial energy levels and the regulation of electrolytes.

Possible causes of reduced intracellular water are:

  1. Electrolytes are ineffective at maintaining an osmotic gradient that holds water within the cell. Magnesium is the key mineral responsible for regulating electrolyte pumping into and out of the cell. Low magnesium levels result in sodium accumulation within cells and the failure of potassium to be pumped through the cell membrane into the cell.
  2. For effective cellular function, the cell membrane requires its constituents to be able to move about efficiently. Adequate levels of essential fatty acids ensure membrane fluidity and the efficient passage of nutrients and factors passing into and out of the cell.

Stress, inflammation and oxidant stress are associated with cellular catabolism, decreased mitochondrial energy production and loss of intracellular electrolytes necessary to regulate ICW.

Extracellular Water

Extracellular water (ECW) is the sodium?rich fluid volume found outside the cells. These fluids include plasma, interstitial and transcellular (normal and pathologic) fluids. The plasma represents the major proportion and the most labile of the extracellular fluids. Any oedematous condition (such as PMT) increases ECW.

Fluids can be held outside the cell in the extracellular space by various toxins. Toxic chemicals, metabolic wastes, infections and other foreign antigens (foods etc.) can initiate inflammatory and catabolic reactions associated with increasing ECW. High extracellular water may be due to a reduced ability to maintain normal intracellular water volume. Typically, high extracellular water will be seen with low intracellular water.

The toxic cause of high extracellular water can be addressed with Bowel and Gut/Liver Detoxification.

A depleted ECW (dehydrated) is often due to dietary indiscretion, inadequate water intake or malabsorption.

There is increasing evidence that people who accumulate fat around their waist (apple?shapes), have a significantly higher risk for developing heart disease, stroke and diabetes, than people who store fat around their hips (pear?shapes). Monitoring waist?to?hip ratios can be a valuable indicator of health and aging status.

Biomarker #6               Aerobic Capacity

This refers to your body’s ability to take in and properly utilise oxygen. It requires healthy lungs, a strong heart and an efficient circulatory system (vascular network). Aerobic capacity typically declines with age: men peak at approximately 20 years of age and women at around 30 years of age. By age 65 oxygen utilisation has typically declined by thirty to forty percent. The key word here is “typically”.

As with each of the previously discussed biomarkers, proper exercise and nutrition can markedly improve your aerobic capacity, commonly referred to as your V02max. (the maximum volume of oxygen you can utilise over a given period of time). The older you are however, the longer it takes, exercising regularly, to achieve the V02max. of young people.

The healthy changes in oxygen utilization or V02max. that we see in those who exercise properly, are primarily due to adaptations in the skeletal muscles, far more so than changes in heart function.

Biomarker #7             Blood?Sugar Tolerance

For most, ageing is synonymous with increasing blood?sugar (glucose) levels. This compromised ability to regulate and utilise glucose is quite insidious, with the first sign of trouble for many being a diagnosis of diabetes.

The inability to efficiently regulate and utilise glucose is due to reduced insulin signalling effectiveness ? insulin resistance. Insulin resistance leads to higher insulin secretion in an attempt to maintain control. Eventually, control cannot be maintained and glucose levels begin to rise. This is noncompensated insulin resistance and is characterised by high insulin and glucose levels. Both of these can be damaging chemicals.


High levels of insulin promote Syndrome X and its associated pathologies: hypertension, dyslipidaemia and obesity.

Each of these conditions is becoming an epidemic and is associated with significant mortality and morbidity.


Glucose becomes a toxic chemical at high doses and causes the considerable damage in diabetic complications. Glucose can glycate biomolecules, rendering them ineffective and potentially pathogenic.

High glucose levels are associated with microangiopathy, cataracts, retinopathy and peripheral neuralgia.

Poor glucose control is a strong promoter of the ageing process and is clearly environmentally mediated.


The most useful test available to diagnose glucose intolerance or hyperinsulinaemia is the two?hour glucose tolerance test, which measures glucose and insulin levels after a glucose challenge. No other test is capable of measuring abnormalities in insulin secretion, the major determinant of blood sugar abnormalities.

Biomarker #8               Cholesterol/HDL Ratio

Cholesterol is a fatty substance that is a necessary component of your body chemistry. It plays an essential role on the health of your cell membranes and in sex hormone metabolism. Under certain conditions, it can accumulate in artery walls and form fatty plaques, restricting blood flow and leading to arteriosclerosis, a form of heart and circulatory disease.

