Metabolic Evaluation Training Video

This video is about 9 minutes long and walks you through the process of doing a metabolic evaluation.

How to use the Scale: Tanita Scale Image

  1. Client must be with bare feet.  Remove extra clothing, if desired.
  2. Press “Guest” on scale to turn on the scale.
  3. Enter client’s age using the up/down arrows. Press “SET”. (18 is the youngest allowed)
  4. Identify as male or female using the up/down arrows (do not use athletic modes).  Press “SET”.
  5. Enter client’s height using the up/down arrows.  Press “SET”.
  6. Wait 3 or so seconds until you hear a double-beep which means the scale is ready.
  7. Grab handles, draw upward and hand to client.
  8. Have client grasp handles with contact all around but with relaxed arms and shoulders.
  9. Have client stand on scale with bare feet firmly on pads of scale.
  10. After a few seconds, be certain scale has begun analyzing as evidenced by digital figure being scanned and “cycling zeros”.
  11. Consider asking a benign question to distract the client as being on a scale is anxiety inducing.
  12. The evaluation will end with a double beep after roughly 20-30 seconds.  It will begin cycling the results.
  13. Take the handles from the client and replace.  The client can get off the scale, now.
  14. Begin taking down the results as the machine will clear them after roughly 15 seconds of remaining idle.

How to get results:Tanita Scale Buttons Image

  1. Weight: Press the “weight” image at 10 o’clock on scale.
  2. Body Fat %: Press the figure with % sign on body at 8 o’clock on scale.
  3. % body water: Press figure with droplet on body at 12 o’clock on scale.
  4. Muscle Mass: Press figure weight lifting at 4 o’clock on scale.
  5. Physique rating: Press weight-lifting figure 6 more times until 1-9 grid shows one highlighted number.
  6. Bone Mass: Press skeleton figure at 2 o’clock on scale
  7. BMR (Resting Metabolic Rate): Press figure with battery charge on body at 11 o’clock on scale.
  8. Metabolic Age: After writing down BMR, wait for metabolic age to appear.
  9. Visceral Fat: Press figure with arms spread and circled belly at 1 o’clock on scale.

Downloads:

Metabolic Evaluation Training Handout

Metabolic Evaluation Results Sheets (triplicate)

Metabolic Evaluation Reference Chart

Parting Thoughts:

Weight –
I explain that while we mostly understand weight… there is some interesting stuff to glean.  First, weight is more than just fat… it’s also muscle, bone, water, etc.  (It also should say nothing about self worth even though we give it that power.)
Depending on your frame it can be quite common to gain 5-10 pounds in a day.  So, of course, this time of night is about the worst time to weigh.  The fluctuation in weight is due to water primarily… not muscle or fat.  If a person is prone to fluctuating, they tend to know it, but it’s a sign that they’re eating something that causes inflammation in their gut and the accumulation of water, like with a swollen ankle, is a sign that inflammation has set in… as inflammation resolves, so will the water.  Even though they may not say it, people know the weight that they like and will think that the scale does not work because, they often times don’t like the results.
Body Fat % –
Despite what images on Shape magazine, Prevention and others suggest, your body needs body fat.  As you look at the range on the chart, ideally your body fat is in the darker grey area for your age and gender.  It is the range at which the average person has an adequate amount of body fat as a building block for the physiological needs of the body… not too little fat, and not enough.  Too little fat and we begin to see deficits in physiologic function… impairing systems and structures of nervous system, skin, hormones, immune system, etc…  Our office is full of clients that look great with their shirt off but they feel like crap.  I offer this because so many people in our culture have an idea that their body fat should be super low and we disagree.  As well, too much body fat and we begin to see deficits in function as well.  It slows and depresses the function of these symptoms.
Hydration – I like to see people at the higher side of the range.  Billions of times every second reactions occur in your cells.  This happens in a liquid environment.  As a visual, we want the metabolism of the cells to look like a chicken noodle soup at a full boil with all of the ingredients freely and rapidly banging and moving.  Themetabolism of a dehydrated body is more like a chili soup that is drying out… the ingredients are all kind of stuck and not moving… this creates a sluggishmetabolism… fatigue, depression, etc…  If the people don’t drink water… start.  Some medications cause dehydration.  Can’t tell from the scale but if people have poor nutrient status from deficient diet then they need to increase nutrient density of their diet… higher nutrients in cells hold more water in the body.  Also, body fat and percent hydration tend to be inversely related.
Muscle Mass – There is no range for how much muscle a person should have on their frame… too much variability but the scale combines muscle mass and percent body fat to create the next number, the physique rating.
Physique rating – this is used as a reference for the ideal relationship of body fat to muscle mass on the person’s frame.  Number 5 is considered ideal.  I always caution people that the “people like” figures are not meant to reflect the body shape of the person, just offer a visual of the relationship of body fat and muscle mass.  You can get a sense if people have less, average, or high muscle mass for their frame.
Bone Mass – This is the mass of the mineral content their bones.  We don’t like using the reference range given by the sheet.  We explain that the take home point is that this number is for all purposes their ideal bone mass and it should never really go down.  Contrary to many opinions, there is no reason a healthy female (or male) loses bone.  While osteoporosis is often considered a normal progression of aging… it is not.  It is incredibly common, not normal.  So 5, 10, 40 years from now, these people should have the bone mass.  Beyond a few metabolic conditions like hyperthyroidism, the number one reason we see bone loss so commonly in our culture is due to our highly acidic lifestyles.  It’s complicated but as a culture, we eat, think, do and live in ways that promote metabolic acidosis.  In the same manner that one might take a Tums antacid for an upset stomach, the body simply takes calcium salts (buffers like Tums) from the bone to maintain a near perfect pH of the body.  With a perfect pH a person dies, so it’s kinda important.  People should know that bone is a dynamic organ and can be grown or regenerated like muscle but first step is to address why it’s being lost.
BMR – Basal Metabolic Rate.  This is how many calories of energy a person burns in 24 hours doing nothing more than lying in bed all day.  It is an interesting number that we use to explain should not be used for calorie counting.  It largely aligns with the amount of muscle mass a person has but many people try to use it as a guide for weight loss.  Depending on how active a person is, they use more energy than that in any given day.  If a person engages in calorie counting weight loss, a starvation state metabolism kicks into gear, guided by hormones.  The person may achieve short term weight loss but weight loss resistance will soon begin and then at some point the person will gain the weight back and then some.  The wisdom of the body is that starvation sucks and that it will do anything to prevent that from being an issue… ultimate result is to carry extra energy on the person’s frame as fat.
Metabolic Age – This is a reflection of how the person is doing with all of the numbers/ranges on the scale. If it is older than the person’s chronological then they have some health goals somewhere on the numbers.  If it is younger than their actual age then they’re doing well.  It is the machine’s way of tying up all the numbers in a nice little “bow”.  They can use the number to assess whether a lifestyle change is working for them by checking the metabolic age before and after a lifestyle change.  For instance many weight loss programs will cause the person to lose muscle mass (thereby losing weight) but I would offer that this is a terrible program for someone to be on… they will see their metabolic age go up.  They can quickly determine that the program is likely bad for their health.
Visceral Fat – This is fat around the viscera (internal organs).  Fat around the middle.  We like to see it under 9.  Then under 5… then as low as possible (1).  It reflects levels of cycling insulin and cortisol in the person’s body.  They can’t do sit ups or spot reduce or cut calories to address this type of fat.  They need to lower either their cycling insulin or cortisol or both to get this weight to go away.  Aesthetically it bothers people but for us it reflects hormonal changes that increase risks for chronic disease such as diabetes, cardiovascular disease, stroke, etc…