Understanding your body's physical composition, metabolic characteristics, and cardiovascular measurements.

Your evaluation begins with a detailed assessment of your body's physical measurements and composition to establish a meaningful baseline of your current health. While conventional assessments often emphasize height, weight, and body mass index (BMI), these measurements alone cannot adequately distinguish between muscle, fat, and other important components of your body. We therefore take a more comprehensive approach, incorporating measurements such as waist and hip circumference, waist-to-hip ratio, and, when appropriate, bioelectrical impedance analysis (BIA) to estimate body fat percentage, skeletal muscle mass, fat-free mass, and total body water. This assessment helps us better understand how your body is composed, where excess adipose tissue may be distributed, and whether your current body composition is consistent with your metabolic, functional, and performance goals.

When clinically appropriate, your body composition evaluation may also include estimates of intracellular and extracellular water, resting metabolic requirements, and other characteristics associated with muscle mass and fluid distribution. These findings can provide additional context for evaluating nutritional adequacy, hydration, physical conditioning, recovery, and changes in body composition over time. We also assess relevant vital signs, including blood pressure, heart rate, respiratory rate, temperature, and, when indicated, oxygen saturation or respiratory function. Together, these measurements help us identify patterns that may warrant further investigation, including changes associated with cardiovascular and metabolic health, nutritional status, physical inactivity, or inadequate recovery. Most importantly, the evaluation provides objective reference points that allow us to monitor your progress and adjust your nutrition, movement, and lifestyle recommendations according to measurable changes rather than body weight alone.

Investigating your body's internal chemistry, nutrient status, and metabolic function.

Your biomarkers and laboratory evaluation explores the internal biochemical processes that support your health, providing insight into areas that cannot always be determined through symptoms or a physical examination alone. We begin by reviewing your relevant medical history and existing laboratory results to identify what is already known, where additional clarification may be beneficial, and which investigations are appropriate for your individual circumstances. Following the Institute for Functional Medicine's PFC-MVP framework, we organize nutritional biomarkers into six primary categories: Proteins, Fats, Carbohydrates, Minerals, Vitamins, and Phytonutrients. These categories help us evaluate important aspects of nutritional and metabolic health, including protein status, lipid metabolism, glucose regulation, micronutrient availability, and selected markers associated with cellular protection and oxidative stress. Rather than ordering every available laboratory test, we use a tiered approach that prioritizes clinically useful foundational testing and reserves more specialized assessments for circumstances in which they may meaningfully improve diagnostic understanding or patient management.

Depending on your medical history, symptoms, physical examination, and health goals, your laboratory assessment may include measurements such as a complete blood count, comprehensive metabolic panel, lipid profile, glucose and insulin markers, iron studies, and selected vitamin or mineral tests. When clinically justified, more targeted investigations may be considered to evaluate specific nutritional deficiencies, endocrine function, inflammation, gastrointestinal conditions, or other suspected physiologic disturbances. We interpret these findings in relation to your overall clinical presentation, recognizing that laboratory values represent important pieces of information rather than definitive explanations of health in isolation. Our goal is to determine which biochemical findings are clinically relevant, identify potentially modifiable contributors to dysfunction, and translate the results into practical recommendations concerning nutrition, medical follow-up, movement, recovery, and other appropriate interventions. This process also establishes objective markers that may be reassessed over time to evaluate your response to care and guide further clinical decisions.

Recognizing the physical signs and functional patterns that may reveal important information about your health.

The clinical examination is one of the most valuable components of your ABCD evaluation because your body often provides observable and measurable clues about its nutritional and physiologic status. During this comprehensive, head-to-toe assessment, we carefully examine selected physical characteristics and functional responses that may be associated with nutritional insufficiencies, metabolic disturbances, or other underlying health conditions. This includes evaluating the appearance and condition of your hair, skin, nails, eyes, nose, mouth, and oral tissues, along with selected aspects of your peripheral nervous system. We look for changes in tissue integrity, color, texture, sensation, and function that may provide additional context for understanding your medical history and laboratory findings.

