The latest analysis of Bodyscan data is now matched for three age categories (18-29, 30-49 and 50-plus) as well as All Ages (the entire data set). (Note: The median age of all Bodyscan clients, male and female, is 38, and the majority of clients fall into the 30-49 age range.)
From experience, we have always known that the full data set held pretty well for clients up to age 50. It was only beyond 50 or even 55 that the percentile-matching seemed to diverge with any significance, and then chiefly in relation to fat and visceral fat. Today we tend to use the All Ages data for all clients under 50.
But crunching the numbers revealed a truly shocking increase in visceral fat for clients over 50, particularly for women. You can view the full tables of Variation of Key Indicators between Age Ranges in men and women, from which the images below are excerpts, on the Bodyscan Data page.
From the Bodyscan data:
With visceral fat linked to type-2 diabetes, heart disease, cancer and other serious diseases, this data is a very loud wake-up call for all of us (especially over-50s, like me) and it is in line with formal studies (like this one by Hunter, Gower and Kane) that found even higher increases (up to 400%) in female visceral fat.
Of course, the Bodyscan data also shows that it doesn’t have to be this way. The best results in older clients show healthily low levels of all fat, including visceral, often better than for clients many years their junior.
The new year is an obvious time for alarm bells to register and resolutions to be made, but a healthier lifestyle is just that - a sustainable, long-term habit of more exercise and sensible eating. Not a flash-in-the-pan effort you keep up for a week or two.
Rather than plagiarise or paraphrase, here are three points verbatim from the 2010 Hunter, Gower and Kane study that would be worth us all (especially us maturer folk) taking on board. At Bodyscan we know from experience they are all true.
Whenever you commit to your healthier lifestyle (today would be good), the improvement in your DEXA results is a great motivational tool to keep it going. Remember that visceral fat responds very quickly to diet and exercise, so even small changes can help us live more comfortably as we age.
1. Sufficient caloric intake
Muscle mass – and fat mass – doesn’t come out of thin air. You need energy (food) to create it. So by being in a continuous energy deficit for such a long period of time, Chris was never going to have a fair crack at putting on muscle.
A calorie deficit (where you consume less energy than you expend) will return a reduction in weight but the size of the deficit and the activity you perform will determine the composition change of fat and muscle.
Also, calorie-controlled diets (or “not eating enough”) should eventually come to an end and be followed by a period of maintenance calories (to maintain your weight and body composition) or perhaps a surplus to assist in building more muscle.
Building muscle only needs “sufficient” or “adequate” energy. You don’t need to eat thousands of calories above maintenance. As a weights workout typically burns about 300 calories, eating thousands more will only get stored as fat. Generally speaking, an excess of 300-500 is plenty to build muscle without gaining much (or any) fat.
Many Bodyscan clients who achieve body re-composition (losing fat and gaining muscle) do it at close to or even slightly below maintenance.
2. Progressive overload
For two years Chris was stuck in a comfort zone, doing the same exercises for the same duration with the same kettlebell every day. In fact, as he lost weight over time this meant his pull-ups and push-ups were being performed against less resistance not more. His bodyweight exercises were getting easier, not harder, which is why he was able to do more of them (leading him to think he was building muscle).
Progressive overload is the gradual increase of stress placed on the muscles over time. Forcing your body to consistently adapt to a new and enhanced stimulus is what results in an increase in strength and size of skeletal muscles. Progressive overload can be achieved by increasing the weight lifted, the number of reps, the time under tension (how slowly you perform the reps) and the frequency with which you train a particular muscle.
The most common reason people find themselves at a muscle plateau is the absence of progressive overload – performing the same exercises with the same weights.
Another reason clients make no progress is their bad form, as observed in this article, Are you wasting your time with weights?
Truth be told, even on the fat-burning front, what Chris described as HIIT was not optimised as he did not rest at any time during the 12-minute workout (ie, no ‘intervals’) and didn’t work as hard as he could have (at up to 90% of maximum effort) as detailed in this popular blog post: If HIIT isn’t working for you, try VHIIT instead.
We advised Chris to adopt progressive overload by taking his training into the gym and moving from bodyweight exercises to lifting actual weights, as home weights and home gyms will only take you so far.
We also recommended he increase his caloric intake to a more sensible level that allowed him to achieve fat loss but also provide the energy requirements to protect or even increase his lean mass.
We also emphasised the importance of protein (as he didn’t eat much of the macronutrient) and carbs around his workouts for energy. As a general guide you’ll also find this blog post about nutrition needs for different body types helpful. It’s received more positive comments than any blog we’ve ever posted! And if you're over 50, this post about building and preserving muscle in later years will be inspiring too.
One particularly interesting point to Chris's story is that all his friends and colleagues rated his muscles at about 5 or 6 on a 1 (weedy) to 10 (bodybuilder) scale. So, if you think you've got the arms of Popeye, have a DEXA scan to be sure!
Anyone even half-serious about improving their physical performance and physique knows this comes down to changing the two basic elements of body composition – fat and muscle.
The perfect ratio of fat-to-lean will depend on your favoured sport (which is why long-distance runner Mo Farah doesn’t look like England Rugby captain Chris Robshaw) or a simple desire to look better in the buff!
If we put some specialised activities to one side (sorry all you desert-runners and Sumo wrestlers out there), most people want to reduce fat and increase muscle. And the route to your low-fat-high-lean destination depends very much on where you’re starting from.