Cholesterol metabolism is one of the most misunderstood areas in healthcare today. Cholesterol is not an essential nutrient, as your body manufactures it in your liver whenever necessary. It circulates in your blood stream as “lipoproteins”. These are combinations of fat bound to proteins. Some of these cholesterol?containing lipoproteins have been found to actually protect us from heart disease, these are called high density lipoproteins or HDL’s. The other lipoproteins, low density or LDL’s, and very low density VLDL’s are the types associated with the arteriosclerosis mentioned earlier.

Studies have shown that when the ratio of total cholesterol over HDL cholesterol is 4.5 or lower, there is a reduced risk to heart and circulatory disease. Unfortunately it is typical for cholesterol 1 HDL ratios to increase or worsen with age, increasing your risk to disability and premature death.

Here again, the key to reducing LDL’s (the most harmful form of cholesterol) and raising HDL’s (the beneficial form), is better dietary management, proper supplementation and a proper exercise program. More specifically, diet changes can lower LDL’s, but it takes both exercise and a reduction in body fat to raise HDL’s.

The paradox here, is that for some people to reduce body fat, they must actually increase their intake of the “healthy” fats and oils, while decreasing their intake of the “cholesterol?free” carbohydrates.

Is it any wonder that so many people today find themselves feeling confused and bewildered about what and how to best meet their nutrition needs.

Ibis area of fats and health, further exemplifies the need for individual assessment and targeted recommendations with respect to ones nutritional needs.

Biomarker #9               Blood Pressure

Although there are cultures around the world who show no increases in blood pressure with age, the United States and Canada are not among them. Hypertension, often referred to as “the silent killer”, affects 65 million North Americans, increasing their risk to heart attacks, stroke and other serious diseases with seldom any warning symptoms.

Your blood pressure has two components:

  1. i) Your systolic pressure (read first) which reflects the

pressure on your arteries when your heart contracts.

  1. Your diastolic pressure (read second) which represents

the pressure in your arteries between heart beats when

your heart is at rest.

Normal blood pressure is less than 140 systolic (with 120 considered ideal) and less than 85 diastolic. Even though some people are genetically predisposed to hypertension, the proper nutrition and exercise program will restore normal healthy pressures in most cases.

You can also have blood pressures which are too low. The symptoms of which are very similar to those of low blood sugar levels. These include: episodes of weakness and light?headedness especially on sudden changes of posture.

In more acute cases, such as hypotension, can be related to dehydration and electrolyte imbalances. For example, following heavy exercise in very warm weather or after protracted vomiting or diarrhoea.

With more chronic cases the hypotension, especially if it is posture­ related can be a sign of adrenal insufficiency as the result of prolonged distress. If this. is suspected further tests on adrenal function should be conducted. Conducting blood pressure tests in several different postures, can be a valuable screening tool here.

Biomarker #10                      Bone Mineral Density

There is typically an age?related decline in bone mineral density that leaves older people with weakened bones and at risk to disability and life threatening complications. The later stages of this bone mineral loss is called “osteoporosis”. Contrary to popular belief, it affects men and women. Although it is accelerated in menopausal women it is not a problem which is exclusive to them.

Studies show a typical decline in bone mineral density if one percent per year after peak bone density is reached at between ages 28 to 35 years in men and women. After menopause, typical bone loss increases to three percent per year and for some it can be as high as fifteen percent.

What may shock you is that your rate of bone loss increases 50?fold during prolonged bed rest. Research shows, that two weeks of bed rest can cause as much calcium loss as one full year of ageing! Needless to say, the very best prescription for the prevention and treatment of bone loss is proper exercise and proper nutrition. The nutrition component must include adequate levels of calcium and associated bone building nutrients.

As with each of our biomarkers, there is a simple test that can be conducted to assess whether you are losing significant bone density or not. It involves analysis of your urine to assess the levels of several by?products of bone breakdown, which when elevated signals an accelerated loss of bone. Corrective measures can then be initiated and a re?test done several weeks later to ensure resolution of the condition.

BIA offers a unique window in to the body. It is simple non-invasive and there are no contra-indication to its use. Linked with computing programs it is able to give us a snap shot of the body at that time.



Typical lifeline Ideal lifeline

Old age in our society is linked with declining mobility and increasing morbidity. Typically in our 40th or 50th decade we begin to experience a decline in our health as can be seen in the illustration of typical lifeline. Unfortunately without any corrective measures this progresses to poor health and then progressive disability. Fortunately with the knowledge available today this need not be the picture of our life. The ideal lifeline shows that with correct intervention our wellbeing can be extended well beyond the norm giving us a fruitful old age.

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