Unlike an examination focused exclusively on identifying overt disease, our functional nutrition physical examination also considers more subtle findings that may otherwise receive limited attention. Changes such as brittle nails, altered skin pigmentation, oral tissue abnormalities, or reduced peripheral sensation can sometimes occur alongside nutritional deficiencies or other medical conditions. However, no individual physical sign is considered diagnostic of a nutritional imbalance on its own. Instead, we interpret these observations alongside your symptoms, nutritional intake, health history, and relevant laboratory evidence to determine whether further assessment is warranted. By combining careful observation with appropriate clinical testing, we develop a more complete understanding of how your body's internal physiology may be reflected in its external appearance and functional performance.

Your hair and scalp evaluation examines characteristics such as hair density, distribution, texture, strength, and patterns of shedding or hair loss, along with the general condition of the scalp. Because hair follicles are metabolically active structures, changes in hair growth or quality may sometimes accompany alterations in nutritional status, endocrine function, systemic illness, medication use, or physiologic stress. We assess whether visible findings may be consistent with concerns involving protein adequacy, iron status, or selected micronutrients, while considering other common medical and dermatologic explanations. These observations are interpreted within the context of your health history and, when appropriate, laboratory findings to determine whether further investigation or referral is needed.

The nasal examination involves observing the condition of your nasal passages and visible mucosal tissues for characteristics such as dryness, irritation, inflammation, discoloration, or other abnormalities. The integrity of these tissues can be influenced by multiple factors, including environmental exposures, allergies, infections, hydration, and nutritional status. We consider how these findings relate to your respiratory health and the broader clinical picture, particularly when symptoms such as nasal congestion, chronic irritation, or recurrent upper respiratory complaints are present. When relevant, observations from this examination may help identify the need for further evaluation of underlying inflammatory, allergic, infectious, or nutritional contributors.

Your oral examination provides an opportunity to evaluate tissues that can sometimes reveal early or clinically meaningful signs of nutritional and systemic health concerns. We carefully inspect the lips, corners of the mouth, gums, tongue, and visible oral mucosa, noting changes in color, texture, moisture, surface appearance, or tissue integrity. Findings such as cracking at the corners of the mouth, tongue inflammation, altered tongue surface characteristics, oral lesions, or changes in gum health may prompt consideration of nutritional insufficiencies involving iron, folate, vitamin B12, or other nutrients, alongside a broad range of non-nutritional causes. Because oral health is also influenced by dental conditions, medications, hydration, and systemic disease, we assess these observations in the context of your overall health and coordinate additional evaluation when necessary. This portion of the examination helps connect visible oral findings with your nutritional history, symptoms, and other clinical measurements.

Your skin provides a visible window into several aspects of general health, including tissue integrity, hydration, circulation, and certain nutritional or metabolic conditions. During this assessment, we examine relevant areas of your skin for changes in texture, pigmentation, dryness, scaling, bruising, inflammation, and wound healing, as well as other findings that may warrant clinical attention. Some skin changes can occur in association with inadequate nutrient intake, impaired absorption, vitamin or mineral deficiencies, endocrine disturbances, or chronic medical conditions. We also consider common dermatologic conditions, environmental exposures, medications, and individual variations in skin appearance. By evaluating these characteristics alongside your medical history and laboratory findings, we can determine whether they suggest a potentially correctable nutritional concern or require additional medical or dermatologic investigation.

The appearance and structure of your fingernails and toenails may offer additional clues about your nutritional status and general health. We assess nail shape, color, thickness, surface characteristics, strength, and surrounding tissues, looking for findings such as unusual ridging, brittleness, discoloration, or changes in nail curvature. Certain nail abnormalities may occur alongside iron deficiency, other nutritional insufficiencies, systemic illness, or circulatory conditions, although many are also caused by aging, repetitive trauma, fungal infection, and other localized factors. Our evaluation considers these possibilities rather than assigning a nutritional explanation to an isolated finding. When appropriate, nail and peripheral tissue observations help guide further clinical assessment and contribute to our understanding of your overall health.

