fix(insights): wire grip / pain / waist / waist-to-height across web and MCP

Grip strength, pain (0–10 NRS), waist circumference, and waist-to-height
existed in the measurement enum, signal registry, and FHIR export but had
no web entry, no detail page, single non-sex-aware bands, and a split-brain
MCP exposure. This closes those gaps.

Web capture: the four signals join the manual measurement form, so a
web-only self-hoster can log them (the iOS client and the measurements API
already could).

Detail pages: flip detailPage on for the four signals and mount each on the
shared HealthKit metric template (chart, stat strip, Coach-read strip,
assessment card) via routed sub-pages and tab-strip pills, the same detail
spine every other metric carries.

Sex-aware bands: grip strength (EWGSOP2 men 27 / women 16 kg) and waist
(WHO men 94 / women 80 cm) now classify by the profile sex through the
age/sex norm resolver the assessment already threads; the resolver also
returns a sex-specific, age-independent band when no date of birth is set.
Fix the waist-to-height boundary so the NICE >= 0.5 rule is correct (the
last in-range value is 0.49).

MCP single source of truth: decouple the registry mcp facet from the Coach
snapshot — a signal can be MCP-readable without being on the Coach surface.
Mark the four physical signals mcp:true, derive the MCP rich-reads clinical
set from the registry flag instead of a duplicate allowlist, and relax the
invariant to coachSnapshot implies mcp (not the reverse). PHQ-9 / GAD-7 and
the environmental signals stay mcp:false and unreachable. compare_metric and
detect_changepoints now advertise clinical-signal support to match
get_metric_baseline.

docs/api/openapi.yaml

@@ -6086,6 +6086,10 @@ paths:
               - AVERAGE_HEART_RATE
               - MAX_HEART_RATE
               - ENERGY_EXPENDITURE_KJ
+              - GRIP_STRENGTH
+              - PAIN_NRS
+              - WAIST_CIRCUMFERENCE
+              - WAIST_TO_HEIGHT
             description: "HealthKit metric id to assess (e.g. RESTING_HEART_RATE, SLEEP_DURATION). Closed enum: an unknown id 422s.
               The seven specialised metrics are served by their own routes and are not accepted here."
           required: true
@@ -10273,7 +10277,7 @@ components:
               - order
         tiles:
           minItems: 1
-          maxItems: 50
+          maxItems: 61
           type: array
           items:
             type: object
@@ -10287,6 +10291,7 @@ components:
                   - oxygen
                   - body-temperature
                   - respiratory-rate
+                  - pain
                   - weight
                   - bmi
                   - body-water
@@ -10296,6 +10301,8 @@ components:
                   - muscle-mass
                   - visceral-fat
                   - lean-body-mass
+                  - waist
+                  - waist-to-height
                   - steps
                   - active-energy
                   - workouts
@@ -10312,6 +10319,7 @@ components:
                   - six-minute-walk
                   - stair-ascent-speed
                   - stair-descent-speed
+                  - grip-strength
                   - sleep
                   - breathing-disturbances
                   - resting-pulse
@@ -25476,7 +25484,7 @@ components:
             additionalProperties: false
         tiles:
           minItems: 1
-          maxItems: 50
+          maxItems: 61
           type: array
           items:
             type: object
@@ -25490,6 +25498,7 @@ components:
                   - oxygen
                   - body-temperature
                   - respiratory-rate
+                  - pain
                   - weight
                   - bmi
                   - body-water
@@ -25499,6 +25508,8 @@ components:
                   - muscle-mass
                   - visceral-fat
                   - lean-body-mass
+                  - waist
+                  - waist-to-height
                   - steps
                   - active-energy
                   - workouts
@@ -25515,6 +25526,7 @@ components:
                   - six-minute-walk
                   - stair-ascent-speed
                   - stair-descent-speed
+                  - grip-strength
                   - sleep
                   - breathing-disturbances
                   - resting-pulse

messages/de.json

@@ -582,7 +582,9 @@
     "typeGripStrength": "Griffstärke",
     "typePainNrs": "Schmerz (0–10)",
     "typeWaistCircumference": "Taillenumfang",
-    "typeWaistToHeight": "Taille-Größe-Verhältnis"
+    "typeWaistToHeight": "Taille-Größe-Verhältnis",
+    "unitScore": "Pkt.",
+    "unitRatio": "Verhältnis"
   },
   "mood": {
     "title": "Stimmung",
@@ -3705,6 +3707,54 @@
       "statusBelow": "unter dem Bereich",
       "statusAbove": "über dem Bereich",
       "directionFlat": "keine Änderung"
+    },
+    "navGripStrength": "Griffkraft",
+    "navPainNrs": "Schmerz",
+    "navWaistCircumference": "Taille",
+    "navWaistToHeight": "Taille/Größe",
+    "gripStrength": {
+      "title": "Griffkraft",
+      "description": "Maximale Handgriffkraft — ein robuster Stellvertreter für die Ganzkörperkraft. Unter dem geschlechtsspezifischen Grenzwert (Männer 27 kg, Frauen 16 kg) deutet sie auf eine mögliche Sarkopenie hin; dein eigener Verlauf führt die Einschätzung.",
+      "chartTitle": "Griffkraft",
+      "emptyState": {
+        "title": "Noch keine Griffkraft",
+        "description": "Erfasse einen Wert mit einem Handdynamometer — notiere den besten von mehreren Versuchen — und der Verlauf erscheint hier.",
+        "cta": "Griffkraft erfassen"
+      },
+      "coachPrefill": "Ich habe noch keine Griffkraft erfasst — was sagt sie über meine Muskelgesundheit aus, und wie messe und verbessere ich sie?"
+    },
+    "pain": {
+      "title": "Schmerz (0–10)",
+      "description": "Selbstberichtete Schmerzintensität auf der numerischen Skala 0–10, wobei 0 keinen Schmerz und 10 den stärksten vorstellbaren Schmerz bedeutet. Eine anhaltende Änderung um 2 Punkte ist das beobachtenswerte Signal.",
+      "chartTitle": "Schmerz (0–10)",
+      "emptyState": {
+        "title": "Noch keine Schmerzwerte",
+        "description": "Erfasse auf der Skala 0–10, wie sich dein Schmerz gerade anfühlt, und der Verlauf erscheint hier.",
+        "cta": "Schmerzwert erfassen"
+      },
+      "coachPrefill": "Ich habe noch keine Schmerzwerte erfasst — wie sollte ich Schmerz auf der Skala 0–10 verfolgen, und was gilt als bedeutsame Veränderung?"
+    },
+    "waist": {
+      "title": "Taillenumfang",
+      "description": "Taillenumfang in Zentimetern — ein Marker für Bauchfett. Der WHO-Grenzwert für erhöhtes Risiko ist geschlechtsspezifisch (Männer 94 cm, Frauen 80 cm); dein eigener Verlauf führt die Einschätzung.",
+      "chartTitle": "Taillenumfang",
+      "emptyState": {
+        "title": "Noch keine Taillenwerte",
+        "description": "Miss deine Taille mittig zwischen der untersten Rippe und dem Hüftknochen am Ende einer normalen Ausatmung und erfasse den Wert hier.",
+        "cta": "Taillenumfang erfassen"
+      },
+      "coachPrefill": "Ich habe noch keine Taillenwerte erfasst — wie messe ich meine Taille richtig, und was bedeutet der Wert für meine Gesundheit?"
+    },
+    "waistToHeight": {
+      "title": "Taille-zu-Größe-Verhältnis",
+      "description": "Deine Taille geteilt durch deine Größe — die ethnienunabhängige Einzelzahl. Sie unter 0,5 zu halten (Taille unter der halben Körpergröße) ist das einfache Ziel.",
+      "chartTitle": "Taille-zu-Größe-Verhältnis",
+      "emptyState": {
+        "title": "Noch kein Taille-zu-Größe-Verhältnis",
+        "description": "Erfasse ein Taille-zu-Größe-Verhältnis, und der Verlauf erscheint hier. Faustregel: Halte deine Taille unter der halben Körpergröße.",
+        "cta": "Taille-zu-Größe-Verhältnis erfassen"
+      },
+      "coachPrefill": "Ich habe noch kein Taille-zu-Größe-Verhältnis erfasst — warum ist es eine nützliche Zahl, und wie halte ich es unter 0,5?"
     }
   },
   "thresholds": {

