Inner West Allied Health Cente integrates high precision science with expert interpretation and guidance, to ensure the most effective fitness and health outcomes are achieved. Three specific evaluations that provide significant metrics for understanding and improving common health risks, such as preventable cardio metabolic diseases, are briefly described here.
Cardiologists and exercise physiologists recommend that VO2max (the global gold standard measure of cardiorespiratory fitness) should be considered as a fundamental “vital sign” evaluation; since low VO2max is strongly associated with numerous serious heart conditions; cancers; dementia; type 2 diabetes; and depression, amongst other chronic diseases. Furthermore, VO2max is a strong predictor of all-cause morbidity and mortality. Assessing VO2max also provides the beneficiary with a specific outcome focus that is realistic and targeted.
VO2max – what’s involved?
The evaluation starts at approximate 50% of your maximal intensity, increasing in intensity every 1-3 minutes until fatigue. The total duration of the test is typically ~8-20 minutes. A face mask is secured around your head in order to continuously measure oxygen consumption. Heart rate is also monitored continuously. You will also be asked to rate your perceived intensity during each stage (using a 6-20 point BORG scale), which is then integrated with your physiological metrics.
For those undertaking the 3 minute interval test, blood lactate is also measured at each workload increase.
Following the test, comprehensive feedback is provided, highlighting key results and recommendations that are unique to your physiology and health risks.
Progressive graded VO 2max - run or cycle; Steady state ; lactate levels ; performance test
Fee: $380; $295 without blood lactate
Body composition is assessed via Dual energy X-ray absorptiometry (DXA) which is a well-established and high precision technique for measuring bone mineral density (BMD), body fat and lean muscle mass. Increased body fat, particularly within the visceral cavity (deep abdominal region) increases the risk of developing type 2 diabetes; heart disease; and a number of cancers. Decreased muscle mass and bone mineral density increases risk of musculoskeletal diseases and accelerated ageing and frailty. Similar to VO2max, assessing body composition provides beneficiaries with an outcome focus specific to the metric measured.
DEXA scan is very safe, and there are no complications associated with the procedure. The radiation doses are very low, which, in fact, is less than one day’s exposure to natural environmental or background radiation. The average person in Australia receives about 1500 microsieverts every year from natural background radiation. The amount of radiation received from DXA scan is approximately 4 microsieverts of radiation, which is well below the International Commission on Radiological Protection (ICRP) limit of 1000 microsieverts per annum (over and above natural background).
A fasted blood test that encompasses cardio metabolic and inflammatory markers, provides an understanding of cardiovascular and metabolic disease risk, and also ties in with fitness and body composition outcomes. Metabolic dysfunction (particularly insulin resistance) impairs the body’s ability to maintain a healthy body composition. Exercise, dietary and other lifestyle guidelines are specifically targeted to mitigate insulin resistance, fatty liver, lipids and systemic inflammation. Panels tested include; full blood count; urea and electrolytes; liver function; insulin; glucose; HbA1C; lipids; hs-CRP. The magnitude of insulin resistance is quantified by HOMA-IR method (via Glucose and Insulin calculations).
Preparing for VO2max:
Similar to how you would normally prepare for a challenging training session. We advise to refrain from exercise, food and caffeine for ~3-4hrs prior to the test. If you are training the previous day, light or recovery paced exercise is advised. A medical questionnaire will be sent to you, and is required to be sighted by the administering physiologist prior to commencing the test. You will wear your regular training apparel.
In preparation for DXA, it is helpful to wear clothing which is loose fitting and free of metallic attachments such as buttons, zippers, buckles, wired bras and fasteners. You will also need to remove any attached metallic devices, such as jewelry. You must notify the practitioner if you think you could be pregnant. DO NOT schedule your DEXA scan within one week of having a barium x-ray, a nuclear medicine study or an injection of x-ray dye. Prior to your test, do not eat a heavy meal or exercise vigorously. DEXA is a simple and fast procedure, involving no injections and is not painful. You will be required to lie face up on a padded table for ~5 minutes.
A blood test order form is raised, and sent to you. A link for a pathology collection centre convenient to your location is provided. Avoid heavy exercise the day before the blood test, and refrain from exercise or eating in the morning of the test. An overnight fast of 10-12 hours is required.
* Private health insurance rebates (extras cover) are also available for the cardiorespiratory and body composition evaluations.
Dr Simon Sostaric, Exercise Physiologist
Mr Anton Sostaric Musculoskeletal Physiotherapist/DEXA Technologist