Your peripheral neurological examination evaluates selected aspects of how effectively your nervous system detects sensory information and coordinates basic motor and reflex responses. Depending on your clinical presentation, we may assess light-touch sensation, vibration sense, position awareness, deep tendon reflexes, and other relevant neurological functions. These assessments help identify sensory changes or patterns of peripheral nerve dysfunction that may warrant additional investigation. Because certain nutritional deficiencies, including vitamin B12 deficiency, can contribute to neurological abnormalities, these findings may be particularly relevant when you experience symptoms such as numbness, tingling, burning sensations, altered sensation, or difficulties with balance and coordination.

We interpret neurological findings within the broader context of your medical history, medications, metabolic health, and other potential causes of nerve dysfunction. When indicated, additional neurological testing or referral may be recommended to clarify the source of an abnormal finding. Integrating this examination into your nutritional assessment allows us to evaluate not only the biochemical markers associated with nutritional health, but also whether there are measurable changes in nervous system function that deserve clinical attention.

Understanding the daily behaviors, environmental influences, and personal circumstances that shape your long-term health.

The final component of your ABCD evaluation focuses on understanding how your everyday choices, routines, and environmental circumstances influence your nutritional status, physiological function, and overall well-being. We conduct a detailed review of your dietary intake, meal composition, eating patterns, food preferences, and nutritional habits, considering not only what you eat but also when, how, and under what circumstances you eat. Using a structured nutritional framework, we evaluate your intake of proteins, fats, carbohydrates, vitamins, minerals, and a variety of plant-derived nutrients. We may also examine food variety, meal timing, hydration, dietary restrictions, and other patterns relevant to your individual needs. When appropriate, food records or dietary recall tools help us identify potential gaps in nutritional adequacy and develop recommendations that reflect your goals, preferences, medical requirements, and real-world circumstances.

Beyond nutrition, we assess several important lifestyle domains that may influence your ability to maintain health and adapt to the demands of daily life. These include sleep quality and duration, physical activity and exercise, opportunities for recovery and relaxation, perceived stress, emotional well-being, relationships, and sources of social support. We consider how these factors interact rather than treating them as unrelated behaviors. For example, demanding work schedules, inadequate sleep, chronic stress, or inconsistent eating patterns may create practical obstacles to meeting nutritional needs or sustaining healthy habits. Understanding your environment, responsibilities, resources, and personal priorities helps us distinguish between recommendations that are theoretically beneficial and those that are genuinely realistic and sustainable for you.

The purpose of this assessment is not to impose a rigid diet or an unrealistic list of lifestyle rules. Instead, we work collaboratively with you to identify meaningful opportunities for improvement, prioritize the changes most relevant to your health, and develop strategies that can be integrated into your daily life. Whether your goals involve improving nutritional adequacy, supporting metabolic health, enhancing exercise recovery, managing an existing condition, or establishing healthier long-term routines, your recommendations are designed around your unique circumstances. Through education, individualized planning, and appropriate follow-up, we aim to help you develop the knowledge, practical skills, and consistency necessary to take an increasingly active role in your own health.

The greatest value of the ABCD Functional Nutrition Evaluation comes from understanding how its four components relate to one another. Your physical measurements provide information about body composition and cardiovascular characteristics. Your laboratory findings offer insight into selected biochemical and metabolic processes. Your clinical examination identifies observable signs and functional changes that may be relevant to nutritional and systemic health. Finally, your dietary and lifestyle assessment helps us understand the daily circumstances and behaviors that may be contributing to these findings.

By integrating this information with your medical history, symptoms, health timeline, and personal goals, we develop a more comprehensive clinical picture than any one assessment could provide independently. Your findings are reviewed with you in a clear, collaborative manner, with an emphasis on explaining what the results mean, which concerns are most important, what remains uncertain, and which next steps are appropriate.

At Arête Health, we believe that meaningful healthcare begins with understanding the individual rather than simply responding to isolated symptoms or measurements. The ABCD evaluation helps establish that foundation by connecting objective clinical information with the realities of your everyday life. From there, we can develop a personalized plan focused on addressing clinically relevant concerns, improving the health behaviors within your control, supporting physiological function, and monitoring meaningful outcomes over time.

Our goal is not simply to tell you what to change, but to help you understand why those changes matter, how they relate to your health, and how to make them sustainable.