Measurement came first
In 2010, a thorough physical told you your blood pressure, your cholesterol, and whether anything had already gone obviously wrong. It said almost nothing about how well your body actually performed — how efficiently your heart and lungs delivered oxygen, how much working muscle you carried, how close you were to losing your independence two decades out. Those struck us as the more useful questions. So we built the practice around measuring them.
From the start, that meant objective physiological testing rather than symptom management. We assessed cardiorespiratory fitness directly with a metabolic cart — the gold-standard way to measure how much oxygen the body can actually use under load. We mapped body composition with DEXA, separating muscle from fat from bone instead of trusting a single number on a scale. We measured strength and movement. None of this was exotic equipment. What was unusual was treating those numbers as the center of a person’s health picture rather than a footnote to it.
A visitor from the radio
That year, NPR’s Ray Hardman came to West Hartford to see what the approach looked like in practice, and went through the testing himself. What he found was not a wellness fad but a clinical discipline: the same objective measurement elite sport had relied on for years, turned toward ordinary people who simply wanted to know how they were aging while there was still time to change the trajectory.
“We were measuring biological fitness, not just disease.”
Desmond Ebanks, MDWhat changed, and what didn’t
In the years since, the culture caught up. The vocabulary arrived — healthspan, biological age, VO₂ max — and with it a marketplace eager to sell the words faster than the work behind them. We have written separately about why we keep our distance from that marketplace, in our view on longevity.
What hasn’t changed is the method. We still begin with measurement, and we still hold the same three pillars at the center: cardiorespiratory fitness, body composition, and strength. What has improved is the instrument. Those measures now feed the Metabolic Precision Suite — an instrument we use to compile them into figures a physician can act on, among them a Biological Fitness Age, a Healthspan Index, and a Sarcopenia Risk Score.
We also hold the underlying measures at different levels of confidence, and we are candid about it. A metabolic cart remains the most precise way to measure oxygen uptake, and it sits at the top tier alongside DEXA and a calibrated grip dynamometer. For everyday assessment we lead with a validated seismocardiography reading from a VentriJect sensor — a step down in tier, but accurate enough, and accessible enough, to repeat often and track over time. The right tool depends on the question in front of us.
The three underlying tests are established medicine, available anywhere with the right equipment — that has always been true, and we would distrust anyone who told you otherwise. What is proprietary, and patent pending, is the way the Suite compiles those measures into the named outputs above, tracks them over time, and stands behind the interpretation.
Why the history matters
We mention 2010 not to claim a trophy, but because it explains how we think. A practice that arrives at measurement because it is fashionable will leave it when fashion moves on. We arrived because it was the honest way to understand a person — and a decade and a half of doing it the same way, through the trend and before it, is its own kind of evidence.