Fortunately, high-tech methods to measure body composition, such as DEXA, measure fat and lean mass separately and therefore accurately establish your starting point and the optimum route in terms of exercise, nutrition and supplementation to get from ‘A’ to ‘B’.
Let’s look at your possible starting points:
1. Low Fat, Low Muscle
Commonly referred to as an ectomorph or a hard-gainer, you have the advantage of low fat but may struggle with building muscle mass. Or maybe you’ve simply never tried to build any muscle and you could find you actually make lean mass gains very quickly.
Your goal is to build muscle with little or no increase in fat. So you’ll need a small calorie surplus of roughly 10% above maintenance with a fairly high proportion of carbohydrates to provide the energy around your fairly frequent (4-5 times a week) weight training. Make sure you up the weights when you can (progressive overload), while keeping a close eye on correct form.
As you’re low in fat to start with, adding cardio to your routine is going to be of little benefit.
A macro-split of 35P/45C/20F might be a good starting point. Opt for complex carbohydrates such as oats and consume close to your weights sessions to provide energy and build muscle.
At least a gram of protein per pound (450g) of body weight is a good rule of thumb and, in addition to high-protein foods like chicken and fish, Whey Protein is a great supplement thanks to its ultra pure form that’s high in protein and low in fat and sugar.
2. High Fat, Low Muscle
There’s no easy way to say it but if you’re in this quadrant on the fat-muscle axis you have the hardest task – reduce fat AND gain muscle. It’s quite rare, actually, to be at this starting point because as we gain weight with increased fat our bodies adapt to carry it around. Most people with a lot of fat (commonly known as endomorphs) actually carry vast amounts of muscle because they’re doing a high-weight full-body workout with every step they take.
If you’re high-fat-low-muscle your diet and exercise priorities are as follows.
To lose fat you need to be in a calorie deficit, typically between 500-1000 calories. The more fat you have, the higher the deficit can be. We’re all aware of the yo-yo weight problems of ultra-low calorie crash-diets caused by the loss of large amounts of muscle but if you don’t reduce calories enough you’ll take forever to shift the fat and just get demoralised.
To prevent muscle loss (and even increase muscle) you must do bodybuilding-style resistance training with progressive overload. A calorie deficit without weight training is a surefire way to lose muscle (and quite a lot of it if the deficit is big).
Adding some HIIT (high-intensity interval training) to the weight-training will help accelerate the fat loss.
For nutrition, you’ll need to keep protein pretty high to maintain and build muscle but reduce carbohydrates to assist fat loss. Diet Whey Protein is one of the best ways to hit this particular higher protein need thanks to its low carbohydrate and sugar content in one supplement. You might also want to get the most out of your workout and burn more calories with the helping hand of a caffeine booster or thermogenic to really get you working up a sweat.
A potential macro split for you is 50P/25C/25F.
3. High Fat, High Muscle
As with (2), your goal here is to burn fat but with the added pressure of not losing any lean muscle, so weight-training three times a week with some steady-state cardio to round off your sessions would be a good strategy.
Protein intake needs to be high, around 1g-1.2g per pound of body weight to keep muscle loss to a minimum but carbohydrates should be kept low to very low. Diet Whey Protein is a good source of supplementary protein without the carbs, and a pre-workout will help to keep you focused for your entire session.
A good macro split might be 50P/20C/30F.
4. Low Fat, High Muscle
Lucky you, you’ve arrived! This is many people's dream composition, but how do you mesomorphs stay there? Your calories are obviously on point so keep them where they are. As for the macro split, moderation in everything is the order of the day, so 35P/40C/25F would be a good strategy.
Around 1g of protein per pound (450g) of body weight together with a balanced amount of carbohydrates and weight training three times a week will ensure you maintain your lean muscle mass and keep your fat enviably low. Make sure you eat enough essential fats, such as those found in peanut butter, which is nutrient-dense to help curb cravings and keep you fuller longer – but remember to keep an eye on overall calories.
This is a Guest Blog by our friends at The Protein Works. You can win a share of 100,000 TPW Loyalty Points in our competition (and a package of DEXA scans) before October 30th.
Remember, for a customised, calorie- and macro-specific food plan and training programme, consider Bodyscan Personal Coaching.
Below is the progress report (and above are the DEXA images) from a Bodyscan customer, Enzo, who came for his sixth scan in September.
Reading up from the bottom of each yellow table you can see that he has made almost no progress since he first came to Bodyscan on 13th October 2015.
If you look at the ‘Change vs Baseline’ column, Enzo has gained no muscle mass at all (down 30g, which is less than the margin of error) and his fat is down less than 2kg (1835g) after two years).
And the ‘Change per month vs Baseline’ column shows he has lost an average of just 78 grams of fat and 1 gram of lean per month over the two year period.
These results are at once woeful and scandalous!
Woeful because nothing has changed after two years. Scandalous because Enzo has been paying a personal trainer three times a week to go absolutely nowhere.
Compare those results over two years to the following, which show excellent progress in just three to four months. The first (below) shows a simultaneous fat loss of 3.7kg and lean mass gain of 3kg in 18 weeks.
The second (below) shows a simultaneous 3.3kg drop in fat and 2.5kg lean gain in 14 weeks.
And the third shows a lean mass gain of 3kg with no corresponding gain in fat (53 grams) in exactly three months.
All these individuals (two of whom are of a similar age and slightly older then Enzo, in their forties) are clients of Bodyscan Personal Coaching, at the heart of which is a calorie- and macro-specific food plan based on your unique DEXA data and a weights-based resistance training programme.
