Understanding your DXA results

Understanding Your Body Fat Results: A Guide to Reducing Health Risks

What Is Body Fat and Why Does It Matter?

Not all body fat is the same. Your body stores fat in different locations, and where it is stored has a major impact on your overall health.

Subcutaneous fat: This fat sits just beneath your skin. You can pinch it with your fingers on your arms, legs, and abdomen. This type of fat is relatively harmless to your health.
Visceral adipose tissue (VAT): This is deep belly fat that wraps around your internal organs, including your liver, pancreas, and intestines. This is the dangerous type of fat that actively increases your risk of serious health problems.

Beyond BMI: Understanding Your Fat Mass Index (FMI)

When most people evaluate their weight, they use BMI (Body Mass Index). However, BMI is fundamentally flawed because it only looks at your total weight—it cannot tell the difference between heavy, dense muscle and excess fat.

Your DXA scan solves this by providing your Fat Mass Index (FMI). FMI measures exactly how much fat you are carrying relative to your height, completely removing your muscle and bone weight from the equation.

Digging Deeper: Your Visceral Fat (VAT) Scan

While FMI looks at all the fat on your body, your DXA scan also uses advanced technology called InnerCore™ Visceral Adipose Tissue assessment to measure the exact amount of dangerous, deep belly fat (VAT) in your abdomen. This measurement is highly accurate and validated against CT and MRI scans, but it exposes you to significantly less radiation.

Your VAT result is reported in square centimeters (cm²). see white table above "what do your numbers mean"

Why Visceral Fat Is Dangerous

Visceral fat is not just stored energy—it is metabolically active tissue that releases harmful substances into your bloodstream. Excess visceral fat directly contributes to the following health risks:

Increases insulin resistance and the risk of type 2 diabetes
Raises blood pressure
Causes unhealthy cholesterol levels (high LDL "bad" cholesterol, low HDL "good" cholesterol, high triglycerides)
Promotes chronic inflammation throughout your body
Increases the risk of heart attack and stroke
Contributes to fatty liver disease
Raises the risk of certain cancers

Evidence-Based Steps to Reduce Excess Fat

The good news: Body fat—especially visceral fat—responds exceptionally well to lifestyle changes. Even modest reductions can significantly improve your health metrics.

Nutrition: What to Eat

Follow a Mediterranean-style pattern: Emphasize vegetables, fruits, whole grains, legumes, nuts, and seeds. Use extra virgin olive oil as your primary fat source.
Optimize protein intake: Aim for 1.2 to 1.4 grams of protein per kilogram of body weight daily. Distribute lean sources (fish, poultry, legumes, low-fat dairy, eggs) throughout your meals.
Control portions and calories: Create a moderate calorie deficit (reducing intake by 500-750 calories per day typically leads to healthy weight loss). Use smaller plates and eat slowly.
Increase fiber: Aim for at least 25-30 grams of fiber daily to help control appetite and improve metabolic health.
Avoid liquid calories and processed foods: Completely eliminate sugar-sweetened beverages (soda, sweetened tea, energy drinks, fruit juice). Limit ultra-processed foods, refined carbohydrates, and excessive alcohol.

Physical Activity: How to Move

Prioritize aerobic exercise: Aim for 150-300 minutes per week of moderate-intensity activity (brisk walking, cycling) or 75-150 minutes of vigorous-intensity activity. Even 30-45 minutes of daily walking produces significant fat reduction.
Add resistance training: Perform muscle-strengthening exercises (weight lifting, resistance bands, bodyweight exercises) 2-3 times per week to preserve your metabolism-boosting lean muscle mass while losing fat.
Reduce sedentary time: Stand up and move for 2-3 minutes every hour. Take the stairs, park farther away, or consider a standing desk.

Sleep and Stress Management

Prioritize quality sleep: Aim for 7-9 hours of consistent sleep per night. Poor sleep increases visceral fat accumulation and makes fat loss much harder.
Manage stress: Chronic stress produces cortisol, a hormone that directly promotes visceral fat storage. Practice stress-reduction techniques like deep breathing or yoga, and seek support when needed.

Additional Strategies

Stay consistent: Small, sustainable changes are better than extreme diets. Focus on building lifelong healthy habits rather than perfection.
Work with your healthcare team: Discuss your goals with your doctor, consider a referral to a registered dietitian, and utilize repeat DXA scans every 6-12 months to track your FMI and VAT changes.

What Results Can You Expect?

With consistent lifestyle changes, you can expect the following results:

A loss of 20-25% of your visceral fat alongside a 5-7% reduction in overall body weight.
Visceral fat loss from exercise, even if your total body weight does not change significantly.
Improvements in blood sugar, blood pressure, and cholesterol occurring well before major weight loss.
Measurable health improvements within 3-6 months.

