Body Compostition: Part 2
Body Composition: Digging Deeper and Building Stronger
In part one of this series, the critical importance of building healthy body composition was explored along with the following specific areas:
- Types of testing used to quantify body composition including:
- Body weight
- BMI
- Waist circumference
- DEXA scan
- Muscle mass
- An overview of target ranges for optimal body composition
In part two of the body composition blog series, the following aspects will be reviewed.
- Continued exploration of insights presented by DEXA scans
- Protocols and practices for optimal body composition
DEXA Body Composition Scan: Continued
As explored in part one of this series, DEXA scans are an invaluable tool for quantifying body composition.
Additional aspects of body composition DEXA scans measure include the following:
- Lean body mass
- Appendicular lean mass index
- Bone density
- Fat mass
- Visceral adipose tissue
Appendicular Lean Mass
The appendicular lean mass index quantifies the level of lean mass on the arms and legs. Leg strength is vital for ambulation and balance, which is a critical component of reducing the risk of falls during the aging process. The level of lean mass and strength in the arms is also a crucial component of maintaining activities of daily living as we age. The overall benefits of maintaining robust levels of appendicular lean mass index are similar to those for muscle mass in general as noted in the previous section.
Optimal levels of appendicular lean mass for women and men are:
Appendicular lean mass is also a recognized indicator of sarcopenia and cut-off levels are:
The next component of healthy body composition is bone density.
Bone Density
Bone density generally peaks around age 30 and the rate that the body breaks down bone starts to exceed the rate it builds bone at around age 35. After age 35, even healthy individuals start to lose bone at a rate of up to 1% per year (Cleveland Clinic).
Being proactive about preventing or minimizing bone loss as we age is critical for a healthy aging process as developing osteopenia (a milder form of bone loss) or osteoporosis (more serious bone loss) increases the risk of bone fracture. As noted previously, bone fractures can lead to serious consequences.
DEXA measures bone density in relation to both age-matched individuals and healthy 30-year-olds.
- T-score:
- This number is measured in units of Standard Deviation (SD). Each unit of SD is equal to an approximate 10% difference in bone mass compared to a healthy 30-year-old and shows how far your bone mass deviates from the average.
- Z-score:
- This number is measured in units of Standard Deviation (SD). Each unit of SD is equal to an approximate 10% difference in bone mass compared to age-matched individuals and shows how far your bone mass deviates from the average.
- Ranges for T and Z scores are:
- +1 to –1 indicates normal bone density
- –1 to –2.5 indicates osteopenia
- –2.5 or lower means osteoporosis
Fat mass is the next important indicator of body composition and is an aspect that often receives significant attention due to the perceived perception around its impact on aesthetics.
Fat Mass
Fat mass is the total amount of fat in the body measured as either a percentage or in grams. Fat is a vital organ and is metabolically active. It serves the following functions:
- Stores energy for future demands
- Releases hormones that control metabolism and appetite (leptin and adiponectin)
- Releases hormones that negatively impact insulin sensitivity (tumor necrosis factor-alpha, interleukin-6)
- Secretes proteins and builds enzymes involved with immune function and the creation of steroid hormones
- Macrophages, neutrophils, and eosinophils are immune cells found in fat tissue that play a role in inflammation—both anti-inflammatory and proinflammatory
Fat cells can grow in size and number. The amount of fat cells in our bodies is determined soon after birth and during adolescence, and tends to be stable throughout adulthood if weight remains fairly stable (Harvard). Consuming excess calories over time can potentially cause fat cells to increase in size and be stored in various areas throughout the body, which leads to a risk of chronic inflammation and dysfunctional metabolism, with the potential for new fat cells to grow. Weight loss reduces the size of fat cells but not the total quantity.
Larger fat cells and excess adiposity in general can increase the risk of:
- Insulin resistance
- Type 2 diabetes
- Cardiovascular disease
- Hypertension
- Liver disease
- Sleep apnea
- Cancer
A DEXA body composition scan measures the following parameters of body fat. The percentage is most important as the measured weight is relative to height. Optimal body fat percentage levels are shown.
- Total amount, including the volume in various bodily regions.
- Total percentage and percentage in various bodily regions.
- Optimal body fat percentages (based on levels for athletic and fit individuals) for women and men are:
- Women: 14 – 24%
- Men: 6 – 17%
- Optimal body fat percentages (based on levels for athletic and fit individuals) for women and men are:
More specific and revealing in terms of health outcomes than overall body fat levels is visceral adipose tissue.
To Read About Blog Topic, Scroll Down
Want To Work With Our Clinic?
Do you have a chronic or mystery illness that no one has been able to help you with? Are you simply wanting to re-connect with a healthier version of yourself? It’s Time To Finally Feel Better!
Visceral Adipose Tissue (VAT)
Visceral adipose (fat) tissue is fat found primarily around the internal organs and behind the abdominal muscles. Subcutaneous fat, on the other hand, is found more superficially under the skin and can be pinched with fingers.
VAT is a hormonally active component of total body fat, which possesses unique biochemical characteristics that influence several normal and pathological processes in the human body (5). A certain level of visceral fat is healthy and normal as it is necessary for padding the internal organs and only begins to pose a concern when an excess builds up.
Individual genetics play a role in the level of visceral fat though lifestyle factors, such as nutrition, exercise, and stress also play a significant role.
Excess visceral fat can increase the likelihood of certain diseases such as:
- Metabolic syndrome
- Insulin resistance
- Type 2 diabetes
- Hypertension
- Cancer
- Liver disease
- Dementia
Visceral fat is sometimes called ‘toxic fat’ as it secretes higher levels of potentially deleterious compounds than subcutaneous fat, including interleukin 6 (6), which is an inflammatory cytokine. Interleukin 6 then enters systemic circulation, increasing inflammation in various organs and increasing disease risk.
