Lung Function Peak Flow Test (PEF)

Quite simply, your peak flow is the maximum flow rate during a forced expiration, this gives an indication of the size and power of your lungs. Commonly used for the diagnosis and treatment of asthma. It can also be useful in understanding a person’s lung function ability and progression. Having a good level of physical activity helps to increase your lung function. It is impaired by smoking, if you have a cold or various pulmonary disorders, or as mentioned, Asthma.

Your Peak Flow reading is taken and recorded as part of the Kiss Fitness Health MOT, part of the personal training consultation.

Normal readings vary, depending on your age, height and gender and can also fluctuate throughout the day by as much as 20%. When monitoring Asthma, a Peak Flow test should be conducted regularly, either daily or multiple times a day. In terms of health & fitness, monthly tests or longer would be adequate for testing progressions and adaptations in lung function. 

You can easily test your peak flow yourself, it can be conducted at home with an inexpensive Peak Flow Meter usually for less than £20 available, online via Amazon.co.uk. You can use the Kiss Fitness Monitoring sheet available for download below to help you track your results and compare against the normal values chart.
The Predicted Peak Flow is the expected ideal value based on your age, height and gender. Your Acceptable range is 80 to 100% of this

Testing your Peak Flow

This is the procedure for conducting a peak flow test.

Required resources

Procedure

  1. Insert the mouthpiece into the meter if not already fitted. Ensure the pointer is set at zero (L/MIN position)
  2. Hold the Peak Flow Meter so that your finger are clear of the scale and slot. Do not obstruct the holes at the end of the Peak Flow Meter.
  3. Stand up if possible. Take a deep breath, place the Peak Flow Meter in the mouth and hold horizontally, closing the lips around the mouthpiece, then blow as hard and as fast as you can. Please Note that any coughing or spitting into the mouthpiece will adversely affect your readings and should be avoided.
  4. Note the number on the scale indicated by the pointer.
  5. Return the pointer to zero (L/MIN position) and repeat twice more to obtain three readings. Mark the highest of the three readings on your Peak Flow Diary. (see download at bottom of page)

Normal Values Chart

Peak Flow Normal Values Chart

 

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Alternatively you can use the Peak Flow calculator on the mini wright Peak Flow Meter Website

Result Range

Determining how well you score on the Peak Flow Test is normally compared to the normal ranges shown in the chart above, your range is determined by the percentage of the of the normal value that you reach for your Age, Sex and Height. 

Range

Percentage Reached of Normal Value

Feedback

Excellent (GREEN ZONE)

>95%

A peak flow reading in the green zone indicates that the asthma is under good control.

Normal (GREEN ZONE)

81-95% of Predicted

A peak flow reading in the green zone indicates that the asthma is under good control.

Mild Obstruction (YELLOW ZONE)

66-80% of predicted

Indicates caution. It may mean respiratory airways are narrowing and additional medication may be required.

Moderate Obstruction (YELLOW ZONE)

51-65% of Predicted

Indicates caution. It may mean respiratory airways are narrowing and additional medication may be required.

Server Obstruction (RED ZONE)

<50% of predicted

Indicates a medical emergency. Severe airway narrowing may be occurring and immediate action needs to be taken. This would usually involve contacting a doctor or hospital.

Kiss Fitness Monitoring Sheets

We have designed a couple of simple sheets that can be used to monitor your Peak Flow on a daily basis, this is useful for charting progressions or regressions in Peak Flow which can be useful for both fitness testing and monitoring of asthma.

{rsfiles path=”Peak Flow/peak_flow_moniroting_chart_7 week.pdf”}

{rsfiles path=”Peak Flow/peak_flow_monitoring_chart_17_Day.pdf”}


 You can easily complete this test at home, all you need is a Mini Wrights Peak Flow Meter (Standard Eu)

Bio Impedance Analysis

This is just one method for testing your body composition, it is, however a very convenient and portable way of performing a body composition assessment to determine body fat percentage, total body water and fat-free mass.