messages/en.json

@@ -582,7 +582,9 @@
     "typeGripStrength": "Grip strength",
     "typePainNrs": "Pain (0–10)",
     "typeWaistCircumference": "Waist circumference",
-    "typeWaistToHeight": "Waist-to-height ratio"
+    "typeWaistToHeight": "Waist-to-height ratio",
+    "unitScore": "pts",
+    "unitRatio": "ratio"
   },
   "mood": {
     "title": "Mood",
@@ -3705,6 +3707,54 @@
       "statusBelow": "below range",
       "statusAbove": "above range",
       "directionFlat": "no change"
+    },
+    "navGripStrength": "Grip strength",
+    "navPainNrs": "Pain",
+    "navWaistCircumference": "Waist",
+    "navWaistToHeight": "Waist-to-height",
+    "gripStrength": {
+      "title": "Grip strength",
+      "description": "Maximal handgrip force — a robust proxy for whole-body strength. Below the sex-specific cut-off (men 27 kg, women 16 kg) flags probable sarcopenia; your own trend leads the read.",
+      "chartTitle": "Grip strength",
+      "emptyState": {
+        "title": "No grip strength yet",
+        "description": "Log a reading from a hand dynamometer — record the best of a few squeezes — and the trend will appear here.",
+        "cta": "Log grip strength"
+      },
+      "coachPrefill": "I haven't logged any grip strength yet — what does it tell me about my muscle health, and how do I measure and improve it?"
+    },
+    "pain": {
+      "title": "Pain (0–10)",
+      "description": "Patient-reported pain intensity on the 0–10 numeric rating scale, where 0 is no pain and 10 is the worst imaginable. A sustained 2-point change is the signal to watch.",
+      "chartTitle": "Pain (0–10)",
+      "emptyState": {
+        "title": "No pain scores yet",
+        "description": "Log how your pain feels right now on the 0–10 scale and the trend will appear here.",
+        "cta": "Log a pain score"
+      },
+      "coachPrefill": "I haven't logged any pain scores yet — how should I track pain on the 0–10 scale, and what counts as a meaningful change?"
+    },
+    "waist": {
+      "title": "Waist circumference",
+      "description": "Waist girth in centimetres — a marker of central fat. The WHO increased-risk threshold is sex-specific (men 94 cm, women 80 cm); your own trend leads the read.",
+      "chartTitle": "Waist circumference",
+      "emptyState": {
+        "title": "No waist measurements yet",
+        "description": "Measure your waist at the midpoint between the lowest rib and the hip bone, at the end of a normal breath, and log it here.",
+        "cta": "Log waist circumference"
+      },
+      "coachPrefill": "I haven't logged any waist measurements yet — how do I measure my waist correctly, and what does the number mean for my health?"
+    },
+    "waistToHeight": {
+      "title": "Waist-to-height ratio",
+      "description": "Your waist divided by your height — the ancestry-robust single number. Keeping it under 0.5 (waist below half your height) is the simple target.",
+      "chartTitle": "Waist-to-height ratio",
+      "emptyState": {
+        "title": "No waist-to-height ratio yet",
+        "description": "Log a waist-to-height ratio and the trend will appear here. The rule of thumb: keep your waist under half your height.",
+        "cta": "Log waist-to-height ratio"
+      },
+      "coachPrefill": "I haven't logged a waist-to-height ratio yet — why is it a useful number, and how do I keep it under 0.5?"
     }
   },
   "thresholds": {

messages/es.json

@@ -582,7 +582,9 @@
     "typeGripStrength": "Fuerza de agarre",
     "typePainNrs": "Dolor (0–10)",
     "typeWaistCircumference": "Perímetro de cintura",
-    "typeWaistToHeight": "Índice cintura-altura"
+    "typeWaistToHeight": "Índice cintura-altura",
+    "unitScore": "pts",
+    "unitRatio": "ratio"
   },
   "mood": {
     "title": "Estado de ánimo",
@@ -3705,6 +3707,54 @@
       "statusBelow": "por debajo del rango",
       "statusAbove": "por encima del rango",
       "directionFlat": "sin cambios"
+    },
+    "navGripStrength": "Fuerza de agarre",
+    "navPainNrs": "Dolor",
+    "navWaistCircumference": "Cintura",
+    "navWaistToHeight": "Cintura/altura",
+    "gripStrength": {
+      "title": "Fuerza de agarre",
+      "description": "Fuerza máxima de agarre de la mano: un indicador robusto de la fuerza de todo el cuerpo. Por debajo del umbral según el sexo (hombres 27 kg, mujeres 16 kg) indica probable sarcopenia; tu propia tendencia guía la lectura.",
+      "chartTitle": "Fuerza de agarre",
+      "emptyState": {
+        "title": "Aún no hay fuerza de agarre",
+        "description": "Registra una lectura con un dinamómetro de mano (anota el mejor de varios apretones) y la tendencia aparecerá aquí.",
+        "cta": "Registrar fuerza de agarre"
+      },
+      "coachPrefill": "Aún no he registrado la fuerza de agarre: ¿qué dice sobre mi salud muscular y cómo la mido y la mejoro?"
+    },
+    "pain": {
+      "title": "Dolor (0–10)",
+      "description": "Intensidad del dolor referida por el paciente en la escala numérica 0–10, donde 0 es sin dolor y 10 el peor imaginable. Un cambio sostenido de 2 puntos es la señal a vigilar.",
+      "chartTitle": "Dolor (0–10)",
+      "emptyState": {
+        "title": "Aún no hay puntuaciones de dolor",
+        "description": "Registra cómo sientes el dolor ahora mismo en la escala 0–10 y la tendencia aparecerá aquí.",
+        "cta": "Registrar una puntuación de dolor"
+      },
+      "coachPrefill": "Aún no he registrado puntuaciones de dolor: ¿cómo debo seguir el dolor en la escala 0–10 y qué cuenta como un cambio significativo?"
+    },
+    "waist": {
+      "title": "Perímetro de cintura",
+      "description": "Perímetro de la cintura en centímetros: un marcador de grasa central. El umbral de riesgo aumentado de la OMS depende del sexo (hombres 94 cm, mujeres 80 cm); tu propia tendencia guía la lectura.",
+      "chartTitle": "Perímetro de cintura",
+      "emptyState": {
+        "title": "Aún no hay medidas de cintura",
+        "description": "Mide tu cintura en el punto medio entre la costilla más baja y el hueso de la cadera, al final de una espiración normal, y regístrala aquí.",
+        "cta": "Registrar perímetro de cintura"
+      },
+      "coachPrefill": "Aún no he registrado medidas de cintura: ¿cómo mido la cintura correctamente y qué significa el número para mi salud?"
+    },
+    "waistToHeight": {
+      "title": "Índice cintura-altura",
+      "description": "Tu cintura dividida por tu altura: el número único más robusto entre poblaciones. Mantenerlo por debajo de 0,5 (cintura menor que la mitad de tu altura) es el objetivo sencillo.",
+      "chartTitle": "Índice cintura-altura",
+      "emptyState": {
+        "title": "Aún no hay índice cintura-altura",
+        "description": "Registra un índice cintura-altura y la tendencia aparecerá aquí. Regla práctica: mantén tu cintura por debajo de la mitad de tu altura.",
+        "cta": "Registrar índice cintura-altura"
+      },
+      "coachPrefill": "Aún no he registrado un índice cintura-altura: ¿por qué es un número útil y cómo lo mantengo por debajo de 0,5?"
     }
   },
   "thresholds": {

