health-coach

What this skill does

# Health Coach

A clinical-grade personal health management skill. Provides nutritional analysis, medical marker interpretation, exercise programming, and longitudinal health tracking.

## Setup

On first use, initialize a user health profile:

1. Copy `config/profile.template.md` → user workspace as `health/profile.md`
2. Copy `config/goals.template.md` → user workspace as `health/goals.md`
3. Copy `config/reminders.template.md` → user workspace as `health/reminders.md`
4. Create `health/logs/` directory for daily logs

All personal data stays in the user's workspace. Never commit health data to shared repos.

## Core Workflows

### 1. Meal Analysis (Photo or Text)

When user shares a meal photo or describes food:

1. Identify all food items, estimate portion sizes
2. Reference `references/nutrition.md` for caloric density, macro ratios
3. For Chinese brand products (bubble tea, convenience store items, packaged foods), reference `references/cn-brands.md` for accurate nutritional data
3. Calculate: calories, protein (g), carbs (g), fat (g), fiber (g)
4. Compare against user's daily targets from `health/goals.md`
5. Provide remaining budget for the day
6. Flag nutritional gaps or excesses

Output format: concise, no lecture. Numbers first, advice second.

### 2. Lab Result Interpretation

When user shares blood work, FeNO, urinalysis, or other medical data:

1. Reference `references/medical-markers.md` for normal ranges and clinical significance
2. Flag out-of-range values with severity (mild/moderate/concerning)
3. Explain what each marker means in plain language
4. Note trends if historical data exists in profile
5. **Always remind: this is informational, not a diagnosis. Consult their doctor.**

### 3. Exercise Logging & Programming

When user shares workout data or asks for exercise advice:

1. Log workout to daily record: type, duration, calories, heart rate
2. Reference `references/exercise.md` for programming principles
3. Check user's injury history from profile before recommending exercises
4. Suggest modifications for known limitations
5. Track weekly volume and progressive overload

### 4. Body Metrics Tracking

When user reports weight, body fat, measurements:

1. Update `health/profile.md` with new data point
2. Calculate trend (7-day average, 30-day trend)
3. Compare against goal trajectory
4. Provide context: "On track" / "Ahead" / "Behind by X"

### 5. Supplement Guidance

When user asks about supplements or reports what they take:

1. Reference `references/supplements.md`
2. Check for interactions with user's medications (from profile)
3. Advise timing (with meals, empty stomach, etc.)
4. Evidence-based recommendations only — no hype

### 5b. Weight Loss Medication Guidance

When user asks about GLP-1, semaglutide, Ozempic, Wegovy, tirzepatide, or any weight loss medication:

1. Reference `references/medications.md` for mechanism, efficacy, side effects, contraindications
2. Cross-reference user's profile: BMI, comorbidities, current medications, medical history
3. Use the clinical decision framework to assess whether medication is appropriate
4. Discuss realistic expectations: typical weight loss %, timeline, muscle loss risk
5. Emphasize: medication + lifestyle > medication alone; stopping without habits = rebound
6. **Always: this requires a physician's prescription and monitoring. Never self-prescribe.**

### 6. Progress Reports

Generate weekly or monthly reports using `templates/weekly-report.md` or `templates/monthly-report.md`:

- Weight/body composition trend
- Exercise frequency and volume
- Average daily calories and macro split
- Notable lab results or health events
- Adherence score
- Next period focus areas

### 7. Apple Health Integration

When Apple Health data is available (via Shortcuts or export):

1. Parse activity, workout, body measurement, and sleep data
2. Cross-reference with manual logs
3. Use for more accurate calorie expenditure estimates
4. Reference `references/apple-health.md` for data format and fields

## Reminders

Configure reminders in `health/reminders.md`. Supported types:
- Wake-up / sleep
- Meal times (with pre-meal supplement reminders)
- Movement breaks (sedentary alerts)
- Workout schedule
- Medication / supplement timing
- Weigh-in schedule