In just a few weeks these individuals have achieved what Enzo and his trainer have failed to do in two years. So if your body recomposition plans are going nowhere, change your regime, dump your PT or consider Bodyscan Personal Coaching (BPC).
BPC is not for everyone. It requires you to be disciplined, to go to the gym three times a week under your own steam, be familiar and comfortable with weights and understand the importance of good form. If you need a real live personal trainer standing over you to keep you honest then BPC is not for you.
Also, because it is uniquely customised for you and your lifestyle, we can take on only a small number of clients at any one time. But if your last few results are more like Enzo's than our three clients' above, give it some thought.
And of course, if your personal trainer is any good and helping you achieve great results, then stick with them! They are worth the money!
Just how futile are our attempts to keep trim, taut and terrific as we get older? After all, our muscles just waste away and we get inexorably fatter, don’t we?
Certainly, on average, and without intervention, muscle declines as we age. But by how much? And can we prevent or slow muscle loss or even turn it around?
While Bodyscan clients do not represent a random sample of the UK population, our dataset is big and varied enough to suggest that muscle mass does not begin to diminish as early as many say. It also contradicts the popular view that the rate of decline is very steep.
Bodyscan’s previous data, for 1400 men and 850 women, showed average lean mass index (lean mass divided by height-squared) to be almost unchanged up until age 50, and data points as likely to be above the median line as below it up until age 55.
It’s only when data beyond age 55 is included that there is a noticeable decreasing trend. (Please note the red line on each graph is the median value, not the line of best fit or a trend line.)
Bodyscan has recently segmented its latest dataset of 2700 men and 1300 women into four age categories and the results point to the same conclusion. Below are the average (50th percentile) and top quartile (75th percentile) lean mass indices for both sexes.
For a man 1.78m (5’10”) tall, the difference in lean mass between an LMI of 19.2 and 18.9 is exactly one kilogram. The women show no difference in LMI between the youngest and oldest age groups. Not what you’d call a cliff edge.
If you think Bodyscan’s client base is super-fit (it’s not), then for a random population sample, take a quick look at the US NHANES (National Health and Nutrition Examination Survey) data below. Its charts show that average LMI (the middle line on both charts) peaks for white men and women as late as 50, and points to about the same LMI at age 70 as at age 20.
As for actively building muscle and defying increasing age and falling testosterone, Bodyscan client Mitchell, aged 62, is proof enough that it is perfectly achievable. Mitchell’s LMI is 21.9, which is above the 80th percentile (what we at Bodyscan call “amateur bodybuilder muscle”) for men less than half his age. His fat mass index is very good too, at just 4.37.
Mitchell trains under James Blanchard, who applies the same training rules to older clients as younger ones, though with more alertness to pain, injury and recovery time. “Age is just one factor, together with overall health, fitness and experience,” he says. “Young and old alike need to listen to their bodies. Mitchell doesn’t train through pain or do anything stupid, that is key in allowing him to train and perform exactly like a younger guy would.”
Muscle mass and strength come through four sessions a week of the big, powerlifting moves, such as bench press, squat and deadlift. The only diet parameters were 2g protein per kilo of body weight and overall calories, which were set at James’s own formula of 12 x bodyweight in pounds, varied by how active the client is.
“This amount of protein was more than sufficient enough to maintain muscle mass and helped to keep Mitchell satiated. Carbohydrate and fat were set however he liked according to his preference.” James believes that the quantity or ratio of carbs and fat “makes no difference over the long term as long as the total calorie intake is respected.”
While it is easy to think that 62-year-old Mitchell’s achievement of high muscle mass is an exception to the rule, another look at Bodyscan’s data shows that it’s not. Take a look at the charts plotting FMI vs LMI for Bodyscan's entire dataset.
Across both sexes and all ages, as people get fatter and heavier, they always develop more muscle mass to be able to carry the extra weight. They are effectively doing a high-weight workout with every step they take. Everyone with a high fat mass index has a high lean mass index. We’re not suggesting that you get fat to build muscle but it’s proof enough that weights-based resistance training – at any age and for both sexes – will maintain and build muscle mass.
Finally, it should also be stressed that resistance training is perhaps the best strategy for increasing bone density, something that naturally declines in later years. The decline is particularly steep (and therefore the benefit of weights greater) for women after menopause.
Mitchell’s bone density (in the light blue area) is 112% of average for his age and well above the average (the line that separates the two blue areas) for a man at peak bone density (about age 35).
For the majority of strength athletes, gym goers and exercise enthusiasts, protein will always be the number one macronutrient due to its enhancing effects on muscle protein synthesis (that’s gainz to you, bro!)
There have been a number of recent news stories warning of the dangers of eating too much protein and suggesting that we have become obsessed with this particular macronutrient. (Remember when fat was the dietary whipping boy?)
These stories have linked excess protein with nausea, kidney stones, osteoporosis, diabetes and cancer, but it’s not entirely clear if they are the result of the protein itself or, for example, the saturated fat or salt in the foods that contain the protein, such as cooked or processed meats.
While the list of dangers are sobering, the problem with so much food research is that it is usually done on sedentary populations who, let’s face it, suffer the gamut of health problems from doing too little and eating too much of just about everything.
So what exactly is ‘high protein’ and for whom might there be benefits?
The UK recommendation for protein is 0.75 grams per kilograms of body mass per day (g/kg/d), which equates, on average, to around 55g for men and 45g for women.
However, it’s universally agreed that regular exercisers, particularly those involved in strength sports and resistance training require a much higher protein intake than the baseline in order to effectively support their activity demands and fuel increases in muscle mass.