messages/fr.json

@@ -582,7 +582,9 @@
     "typeGripStrength": "Force de préhension",
     "typePainNrs": "Douleur (0–10)",
     "typeWaistCircumference": "Tour de taille",
-    "typeWaistToHeight": "Rapport taille-taille"
+    "typeWaistToHeight": "Rapport taille-taille",
+    "unitScore": "pts",
+    "unitRatio": "ratio"
   },
   "mood": {
     "title": "Humeur",
@@ -3705,6 +3707,54 @@
       "statusBelow": "sous la plage",
       "statusAbove": "au-dessus de la plage",
       "directionFlat": "aucun changement"
+    },
+    "navGripStrength": "Force de préhension",
+    "navPainNrs": "Douleur",
+    "navWaistCircumference": "Tour de taille",
+    "navWaistToHeight": "Taille/hauteur",
+    "gripStrength": {
+      "title": "Force de préhension",
+      "description": "Force maximale de préhension de la main : un indicateur robuste de la force corporelle globale. Sous le seuil selon le sexe (hommes 27 kg, femmes 16 kg), elle signale une sarcopénie probable ; votre propre tendance guide la lecture.",
+      "chartTitle": "Force de préhension",
+      "emptyState": {
+        "title": "Pas encore de force de préhension",
+        "description": "Enregistrez une mesure avec un dynamomètre à main (notez le meilleur de plusieurs serrages) et la tendance apparaîtra ici.",
+        "cta": "Enregistrer la force de préhension"
+      },
+      "coachPrefill": "Je n'ai pas encore enregistré de force de préhension — que dit-elle sur ma santé musculaire, et comment la mesurer et l'améliorer ?"
+    },
+    "pain": {
+      "title": "Douleur (0–10)",
+      "description": "Intensité de la douleur rapportée par le patient sur l'échelle numérique 0–10, où 0 signifie aucune douleur et 10 la pire imaginable. Une variation soutenue de 2 points est le signal à surveiller.",
+      "chartTitle": "Douleur (0–10)",
+      "emptyState": {
+        "title": "Pas encore de scores de douleur",
+        "description": "Enregistrez votre douleur actuelle sur l'échelle 0–10 et la tendance apparaîtra ici.",
+        "cta": "Enregistrer un score de douleur"
+      },
+      "coachPrefill": "Je n'ai pas encore enregistré de score de douleur — comment suivre la douleur sur l'échelle 0–10, et qu'est-ce qu'un changement significatif ?"
+    },
+    "waist": {
+      "title": "Tour de taille",
+      "description": "Tour de taille en centimètres : un marqueur de la graisse abdominale. Le seuil de risque accru de l'OMS dépend du sexe (hommes 94 cm, femmes 80 cm) ; votre propre tendance guide la lecture.",
+      "chartTitle": "Tour de taille",
+      "emptyState": {
+        "title": "Pas encore de mesures de tour de taille",
+        "description": "Mesurez votre tour de taille à mi-chemin entre la dernière côte et l'os de la hanche, en fin d'expiration normale, et enregistrez-le ici.",
+        "cta": "Enregistrer le tour de taille"
+      },
+      "coachPrefill": "Je n'ai pas encore enregistré de tour de taille — comment le mesurer correctement, et que signifie ce chiffre pour ma santé ?"
+    },
+    "waistToHeight": {
+      "title": "Rapport taille-hauteur",
+      "description": "Votre tour de taille divisé par votre taille : le nombre unique le plus robuste selon les populations. Le maintenir sous 0,5 (tour de taille inférieur à la moitié de votre taille) est l'objectif simple.",
+      "chartTitle": "Rapport taille-hauteur",
+      "emptyState": {
+        "title": "Pas encore de rapport taille-hauteur",
+        "description": "Enregistrez un rapport taille-hauteur et la tendance apparaîtra ici. Règle simple : gardez votre tour de taille sous la moitié de votre taille.",
+        "cta": "Enregistrer le rapport taille-hauteur"
+      },
+      "coachPrefill": "Je n'ai pas encore enregistré de rapport taille-hauteur — pourquoi est-ce un chiffre utile, et comment le maintenir sous 0,5 ?"
     }
   },
   "thresholds": {

messages/it.json

@@ -582,7 +582,9 @@
     "typeGripStrength": "Forza di presa",
     "typePainNrs": "Dolore (0–10)",
     "typeWaistCircumference": "Circonferenza vita",
-    "typeWaistToHeight": "Rapporto vita-altezza"
+    "typeWaistToHeight": "Rapporto vita-altezza",
+    "unitScore": "pti",
+    "unitRatio": "rapporto"
   },
   "mood": {
     "title": "Umore",
@@ -3705,6 +3707,54 @@
       "statusBelow": "sotto l'intervallo",
       "statusAbove": "sopra l'intervallo",
       "directionFlat": "nessuna variazione"
+    },
+    "navGripStrength": "Forza di presa",
+    "navPainNrs": "Dolore",
+    "navWaistCircumference": "Vita",
+    "navWaistToHeight": "Vita/altezza",
+    "gripStrength": {
+      "title": "Forza di presa",
+      "description": "Forza massima di presa della mano: un indicatore robusto della forza di tutto il corpo. Sotto la soglia specifica per sesso (uomini 27 kg, donne 16 kg) segnala una probabile sarcopenia; il tuo andamento personale guida la lettura.",
+      "chartTitle": "Forza di presa",
+      "emptyState": {
+        "title": "Ancora nessuna forza di presa",
+        "description": "Registra una misura con un dinamometro manuale (annota la migliore di alcune strette) e l'andamento apparirà qui.",
+        "cta": "Registra la forza di presa"
+      },
+      "coachPrefill": "Non ho ancora registrato la forza di presa — cosa dice sulla salute dei miei muscoli e come la misuro e la miglioro?"
+    },
+    "pain": {
+      "title": "Dolore (0–10)",
+      "description": "Intensità del dolore riferita dal paziente sulla scala numerica 0–10, dove 0 è nessun dolore e 10 il peggiore immaginabile. Una variazione costante di 2 punti è il segnale da osservare.",
+      "chartTitle": "Dolore (0–10)",
+      "emptyState": {
+        "title": "Ancora nessun punteggio del dolore",
+        "description": "Registra come senti il dolore in questo momento sulla scala 0–10 e l'andamento apparirà qui.",
+        "cta": "Registra un punteggio del dolore"
+      },
+      "coachPrefill": "Non ho ancora registrato punteggi del dolore — come dovrei monitorare il dolore sulla scala 0–10 e cosa conta come variazione significativa?"
+    },
+    "waist": {
+      "title": "Circonferenza vita",
+      "description": "Circonferenza della vita in centimetri: un marcatore del grasso addominale. La soglia di rischio aumentato dell'OMS dipende dal sesso (uomini 94 cm, donne 80 cm); il tuo andamento personale guida la lettura.",
+      "chartTitle": "Circonferenza vita",
+      "emptyState": {
+        "title": "Ancora nessuna misura della vita",
+        "description": "Misura la vita nel punto medio tra l'ultima costola e l'osso dell'anca, a fine espirazione normale, e registrala qui.",
+        "cta": "Registra la circonferenza vita"
+      },
+      "coachPrefill": "Non ho ancora registrato misure della vita — come misuro la vita correttamente e cosa significa il numero per la mia salute?"
+    },
+    "waistToHeight": {
+      "title": "Rapporto vita-altezza",
+      "description": "La tua vita divisa per la tua altezza: il singolo numero più robusto tra le popolazioni. Tenerlo sotto 0,5 (vita inferiore alla metà dell'altezza) è l'obiettivo semplice.",
+      "chartTitle": "Rapporto vita-altezza",
+      "emptyState": {
+        "title": "Ancora nessun rapporto vita-altezza",
+        "description": "Registra un rapporto vita-altezza e l'andamento apparirà qui. Regola pratica: tieni la vita sotto la metà della tua altezza.",
+        "cta": "Registra il rapporto vita-altezza"
+      },
+      "coachPrefill": "Non ho ancora registrato un rapporto vita-altezza — perché è un numero utile e come lo tengo sotto 0,5?"
     }
   },
   "thresholds": {