In this method you are either connected to electrodes on your hands and feet or use a cheaper alternative in the form of scales or hand held devices, a small current (about 0.4-0.8 amps) is passed though the body, it’s OK, you won’t feel anything. Whichever devioce is used, they all achieve the same things with varying accuracy and likewise range in price from affordable to very expensive. The electrodes measure resistance as it passes through the body, it works on the principle that the resistance is inversely related to fat-free mass contained within the body, a body fat percentage can then be calculated.

We use this method at Kiss Fitness to test our clients body fat percentage and total body water and is part of the Kiss Fitness Health MOT

Because bio-impedance testing is largely dependent on your total body water, it’s important to ensure you test under standardised conditions, the following is advised although is not always possible in order to obtain an accurate result.

  • No eating or drinking in the four hours before the test
  • No exercise for 12 hours before the test
  • Urinate within 30 minuets before the test
  • No alcohol consumption within 48 hours of the test
  • No diuretics within 7 days of the test.

at the minimum we recommended our clients leave 3 hours between rising, eating or hard exercise before taking a body composition ready.

Results

Kiss Fitness personal trainer use Tanita Body Fat Scales for determining a clients body fat percentage, below is chart showing health risk ranges relating to age, sex and body fat percentage.

Kiss Fitness Body Fat Ranges Chart

 

What your range means to you

Body Fat Range Range Description & Advice
Minimal

You have a healthy body fat percentage, you should continue regular exercise and healthy eating to maintain weight.

Low

Your body fat percentage is within healthy ranges, however it’s a little above normal, it’s recommended that you should look to increase activity levels, check your diet to ensure it is healthy & balanced and reduce calorie intake if required.

Moderate

You have a moderately high body fat percentage, you should check your current diet and eating habits and adhere to a reduced calorie diet to achieve a healthy percentage. Increasing physical activity level is strongly recommended to increase overall health and reduce body fat.

Moderate to High

You have a low body fat percentage, this could be for many reasons, low body fat can lead to health risk and you should consult your GP to ensure no immediate action is necessary.

High

Your body fat is high, your should evaluate your current lifestyle and habits make changes to your diet with low calorie diet and increased exercise.

Very High

You have a very high body fat percentage, your health is as risk and action is required, you should consult your GP for further advice. A low calorie diet, a complete lifestyle change and increased physical activity will be required to curb your percentage body fat and reduce to normal and healthy levels.

Extremely High

Your body fat percentage is extremely high, you’re at immediate risk, you should seek further advice from your GP, you’ll ;likely need a reduced calorie diet and increased physical activity to achieve a fundamental lifestyle change. At this percentage, surgical treatment might be needed to achieve a healthy body fat percentage.

Basal Metabolic Rate (BMR/RMR)

Your body like any living thing requires energy, all the time, to function, whether at rest, exercising , working or reading a book your body will be consuming energy, this is your metabolic rate. Your metabolic rate is the rate in which your body outputs energy, usually expressed as a per hour figure.

Measuring our base level of energy expenditure (Basal Metabolic Rate) BMR requires a scientific test using either a calorimeter or a respirometer, most people don’t have these resources available to them and we therefore use a formula to estimate the Basal Metabolic Rate, this estimation is actually referred to as your Resting Metabolic Rate (RMR) essentially both BMR & RMR represent the same sum (the base level of energy expenditure) they are often used interchangeably with the difference being that BMR is the sum calculated under strict scientific conditions and much more accurate while RMR is an estimation using a formula and thus an approximate value and less accurate.

BMR or RMR then is the energy required to sustain normal bodily functions, that is, to breath, pump blood around the body, organs and cell function and to regulate body temperature, This would generally be what you would burn if you stayed in bed all day awake but not moving or doing anything. BMR is expressed as kilo-calories per square meter of body surface per hour (kcal/m2/h). BMR is commonly reported as a daily figure, your resting metabolic rate x 24 giving a baseline guide of calories required per day, e.g 1771 (not including any physical activity).

