Body Composition Analysis
At Valle Health we use body composition analysis to help you understand your risks and to track your progress towards your goals.
Undoubtedly, you’ve heard about Body Mass Index (BMI). This is the most widely used (and least informative) tool to estimate body composition. BMI standardizes your weight in conjunction with your height to give a measure whether your weight is within a healthy range: underweight, normal weight, overweight, obese and morbidly obese (now severe obesity). BMI is mostly helpful because it’s so easy to measure, and results correlate well with health outcomes. Unfortunately this crude measure quickly becomes unhelpful for people who care about more than the most basic health goals.
The clear deficit in BMI is that it does not take into account what your particular body might be made of, particularly the amount of your weight contributed by either muscles or adipose tissue (fat).
Link to App State’s Community Testing Program
The gold standard for body composition analysis is called DEXA (Dual Energy X-ray Absorptiometry). This uses two types of X-ray to complete a full scan of your body. You may have had one of these to quantify the density of your bones. You probably were unaware that it also gathered the most comprehensive data available about the amount of muscle and adipose tissue you have. Unfortunately this data is usually discarded and not even recorded in the report that you or the radiologist (the doctor who interprets the study) receive.
Pros: It’s the gold standard (the best and most accurate available)
Cons: It exposes you to radiation (small amount), availability is limited (currently the only place to get one in the high country is through ASU - and at the hospital soon), and it’s expensive.
Moving on down the line, you’ll exchange practicality for reliability.
The next most reliable tool is air displacement plethymography. This uses an enclosed capsule that measures your weight, the amount of air you displace and the amount of heat your body releases.
Next up is the largest grouping, which uses a method called Bio-impedance analysis. Bio-impedance sends different frequencies to travel through your body and uses the return data to estimate what’s inside. The most basic version is a scale that you stand on with bare feet. More sophisticated machines also have hand holds that add the ability to isolate the composition of each limb, along with your core.
This is the Inbody Machine we use at Valle Health. It provides a detailed account of body composition.
At Valle Health we use InBody bioimpedance machines. InBody is a trusted brand, whose results are validated in many studies. These machines have been used in the highest levels of academic research.
We chose these machines because the scans can be easily done in the office: they only require you to remove your socks and only take about 30 seconds, and don’t expose you to anything harmful. This means you can check your scan at every office visit to check your progress to your goals.
There are other devices that add a visual component (Fit 3D). This requires you to undress to your under clothes. Other methods use only pictures, but again are limited by your attire.
So, why is all this important? This mostly hinges on muscle mass. If you are under-muscled, you may be a normal weight, but at risk for other serious problems. If you are heavily muscled, you may be told that you are overweight or obese, when you are actually at the peak of health. If you are overweight and under-muscled, you need to cautiously drop your weight while ensuring the lean mass (muscle) lost is minimal. Your InBody scans will track the progress clearly.
Here is a link to mine, on the same machine we’ll use in the office.
The Inbody gives measures of:
Body Fat Percentage
Lean Mass
Visceral Fat Mass
Here are two scenarios to consider:
- Height: 5’10”
- Weight: 220 lbs
- BMI: 31.6 (obesity)
This person could be any of the following:
High Body Fat/Low Muscle Mass (metabolically unhealthy)
Mod. Body Fat/Mod. Muscle mass (metabolically unhealthy)
Low Body Fat/High Muscle Mass (metabolically healthy)
And each with the following needed recommendations:
Increase muscle mass before attempt at weight loss
Target Fat Loss with caution to not lose lean mass
Maintain current weight and body composition
And Next:
- Height: 5’5”
- Weight: 120 lbs
- BMI: 20 (lower end of normal)
Again, this person could run the range of:
Mod. Body Fat/Low Muscle Mass (metabolically unhealthy)
Normal Body Fat/Mod. Muscle mass (metabolically healthy)
Normal Body Fat/High Visceral Fat/Normal Muscle Mass (metabolically healthy)
With the following needed counseling:
Increase Muscle Mass while maintaining weight
Maintain Current Body Composition and weight
Target visceral fat loss and increase lean mass
Our InBody scans will provide a detailed breakdown of your body composition and we will formulate a plan to help you make needed changes or to maintain the results you’ve already achieved.
While BMI is a powerful predictor of health outcomes, the measures we will routinely rely on at Valle Health are much more so:
Body Composition Analysis:
Body Fat Percentage
Appendicular Lean Mass Index
VO2 Max (this will have to wait until a later time)
Grip Strength
Stability
The combination of these measures will help you assess the effectiveness of dietary and exercise interventions and provide objective measures to direct your goals for aging well.