messages/pl.json

@@ -582,7 +582,9 @@
     "typeGripStrength": "Siła chwytu",
     "typePainNrs": "Ból (0–10)",
     "typeWaistCircumference": "Obwód talii",
-    "typeWaistToHeight": "Stosunek talii do wzrostu"
+    "typeWaistToHeight": "Stosunek talii do wzrostu",
+    "unitScore": "pkt",
+    "unitRatio": "stosunek"
   },
   "mood": {
     "title": "Nastrój",
@@ -3705,6 +3707,54 @@
       "statusBelow": "poniżej zakresu",
       "statusAbove": "powyżej zakresu",
       "directionFlat": "bez zmian"
+    },
+    "navGripStrength": "Siła chwytu",
+    "navPainNrs": "Ból",
+    "navWaistCircumference": "Talia",
+    "navWaistToHeight": "Talia/wzrost",
+    "gripStrength": {
+      "title": "Siła chwytu",
+      "description": "Maksymalna siła chwytu dłoni — solidny wskaźnik ogólnej siły ciała. Poniżej progu zależnego od płci (mężczyźni 27 kg, kobiety 16 kg) sygnalizuje prawdopodobną sarkopenię; odczyt prowadzi Twój własny trend.",
+      "chartTitle": "Siła chwytu",
+      "emptyState": {
+        "title": "Brak pomiarów siły chwytu",
+        "description": "Zapisz pomiar z dynamometru ręcznego (zanotuj najlepszy z kilku ściśnięć), a trend pojawi się tutaj.",
+        "cta": "Zapisz siłę chwytu"
+      },
+      "coachPrefill": "Nie zapisałem jeszcze siły chwytu — co mówi o zdrowiu moich mięśni i jak ją zmierzyć oraz poprawić?"
+    },
+    "pain": {
+      "title": "Ból (0–10)",
+      "description": "Zgłaszana przez pacjenta intensywność bólu w skali numerycznej 0–10, gdzie 0 to brak bólu, a 10 najgorszy wyobrażalny. Utrzymująca się zmiana o 2 punkty to sygnał do obserwacji.",
+      "chartTitle": "Ból (0–10)",
+      "emptyState": {
+        "title": "Brak ocen bólu",
+        "description": "Zapisz, jak odczuwasz ból teraz, w skali 0–10, a trend pojawi się tutaj.",
+        "cta": "Zapisz ocenę bólu"
+      },
+      "coachPrefill": "Nie zapisałem jeszcze ocen bólu — jak śledzić ból w skali 0–10 i co liczy się jako istotna zmiana?"
+    },
+    "waist": {
+      "title": "Obwód talii",
+      "description": "Obwód talii w centymetrach — wskaźnik tłuszczu brzusznego. Próg zwiększonego ryzyka WHO zależy od płci (mężczyźni 94 cm, kobiety 80 cm); odczyt prowadzi Twój własny trend.",
+      "chartTitle": "Obwód talii",
+      "emptyState": {
+        "title": "Brak pomiarów talii",
+        "description": "Zmierz talię w połowie odległości między najniższym żebrem a kością biodrową, na końcu normalnego wydechu, i zapisz tutaj.",
+        "cta": "Zapisz obwód talii"
+      },
+      "coachPrefill": "Nie zapisałem jeszcze pomiarów talii — jak prawidłowo zmierzyć talię i co oznacza ta liczba dla mojego zdrowia?"
+    },
+    "waistToHeight": {
+      "title": "Stosunek talii do wzrostu",
+      "description": "Twoja talia podzielona przez wzrost — najbardziej uniwersalna pojedyncza liczba. Utrzymanie go poniżej 0,5 (talia mniejsza niż połowa wzrostu) to prosty cel.",
+      "chartTitle": "Stosunek talii do wzrostu",
+      "emptyState": {
+        "title": "Brak stosunku talii do wzrostu",
+        "description": "Zapisz stosunek talii do wzrostu, a trend pojawi się tutaj. Zasada: utrzymuj talię poniżej połowy wzrostu.",
+        "cta": "Zapisz stosunek talii do wzrostu"
+      },
+      "coachPrefill": "Nie zapisałem jeszcze stosunku talii do wzrostu — dlaczego to przydatna liczba i jak utrzymać ją poniżej 0,5?"
     }
   },
   "thresholds": {

src/app/api/insights/layout/route.ts

@@ -87,7 +87,11 @@ const layoutSchema = z.object({
       }),
     )
     .min(1)
-    .max(50)
+    // Cap at the accepted-id universe (canonical slugs + legacy aliases) so a
+    // single PUT can cover every tile the layout knows about — the cap grows
+    // automatically as new sub-page slugs land, rather than tripping a 422
+    // once the slug count crosses a hard-coded ceiling.
+    .max(ACCEPTED_INSIGHTS_TILE_IDS.length)
     .optional(),
 });
 

src/app/insights/grip-strength/page.tsx

@@ -0,0 +1,34 @@
+"use client";
+
+import { Dumbbell } from "lucide-react";
+
+import { HealthKitMetricPage } from "@/components/insights/healthkit-metric-page";
+import { useTranslations } from "@/lib/i18n/context";
+
+/**
+ * v1.25 — `/insights/grip-strength`.
+ *
+ * Grip-strength sub-page. Rides the generic HealthKit metric template so the
+ * signal gets the same detail spine as every other metric (chart, stat strip,
+ * Coach-read strip, assessment card). The assessment threads the sex-aware
+ * EWGSOP2 cut-off (men 27 / women 16 kg) via the `norms.ts` table.
+ */
+export default function InsightsGripStrengthPage() {
+  const { t } = useTranslations();
+  return (
+    <HealthKitMetricPage
+      measurementType="GRIP_STRENGTH"
+      statusMetric="GRIP_STRENGTH"
+      insightMetric="GRIP_STRENGTH"
+      chartKey="gripStrength"
+      i18nPrefix="insights.gripStrength"
+      color="#22c55e"
+      unit="kg"
+      yAxisUnit="kg"
+      statIcon={Dumbbell}
+      emptyStateIcon={<Dumbbell className="size-6" />}
+      emptyStateCtaType="GRIP_STRENGTH"
+      coachPrefill={t("insights.gripStrength.coachPrefill")}
+    />
+  );
+}

src/app/insights/pain/page.tsx

@@ -0,0 +1,33 @@
+"use client";
+
+import { Activity } from "lucide-react";
+
+import { HealthKitMetricPage } from "@/components/insights/healthkit-metric-page";
+import { useTranslations } from "@/lib/i18n/context";
+
+/**
+ * v1.25 — `/insights/pain`.
+ *
+ * Pain (0–10 NRS) sub-page. Patient-reported pain intensity on the validated
+ * numeric rating scale; rides the generic metric template for its detail
+ * spine + assessment (no-pain / mild band at 0–3).
+ */
+export default function InsightsPainPage() {
+  const { t } = useTranslations();
+  return (
+    <HealthKitMetricPage
+      measurementType="PAIN_NRS"
+      statusMetric="PAIN_NRS"
+      insightMetric="PAIN_NRS"
+      chartKey="painNrs"
+      i18nPrefix="insights.pain"
+      color="#f97316"
+      unit=""
+      yAxisUnit="/10"
+      statIcon={Activity}
+      emptyStateIcon={<Activity className="size-6" />}
+      emptyStateCtaType="PAIN_NRS"
+      coachPrefill={t("insights.pain.coachPrefill")}
+    />
+  );
+}