Formulas for Calculating RMR/BMR

As most people do not have the required resources, scientific equipment and trained techniques to administer a comprehensive assessment on a persons BMR, we have to estimate it. There are various formulas for achieving this, some basic, some more complicated. The most simple method is:

multiply your weight in kg by the factor ‘1’ for MALES and ‘0.9’ for FEMALES, than simply times this by 24 to give you your daily RMR (1)

The formula used by Kiss Fitness for our Health MOT

We use the formula from Katch-McArdle which requires you to have the body fat & lean body fat percentages of the subject, take via bio impedance test.

RMR = 370 + (21.6 x LBM)

Body Composition & BMR

Your RMR value will account for around two thirds of the energy consumption of an individual in one day. Therefore this is not the actual energy expenditure of an individual in one day only the basal energy level requirements however this value is used to calculate a persons Daily Energy Expenditure (DEE). The more an individual weighs the more their BMR/RMR will be, however body composition has a large role to play in BMR and RMR as lean muscle tissue is more metabolically active requiring more calories in order to maintain them while fat cells require much less. Therefore resistance training will increase an individuals BMR/RMR and thus aid weight control as metabolic rate increases. By studying healthy individuals, scientists have found that as people age, their metabolic rate changes. Basal metabolism rises as a child matures. After a peak at the age of 16 or 17, it typically starts to decrease gradually but will decline rapidly as skeletal muscle start to atrophy (reduce in size), this explains why those elderly who fail to adjust their calorific intake often gain weight.

The male/female difference

Metabolic rate is disproportional higher in males than in females, males typically have a higher lean body percentage while fatty tissue is present in greater relative amounts in females which is metabolic sluggish.

Having a higher basal metabolism will increase the number of calories used and help to decrease the amount of body fat. A low basal metabolic rate will make it harder to lose body fat and overall weight.

References:

  1. Human Anatomy & Physiology (fifth edition) – Elaine N. Marieb

Blood Pressure

Remember going to the doctors and having the blood pressure cuff put on your arm, makes you feel a little nervous and sometimes increases your blood pressure just thinking about it, that cuff and the machine or hand pump it’s connected to measures your blood pressure. Blood pressure is the pressure of blood in your arteries, the transport system that takes your blood from your heart to your brain and the rest of your body.

Your Blood Pressure readings are taken and recorded as part of the Kiss Fitness Health MOT, part of the personal training consultation.

You need a certain amount of pressure to get the blood round your body. The pressure of the blood flowing through your arteries changes at different times in the heartbeat cycle, pressure in your arteries will be highest when your heart is contracting (Systolic) and lowest as it relaxes (Diastolic) before it pumps again. This result of the blood pressure reading consists of two numbers or levels. They are shown as one number on top of the other and measured in mmHg, that is; millimetres of mercury. If your reading is 120/80mmHg, your personal trainer will likely say your blood pressure is “120 over 80”.

White coat syndrome

Often, your blood pressure might be higher when taken in a medical situation, referred to as white coat syndrome or effect due to the white coats traditionally worn by your doctor or nurse. Your blood pressure is fluid and constantly changes, emotional triggers can raise your blood pressure. In this case the effect of a medical professional or even your trainer taking your blood pressure.
Due to variations in blood pressure with white coat syndrome, you’ll normally have your blood pressure taken at least twice to find an average.

What is blood pressure?

Simply, blood pressure is the force that is applied to the walls of blood vessels when your heart pumps blood around the body, the higher this force, the higher your blood pressure and the more chance there is of developing a heart condition or suffering heart attacks and strokes, this is due to the extra pressure being put onto the vessels and the heart. High blood pressure is also known as hypertension and for most of us it is unlikely we would notice if we had high blood pressure or for that matter low blood pressure (hypotension). To find out, you need to get your blood pressure measured, either by a health professional or alternatively by buying your own machine and taking your own readings.

