Health Assessment Report
Function Bone Health

COMPREHENSIVE HEALTH ASSESSMENT REPORT

Strength Lab Plus 3341 Tamiami Trl N
Naples, FL 34103
+1 (239) 544-4114
[email protected]

PATIENT DETAILS

Patient Name
Lisa Panos
Date of Birth
March 19, 1967
Chronological Age
58 years
Assessment Date
October 2, 2025
Anthropometrics
163 cm (5'4") • 58.0 kg (128 lb) • BMI 21.83 kg/m²
Menopause Status
Postmenopausal (age 55)
Next Biody (3 months)
January 2, 2026
Next REMS (6 months)
April 2, 2026

Biological vs Chronological Age

Legend: Green = at or better than chronological age • Yellow = mildly accelerated • Red = significantly accelerated

EXECUTIVE SUMMARY

Critical Findings

Left femoral neck osteoporosis (T-score −2.5) Osteopenia in spine and right hip Sarcopenia risk: ASMI buffer 0.99 kg/m²

Significant Findings

Cellular vitality at lower threshold Body composition imbalance MONW phenotype despite normal BMI

Positive Indicators

Normal hydration status Adequate protein mass No acute inflammation
Overall Assessment: Patient presents with accelerated musculoskeletal aging requiring immediate intervention to prevent fracture risk progression and functional decline. Prognosis is favorable with comprehensive treatment adherence.

BONE HEALTH ASSESSMENT

Spine (L1–L4) — REMS Densitometry

Bone Mineral Density (BMD)

  • Total BMD: 0.842 g/cm²
  • T-score: −1.9 (Osteopenia)
  • Z-score: −0.6 (within expected range for age)

Fragility Score

25.1/100
Green = normal • Yellow = borderline • Red = degraded
R3 Risk Class — 5-year major osteoporotic fracture: 1.0-2.0%

Bone Mineral Content (BMC)

Measured: 2.22 kg Reference: 2.05 kg +8.3%
Summary (Spine): Mineral deficit (T-score −1.9) with preserved microarchitecture (Fragility 25.1). This dissociation indicates primary mineral loss rather than structural deterioration, suggesting excellent treatment response potential.

Right Femur — REMS Densitometry

Bone Mineral Density (BMD)

  • Neck: 0.593 g/cm² (T-score −2.3, Osteopenia)
  • Total: 0.699 g/cm² (T-score −2.0, Osteopenia)
  • Trochanter: 0.722 g/cm² (T-score −1.6, Osteopenia)

Fragility Score

19.1/100
Green = normal • Yellow = borderline • Red = degraded
R4 Risk Class — 5-year hip fracture: 0.8-1.5%
Summary (Right Hip): Bilateral femoral osteopenia with lower fragility score (19.1) indicating better preserved hip architecture than spine. Normal bone quality despite reduced density.

Left Femur — REMS Densitometry

Bone Mineral Density (BMD)

  • Neck: 0.575 g/cm² (T-score −2.5, Osteoporosis)
  • Total: 0.678 g/cm² (T-score −2.2, Osteopenia)
  • Trochanter: 0.700 g/cm² (T-score −1.7, Osteopenia)

Fragility Score

19.4/100
Green = normal • Yellow = borderline • Red = degraded
R4 Risk Class — 5-year hip fracture: 0.8-1.5%
Summary (Left Hip): WHO diagnostic threshold for osteoporosis reached in left femoral neck (T-score −2.5). Similar fragility score (19.4) to right hip indicates maintained bone quality. Left-right asymmetry suggests mechanical loading differences.
Combined Bone Health Summary: Mixed osteopenia and osteoporosis with bilateral femoral involvement more severe than spinal. Critical distinction: while BMD is reduced (quantitative deficit), preserved Fragility Scores (19.1-25.1) indicate maintained bone microarchitecture quality (qualitative preservation). This dissociation suggests primary mineral loss rather than structural deterioration, indicating better treatment response potential and lower fracture risk than BMD alone would suggest. Immediate intervention required to prevent progression.

BODY COMPOSITION ANALYSIS

Fat Mass Assessment

Total Fat Mass 13.17 kg (22.95% at constant hydration)
Body Fat Percentage 32.6%
Fat Mass Index (FMI) 4.98 kg/m²
Age-Specific Classification Fit (31-34% for age 55-59)

Muscle Mass Assessment

Skeletal Muscle Mass (SMM) 23.26 kg (40.10% of body weight)
ASMI (Appendicular SMI) 6.69 kg/m²
Sarcopenia Threshold <5.70 kg/m²
Safety Margin +0.99 kg/m² (17.4% above threshold)

Body Mass Index (BMI)

21.83
Normal Weight
Underweight • Slim • Fit • Overweight • Obese
Note: BMI has limitations as it doesn't distinguish muscle from fat. Body composition analysis provides more accurate health assessment.
Body Composition Summary: Despite normal BMI (21.83 kg/m²), patient exhibits "metabolically obese normal weight" (MONW) phenotype with elevated body fat (32.6%) and minimal sarcopenia buffer (0.99 kg/m² above threshold). While fat percentage is within "fit" range for age, the unfavorable muscle-to-fat ratio and narrow safety margin above sarcopenia threshold require immediate intervention. Annual muscle loss of 1-2% without intervention could reach sarcopenia threshold within 4-8 years.