This is especially true when people are following a calorie-restricted diet in an attempt to reduce body fat because a calorie deficit increases the likelihood of losses in lean tissue, something we see at Bodyscan every day.
It has previously been thought that individuals pursuing strength activities, such as lifting weights, should be consuming between 1.5-2g/kg/d of protein in order to meet the protein requirements of the exercise activity and promote optimal muscle protein synthesis. Other research claims that 2g/kg/d is the ‘maximally beneficial’ limit of protein intake and any more provides no extra benefit in terms of body composition and strength. Indeed, the extra calories provided by the excess protein have been assumed to have a negative effect on body composition (ie, an increase in body fat).
However, recent research looking into daily protein requirements for resistance-trained individuals suggest that 2g/kg/d is not the upper limit. Far from it.
American studies led by Dr Jose Antonio suggest that protein intakes of above 3g/kg/d appear to increase fat-free mass and strength, with a simultaneous decrease in fat mass when compared to lower intakes (between 1.8-2.6g/kg/d).
Chronic high protein ingestion of 3.3g/kg/d for six months has been shown to have no negative effects in terms of fat gain or kidney function when compared to a lower intake of 2.5g/kg/d. Even a hyper-energetic diet consisting of more than 4g/kg/d (5.5x greater than the recommended daily amount) had no negative effects and did not result in significant negative changes over time or between groups for total body mass, fat mass, fat-free mass, or percentage body fat, when compared to a lower protein control group (consuming 1.8g/kg/d). This was despite the high protein group consuming significantly more protein and calories than the control group for a period of eight weeks.
Consequently, these recent findings seem to suggest that it is beneficial to consume protein amounts higher than 2g/kg/d, especially when calories are restricted, as the research shows improved preservation of muscle tissue combined with greater reduction or minimal gains in fat from intakes of more than 2g/kg/d.
These emerging findings suggest that for non-sedentary populations, and in particular strength-trained athletes, 2g/kg/g could actually be the floor, rather than the cap, for protein intake, especially when gains in lean mass are the primary focus.
You may like to check out a further discussion of protein requirements and a protein calculator at Fitness Savvy.
In the space of a fortnight, I have had two male clients, Maurice and Will, frustrated at not being able to shift fat. The similarities were uncanny. Both were in their fifties with stressful jobs and both were exercising pretty hard regularly with a mix of weights and HIIT and eating a “clean” diet of freshly-made low-carb meals.
While we all respond very differently to food and exercise plans, a regime like that works well for many Bodyscan clients, so I was initially curious why they were still carrying relatively high fat.
The reason soon became clear.
As the two men’s circumstances were so similar, let’s just look at Maurice’s numbers.
His fat mass index (fat mass divided by height-squared) of 8.9 and body fat percentage of 30.1% put him in the 85th percentile in the fat stakes. Not a good place to be. Not only that but his fat ratios were all very high, above the 90th percentile (likely caused by his stressful, cortisol-increasing, belly-fattening job), leading to an “increased risk” level of visceral fat.
It wasn’t until we put his numbers into the Bodsycan calculator that the problem was immediately obvious - Maurice (and Will) was drastically under-eating.
With a ‘moderately active’ profile, Maurice’s maintenance energy requirement is estimated at 2461 calories. A ‘standard’ 20% deficit for gradual, sustainable fat loss would be 1970 calories. Maurice was eating only 1200 calories. That is only three-quarters of his RESTING calorie requirement!
With such little fuel coming in, Maurice’s body will do everything it can to store energy (ie, hold on to fat) and rid itself of anything that burns energy (calorie-intensive muscle).
The saddest thing about Maurice’s dilemma was his doctor’s take on the situation: “If you keep on reducing your calories you must eventually lose fat.” When you hear statements like that it’s no surprise that most GPs are still using BMI and weight to assess health.
To lose fat, both men need to close the gap between their maintenance calories and what they’re actually eating so their bodies switch out of famine mode and relinquish fat stores. It’ll also help them maintain and increase muscle mass, which is almost certainly not happening now.
So if you’re having the same problem as Maurice and Will, take a longer look at what (and how much) you’re eating and check that your calories deficit is not too big. Drastically slashing calories is counter-productive.
High intensity interval training (HIIT) is becoming increasingly popular as it has been shown to improve both aerobic and anaerobic fitness as well as significantly enhancing insulin sensitivity, blood glucose regulation and the body’s ability to burn fat, compared to much longer periods of steady state cardiovascular activity.
The benefits of HIIT are the result of a greatly amplified ‘excess post-exercise oxygen consumption’ (EPOC), which gets the body back to its natural state and includes elevated fuel consumption (including fat metabolism) in an attempt to restore depleted nutrient stores within the body. In other words, while you might feel like death during your HIIT routine, the benefits don’t actually come until you’ve stopped and your body works hard to get things back to normal – the after burn effect.
Many Bodyscan clients wanting to lose fat say they include HIIT in their routine but only a minority get the great results that can be achieved. The main reason for poor results is that most people simply aren’t working hard enough.
Perhaps HIIT should be renamed VHIIT, because the sweaty bits of a HIIT workout should achieve a VERY high heart rate - about 90% of your maximum (HRmax).
That’s why the work periods of a proper HIIT session should not be more than a minute and the entire session should not last more than 20 minutes because it would be impossible to maintain such a high exercise intensity beyond those limits. If you're exceeding those limits then you're not going to get the benefits.