src/app/insights/waist-to-height/page.tsx

@@ -0,0 +1,32 @@
+"use client";
+
+import { Scaling } from "lucide-react";
+
+import { HealthKitMetricPage } from "@/components/insights/healthkit-metric-page";
+import { useTranslations } from "@/lib/i18n/context";
+
+/**
+ * v1.25 — `/insights/waist-to-height`.
+ *
+ * Waist-to-height ratio sub-page. The ancestry-robust single number (NICE:
+ * keep waist under half your height — WHtR ≥ 0.5 flags increased risk). Rides
+ * the generic metric template for its detail spine + assessment.
+ */
+export default function InsightsWaistToHeightPage() {
+  const { t } = useTranslations();
+  return (
+    <HealthKitMetricPage
+      measurementType="WAIST_TO_HEIGHT"
+      statusMetric="WAIST_TO_HEIGHT"
+      insightMetric="WAIST_TO_HEIGHT"
+      chartKey="waistToHeight"
+      i18nPrefix="insights.waistToHeight"
+      color="#8b5cf6"
+      unit=""
+      statIcon={Scaling}
+      emptyStateIcon={<Scaling className="size-6" />}
+      emptyStateCtaType="WAIST_TO_HEIGHT"
+      coachPrefill={t("insights.waistToHeight.coachPrefill")}
+    />
+  );
+}

src/app/insights/waist/page.tsx

@@ -0,0 +1,33 @@
+"use client";
+
+import { Ruler } from "lucide-react";
+
+import { HealthKitMetricPage } from "@/components/insights/healthkit-metric-page";
+import { useTranslations } from "@/lib/i18n/context";
+
+/**
+ * v1.25 — `/insights/waist`.
+ *
+ * Waist-circumference sub-page. Rides the generic metric template; the
+ * assessment threads the sex-aware WHO cut-off (men 94 / women 80 cm) via the
+ * `norms.ts` table.
+ */
+export default function InsightsWaistPage() {
+  const { t } = useTranslations();
+  return (
+    <HealthKitMetricPage
+      measurementType="WAIST_CIRCUMFERENCE"
+      statusMetric="WAIST_CIRCUMFERENCE"
+      insightMetric="WAIST_CIRCUMFERENCE"
+      chartKey="waistCircumference"
+      i18nPrefix="insights.waist"
+      color="#0ea5e9"
+      unit="cm"
+      yAxisUnit="cm"
+      statIcon={Ruler}
+      emptyStateIcon={<Ruler className="size-6" />}
+      emptyStateCtaType="WAIST_CIRCUMFERENCE"
+      coachPrefill={t("insights.waist.coachPrefill")}
+    />
+  );
+}

src/components/insights/insights-tab-strip.tsx

@@ -185,6 +185,8 @@ export const SUB_PAGE_TABS: Record<
     labelKey: "insights.navRespiratoryRate",
     metric: "RESPIRATORY_RATE",
   },
+  // v1.25 — pain (0–10 NRS).
+  pain: { labelKey: "insights.navPainNrs", metric: "PAIN_NRS" },
   // ── body composition ──
   weight: { labelKey: "insights.navWeight", metric: "WEIGHT" },
   bmi: { labelKey: "insights.navBmi", metric: "BMI" },
@@ -207,6 +209,15 @@ export const SUB_PAGE_TABS: Record<
     labelKey: "insights.navLeanBodyMass",
     metric: "LEAN_BODY_MASS",
   },
+  // v1.25 — waist circumference + waist-to-height ratio.
+  waist: {
+    labelKey: "insights.navWaistCircumference",
+    metric: "WAIST_CIRCUMFERENCE",
+  },
+  "waist-to-height": {
+    labelKey: "insights.navWaistToHeight",
+    metric: "WAIST_TO_HEIGHT",
+  },
   // ── activity ──
   steps: {
     labelKey: "insights.navSteps",
@@ -270,6 +281,11 @@ export const SUB_PAGE_TABS: Record<
     labelKey: "insights.navStairDescentSpeed",
     metric: "STAIR_DESCENT_SPEED",
   },
+  // v1.25 — grip strength.
+  "grip-strength": {
+    labelKey: "insights.navGripStrength",
+    metric: "GRIP_STRENGTH",
+  },
   // ── sleep ──
   sleep: { labelKey: "insights.navSleep", metric: "SLEEP_DURATION" },
   // v1.10.0 — sleep breathing-disturbance index.

src/components/measurements/measurement-form.tsx

@@ -95,6 +95,32 @@ const MEASUREMENT_TYPES = [
     unit: "°C",
     placeholder: "36.6",
   },
+  // v1.25 — physical / clinical signals. Manual web capture so a web-only
+  // self-hoster can log them (the iOS client + measurements API already do).
+  {
+    value: "WAIST_CIRCUMFERENCE",
+    labelKey: "measurements.typeWaistCircumference",
+    unit: "cm",
+    placeholder: "84",
+  },
+  {
+    value: "WAIST_TO_HEIGHT",
+    labelKey: "measurements.typeWaistToHeight",
+    unitKey: "measurements.unitRatio",
+    placeholder: "0.48",
+  },
+  {
+    value: "GRIP_STRENGTH",
+    labelKey: "measurements.typeGripStrength",
+    unit: "kg",
+    placeholder: "38",
+  },
+  {
+    value: "PAIN_NRS",
+    labelKey: "measurements.typePainNrs",
+    unitKey: "measurements.unitScore",
+    placeholder: "0",
+  },
 ] as const;
 
 // v1.4.34 IW-G — single source of truth for the `/measurements?add=<TYPE>`

src/lib/dashboard-layout.ts

@@ -280,6 +280,12 @@ export const CHART_OVERLAY_KEYS = [
   "averageHeartRate",
   "maxHeartRate",
   "energyExpenditureKj",
+  // v1.25 — chart-overlay slots for the physical / clinical signal sub-pages.
+  // One per chart surface; camel-case keys mirror the existing convention.
+  "gripStrength",
+  "painNrs",
+  "waistCircumference",
+  "waistToHeight",
 ] as const;
 export type ChartOverlayKey = (typeof CHART_OVERLAY_KEYS)[number];
 

src/lib/insights/derived/norms.ts

@@ -101,6 +101,31 @@ const RESPIRATORY_RATE_NORMS: NormRow[] = [
   { minAge: 18, maxAge: 120, sex: null, range: { low: 12, high: 18 } },
 ];
 
+/**
+ * Grip-strength normal band (kg) by sex — the EWGSOP2 "probable sarcopenia"
+ * cut-off (Cruz-Jentoft et al., Age Ageing 2019): men < 27 kg, women < 16 kg.
+ * The band brackets the at-or-above-cut-off "normal" placement; `direction`
+ * is `higher-better`, so the read flags a value below the low bound. A single
+ * adult bracket per sex — the cut-off is sex-specific, not age-banded — so the
+ * resolver returns it whenever the profile sex is known, even with no age.
+ */
+const GRIP_STRENGTH_NORMS: NormRow[] = [
+  { minAge: 0, maxAge: 120, sex: "MALE", range: { low: 27, high: 60 } },
+  { minAge: 0, maxAge: 120, sex: "FEMALE", range: { low: 16, high: 60 } },
+];
+
+/**
+ * Waist-circumference normal band (cm) by sex — the WHO European-origin
+ * increased-risk threshold (WHO 2008/2011; NIH/NHLBI 1998): men > 94 cm,
+ * women > 80 cm. `direction` is `lower-better`, so the normal band runs from
+ * 0 up to the sex cut-off. Single adult bracket per sex (sex-specific, not
+ * age-banded). No ethnicity adjustment — HealthLog does not collect ancestry.
+ */
+const WAIST_CIRCUMFERENCE_NORMS: NormRow[] = [
+  { minAge: 0, maxAge: 120, sex: "MALE", range: { low: 0, high: 94 } },
+  { minAge: 0, maxAge: 120, sex: "FEMALE", range: { low: 0, high: 80 } },
+];
+
 /**
  * The norm tables, keyed by the assessment-registry metric id. A metric
  * absent from this map has no age/sex sharpening — the caller keeps the
@@ -110,6 +135,9 @@ const NORM_TABLES: Partial<Record<MetricStatusMetricId, NormRow[]>> = {
   VO2_MAX: VO2_MAX_NORMS,
   RESTING_HEART_RATE: RESTING_HEART_RATE_NORMS,
   RESPIRATORY_RATE: RESPIRATORY_RATE_NORMS,
+  // v1.25 — sex-specific (age-independent) cut-offs.
+  GRIP_STRENGTH: GRIP_STRENGTH_NORMS,
+  WAIST_CIRCUMFERENCE: WAIST_CIRCUMFERENCE_NORMS,
 };
 
 /** The age a bracket row is anchored at for interpolation — its centre. */
@@ -161,18 +189,24 @@ export function lookupNormalRange(
   ageYears: number | null | undefined,
   sex: NormSex,
 ): NormRange | null {
-  if (ageYears == null || !Number.isFinite(ageYears) || ageYears < 0) {
-    return null;
-  }
   const table = NORM_TABLES[metricId];
   if (!table) return null;
 
   const rows = resolveSexRows(table, sex);
   if (!rows || rows.length === 0) return null;
 
-  // Single band — no neighbour to interpolate against.
+  // Single band — no neighbour to interpolate against. A sex-specific,
+  // age-independent cut-off (grip strength, waist circumference) resolves
+  // here without an age, so the sex-aware band still applies when the
+  // profile carries sex but no date of birth.
   if (rows.length === 1) return { ...rows[0].range };
 
+  // Multi-bracket tables are age-banded — without a usable age there is no
+  // honest placement, so the caller keeps the flat registry anchor.
+  if (ageYears == null || !Number.isFinite(ageYears) || ageYears < 0) {
+    return null;
+  }
+
   // Clamp below the youngest centre / above the oldest centre: hold the
   // nearest cited band flat rather than extrapolate past the table.
   const first = rows[0];

src/lib/insights/metric-availability.ts

@@ -112,7 +112,14 @@ export type InsightMetric =
   | "SIX_MINUTE_WALK_DISTANCE"
   | "STAIR_ASCENT_SPEED"
   | "STAIR_DESCENT_SPEED"
-  | "BREATHING_DISTURBANCES";
+  | "BREATHING_DISTURBANCES"
+  // v1.25 — physical / clinical signals. Each key equals its MeasurementType,
+  // so the generic `hasMetricData` fallback gates it on
+  // `summaries[metric].count > 0` (auto-light-up on the first reading).
+  | "GRIP_STRENGTH"
+  | "PAIN_NRS"
+  | "WAIST_CIRCUMFERENCE"
+  | "WAIST_TO_HEIGHT";
 
 /**
  * Inputs the gating helper consumes. The `summaries` shape mirrors

src/lib/insights/metric-status-registry.ts

@@ -140,7 +140,14 @@ export type MetricStatusMetricId =
   | "CARDIO_LOAD"
   | "AVERAGE_HEART_RATE"
   | "MAX_HEART_RATE"
-  | "ENERGY_EXPENDITURE_KJ";
+  | "ENERGY_EXPENDITURE_KJ"
+  // v1.25 — physical / clinical signals promoted to detail pages. Grip
+  // strength + waist carry a sex-aware band via the `norms.ts` tables the
+  // generic generator already threads through `lookupNormalRange`.
+  | "GRIP_STRENGTH"
+  | "PAIN_NRS"
+  | "WAIST_CIRCUMFERENCE"
+  | "WAIST_TO_HEIGHT";
 
 /**
  * The registry. Keyed by the HealthKit metric id. Each entry's
@@ -635,6 +642,54 @@ const REGISTRY: Record<MetricStatusMetricId, MetricStatusMeta> = {
     direction: "higher-better",
     archetype: "activity-fitness",
   },
+  // ── v1.25 — physical / clinical signals ──
+  // Grip strength — EWGSOP2 strength-limb marker. The flat 16 kg floor is the
+  // women's cut-off; the sex-aware `norms.ts` table sharpens it (men 27 /
+  // women 16) when the profile carries sex. Fields mirror the signal-registry
+  // entry exactly so the registry-invariant projection deep-equals this row.
+  GRIP_STRENGTH: {
+    id: "GRIP_STRENGTH",
+    measurementType: "GRIP_STRENGTH",
+    displayName: "Grip strength",
+    unit: "kg",
+    direction: "higher-better",
+    normalRange: { low: 16, high: 60 },
+    archetype: "activity-fitness",
+  },
+  // Pain NRS — the validated 0–10 numeric rating; lower is better, the
+  // no-pain/mild band sits at 0–3.
+  PAIN_NRS: {
+    id: "PAIN_NRS",
+    measurementType: "PAIN_NRS",
+    displayName: "Pain (0–10 NRS)",
+    unit: "score",
+    direction: "lower-better",
+    normalRange: { low: 0, high: 3 },
+    archetype: "physiological-vital",
+  },
+  // Waist circumference — WHO increased-risk threshold. The flat 94 cm anchor
+  // is the men's cut-off; the sex-aware `norms.ts` table sharpens it (men 94 /
+  // women 80) when the profile carries sex.
+  WAIST_CIRCUMFERENCE: {
+    id: "WAIST_CIRCUMFERENCE",
+    measurementType: "WAIST_CIRCUMFERENCE",
+    displayName: "Waist circumference",
+    unit: "cm",
+    direction: "lower-better",
+    normalRange: { low: 0, high: 94 },
+    archetype: "body-composition",
+  },
+  // Waist-to-height ratio — NICE keep-waist-under-half-your-height rule. WHtR
+  // ≥ 0.5 flags increased risk, so the last in-range value is 0.49.
+  WAIST_TO_HEIGHT: {
+    id: "WAIST_TO_HEIGHT",
+    measurementType: "WAIST_TO_HEIGHT",
+    displayName: "Waist-to-height ratio",
+    unit: "ratio",
+    direction: "lower-better",
+    normalRange: { low: 0, high: 0.49 },
+    archetype: "body-composition",
+  },
 };
 
 /** Closed set of ids the generic route accepts (Zod enum source). */

src/lib/insights/sub-page-metric.ts

@@ -53,6 +53,9 @@ const SUB_PAGE_METRIC = {
   "body-temperature": ["BODY_TEMPERATURE"],
   // v1.7.0 — respiratory rate joins the vitals cluster.
   "respiratory-rate": ["RESPIRATORY_RATE"],
+  // v1.25 — pain (0–10 NRS) joins the vitals cluster as a patient-reported
+  // signal with its own detail page + assessment.
+  pain: ["PAIN_NRS"],
   // ── body composition ──
   weight: ["WEIGHT"],
   // BMI is derived from WEIGHT + profile height (no separate series).
@@ -65,6 +68,9 @@ const SUB_PAGE_METRIC = {
   "muscle-mass": ["MUSCLE_MASS"],
   "visceral-fat": ["VISCERAL_FAT"],
   "lean-body-mass": ["LEAN_BODY_MASS"],
+  // v1.25 — waist circumference + waist-to-height ratio join the body cluster.
+  waist: ["WAIST_CIRCUMFERENCE"],
+  "waist-to-height": ["WAIST_TO_HEIGHT"],
   // ── activity ──
   // v1.12 — Steps gains a routed sub-page. Stored as `ACTIVITY_STEPS`;
   // the tile already surfaced on the dashboard but the metric was never
@@ -94,6 +100,9 @@ const SUB_PAGE_METRIC = {
   "six-minute-walk": ["SIX_MINUTE_WALK_DISTANCE"],
   "stair-ascent-speed": ["STAIR_ASCENT_SPEED"],
   "stair-descent-speed": ["STAIR_DESCENT_SPEED"],
+  // v1.25 — grip strength (EWGSOP2 strength-limb marker) joins the activity
+  // cluster as a manual / device physical-fitness signal.
+  "grip-strength": ["GRIP_STRENGTH"],
   // ── sleep ──
   sleep: ["SLEEP_DURATION"],
   // v1.10.0 — sleep breathing-disturbance index joins the sleep cluster.
@@ -204,6 +213,13 @@ export const SUB_PAGE_GROUP: Partial<Record<SubPageSlug, SubPageGroup>> = {
   "cardio-recovery": "cardiovascular",
   // metabolic cluster (overnight wrist reading)
   "wrist-temperature": "metabolic",
+  // ── v1.25 — physical / clinical signals ──
+  // Pain rides the vitals popover (patient-reported physiological signal);
+  // waist + WHtR sit with body composition; grip with activity / fitness.
+  pain: "vitals",
+  waist: "body",
+  "waist-to-height": "body",
+  "grip-strength": "activity",
 };
 
 /**

src/lib/mcp/__tests__/rich-reads.test.ts

@@ -95,7 +95,8 @@ describe("resolveRichMetric", () => {
 
     const whtr = resolveRichMetric("waist-to-height ratio");
     expect(whtr?.measurementType).toBe("WAIST_TO_HEIGHT");
-    expect(whtr?.band).toEqual({ low: 0, high: 0.5 });
+    // WHtR ≥ 0.5 flags increased risk, so the last in-range value is 0.49.
+    expect(whtr?.band).toEqual({ low: 0, high: 0.49 });
 
     // The exact registry key resolves too.
     expect(resolveRichMetric("GRIP_STRENGTH")?.measurementType).toBe(

src/lib/mcp/rich-reads.ts

@@ -43,7 +43,7 @@ import {
   getMetricStatusMeta,
   METRIC_STATUS_IDS,
 } from "@/lib/insights/metric-status-registry";
-import { getSignal } from "@/lib/signals/registry";
+import { allSignals, getSignal } from "@/lib/signals/registry";
 import { classifyReferenceRange } from "@/lib/labs/reference-range";
 import { resolveLabFields } from "@/lib/labs/serialise";
 import { sanitizeValueText } from "@/lib/ai/coach/labs-snapshot";
@@ -182,24 +182,21 @@ function fromRegistry(id: string): RichMetric | null {
 //
 // The v1.25 clinical-signals wave added a set of physical / clinical
 // measurements to the signal registry. They sit OFF the Coach snapshot by
-// design (`coachSnapshot:false ⇒ surfaces.mcp:false`), so the Coach-driven
-// reads (`get_metric_series`, the data inventory) never surface them. The MCP
-// layer exposes them here through the rollup-backed rich reads — `compare_metric`,
-// `get_metric_baseline`, `detect_changepoints` — and through `search` / `fetch`.
+// design (`coachSnapshot:false`), so the Coach-driven reads
+// (`get_metric_series`, the data inventory) never surface them — that path
+// would report no data for a signal it does not carry. The MCP layer exposes
+// them here through the rollup-backed rich reads — `compare_metric`,
+// `get_metric_baseline`, `detect_changepoints` — and through `search` /
+// `fetch`.
 //
-// Exposure is an EXPLICIT allowlist owned by this module, not the registry's own
-// `surfaces.mcp` flag: the registry keeps these off the Coach surface, while the
-// MCP read surface opts them in one signal at a time. The registry remains the
-// single source of truth for grounding (the backing `MeasurementType`, unit, and
-// population band). Deliberately ABSENT and therefore unreachable over MCP: the
-// PHQ-9 / GAD-7 mental-health screeners and every environmental (`ENV_*`) signal
-// — they never reach AI / MCP by construction.
-export const MCP_CLINICAL_SIGNAL_KEYS = [
-  "GRIP_STRENGTH",
-  "PAIN_NRS",
-  "WAIST_CIRCUMFERENCE",
-  "WAIST_TO_HEIGHT",
-] as const;
+// The registry's own `surfaces.mcp` flag is the SINGLE source of truth for
+// MCP exposure: a signal surfaces here iff it is a measurement marked
+// `mcp:true` while staying off the Coach snapshot (`coachSnapshot:false`).
+// The `mcp` and `coachSnapshot` facets are independent — a signal can be
+// MCP-readable without being on the Coach surface. Deliberately ABSENT and
+// therefore unreachable over MCP: the PHQ-9 / GAD-7 mental-health screeners
+// and every environmental (`ENV_*`) signal — they carry `mcp:false` and never
+// reach AI / MCP by construction.
 
 /** Build a `RichMetric` from a registry signal key (measurement-kind only). */
 function richMetricFromSignal(key: string): RichMetric | null {
@@ -215,11 +212,23 @@ function richMetricFromSignal(key: string): RichMetric | null {
   };
 }
 
-/** Resolved clinical signals, keyed by their registry key (built once). */
+/**
+ * The MCP-only clinical signals, derived from the registry: every measurement
+ * signal marked `mcp:true` that stays off the Coach snapshot. This is the one
+ * place the registry's `surfaces.mcp` flag is consumed for the rich reads —
+ * no duplicate allowlist to drift against.
+ */
 const CLINICAL_SIGNAL_BY_KEY = new Map<string, RichMetric>();
-for (const key of MCP_CLINICAL_SIGNAL_KEYS) {
-  const metric = richMetricFromSignal(key);
-  if (metric) CLINICAL_SIGNAL_BY_KEY.set(key, metric);
+for (const sig of allSignals()) {
+  if (
+    sig.kind !== "measurement" ||
+    sig.surfaces.mcp !== true ||
+    sig.surfaces.coachSnapshot !== false
+  ) {
+    continue;
+  }
+  const metric = richMetricFromSignal(sig.key);
+  if (metric) CLINICAL_SIGNAL_BY_KEY.set(sig.key, metric);
 }
 
 /**
@@ -256,9 +265,9 @@ const CLINICAL_ALIASES: Record<string, string> = {
 
 /**
  * Resolve a free-text name to a clinical signal the MCP layer exposes, or
- * `null`. Closed by construction to the `MCP_CLINICAL_SIGNAL_KEYS` allowlist, so
- * a screener key (PHQ9_SCORE / GAD7_SCORE) or an `ENV_*` key can never resolve
- * here even though they exist in the registry.
+ * `null`. Closed by construction to the registry-derived `mcp:true` measurement
+ * set, so a screener key (PHQ9_SCORE / GAD7_SCORE) or an `ENV_*` key — all
+ * `mcp:false` — can never resolve here even though they exist in the registry.
  */
 function resolveClinicalSignal(key: string): RichMetric | null {
   const aliased = CLINICAL_ALIASES[key];