CELLULAR HEALTH & HYDRATION

Phase Angle (50 kHz)
6.8° (Normal threshold: >6.0°)
Total Body Water (TBW)
33.53 L (57.82% of body weight)
Intracellular Water (ICW)
20.02 L (59.71% of TBW)
Extracellular Water (ECW)
13.51 L (40.29% of TBW)
ECW/TBW Ratio
40.29% (Normal: 39-45%)
Fat-Free Mass Hydration
74.80% (Normal)
Cellular Health Summary: Phase angle of 6.8° indicates adequate cellular membrane integrity but positions at lower acceptable threshold, suggesting suboptimal cellular function with room for improvement. Hydration status is well-balanced with no evidence of fluid retention or dehydration. Normal ECW/TBW ratio (40.29%) indicates absence of acute inflammation. The suboptimal phase angle may reflect mitochondrial dysfunction, a hallmark of biological aging, responding well to targeted nutritional intervention (CoQ10, PQQ, NAC) and exercise.

METABOLIC ASSESSMENT

Basal Metabolic Rate (BMR)
1,254 kcal/day
Reference BMR
1,222 kcal/day
Deviation
+32 kcal/day (+2.6%)
Sedentary (maintenance)
1,545 kcal/day
Moderate Activity (3-5×/week)
1,996 kcal/day
Very Active (6-7×/week)
2,221 kcal/day
Metabolic Summary: BMR slightly elevated (+2.6%) compared to reference, indicating adequate muscle mass and no metabolic suppression. For body recomposition goals (fat loss with muscle preservation), recommended caloric intake of 1,400-1,600 kcal/day with moderate exercise creates appropriate deficit for 0.5-1 kg/month fat loss. Protein requirement: 90-110 g/day (1.6-1.9 g/kg lean body mass) distributed across 3 meals. Despite normal BMI, elevated fat percentage warrants screening for metabolic syndrome components (insulin resistance, dyslipidemia, inflammatory markers).

CLINICAL RECOMMENDATIONS

Immediate Actions Required

  • Bone Health: Initiate osteogenic loading therapy (Biodensity 1×/week) + vitamin D3 (2,000-4,000 IU), K2-MK7 (100-200 mcg), calcium hydroxyapatite (1,000 mg), magnesium glycinate (300-400 mg)
  • Muscle Preservation: Progressive resistance training 2-3×/week + protein optimization 90-110g daily + EAA supplementation (15g post-training) + creatine monohydrate (5g daily)
  • Body Recomposition: Low-carb Mediterranean diet + 16:8 intermittent fasting + moderate aerobic activity 150-200 min/week
  • Cellular Health: CoQ10 (100-200mg), PQQ (20mg), NAC (600-1,200mg), Omega-3 (2-3g EPA+DHA daily)
  • Laboratory Assessment: Bone turnover markers (CTX, P1NP), vitamin D, inflammatory markers (hs-CRP), metabolic panel (glucose, insulin, HbA1c, lipids), hormone panel

12-Week Goals

Fat mass: −1.5-2.5 kg ASMI: Stable or increased Strength: +15-25% Phase angle: Improve toward 7.0°+

12-Month Goals

BMD: +2-5% improvement ASMI: >7.0 kg/m² Body fat: <30% Biological age: −2-3 years

Monitoring Schedule

Week 12: Biody reassessment Month 6: REMS + labs Month 12: Comprehensive review Quarterly: Functional testing

PROGNOSIS & OUTCOMES

With Full Adherence (Best Case)

12-Month Outcomes:
• BMD improvement: 3-5%
• ASMI: Increased to 7.0-7.3 kg/m²
• Body fat: Reduced to 28-30%
• Phase angle: 7.0-7.5°
• Fracture risk: Reduced to R2-R3
• Biological age: −2-3 years
• Quality of life: Significantly improved

70-80% Adherence (Realistic)

12-Month Outcomes:
• BMD: Stable or +1-2%
• ASMI: Maintained above 6.5 kg/m²
• Body fat: Reduced to 30-31%
• Phase angle: 6.9-7.2°
• Fracture risk: Stable
• Biological age: −1 year

Without Intervention

12-24 Month Trajectory:
• BMD decline: 1-2% annually
• Progression to osteoporosis
• Muscle loss: 1-2% annually
• ASMI: Approaching sarcopenia
• Body fat: Increased to 34-36%
• Fracture risk: Escalation to R5-R6
• Accelerated biological aging
Key Success Factors: Patient has significant positive prognostic factors including normal fragility scores (preserved bone quality), adequate current muscle mass, and normal hydration. The critical distinction between reduced BMD but preserved bone microarchitecture indicates excellent treatment response potential. Consistent adherence to resistance training, adequate protein intake, Biodensity program, and supplement protocol are essential for optimal outcomes.
This report synthesizes data from Biody bioelectrical impedance analysis and REMS ultrasound densitometry. All recommendations are evidence-based but must be reviewed and approved by the patient's treating physicians before implementation. This document is for informational and educational purposes and does not constitute medical advice.
Report Generated: October 2, 2025 • Next Review: January 2, 2026