Blood Pressure Ranges and Normal Values

Your readings, typically are compared against normal values, the table below shows the readings for both systolic and diastolic and the ranges in which they fall, you don’t need both numbers to be high or low to be classified as suffering from hypertension (high) or hypotension (low) blood pressure.
You would be considered to have high blood pressure if either your top number was 140 or more or if your bottom number was 90 or more. Likewise low blood pressure would be the case if either your top number was 90 or less or your bottom number was 60 or less.

 
Range Low Ideal Pre-High High Very High
Systolic 70-90 91-120 121-140 141-160 161+
Diastolic 40-60 61-80 81-90 91-100 100+

Your blood pressure is an important health assessment as knowing if you have normal, high or low blood pressure can help us understand your current health status and remedial steps necessary to help you lead a healthy lifestyle.

Kiss Fitness personal trainers take your blood pressure as part of the consultation process and forms an important test within the Health MOT. This is important as it first ensures you are fit to undertake a physically demanding exercise programme and provides an insight into your current health status.

Blood Pressure Chart

Chart Credit: bloodpressure.org

What if I have High Blood Pressure at my consultation

If your trainer takes a high blood pressure reading they will allow you to sit and calm yourself before re taking it. Often this is simply due to white coat syndrome. Sometimes however, a consistent high blood pressure reading might be taken, our trainers operate within strict guidelines on when they should refer you to a medical professional, a nurse or your GP. This is common practice and ensures you are safe to exercise before commencing an exercise programme with your trainer.

Often is the case that people only find they have high/low blood pressure during a personal training consultation or simular situation within a gym or health club induction. This is because in most cases you won’t really know if you do have high or low blood pressure.

Further reading

There are plenty of resources available for dealing with high and low blood pressure, please see the following links if you are concerned about or would like more info on high, low or normal blood pressure.

Waist to Hip Ratio (WHR) Test

While body mass index (BMI) is a good way to tell if you’re a healthy weight. This does not however tell us much about where the fat is stored which can be a greater concern to our health. We store spare body fat under the skin, and also around the vital organs in our abdomen. We now know that this fat around the abdomen causes more health problems than, say, fat carried around the bottom or on the thighs. Having a large amount of tummy fat (when compared to having fat around the bottom or thighs) makes you more likely to develop type 2 diabetes and heart problems. If you carry excess weight around your abdomen, that means you’re an “apple” shape. Those who carry excess fat around the bottom and thighs are “pear” shaped.


Are you a PEAR or an APPLE and what does this mean for your health and fitness?

This test will provide you with insight into your general health by determining your waist to hip ratio, this is achieved by taking the measurement of your waist and dividing it by the measurement of your hips. This test is applicable to both men and women, the results from the test are a good indicator of general health and highlight those that are likely to be less healthy and suffer from potential medical conditions.

How to find your waist to hip ratio

The testing procedure is actually very simple, it involves taking two measurements, one from your waist and one from your hips. You can take it yourself using a tape measure, or if you have a someone who could measure for you that would be preferred for accurate measurements.

Your waist to hip ratio is taken and calculated as part of the mobile personal training consultation & Health MOT

Required Resources

Tape measure

Testing Procedure

  1. You should stand erect, abdominal & buttocks relaxed, arms at the side and feet together.
  2. Measure your waist at it’s narrowest point and then measure the hips at the widest point.
  3. Waist circumference is measured midway between the lower rib margin and the iliac crest in the horizontal plane.
  4. The hip circumference is measured at the point yielding the maximum circumference over the buttocks.
  5. Now divide the waist measurement by the hip measurement.

What your WHR result means?

Use the table below to identify your range 

 

Low Risk

Moderately Low Risk

Moderate Risk

Moderately High Risk

High Risk

Male

<0.85

0.85-0.90

0.91-0.95

0.96-1.00

>1.00

Female

<0.75

0.75-0.80

0.81-0.85

0.86-0.90

>0.90

Aplle or Pear - Body Shape - WHR

Those that carry excess weight around our buttocks and thighs are PEAR shaped.