Whatever your fitness level you need to work with MAXIMUM effort to get the required physiological response. If you’re unfit you’ll reach your 90% HRmax quickly (say, after 30 seconds of work) and need a longer rest period (maybe two minutes) to be able to repeat the process at high output again. As your fitness increases you’ll need shorter rest periods and be able to repeat more cycles but the 60-second and 20-minute limits will apply even for an athlete.
Indeed, research has shown that just ten minutes of work in a 20-minute HIIT session (60-second sprints at 90% HRmax followed by 60-second rests, repeated ten times) has the same effect on 24-hour energy expenditure as performing 50 minutes of steady-state endurance cardio at 70% HRmax.
You can do any type of activity for the working periods, it doesn’t have to be the traditional sprinting or rowing. Pull-ups, push-ups, squats, burpees or anything that gets the heart rate elevated high enough will do.
So if HIIT isn’t working for you, try VHIIT instead. Work shorter but harder.
Written by James Rutherford, Consultant, Bodyscan City. James has a BSc in Sport and Exercise Science and is completing his MSc in Sport and Exercise Nutrition.
If you're a PT, how do you prove (for certain) that you’re making a difference?
If you’re a personal trainer, S&C coach or nutritionist your success rests squarely on your clients’ tangible results. And if you’re any good at what you do that should primarily mean reducing their body fat and/or increasing their lean muscle mass – both in absolute terms and as percentages of total body mass.
The accuracy with which you measure those changes therefore reflects how truly successful you really are. If your clients don’t have faith in the way you measure their body composition that will reflect badly on you. If they don’t believe the results, they won’t believe in you.
Unfortunately, the most accessible, lowest cost and therefore popular methods of measuring body composition are also the most unreliable and imprecise.
At the very back of the pack are plain old bathroom weighing scales (and their fraudulent offshoot, body mass index). Scales tell you nothing more than your relationship with gravity, so unless your client is a jockey or a boxer who needs to compete in a weight class, scales should play no part in your armory.
Skinfold calipers are cheap, prevalent and have their place in measuring body changes but, like a gun, in untrained hands they can be dangerous. In Sports Nutrition for Paralympic Athletes (2014), editor Elizabeth Broad quotes studies that state, “…highly skilled technicians are required if reliable data are to be collected. Technicians need to be meticulous in terms of both accurate site location and measurement technique. Measurements just 1-2cm away from a defined site can produce significant differences in results…”
In an article in Cyclist magazine (2015), British Cycling coach Andy Kirkland more bluntly reinforces the need for caliper practitioners to be highly qualified: “Unless you’re a skilled practitioner, for example ISAK certified [International Society for the Advancement of Kinanthropometry], skinfold analysis – using calipers to measure the thickness of fat at certain sites around the body – can be next to useless.”
Another technique for measuring body fat is bio-electrical impedance analysis (BIA), whose form factors range from £50 scales you can buy in a department store to £13,000 devices that resemble airline self-check-in kiosks.
Whatever the cost, the technology (which actually measures electrical resistance to make a guess about body water to, in turn, make a guess about fat) is the same. The variation in price range is only matched by the variability of the results – drink a litre of water and the device will record lower body fat. Or if you’re not thirsty, simply flick the switch on many BIA devices to the ‘athlete’ setting and your fat reading will miraculously drop. Lean at the flick of a switch! Tempting but hardly scientific.
The most accurate way of measuring body composition and now universally regarded as the gold standard is dual-energy X-ray absorptiometry, or DEXA.
As the name suggests, DEXA produces X-ray photons of two different energy levels. Bone and soft tissue slow down the X-rays at different rates, so the composition of bone, fat and lean mass can be separately and precisely analysed.
That’s why DEXA is favoured by the country’s leading sports science universities, such as Bath and Exeter, and professional teams like Chelsea, Arsenal and West Ham football clubs, and England Rugby.
As well as accuracy, DEXA automatically provides regional data and imagery for arms, legs and trunk in order to get an accurate picture of fat and muscle distribution (been skipping leg day, bro?) It also gives a very good estimate of visceral fat, which is the ‘bad’ fat that surrounds the internal organs and is linked to heart disease, diabetes, stroke and even cancer.
As you’ve probably guessed by now, you can’t buy a DEXA scanner in John Lewis. DEXA is an expensive piece of medical-grade equipment that your clients have to travel to and that will cost them £100 or more.
But the accuracy, precision, depth and breadth of body composition data makes it essential for baseline and quarter-to-half-yearly measurement. In Australia, Canada and the US, where DEXA is well established, it’s common practice for PTs to insist on a DEXA scan before signing up a new client.
If you’re a personal trainer DEXA gives you research-quality, high-calibre information that adds to your credibility, motivates your clients and differentiates you in what is undeniably an overcrowded industry.
A mediocre PT will fear DEXA because it doesn’t discriminate. Unlike calipers and BIA, you can’t squeeze harder or flick the ‘athlete’ switch to fudge the result.
On the other hand, if you’re a PT who values accuracy, veracity and professionalism you will embrace DEXA because it will prove beyond doubt that you’re making a difference. Your clients will stay motivated and keep coming back for more.
Bodyscan (bodyscanuk.com) is the UK’s only company dedicated to DEXA body composition measurement and has two sites in central London. Clients book online, receive an immediate printed report and can opt for an in-depth consultation that brings the report alive with a highly personalised analysis.
Bodyscan’s customer reviews are 95% five-star, so your clients are in very safe hands and will thank you for the introduction.