## Important Guidelines

- **Privacy first**: All data local, never suggest uploading health data
- **Not a doctor**: Always caveat medical interpretations
- **No extremes**: Never recommend <1200 cal/day, crash diets, or dangerous supplements
- **Injury-aware**: Always check profile for injuries before exercise advice
- **Evidence-based**: Cite clinical guidelines where possible
- **Culturally aware**: Support diverse cuisines and food traditions in meal analysis
- **Metric + Imperial**: Support both unit systems based on user preference

## 8. Weight Loss Analysis & Metabolism

> Integrated from [weightloss-analyzer](https://github.com/MedClaw-Org/OpenClaw-Medical-Skills) by WellAlly Tech

When tracking weight loss progress or calculating metabolic targets:

### Body Composition Assessment
- **BMI** (WHO Asian standards): Normal 18.5-24, Overweight 24-28, Obese ≥28
- **Body fat**: Male normal 15-20%, elevated 20-25%, obese >25%
- **Waist circumference**: Male ≥90cm = abdominal obesity risk
- **Waist-to-hip ratio**: Male ≥0.9 = abdominal obesity
- **Ideal weight**: BMI method = height(m)² × 22; Broca = (height(cm) - 100) × 0.9

### Metabolic Rate Calculation
- **Mifflin-St Jeor (recommended)**:
  - Male: BMR = (10 × weight_kg) + (6.25 × height_cm) - (5 × age) + 5
  - Female: BMR = (10 × weight_kg) + (6.25 × height_cm) - (5 × age) - 161
- **Katch-McArdle (body fat based)**: BMR = 370 + (21.6 × lean_mass_kg)
- **TDEE** = BMR × activity factor (sedentary 1.2 / light 1.375 / moderate 1.55 / high 1.725)

### Energy Deficit Management
- Deficit = TDEE - intake + exercise burn
- 1kg fat ≈ 7700 kcal; safe loss rate: 0.5-1kg/week (deficit 500-1000 kcal/day)
- **Minimum intake**: male 1500 kcal/day, female 1200 kcal/day, absolute min = BMR × 1.2

### Phase Management
- **Weight loss phase**: Track rate, monitor speed, adjust deficit
- **Plateau detection**: 2+ weeks with <0.5kg change → consider metabolic adaptation, water retention, muscle gain
- **Maintenance phase**: Target weight ±2kg; monitor and adjust promptly

## 9. Sleep Analysis

> Integrated from [sleep-analyzer](https://github.com/MedClaw-Org/OpenClaw-Medical-Skills) by WellAlly Tech

When analyzing sleep patterns or providing sleep improvement advice:

### Sleep Quality Assessment
- **Duration trend**: Track average sleep hours over time
- **Sleep efficiency**: Time asleep / time in bed (target >85%)
- **Sleep latency**: Time to fall asleep (>30min = concern)
- **Night awakenings**: Count and duration
- **Sleep consistency score**: Variability in bed/wake times (0-100)
- **Social jetlag**: Weekend vs weekday sleep difference

### Sleep Problem Identification
- **Insomnia types**: Onset difficulty, maintenance difficulty, early waking, mixed
- **Sleep apnea risk**: STOP-BANG screening (score ≥3 = refer to doctor)
- **Sleep debt**: Ideal duration minus actual duration accumulated over time

### Sleep-Health Correlations
- **Sleep ↔ Exercise**: Exercise days vs rest days sleep quality; exercise timing effects
- **Sleep ↔ Diet**: Caffeine cutoff (2pm), alcohol impact, late meals
- **Sleep ↔ Mood**: Bidirectional relationship, stress impact on latency
- **Sleep ↔ Weight**: Poor sleep → increased appetite hormones, weight gain risk

### Improvement Recommendations (Priority Order)
1. Fix wake time consistency (including weekends)
2. Establish pre-sleep routine (devices off 30min before)
3. Optimize environment (18-22°C, dark, quiet)
4. Lifestyle: move exercise earlier, caffeine before 2pm, no alcohol 3h before bed

## 10. Advanced Nutrition Analysis

> Integrated from [nutrition-analyzer](https://github.com/MedClaw-Org/OpenClaw-Medical-Skills) by WellAlly Tech

Extends Workflow #1 with deeper nutrition