Your Muscle Mass Results: A Guide to Building Strength and Longevity

What Is Lean Muscle Mass and Why Does It Matter?

When we talk about weight, we often focus on losing fat, but maintaining and building muscle is equally critical for long-term health. Muscle is not just for athletes—it is a highly active tissue that drives your metabolism, regulates your blood sugar, and acts as the physical armor that protects your joints and bones.

As we age, we naturally begin to lose muscle mass (a condition called sarcopenia) unless we actively work to preserve it. Low muscle mass can lead to weakness, a slower metabolism, and a loss of independence.

Your DXA Lean Mass Scan and ALMI Score

Your DXA body composition scan provides a highly accurate measurement of your lean tissue. While the scan looks at your whole body, doctors pay special attention to a metric called Appendicular Lean Mass (ALM).

ALM measures the amount of muscle in your arms and legs. When this number is adjusted for your height, it gives you your Appendicular Lean Mass Index (ALMI). This is the gold standard medical measurement used to evaluate your functional strength and assess your risk for sarcopenia.

When it comes to your ALMI score, the bigger the number, the better. A higher number indicates that you have a healthy, robust amount of muscle mass relative to your frame. Because men naturally carry more muscle mass due to different hormonal profiles, the target thresholds differ by sex.

Muscle Asymmetry: The Hidden Injury Risk

Along with total muscle mass, your DXA scan provides a left-to-right breakdown of your body. This allows us to look for muscle asymmetry—a condition where one arm or leg carries significantly more muscle than the other.

Most people have a slight dominance on one side of their body, but a noticeable imbalance acts as a major warning sign for future injuries. When your limbs are asymmetrical, it alters your movement mechanics, forcing your body to compensate and overload your joints and soft tissues.

The Evidence for Women: Research shows that in physically active women, a lower-limb skeletal muscle mass asymmetry of just ~3.6% is associated with a significantly higher risk of injury. Furthermore, for every 1% increase in that asymmetry, the risk of injury spikes by over 80%.
The Evidence for Men: For physically active men, the risk profile slightly differs, being closely tied to strength and force production. An asymmetry in lower-limb peak force of roughly ~4% is the threshold that indicates a substantially increased risk of injury.
The Bottom Line: Across the board, clinical data shows that side-to-side asymmetries above 10% can double or even triple your risk of soft-tissue tears, joint degeneration, and osteoarthritis.

Why Healthy Muscle Mass Is Essential

Muscle is often referred to as an "organ of longevity." Having a healthy, symmetrical amount of lean muscle provides profound benefits across your entire body:

Boosts metabolism: Muscle burns more calories at rest than fat, making it easier to maintain a healthy body weight.
Controls blood sugar: Muscles act like a sponge for the carbohydrates you eat, pulling glucose out of your bloodstream and lowering your risk of type 2 diabetes.
Protects against falls: Strong, balanced leg and core muscles improve your coordination and react quickly to prevent trips and falls.
Supports bone health: Muscles pull on your bones when they contract. This continuous pulling stimulates your bones to stay dense and strong.

Evidence-Based Steps to Build and Preserve Muscle

The good news: You can build muscle at any age. Whether you are 30 or 80, your muscles will respond to the right combination of nutrition and exercise.

Physical Activity: The Signal to Grow

Prioritize resistance training: This is non-negotiable for building muscle. Lifting weights, using resistance bands, or doing bodyweight exercises (like push-ups and squats) forces your muscles to adapt and grow. Aim for 2 to 4 sessions per week.
Address imbalances: If your DXA scan reveals asymmetry, incorporate unilateral exercises (working one arm or leg at a time, like lunges or single-arm rows) to allow your weaker side to catch up without your dominant side taking over.
Use progressive overload: To keep building muscle, you must consistently challenge it. As exercises become easier, gradually increase the weight, the number of repetitions, or the difficulty of the movement.

Nutrition: The Building Blocks

Eat enough protein: Protein provides the essential amino acids your body needs to repair and build muscle tissue. Aim for 1.6 to 2.0 grams of protein per kilogram of body weight if you are actively trying to build muscle.
Distribute your protein: Your body cannot store large amounts of protein at once. Aim for 25 to 35 grams of high-quality protein per meal, spread evenly throughout the day.
Choose high-quality sources: Prioritize lean meats, poultry, fish, eggs, dairy, tofu, and legumes.

Sleep and Recovery: When Growth Happens

Prioritize rest days: Muscles do not grow while you are lifting weights; they grow while you are resting. Avoid intensely training the same muscle groups two days in a row.
Get quality sleep: Aim for 7 to 9 hours of sleep per night. The majority of muscle repair and human growth hormone production occurs during deep sleep.