We recently had a TV crew in to film some people who were committing to lose a lot of weight (ie, fat).
One of them, Julie, has a huge task ahead of her because she is carrying as much fat as my total weight (68.9kg). See part of her report below.
At Bodyscan, while we don’t focus too much on body fat percentage (preferring fat mass index), Julie would be in a far better place at around 26.5% body fat, which means she should lose about 35kg of fat from her total weight of 127kg.
Just a few minutes struggling with the barbells in my local gym yesterday (above) made it easy to know what it would feel like to be 35kg heavier (and then 35kg lighter once I’d managed to put the barbell back in the rack). It was hard work. It also made it obvious why very overweight people have super-high muscle mass – they’re doing a very strenuous workout with every step they take.
If you're overweight, work out how much fat would be good for you to lose: women take 26.5% of your weight, men 18% of your weight, in order to arrive at a better fat mass. Then see how much higher than your current total fat mass it is. That difference is how much fat you could aim to lose. Now go and pick up that weight in the gym to get a sense of how much better you’d feel without that ballast.
If you're below those body fat percentages you're doing well.
A quick web search will find plenty of research and opinion (eg: 1, 2, 3, 4) that weights-based resistance training is a more effective method than cardio-based workouts for burning fat, even before the advantages of increased muscle mass and improved bone density are taken into account.
But a quick look round many gyms suggests that a lot of people are squandering the advantage and simply wasting their time.
No ‘bro’ or alpha male (from whom so much weight-training advice originates) ever likes to admit that he’s doing something wrong (or be told to put his weights back in the rack) so bad form gets handed down and propagated like fake news.
Trying to show off with the heaviest weight known to man (and woman) is probably at the root of most bad technique and a quick physics refresh explains why: The greater the mass of an object, the greater its inertia and momentum. In other words the heavier the weight, the harder it is to move and, once moving, the harder it is to stop.
The easiest way to overcome inertia is to swing the weight back and forth rather than lift it from a still, standing start in order to give it momentum, so often seen with exercises like bicep curl, lateral raise and leg raise (below).
(Click the 'Read more' link below to read the rest of the article.)
Almost everyone who comes to Bodyscan wants to know their body fat percentage (BF%)
But whilst BF% is a better measure of body composition than weight or BMI, it’s still not the best measure because, like weight and BMI, it wraps everything up into a single number.
Body fat percentage is actually just the ratio of your fat to your weight, which means it's affected by your non-fat mass as well as your fat.
The DEXA scans of the two men below show they have exactly the same body fat percentage - 21.6% - but very different body compositions.
Can you see now why BF% is not the best metric?
A DEXA scan measures your fat and lean tissue separately and gives you meaningful indices for each, most importantly your fat mass index (FMI) and your lean mass index (LMI). These two numbers tell you respectively how much fat and lean mass you carry in relation to your height. Crucially, your FMI is unaffected by muscle and your LMI is unaffected by fat. Unlike your body fat percentage, which is affected by both.
If we look at the FMI and LMI for our two male subjects, we see what polar opposites they are. For fat, one man is in the lowest 30%, the other is in the highest 35%. For lean mass and muscle the situation is reversed. In relation to his height, one man has more muscle than 90% of men, the other has less muscle than 90%.
Until you know your FMI and LMI and get a clear picture of your body composition you can't be really sure what your training and nutrition priorities should be.
Just before Christmas 2016 a Bodyscan client presented with the most dramatic change in body re-composition we have ever seen.
In just four months (from August to December), the client lost 11.5kg of fat and gained 6.4kg of muscle.
The numbers are impressive enough on their own, but are even more remarkable when you learn the client:
1. used no drugs, stimulants, supplements or shakes
2. was in a calorie deficit of about 500 calories a day
3. did zero cardio
4. is female
Prepare to forget everything you thought you knew about fat loss, muscle gain and bodybuilding when you read Joanna’s story. It starts with a Bodyscan DEXA scan that was “so mortifying, so shocking that it messed with my head and took me six months to recover from”.
Then in August last year, Joanna began a programme of Bayesian Bodybuilding. Click 'Read more' to continue.
We recommend most clients return for a follow-up scan three months (12-14 weeks) after their first to track their changing body composition.
It is quicker to lose fat than build muscle, so if fat-loss is your priority you should certainly look to return after 12 weeks and check you’re making sufficient progress.
If your re-scan results are good, it will give you reassurance that your training and nutrition programme is right for you and you can continue with more of the same.
Unfortunately for many, re-scan results are a disappointment. But knowledge is power, and you’ll now be able to make adjustments or stop and change course completely. Imagine waiting nine months or a year before you discovered you’ve been wasting all that time.
Typically, disappointment is due to high levels of muscle loss during a fat-loss phase (we regularly see people losing more muscle than fat) and, conversely, big increases in fat with little to show in terms of lean gains.
Uneven muscle gain where certain areas of the body progress faster than others is also common, as is not gaining any muscle at all. This can be due to a number of factors such as a too-low calorie intake (no muscle gain) or the incorrect training programme, intensity or rep range.
It is better to find out now that the desired changes in body composition are not occurring and do something about it.
Another reason for checking-in sooner is to be sure that the direction of travel has been consistent over the entire period. If you have more body fat in January than in the previous June, we’ll never know if it was just Christmas to blame or you wasted seven months doing the wrong thing. A re-scan in September would have provided some insight.
Finally, the constant refrain we hear from new clients is, “I wish I’d done this three months ago so I could see how things have changed.”