A DEXA body composition scan provides an accurate measurement in grams of visceral adipose tissue and optimal levels include:
Knowing your numbers and how they fit into desirable ranges is a crucial first step in the process of developing optimal body composition. Once there is an understanding of measurements, the next step is to implement the protocols and practices needed to move in the direction of optimal in whatever areas are out of range.
Protocols and Practices for Optimal Body Composition
Although there are a wide range of parameters to quantify regarding body composition, fortunately there are just a few areas to focus on regarding the protocols and practices for moving numbers towards optimal.
These areas include:
- Nutrition
- Exercise
- Sleep
- Stress management
Although the overarching components of these areas are generally similar for whatever aspect of the optimization process is being developed (and will be covered in separate blogs), there are some protocols that can specifically address aspects of body composition optimization. Optimizing sleep and stress generally follow the same principles whatever the goal and will be reviewed in other articles.
Examples of specific body-composition approaches include:
- Nutrition:
- Muscle mass (including appendicular lean mass): higher levels of protein intake
- Bone density: optimized levels of calcium, vitamin D, vitamin K2, and silica
- Fat mass (including visceral adipose tissue, BMI, and waist circumference): lower levels of carbohydrate intake and optimized calorie intake
- Exercise:
- Muscle mass: strength training
- Bone density: high-impact exercises
- Fat mass: zone 2 training
Optimizing body composition through an integrative approach supports not only balanced muscle, adipose tissue, and bone, but also various other components of a healthy body and life.
Summary
In this article, we’ve covered the follow aspects of body composition in relation to health and optimal aging:
- Continued exploration of insights presented by DEXA scans including:
- Appendicular lean mass
- Bone density
- Fat mass
- Visceral adipose tissue
- Protocols and practices for optimal body composition
Medicine with Heart is highly experienced at developing comprehensive and individualized programs for optimizing body composition – please reach out to us if you’d like to work with our team and clinic.
References
- Gallagher, D., Visser, M., De Meersman, R. E., Sepúlveda, D., Baumgartner, R. N., Pierson, R. N., Harris, T., & Heymsfield, S. B. (1997). Appendicular skeletal muscle mass: effects of age, gender, and ethnicity. Journal of applied physiology (Bethesda, Md. : 1985), 83(1), 229–239. https://doi.org/10.1152/jappl.1997.83.1.229
- Gallagher, D., Visser, M., De Meersman, R. E., Sepúlveda, D., Baumgartner, R. N., Pierson, R. N., Harris, T., & Heymsfield, S. B. (1997). Appendicular skeletal muscle mass: effects of age, gender, and ethnicity. Journal of applied physiology (Bethesda, Md. : 1985), 83(1), 229–239. https://doi.org/10.1152/jappl.1997.83.1.229
- Suetta C., Haddock B., Alcazar J., Noerst T., Hansen O., Ludvig H., Kamper R. S., Schnohr P., Prescott E., Andersen L. L., Frandsen U., Aagaard P., Bulow J., Hovind P., and Simonsen L. (2019) The Copenhagen Sarcopenia Study: lean mass, strength, power, and physical function in a Danish cohort aged 20–93 years, Journal of Cachexia, Sarcopenia and Muscle, 10, 1316–1329. https://doi.org/10.1002/jcsm.12477.
- Suetta C., Haddock B., Alcazar J., Noerst T., Hansen O., Ludvig H., Kamper R. S., Schnohr P., Prescott E., Andersen L. L., Frandsen U., Aagaard P., Bulow J., Hovind P., and Simonsen L. (2019) The Copenhagen Sarcopenia Study: lean mass, strength, power, and physical function in a Danish cohort aged 20–93 years, Journal of Cachexia, Sarcopenia and Muscle, 10, 1316–1329. https://doi.org/10.1002/jcsm.12477.
- Shuster, A., Patlas, M., Pinthus, J. H., & Mourtzakis, M. (2012). The clinical importance of visceral adiposity: a critical review of methods for visceral adipose tissue analysis. The British journal of radiology, 85(1009), 1–10. https://doi.org/10.1259/bjr/38447238
- Luigi Fontana, J. Christopher Eagon, Maria E. Trujillo, Philipp E. Scherer, Samuel Klein; Visceral Fat Adipokine Secretion Is Associated With Systemic Inflammation in Obese Humans. Diabetes 1 April 2007; 56 (4): 1010–1013. https://doi.org/10.2337/db06-1656
- Meredith-Jones, K., Haszard, J., Stanger, N. and Taylor, R. (2018), Precision of DXA-Derived Visceral Fat Measurements in a Large Sample of Adults of Varying Body Size. Obesity, 26: 505-512. https://doi.org/10.1002/oby.22108
Meredith-Jones, K., Haszard, J., Stanger, N. and Taylor, R. (2018), Precision of DXA-Derived Visceral Fat Measurements in a Large Sample of Adults of Varying Body Size. Obesity, 26: 505-512. https://doi.org/10.1002/oby.22108
Are You Suffering From A Chronic Illness?
Does your current health situation look like this…
- Do you feel that you have tried many things and either nothing works, or the treatment does not hold?
- Have you been told that there is nothing that can be done to reverse your illness and you just need to manage symptoms?
- Does your illness impact your work, your family, your happiness and your social life?
We specialize in finding answers and solutions for complicated chronic illness when people feel like they have tried everything. If this sounds like you, book a free call with us to see if we are the right fit for your health goals.
Dr. Miles has spoken for the following organizations:
