Your Health Status Assessment Report

Wellest estimates your health status each time you make changes to your demographics or measurements. These changes generate a new report that you can refer to later in the Progress > Status section of the app. The report is split into a few sections: 1) Status Assessment, 2) Body Mass, 3) Body Composition, and 4) Metabolism. The report can help you understand the state of your health so you can best plan your goals and see how well you're making progress.

Status Assessment

Wellest optimizes Body Composition with a primary focus on improving Leanness (measured in Body Fat Percentage (BF%)) and then improving Muscularity (measured in Fat-Free Mass Index (FFMI)) secondarily. More on those measurements later.

To help you understand where your health is currently and what risk factors you may have, Wellest compares your health statistics to a range of population studies. You can compare yourself to these references using the Wellest Body Composition Map. As part of your status report, Wellest will provide a Status Assessment summary based on your closest reference points.

💡 Tip | Your current health statistics are at the bottom of the Your Status screen. If you tap on the values you can change them from the default unit system (e.g. 20% body fat) to others if available (e.g. 30 lb body fat).

In general, the overall goal for everyone using Wellest is to move towards the bottom-right of this map as they reduce BF% and increase FFMI. Wellest automatically guides you towards the dark teal section of the map — the "Wellest Zone" — that represents the ideal combination of improvements to general wellness, function, athletic performance, aesthetics, and long-term health.

To better understand your current health status it can be helpful to understand what options exist for you to set your goals by reading the Your Goals FAQ article.

Learn More about Your Goals

Body Mass

Wellest is interested in your Body Mass (or Weight) because it is a required value to help us determine your body composition and to measure how your body changes over time easily.

  • Weight | Quite simply, Weight is the measure of your body's mass on Earth. More interestingly, it can also be thought of as the net energy you've acquired over your lifetime in addition to the water you currently store. Thought of in this way, it is clear that you can manipulate your weight easily through hydration status changes but that effect will be temporary as your body must restore proper hydration to live. To make a lasting change in weight, energy must be either added or removed from your system over time so mass can be accrued or lost. The energy gained from the loss of 1 lb (0.45 kg) of Body Fat is ~3600 kcal and of Lean Body Mass is ~600 kcal. So it may also be obvious that if you want to rapidly lose weight, you would prioritize losing LBM instead of BF as you can lose 6 lb of LBM for the same energy as 1 lb of BF. But this will ultimately make your body less functional, weaker, and possibly less attractive, as well as reduce your metabolism, which will set you up to gain more BF back later. This starts the cycle of yo-yo dieting that plagues the majority of adults in the United States. There are several popular diets, detoxes, cleanses, clinics, coaches, etc., that target these types of rapid weight loss that ultimately harm your long-term health. Clearly you must look beyond just weight to control and optimize your health.

  • Body Mass Index (BMI) | This is the standard measure used by most apps, coaches, and even physicians to easily assess your general health and wellness as it pertains to metabolism and related diseases. It is simply a measure of how your weight compares to your height. It can be a useful measure for very average individuals with average risks. The less average you are or the less average your health risks are, the less useful this measure becomes. The goal of everyone on Wellest is to become far healthier than the average so it is critical to understand, but ultimately devalue, BMI for estimating your health.

Body Composition

Wellest goes beyond the normal health statistics offered by other services. By focusing on Body Composition over the more simplistic Body Mass measures, Wellest is able to more thoroughly assess your health and help you plan to reach your goals.

Body Composition breaks down your weight into its component pieces including Water, Bone-, Organ-, and Muscle-Mass, as well as Body Fat. Water has no energy and can be easily manipulated through fluid, electrolyte, and carbohydrate intake, as well as urination, exercise, menses, etc. Together Bone-, Organ, and Muscle-Mass, along with their portion of total body Water, make up Lean Body Mass. This leaves Body Fat.

The optimization of Body Fat and Lean Body Mass is Wellest's primary focus.

  • Leanness (Body Fat Percentage (BF%) | Body Fat Mass is not a particularly useful statistic to assess your health because it does not take into account the other components in your body composition. To account for this, Body Fat Mass is divided by your Weight to calculate Body Fat Percentage (BF%). When compared this way, it is easy to see how your body compares to the available research for various health conditions as well as visualize how "lean" your body looks. Beyond the obvious benefit of improving aesthetics, BF% is a proxy for the range of far more serious metabolic diseases. These include heart, lung, brain, kidney, and liver diseases as well as various cancers and type II diabetes. These conditions lead to nearly 70% of all causes of death in the United States per the CDC. By reducing BF% below the "Minimally Healthy" level for your gender you significantly reduce your risk of developing these diseases compared to the average. By reducing further into the "Athletic" and "Aesthetic" levels you reduce your risks much further still, and gain the benefits of improved athletic ability, aesthetics, mood, self confidence, and more. Although it is possible to have too low of a BF%, Wellest will not allow you to maintain a value at or below the "Genetic Potential" level where it could impact your health through persistent changes to your metabolic and sex hormones.