Only a DEXA body scan will give you the accurate, consistent, reproducible results that will enable you to optimise your progress.
If you’ve lost some momentum or are just not sure if you’re on the right track, booking a re-scan to see your results will be the motivation you need to kick start your body composition transformation.
We see many clients at Bodyscan who lose a lot of fat but who also lose a great deal of muscle too.
Sometimes so much that their body fat percentage actually goes up.
Look at the Bodyscan reports of these two clients who both did ‘biggest loser’-style diets with severely restricted calories: Nikhil, whose results are above, lost 4.7kg of muscle to his 4.9kg of fat, while Robert lost a whopping 10.8kg of muscle for 25.2kg of fat. Those big muscle losses do not bode well for keeping the fat off.
Indeed, loss of muscle is the reason why so many people who shed a lot of weight (see this article about DEXA and Oprah Winfrey) yo-yo back up again, and it highlights the importance of retaining your muscle mass when you embark on a fat loss regime.
Many people assume that when in a calorie deficit your body will turn first to its fat stores to make up the gap. But your body’s survival instinct takes an opposite view. Carrying muscle mass is calorie inefficient; big muscles burn a lot of calories even at rest. That’s why gaining muscle mass takes a lot of time, effort, heavy weights and loads of food.
Fat, on the other hand, is a great store of energy and helped ensure our ancestors’ survival when food was sparse and before there was convenience food within arm’s reach.
The need to survive and the expensive energy requirement of lean body mass is why your body quickly depletes your muscles - rather than your fat - when you reduce your calorie intake. The double whammy is that with lower muscle mass your body then burns fewer calories when at rest, so if you break your diet and simply go back to what you were eating before there’s now a bigger gap than there used to be between the calories you’re taking in and the calories you’re burning. Result - ballooning fat.
The statistics vary but a quick flick through a number of articles puts the number of people returning to their starting weight or above after a diet anywhere between two-thirds and 97%.
To retain your calorie-burning muscle, therefore, it’s a very good idea to add weight training to your programme. Unlike our big muscle-losers above, these two Bodyscan clients made resistance work a core part of their programmes: You can see from their Bodyscan reports that Katy reversed a fat gain/muscle loss to put on 3.2kg of muscle while losing 2.7kg of fat, and Rupert lost an incredible 14.3kg of fat while still building 2.2kg of muscle. The results speak for themselves.
In my experience as a personal trainer, success is wholly dependent on consistency. There is no point in any diet or exercise programme if you’re not going to stick to it, which is another reason why slashing calories and manic fitness schedules don’t work. In a couple of weeks you’ll be fed up and succumb to temptation. It's better to plan for slower, more gradual fat loss by restricting calories just 10% or 20% below maintenance levels and an achievable exercise and gym schedule. (Note: if you're gaining fat, you're already eating above your maintenance calories. Check out our body composition calculator for an idea of your calorie requirement.)
If your programme has derailed, it’s probably time to get a new Bodyscan baseline. We’ll give you achievable targets and then measure your progress in 3-4 months’ time.
Author - Archie Williams
This month (September 2016) we released the latest updated Bodyscan percentile tables, with data from over 2000 client scans - 1400 men and 650 women.
The new tables now includes regional fat mass, so you can see how typical your fat distribution is. You’ve been able to assess your muscle distribution with the previous tables, as described in this blog post about skipping leg day.
A ’typical’ fat distribution would expect to see fat mass for arms, legs and trunk in a straight horizontal line across the last three columns of the Regional Fat Percentiles table. The table is shown below.
The woman whose scan image appears at the top of this post might look to be carrying all the fat in her legs and trunk but when we plot her fat mass in the tables (shown in the report excerpt next to the image to be about 1.8kg in the arms, 10kg in the trunk and 5.9kg in the legs), we see that she actually carries proportionately most in the arms and least in the trunk.
Of course, you can’t spot-lose fat, but a change in the shape or angle of your plotted line through arms, trunk and leg fat mass will clearly show you how and where fat is shifting.
The data has changed little since March but the big sample size now gives us a very solid, reliable base against which to compare your individual results.
As well as showing fat and lean mass variations between the left and right sides of your body, Bodyscan can show you top-to-bottom variations too.
Using Bodyscan’s percentile tables, you can plot the lean mass in your arms, legs and trunk to spot discrepancies or weaknesses in your muscle distribution.
The most common variation we see is among gym-going men who commit that most heinous of crimes - skipping leg day. Take a look at this guy’s regional results and how they reveal workouts focused on arms and upper body.
The lean mass in his arms (the first two numbers) averages at around 5kg, in his trunk (the third number) at about 33kg, and about 10.8kg in each leg (the fourth and fifth numbers).
When we plot those quantities on our percentile tables (above), we see they equate to approximately these percentiles:
Arms (5kg) 95th percentile; Trunk (33kg) 77th percentile; Legs (10.8kg) 55th percentile.
That is, the lean mass and muscle in his legs is way behind that of his arms and trunk and, in absolute terms, just above average (the 55th percentile).
With a more even distribution we would expect similar percentiles across all regions of the body. To bring his legs into line with his arms, therefore, he needs to increase muscle mass in each leg from 10.8kg to about 13kg - a shortfall of more than 2kg in each leg.
So don't skip leg day!
On Tuesday 12th April, my first client of the day produced an incredible result.
In just four months Martin has lost 13.6kg (that’s over 2 stone) of pure fat. And he did it on a ketogenic diet, in which 70% of his calories come from fat, 25% from protein and almost none from carbs.
