A DEXA scan is traditionally used to measure bone mineral density (BMD) and body composition to delineate body fat content and muscle content.
In further detail, we look at how much of that fat is around vital organs and how much of it is centrally located, and a few other factors.
The critical takeaway of this article is that a DEXA report for body composition tells us if your skinny frame is healthy or harboring ominous fat around organs. And, vice versa, if your larger frame has most of its fat subcutaneously and not anywhere near visceral organs, which would be more protective.
Ideal Body Composition by DEXA Scans
The following report is that of a 29 yo female at 5’5″, 127 lbs.
Reports will vary from person to person and from different companies, but they will have all the data to make the necessary conclusions.
Another sample report can be found here. BodySpec, a favorite DEXA company of our clients at Heart Health Coach, provides this report.
1. Bone Mineral Density (BMD)
Your BMD is reported using a T-score and Z-score, depending on age, and compares you to others in your average age group.
If a compression fracture happens because of low bone density, it will happen in areas such as the hip or lumbar spine.
2. VAT
DEXA for body fat will report the total body fat that encapsulates the fat around the viscera and the fat found under the skin.
We pay close attention to visceral fat since this is the leading inflammatory cause of many metabolic diseases we encounter in practice. It’s this factor that we try to manipulate in our Heart Health practice.
If you are age 50, the ideal total body fat would be around 30%. If you are 25, 27% would be more ideal.
With the main goal of having a total body fat in the 50% percentile and below.
The VAT in grams should be 200 grams for the 50-year-old patient and around 0 for the 25-year-old.
3. Appendicular Lean Mass Index (ALMI)
Lean mass goes down with age, and preserving this is quite protective.
We use ALMI to accurately estimate the amount of lean muscle mass in your body. Each body part – arms, legs – has its own lean mass index.
4. Fat-free Mass Index (FFMI)
FFMI can be used the same as the ALMI, but when there is a discrepancy, we rely on the ALMI. That’s mostly because the FFMI includes the organs and bone and is factored into your height.
The goal would be to stay north of the 97th percentile, but not everyone can achieve this. Your genes may never allow you to reach a 97th percentile of muscle mass, so we approach your health individually.
Addressing Results from a DEXA Body Report
There is a lot of data, and it can feel overwhelming. The main questions to ask are:
- Am I overweight?
- Do I have excess fat around my viscera?
- Do I have enough muscle mass?
- Is my bone mineral density adequate?
The actionable items are:
- More resistance training
- More cardiovascular training
- Increasing protein consumption
- Decreasing insulin resistance
We can manipulate these last 4 levels at Heart Health Coaching, always with the person in mind, aiming to manipulate factors that will result in the biggest gains.
There isn’t a perfect but perhaps ideal body composition by DEXA which should be a second goal. The primary goal is to feel better and lower the Heart Health Risk Score.