src/lib/mcp/tools.ts

@@ -889,7 +889,7 @@ export const MCP_TOOLS: McpToolDefinition[] = [
     name: "compare_metric",
     title: "Compare metrics or windows",
     description:
-      "Compare one metric against another over the same horizon, OR a single metric across two horizons. A horizon is either one of the five fixed trailing windows OR an explicit {from,to} date range (use `range`/`rangeB` for before-vs-after-a-date). Returns each side's rollup statistics (count, mean, min, max) with units and reference bands, plus a delta + percent change when both sides share a unit. Returns { present: false } when a side has no data.",
+      "Compare one metric against another over the same horizon, OR a single metric across two horizons. A horizon is either one of the five fixed trailing windows OR an explicit {from,to} date range (use `range`/`rangeB` for before-vs-after-a-date). Also resolves the clinical-signal metrics (grip strength, pain 0–10 NRS, waist circumference, waist-to-height ratio). Returns each side's rollup statistics (count, mean, min, max) with units and reference bands, plus a delta + percent change when both sides share a unit. Returns { present: false } when a side has no data.",
     inputShape: {
       metric: z.string().min(1).max(60),
       metricB: z.string().min(1).max(60).optional(),
@@ -931,7 +931,7 @@ export const MCP_TOOLS: McpToolDefinition[] = [
     name: "detect_changepoints",
     title: "Detect level shifts in a metric",
     description:
-      "Surface points where a metric's level shifted over a trailing window OR an explicit {from,to} date range (e.g. 'when did my weight trend change?'). Runs a conservative changepoint scan over the rollup tier's bucket means and reports each shift's date, direction, and before/after means with units. High firing bar — returns { present: false } when too little data exists or no shift clears the threshold.",
+      "Surface points where a metric's level shifted over a trailing window OR an explicit {from,to} date range (e.g. 'when did my weight trend change?'). Also resolves the clinical-signal metrics (grip strength, pain 0–10 NRS, waist circumference, waist-to-height ratio). Runs a conservative changepoint scan over the rollup tier's bucket means and reports each shift's date, direction, and before/after means with units. High firing bar — returns { present: false } when too little data exists or no shift clears the threshold.",
     inputShape: {
       metric: z.string().min(1).max(60),
       window: coachScopeWindowSchema.optional(),

src/lib/openapi/routes/coach.ts

@@ -175,7 +175,9 @@ const insightsLayoutSchema = z
         }),
       )
       .min(1)
-      .max(50)
+      // Cap at the accepted-id universe so a PUT can cover every tile the
+      // layout knows about; grows automatically as new sub-page slugs land.
+      .max(ACCEPTED_INSIGHTS_TILE_IDS.length)
       .optional(),
   })
   .meta({

src/lib/signals/__tests__/registry-invariants.test.ts

@@ -48,12 +48,45 @@ describe("signal registry — structural sanity", () => {
     }
   });
 
-  it("mcp exposure follows Coach-snapshot inclusion", () => {
-    // The MCP get_metric_series enum is the Coach scope vocabulary, so a signal
-    // is MCP-readable iff it carries a Coach scope (and vice-versa).
+  it("every Coach-snapshot signal is also MCP-readable", () => {
+    // `mcp` and `coachSnapshot` are INDEPENDENT facets: a Coach-scoped signal
+    // is always reachable over MCP (the Coach `get_metric_series` path), but a
+    // signal can be MCP-readable WITHOUT a Coach scope (the v1.25 physical
+    // signals, exposed only through the rollup-backed rich reads). So the
+    // invariant is one-directional — coachSnapshot ⇒ mcp, never the reverse.
     for (const signal of allSignals()) {
-      const hasScope = signal.surfaces.coachSnapshot !== false;
-      expect(signal.surfaces.mcp).toBe(hasScope);
+      if (signal.surfaces.coachSnapshot !== false) {
+        expect(signal.surfaces.mcp).toBe(true);
+      }
+    }
+  });
+
+  it("the physical clinical signals are MCP-readable but off the Coach snapshot", () => {
+    for (const key of [
+      "GRIP_STRENGTH",
+      "PAIN_NRS",
+      "WAIST_CIRCUMFERENCE",
+      "WAIST_TO_HEIGHT",
+    ]) {
+      const signal = getSignal(key);
+      expect(signal, `${key} missing from registry`).not.toBeNull();
+      expect(signal!.surfaces.mcp).toBe(true);
+      expect(signal!.surfaces.coachSnapshot).toBe(false);
+    }
+  });
+
+  it("the mental-health screeners and environmental signals stay off MCP", () => {
+    for (const key of ["PHQ9_SCORE", "GAD7_SCORE"]) {
+      const signal = getSignal(key);
+      expect(signal, `${key} missing from registry`).not.toBeNull();
+      expect(signal!.surfaces.mcp).toBe(false);
+    }
+    for (const signal of allSignals()) {
+      if (signal.kind === "environment") {
+        expect(signal.surfaces.mcp, `${signal.key} must stay off MCP`).toBe(
+          false,
+        );
+      }
     }
   });
 

src/lib/signals/registry.ts

@@ -1280,13 +1280,18 @@ export const SIGNALS: Record<string, SignalDefinition> = {
     direction: "higher-better",
     archetype: "activity-fitness",
     // Coarse population floor; the EWGSOP2 cut-off is sex-specific (men < 27,
-    // women < 16 kg) and applied at the display edge.
+    // women < 16 kg) and resolved at the display edge by the sex-aware band
+    // resolver (`norms.ts` GRIP_STRENGTH table) the detail-page assessment
+    // threads through `lookupNormalRange`.
     normalRange: { low: 16, high: 60 },
     surfaces: {
-      detailPage: false,
+      detailPage: true,
       correlationEligible: false,
+      // Off the Coach snapshot, but reachable over MCP: the `mcp` facet is
+      // independent of `coachSnapshot`. The MCP rich reads expose it through
+      // the rollup-backed baseline / compare / change-point reads.
       coachSnapshot: false,
-      mcp: false,
+      mcp: true,
     },
     fhir: {
       // TODO(NEEDS-VERIFY): no hand-grip-strength LOINC confirmed this pass —
@@ -1307,10 +1312,11 @@ export const SIGNALS: Record<string, SignalDefinition> = {
     archetype: "physiological-vital",
     normalRange: { low: 0, high: 3 },
     surfaces: {
-      detailPage: false,
+      detailPage: true,
       correlationEligible: false,
+      // Off the Coach snapshot, reachable over MCP (independent facets).
       coachSnapshot: false,
-      mcp: false,
+      mcp: true,
     },
     fhir: {
       loinc: "72514-3",
@@ -1328,14 +1334,16 @@ export const SIGNALS: Record<string, SignalDefinition> = {
     unit: "cm",
     direction: "lower-better",
     archetype: "body-composition",
-    // WHO European-origin increased-risk threshold (men > 94); ethnicity-aware
-    // bands are applied at the display edge.
+    // WHO European-origin increased-risk threshold (men > 94); the sex-aware
+    // resolver (`norms.ts` WAIST_CIRCUMFERENCE table: men 94 / women 80)
+    // sharpens it at the display edge via `lookupNormalRange`.
     normalRange: { low: 0, high: 94 },
     surfaces: {
-      detailPage: false,
+      detailPage: true,
       correlationEligible: false,
+      // Off the Coach snapshot, reachable over MCP (independent facets).
       coachSnapshot: false,
-      mcp: false,
+      mcp: true,
     },
     fhir: {
       loinc: "8280-0",
@@ -1352,13 +1360,16 @@ export const SIGNALS: Record<string, SignalDefinition> = {
     unit: "ratio",
     direction: "lower-better",
     archetype: "body-composition",
-    // NICE: keep waist under half your height — WHtR ≥ 0.5 flags increased risk.
-    normalRange: { low: 0, high: 0.5 },
+    // NICE: keep waist under half your height — WHtR ≥ 0.5 flags increased
+    // risk, so the last in-range value sits just below the 0.5 threshold
+    // (`high: 0.49`) and a 0.50 reading classifies as increased, not normal.
+    normalRange: { low: 0, high: 0.49 },
     surfaces: {
-      detailPage: false,
+      detailPage: true,
       correlationEligible: false,
+      // Off the Coach snapshot, reachable over MCP (independent facets).
       coachSnapshot: false,
-      mcp: false,
+      mcp: true,
     },
     fhir: {
       // TODO(NEEDS-VERIFY): WHtR LOINC not confirmed this pass — local text concept.