Additional Strategies

Stay hydrated: Muscle tissue is roughly 75% water. Dehydration impairs muscle function, decreases strength, and slows recovery.
Track your body composition: Use repeat DXA scans every 6 to 12 months to ensure the weight you are losing is fat, not valuable muscle, and to track your limb symmetry.
Work with a professional: Consider booking a few sessions with a physical therapist or certified personal trainer to learn proper lifting techniques, correct asymmetries, and prevent injury.

Your Resting Metabolic Rate (RMR): A Guide to Fueling Your Body

What Is Resting Metabolic Rate?

Think of your body as an engine that is always running. Your Resting Metabolic Rate (RMR) represents the total number of calories your body burns in a 24-hour period just to keep you alive and functioning at absolute rest.

Even when you are sleeping or sitting perfectly still on the couch, your body is working hard to pump blood, inflate your lungs, repair cells, and keep your brain functioning. For the average person, this baseline vital function accounts for roughly 60% to 75% of all the calories burned in a single day.

How You Can Calculate Your RMR from Your DXA Scan

Many generic internet calculators estimate your metabolism using basic equations based only on your age, sex, height, and total weight. However, these formulas often miss the mark because they do not know what your weight is actually made of. Muscle tissue burns significantly more calories at rest than fat tissue.

Your DXA scan provides a highly precise measurement of your Lean Body Mass. Once you have that exact number from your results, you can use the clinically validated Katch-McArdle formula to calculate your customized RMR:

RMR = 370 + (21.6 × LBM in kg)

By using your actual lean mass rather than an estimate, this formula tells you exactly how much fuel your unique body needs to function optimally. You should never eat below this number long-term. Eating below your RMR forces your body into "starvation mode," slowing down your metabolism and breaking down valuable muscle tissue.

Calculating Your Total Daily Energy Expenditure (TDEE)

While your RMR tells you what your body needs at absolute rest, your Total Daily Energy Expenditure (TDEE) is the total number of calories you burn once you add in your daily movement, work, and exercise. Your TDEE is your daily calorie target: eat this amount to maintain your weight, slightly below it to lose fat, or slightly above it to build muscle.

To find your TDEE, you simply multiply your baseline RMR by an activity factor. The more you move, the higher the multiplier. See the table below all this information for your TDEE

Why Knowing Your RMR Matters

Guessing how many calories you need often leads to frustration. Having an accurate RMR measurement provides several major health advantages:

Prevents metabolic slowdown: Chronic under-eating crashes your metabolism. Knowing your RMR ensures you are eating enough to keep your "engine" running fast and efficiently.
Enables precision weight loss: If you want to lose fat, you need a calorie deficit. Your RMR gives you the exact math needed to create a healthy deficit without starving yourself.
Supports muscle growth: If your goal is to build strength, you must eat enough to fuel that growth. Your RMR acts as the starting line for calculating your nutritional needs.

Evidence-Based Steps to Optimize Your Metabolism

You are not stuck with the metabolism you were born with. While you cannot change your age or genetics, you can take proactive, evidence-based steps to increase your RMR over time.

Physical Activity: Revving the Engine

Build more muscle: Lean muscle is metabolically active. By participating in resistance training (lifting weights, using bands, or doing bodyweight exercises) 2 to 3 times a week, you add muscle mass, which permanently increases your RMR.
Increase your NEAT: Non-Exercise Activity Thermogenesis (NEAT) is the energy you burn doing everything except sleeping and formal exercise. Taking the stairs, pacing while on the phone, standing at your desk, and doing chores all add up to a significantly faster daily metabolism.

Nutrition: The Thermic Effect

Prioritize protein: Your body actually burns calories just digesting the food you eat (known as the Thermic Effect of Food). Protein requires the most energy to digest. By eating adequate protein (1.2 to 2.0 grams per kilogram of body weight), you naturally boost your metabolism and protect your muscle mass.
Avoid crash diets: Severe calorie restriction causes your body to panic, hold onto fat, and shed muscle. Aim for a moderate, sustainable calorie deficit (typically 300 to 500 calories below your Total Daily Energy Expenditure, not your RMR) for healthy, lasting fat loss.
Stay hydrated: Drinking adequate water temporarily boosts your metabolism. Furthermore, your body's cellular processes, including fat burning, slow down significantly when you are dehydrated.

Sleep and Recovery

Get adequate sleep: Chronic sleep deprivation severely disrupts the hormones that regulate your metabolism and appetite (ghrelin and leptin). Aim for 7 to 9 hours of quality sleep per night.
Manage stress: High stress levels produce excess cortisol, a hormone that encourages your body to store visceral fat and break down the lean muscle that drives your metabolism.