  • Lean Body Mass (LBM) | LBM contains your body's Bone-, Organ-, and Muscle-Mass. Bone Mass is generally stable in adults but can be slowly gained or lost over time usually due to changes in muscle mass. Organ Mass is also generally stable in adults except in cases of disease such as fatty liver disease or various cancers. Muscle Mass is highly variable from one individual to another. In addition, all of these tissues store a necessary amount of water to help them function optimally. There is no way, short of surgery, to directly control any portion of your LBM long-term other than muscle mass. Wellest optimizes LBM through muscle mass. LBM can be built strategically to achieve superior function, strength, flexibility, athleticism, aesthetics, and metabolism, as well as reduce the short-term impacts of too high of BF% on metabolism. LBM is developed through the purposeful application of resistance training with progressive overload to increase the size and therefore capability of targeted muscle groups. LBM can also be lost strategically to achieve certain aesthetics goals although there is no research to suggest that reducing LBM is advisable and therefore Wellest does not support the capability.

  • Muscularity (Fat-Free Mass Index (FFMI) | Just as Body Fat Mass needs to be converted to Body Fat Percentage to be useful to assess your health, LBM also needs to be converted. Similar to how BMI is a comparison of your Weight to your Height, FFMI is a comparison of your LBM to your Height. When compared this way, it is easy to see how your body compares to available research as well as visualize how "muscular" your body looks. Observed in conjunction with BF%, FFMI helps us determine the overall look of your body or its "tone". Beyond the benefits to your aesthetics, FFMI is a proxy for important health conditions that will impact you as you age including sarcopenia and osteoporosis. Sarcopenia, or age-related muscle loss, affects up to 50% of those aged 80 or above. Osteoporosis, or age-related bone loss, affect up to greater than 50% of those aged 50 or above and is markedly worse in post-menopausal females. Ultimately, it is these conditions that put the elderly at risk of incapacitation, inability to fulfill activities of daily living (ADLs), and life-threatening falls. By increasing FFMI above the "Minimally Healthy" level for your gender you significantly reduce your risk of developing these conditions compared to the average. By increasing further into the "Aesthetic" level or higher towards your maximum potential can improve your athletic abilities and competitiveness as well as aesthetics.

  • Genetic Potential Achieved (GPA) | Wellest GPA is the ratio of your current level of FFMI compared to your maximum genetic potential FFMI expressed as a percentage. This is similar in concept to what is often referred to as "training status" in the evidence-based fitness community. It describes how far you've been able to progress with your resistance training and muscular development compared to what your body is maximally capable of accomplishing. This is critical to understand because as you increase your GPA and approach your potential, the training stimulus required to motivate additional growth becomes much greater. At the same time, your ability to manage increasing training intensity and duration as well as to recover from strenuous exercise also increase dramatically. In addition, your body's nutritional requirements change significantly depending on your GPA. Finally, it is also useful to understand what is a reasonable level of muscular development for your body so you can balance your goals with the cost of time, money, and effort required to achieve them.

Metabolism

Another way in which Wellest is different from other health services is that we evaluate your individual Energy Balance equation. Energy Balance is equal to the difference of your Energy Intake and Energy Output over time. Energy Intake is directly managed by Wellest through your nutrition plan which includes management of not just energy but also macronutrient and micronutrient intake. And Energy Output, or your Metabolism as it is often called, is both indirectly and directly controlled in different ways depending on the component. Your overall metabolic rate is also sometimes called your Total Energy Expenditure (TEE). It is composed of your Basal Metabolic Rate (BMR), Thermic Effect of Food (TEF), Exercise Activity Thermogenesis (EAT), and Non-Exercise Activity Thermogenesis (NEAT).

It is critically important to evaluate and control all of the components of your metabolism together so that we can most accurately plan the energy balance required to make changes in your body composition and weight through changes in your activity and nutrition.

It is through this complete picture of your metabolism that Wellest is able to guarantee that you achieve results each and every month you use the service. As long as you are able to check-in your measurements each week and are able to reach a reasonable level of plan compliance for the relative difficulty of your goals you will be successful. In other words, if you choose easy goals they should be easy to achieve without being very highly compliant to your plan, but if you choose difficult goals then you will need to be much more precisely compliant.

  • Basal Metabolic Rate (BMR) | BMR is also sometimes called the Resting Metabolic Rate (RMR). Although research shows that it varies based on your age, hormonal sex, weight, body fat, and even menses, the most reliable estimation method uses LBM. This is because the most energy-expensive tissues in your body are your organs such as your brain, heart, liver, etc., as well as maintaining your muscle mass. Body Fat does have a cost as well but is it much smaller. This means that we can improve your BMR over time by increasing your LBM through gains in muscle mass. In addition, due to hormonal changes BMR has been shown to be responsive to your diet. So prolonged periods of energy restriction generally reduce BMR while periods of surplus increase it. This has given rise to a diet trend called "Reverse Dieting" in which dieters deliberately increase their energy intake as high as possible while trying to maintain their weight. However, it has been shown that ultimately when body weight, body composition, and nutrition intakes are controlled there is no permanent change or "metabolic damage" caused by such periods of extended energy deficit or surplus. So this form of dieting is not required beyond the methods used by Wellest to control your nutrition towards your goals already. Depending on which measurements you provide, Wellest will utilize the best-fit formula for determining your baseline BMR. Still, there can be high individual-to-individual variance in BMRs due to other genetic and hormonal factors, which Wellest addresses through the Wellest Energy Anomaly (discussed below). To start with the most accurate baseline BMR measurement it can be useful to perform an “RMR Test” at a local clinical facility. If you have these test results, please remember to share them with your Wellest Coach so they can modify your plan accordingly. Ultimately if your BMR is found to be much lower than expected it may be advisable to consult with an endocrinologist to discuss related symptoms and to receive additional testing.

