Metabolic Health Assessment on the Isle of Man

Metabolic health is assessed poorly in standard primary care. BMI is used as a proxy for metabolic status despite its well-documented failure to detect the sarcopenic obesity that characterises many adults over 50: normal BMI but high body fat, low muscle mass, and high visceral fat. These adults are metabolically at-risk by every relevant marker but classified as healthy by BMI alone.

Metabolic Markers That Matter

• Body fat percentage: more predictive of metabolic disease risk than body weight or BMI
• Visceral fat rating: visceral fat around the organs is an independent cardiovascular and diabetes risk factor regardless of total body weight
• Metabolic age from bioelectrical impedance: an integrated assessment of muscle mass, body composition, and hydration that correlates with measured resting metabolic rate
• Muscle mass as a percentage of body weight: the primary determinant of glucose disposal capacity and resting metabolic rate
• Dietary pattern assessment: identifying the dietary contributors to insulin resistance and metabolic inflammation