Those that carry excess weight around their abdomen are APPLE shape.

 

In both cases, any excess weight will put you at an increased risk to disease and heart conditions and those that are APPLE shaped would be advised to change their shape. This will lead to improved health and life expectancy.

BMI (Body Mass Index)

Body Mass Index is essentially a basic calculation between your height and weight that determines if a you are of normal weight for your height. Not a hugely scientific method admittedly, but this method is used around the globe to measure obesity in children and adults. Used by governments, schools and local health organisations, it plays a fundamental role for national statistics, painting a picture of obese adults and children within society.

Your BMI is calculated as part of the Kiss Fitness Health MOT, part of the personal training consultation.

The BMI scale ranges from under 20 to over 35 based on the BMI calculation, it can be a useful guide for determining if you are a healthy weight relative to your height. 

BUT, this is not a full proof system for determining if someone is healthy and this is why….
Using BMI on the young and elderly can generally be rather inaccurate giving strange results, if you have a large amount lean muscle or you are a well toned athlete it’s certainly NOT very useful as you will likely get a figure in the obese or overweight range even though your body fat percentage is very low.

So who is it good for?

It’s useful for the average person, that has a normal amount of lean muscle, might play a little sport but certainly not an athlete. Therefore if you are a non exercising (sedentary) individual! it is likely that your BMI result will be quite accurate. If however your are a regular gym user training for muscle strength and size and have high lean muscle percentage, it would not be unusual to see your BMI in the obese range. This is because lean muscle weighs about twice as much as fat and therefore your body weight will be above average for your height.

The problem with this system is that it tells you nothing of a persons body composition, making it a very basic test of overall health. A body composition test is more scientific and will give you much better results that can be used effectively for goal setting and monitoring progression towards your personal goals.

Often, gym”s & personal trainers provide this service to their customers, perhaps for a small fee. It will require you being wired up to a body stat machine which fires and electrical charge though your body and measures resistance (it doesn’t hurt). At Kiss Fitness this is included within our Free Personal Training Consultation.

Calculate your BMI

Below is the process for calculating your BMI:

  1. Weigh yourself in KG (for example, 70kg)
  2. Measure your height in metres (for example 1.7
  3. Multiple your height by itself (for example, 1.7 x 1.7 = 2.89)
  4. Now we divide our weight by the figure in step 3 (in this example, 70/2.89 = 24.22

In this example our BMI would be 24.22 (lets round that up to 24)

What does that mean?

OK, we know our BMI so lets see what bracket we fall into;

    • Under 18.5 = Underweight

A BMI score this low means that you may be underweight. There are a number of possible reasons for this. It’s important you obtain balanced & healthy diet, your personal trainer can help you achieve this by identifying your current eating habits & portion control.

    • 18.6-24.9 = Healthy Weight or Normal

A BMI reading in this range means you are healthy and withing normal ranges. It shows that you’re a healthy weight for your height. However, it’s still important to eat a healthy, balanced diet and include physical activity in your daily life if you want to maintain a healthy weight.

    • 25-29.9 = Overweight

A BMI score in this range means you may be overweight. This means that you’re heavier than is healthy for someone of your height. Excess weight can put you at increased risk of heart disease, stroke and type 2 diabetes. It’s time to take action.

    • 30-34.9 = Obese (Class 1)

A BMI score above 30 is classified as obese. Being obese puts you at a raised risk of health problems such as heart disease, stroke and type 2 diabetes. Losing weight will bring significant health improvements.

above this range are further obesity ranges as follows:

    • 35-39.9 = Obese (Class 2)
    • 40 or above = Obese (Class 3)

It’s as simple as that, but remember, two people of relatively similar body size and shape and can get different readings on the BMI scale. Muscle weighs much more than fat, nearly twice the weight, so a toned dancer or well built rugby player will hit high numbers in a BMI reading.

Women naturally have higher fat stores than men and normal values will be seen slightly higher than men.