  • Thermic Effect of Food (TEF) | TEF is the energy that is wasted by your body as it digests and assimilates food. Nearly all foods, except water and zero-calorie foods of course, contain macronutrients including protein, carbohydrate, dietary fiber, fat, and alcohol. Each macronutrient has a related amount of energy that is yielded when your body metabolizes them. TEF is the overhead cost for your body to breakdown, store, and utilize these macronutrients for energy. This is the concept that gave rise to the idea of "negative calorie" foods that would require your body to burn more energy to digest than they contain in the first place. Celery and grapefruit are often-referenced examples of this idea. Sadly, no such foods actually exist as the percentage cost to metabolize any macronutrient is far less than 100% of the energy that it yields. However there is a large difference in the TEF of each macronutrient. And combining macronutrients into the same feeding event also increases the total TEF due to the complexity associated with metabolizing multiple macronutrient types simultaneously. Further, your body is also more or less efficient at metabolizing the difference macronutrients at different levels of BF%, activity, and insulin resistance. Unlike other health services, Wellest utilizes these factors strategically along with activity planning and nutrient partitioning to help you reduce hunger and optimize weight control as your body changes in response to your plan. See the table below for reference values of energy yields and TEFs by macronutrient.


Energy Yield (kcal / g)

TEF (% of energy yield)

Protein

~ 4 kcal / g

~ 20 - 35%

Dietary Fiber

~ 1.5 - 2.5 kcal / g

~ 15%

Fat

~ 9 kcal / g

~ 0 - 15%

Net Carbohydrate

(Total Carbs - Fiber)

~ 4 kcal / g

~ 5 - 15%

Alcohol

~ 7 kcal / g

~ 17 - 23%

Mixed Meals

~ 12 - 25%

  • Exercise Activity Thermogenesis (EAT) | EAT is also sometimes called the Thermic Effect of Activity (TEA). In the past it has been considered all of the energy expended by your body through activity beyond RMR. However, it is now split between energy expended during purposeful exercise, which is the current definition of EAT, and the energy expended through incidental activity (see NEAT below). EAT considers both the Active Energy burnt during the actual exercise duration as well as the additional energy burnt after the exercise concludes or the Excess Post-exercise Oxygen Consumption (EPOC). EPOC is considered a temporary increase to your BMR lasting ≤ 36 hours after exercise. It is usually quite small for the majority of aerobic activities however High-Intensity Interval Training (HIIT) or similarly intense exercise can elevate BMR temporarily. The largest EPOC is generated by intense resistance training due to your body's need to rebuild and adapts your muscle mass for the next bout of training. However, EAT does not contain the portion of your BMR that is naturally expended during the exercise duration. Unlike other health services, Wellest considers the difference between the Active and Basal Energy expended during exercise. Still, due to the very high variability of EPOC, Wellest does not model this effect directly and rather it is addressed through the Wellest Energy Anomaly (discussed below).

  • Non-Exercise Activity Thermogenesis (NEAT) and Wellest Energy Anomaly | NEAT is the portion of your metabolism that is due to physical activities that you do not purposefully schedule as exercise. For example, cleaning your home, biking to work, standing at your desk, walking your dog, playing with your children, etc., are activities that very few people purposefully schedule or track as exercise. Given the very high variability in lifestyles, everyone can have very different levels of NEAT. It is often why some individuals appear to be less active but more fit than others with more planned exercise activity. In addition, NEAT is adaptive: 1) it is usually inversely proportionate to EAT so the more you purposefully exercise the less spontaneous activity you are likely to perform, and 2) it seems to go down over time during energy restriction as your body naturally tries to reduce energy output to maintain homeostasis. Altogether, NEAT can account for anywhere from ~0 up to thousands of calories per day in energy expenditure depending on your health status and lifestyle. Due to its high variability and adaptive nature, it is difficult to measure, track, and account for NEAT. Wellest overcomes this and other issues related to individual variance in your body's metabolism using the Wellest Energy Anomaly. The Wellest Energy Anomaly is a measure of how your body is different from our expectations based on how your body actually responds to your plan each week compared with the scientific literature, your status, your goals, and your compliance to the plan. The adaptability of the Wellest Energy Anomaly is one of the primary capabilities that allows Wellest to uniquely personalize your plan and tune each successive plan to ensure you are always making optimal progress and don't plateau or yo-yo diet.

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