1. Clinical Relevance of BIA “BIA is a simple in-office test that converts easily obtained electrical measurements into information about the patient’s body composition and fluid distribution...” Robert Rakowski DC

2. STEP 1 Total Body Water/Fat Free Mass This marker refers to the hydration of the patient. Must be higher than 69% for a test to be valid. If <69%, patient should be put on hydration protocol and retested in 24-48 hours. Higher is typically better

3. STEP 1 (CONTINUED) TBW/FFM Percentage of fat-free mass that is water Values below 69 indicate dehydration Accurate even when subject is significantly overweight TBW/Total Weight Percentage of total weight that is water Declines with age Shows dehydration if person is significantly overweight.

4. STEP 2 Phase angle General indicator of cellular health Provides info on cell membrane potential at the tissue level

5. Do You Believe in Miracles? Lance Armstrong is monitored with the BIA during his preparation for the Tour de France. Dr. Jeff Spencer uses a variety of Metagenics products to keep his team leading the world.

6. Cellular health tends to be correlated to a person’s phase angle Lance Armstrong Suboptimal

7. STEP 3 Intracellular Water Healthy cells maintain their integrity and hold their fluid inside >60% is optimal. Changes with age Extracellular Water Water volume outside of the body cell mass Higher values may be related to fluid retention

8. STEP 4 Fat Free Mass vs. Fat Determine the amount of metabolically active tissue in the person. Optimal range depends on sex and age of person. BIA can determine both subcutaneous fat (Love Handles) as well as visceral fat found around the organs of the body. Advantage over calipers to assess true health status.

9. STEP 5 ECM/BCM Ratio of extracellular mass (non-metabolically active) to body cell mass (metabolically active) Low value is desirable Upward shift suggests imbalanced weight loss. Downward shift suggests balanced weight loss. Use Body Composition Protocol to shift.

10. STEP 6 Body Mass Index BMI correlates with a person’s health. Studies show even moderate BMI shifts mean health consequences. Lower is better Alter using Body Composition Program.

11. STEP 7 Basal Metabolic Rate BMR- is the amount of calories a person burns during a 24 hour period while at rest. More lean body mass will increase the BMR Higher is typically better. Each person is very unique Essential in establishing a proper body composition program.