Putting It All Together: Next Steps

Find your baseline: You can calculate your exact RMR using the Katch-McArdle formula and the lean body mass measurement from your DXA scan results. This is your absolute minimum daily calorie requirement.
Account for activity: Find the lifestyle level in the table above that best matches your routine to calculate your estimated TDEE.
Set your target: Decide on a goal (fat loss, muscle gain, or maintenance) and adjust your daily calorie and protein targets using this precise data.
Track your progress: Repeat your DXA scan in 6 to 12 months. As you build muscle and lose fat, your metabolism will change. Routine scans ensure your nutrition plan evolves with your body.

Your Bone Density Results: A Guide to Protecting Your Skeletal Health

What Is Bone Densitometry?

Bone densitometry, also known as a DXA or DEXA scan, is a simple, non-invasive test that measures your bone mineral density (BMD). Your bones are living tissue that constantly rebuilds itself. As we age, we often lose bone mass faster than we can build it, which can lead to fragile bones and an increased risk of fractures.

This scan helps your healthcare team assess the strength of your bones, diagnose conditions like osteopenia or osteoporosis, and predict your risk of future fractures.

Whole-Body Scans vs. Clinical Bone Density Scans

If you are tracking your health, you might receive bone density readings from two different types of DXA scans. It is important to understand how they differ:

Whole-Body DXA Scan: This scan is primarily used to measure body composition (the breakdown of fat, muscle, and bone across your entire body). While it provides an overall bone density score, it averages out the dense and porous bones together. It is an excellent tool for tracking general fitness, but it is not the standard for diagnosing osteoporosis.
Clinical Bone Density Scan: This is a targeted scan that focuses exclusively on specific, weight-bearing sites—most commonly the lower spine (lumbar spine) and the hip. These are the areas most vulnerable to serious, life-altering fractures. This targeted scan is the medical "gold standard" used by doctors to diagnose osteoporosis and make treatment decisions.

Why Low Bone Density Is a Concern

Unlike high blood pressure or a fever, low bone density is a "silent" condition. You cannot feel your bones getting weaker. Often, the first sign of osteoporosis is a broken bone from a minor fall or bump. Weak bones increase your risk of:

Fractures in the hip, spine, and wrist
Chronic pain resulting from spinal fractures
Loss of height and stooped posture
Loss of independence and mobility

Evidence-Based Steps to Improve and Protect Bone Health

While you cannot completely reverse severe bone loss, you can take active steps to slow the process down, strengthen your existing bone, and significantly reduce your risk of fractures.

Nutrition: Building Blocks for Bone

Prioritize Calcium: Calcium is the primary mineral that makes up your bones. Aim for 1,000 to 1,200 mg daily. Excellent sources include dairy products, fortified plant milks, leafy greens, and almonds.
Get enough Vitamin D: Your body cannot absorb calcium without Vitamin D. Sunlight is a natural source, but many people require supplements. Your doctor can check your levels and recommend a proper dosage.
Eat adequate protein: Protein makes up the flexible structural framework of your bones. Include lean meats, fish, beans, and legumes in your daily diet.

Physical Activity: Strengthening Through Stress

Do weight-bearing exercises: Bones grow stronger when they are forced to support your weight against gravity. Brisk walking, jogging, dancing, climbing stairs, and tennis are highly effective. (Note: Swimming and cycling are great for your heart, but they do not build bone).
Add resistance training: Lifting weights, using resistance bands, or doing bodyweight exercises (like squats or push-ups) 2 to 3 days a week pulls on the bones, stimulating them to build denser tissue.
Practice balance and flexibility: Activities like yoga, Pilates, and tai chi improve your balance and coordination, which is crucial for preventing the falls that cause fractures.

Important Lifestyle Factors

Quit smoking: Tobacco use significantly accelerates bone loss and decreases your body's ability to absorb calcium.
Limit alcohol: Heavy drinking interferes with the balance of calcium in your body and affects the production of bone-building hormones. Limit alcohol to no more than 1 to 2 standard drinks per day.
Fall-proof your home: Remove tripping hazards like loose rugs, improve lighting in hallways, and install grab bars in the bathroom if necessary.

Work With Your Healthcare Team

Discuss medications: If you are diagnosed with osteoporosis, lifestyle changes alone may not be enough. Your doctor may prescribe specific medications to slow bone loss or help rebuild bone.
Schedule follow-ups: Clinical DXA scans are typically repeated every 1 to 2 years to monitor changes in your bone density and ensure your treatment plan is working.

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