The fat loss would probably have been greater a month ago as recent family events forced Martin to diverge from the high-fat, ultra-low-carb regimen.
The highlights of his report are:
Martin’s results endorse the groundswell of opinion and evidence that it’s OK – in fact, highly beneficial – to eat plenty of naturally occurring fat and that carbohydrates are the underlying cause of obesity.
If you’re interested in Martin's information sources, he kindly points to:
We also found this very interesting 30-minute ‘Catalyst’ programme from ABC Australia, made in 2014.
Since November, Martin has consumed his high-fat diet in a time-restricted window (a version of intermittent fasting) between noon and 8pm, and also aimed to be in a calorie deficit of 30-50%. Some keto advice is that you don’t have to count calories because your hunger levels are very well regulated without carb-induced insulin spikes, but Martin says keeping a sharp eye on calories was crucial because of the high-energy value of high-fat foods – a few macadamia nuts can cause a calorie blowout.
In February, after five months of strict ‘keto’ (he began the keto journey last September), Martin moved to having a carb re-feed once or twice a week, usually the night before bodyweight circuit training (TRX, press-ups, squats and lunges). This ‘cyclical keto’ with heavy-duty carb-ups of between a few hours and two days is outlined in ‘The Best Ever Bodybuilding Diet?’. Martin’s carb content would rise to 50% in these periods.
His more than 5:1 ratio of fat-to-lean loss is excellent by any standard (especially considering the sheer amount of fat he shed) and one wonders if he would have maintained more or even all his lean mass with a lower calorie restriction and by increasing weights beyond body weight.
Martin’s lifestyle changes started last August, when he was 131.5kg (21 stone) and wore XXL shirts and 44-inch trousers. He quit smoking and sugar and began restricting carbs and calories. In September he followed the keto rules more closely and saw improved results. He then replaced breakfast with a ‘bulletproof’ coffee (coffee and coconut oil) before removing the calorie-rich oil to start the 16:8 intermittent fasting.
He’s now a medium, 32-inch waist and below 90kg for the first time since he was 12 years old. Inspiring stuff.
Martin’s says: “It's hard to start, like any diet, but the difficulty is in establishing new habits. The biggest one is losing the starch component of most of your meals – it's culturally ingrained.
“Once you're used to it, it's quite easy. Keto is challenging in that it's a binary proposition – like being pregnant, you're in a ketogenic state or you're not. So you can't cheat (except in very controlled circumstances with strategic carb re-feeds).
“Get enough salts when you start, watch your fibre intake and expect to take a few weeks for your body to adapt. Once it does there are many benefits. For me, fat loss obviously, but also the steady blood sugar, reduced hunger and mental clarity are great side benefits.”
We hope you find Martin's story interesting.
MAN v FAT published one of the very first reviews of Bodyscan when we opened in London in January 2015. Today, the 35,000+ member men's forum is the biggest online referrer of hits to the Bodyscan site after Google Search.
It makes perfect sense, then, for us to team up with MAN v FAT and offer a free DEXA body scan plus face-to-face consultation in our latest competition. We're kicking ourselves we didn't think of it earlier!
You don't have to be a bloke to win, so click this link to go to the MAN v FAT website and enter now. You can ratchet up your entries by getting your friends to enter too.
You'll get the most accurate and precise measurement of your body fat and lean mass, plus data about your visceral fat and bone density too. Plus we'll take you through your report in detail and help you set targets (in kilograms) for fat loss and muscle gain.
The Bodyscan website and, more importantly, the booking pages that ask for your personal information and credit card details are now SSL-secure.
That means all data passed between your browser and the booking engine web server are encrypted and remain private. You can see this marked by the HTTPS (rather than just HTTP) at the front of each page's URL in your web browser.
Due to some software restrictions, we've had to take the booking engine (made by Australian company Bookeo) out of Bodyscan's own website and host it on its native site. It's exactly the same engine and works in exactly the same way but is no longer embedded as a widget on the Bodyscan booking page.
The upshot is that when you book a Bodyscan DEXA body fat test you can be sure your personal and credit card details are completely safe.
If you've been to Bodyscan for a DEXA scan then you can use the Bodyscan body composition calculator to set targets for fat loss, muscle gain or both.
After entering the data (in kilograms, not grams - therefore your bone mass (BMC) will be between one and four kilograms) from your DEXA Bodyscan report on the first (RMR) page (which gives you two formulae's outputs for your resting calorie requirement), you can advance to the Body Composition Calculator, which allows you to set targets for fat and lean mass, using your fat mass index (FMI) and lean mass index (LMI).
To arrive at FMI and LMI targets, you'll want to use the Bodyscan percentile tables (latest update December 2017), which you can see on our Data Page and are also at the back of your printed explanatory notes (download notes here).
The tables in the explanatory notes are for clients of all ages and the numbers hold very well up to age 50. On our Data Page the tables have been split into age bands and you can view and download these too.
Using the 'All Ages' data, you can see from the blue (male) tables, that the median (50th percentile) score for male FMI is 5.79 and the median LMI is 19.3. The orange (female) tables show medians of 7.62 and 15.5 respectively. (These figures have been updated as of December 2017).
If you're already carrying more fat and/or less lean mass than the average Bodyscan client, you might want to use these median values as initial targets for FMI and LMI.
On the body comp calculator you can move the fat and lean slidebars until your FMI and LMI (on the left of the page) reach or come close to those targets. You'll then have (immediately above the slidebars) the absolute amounts, in kilograms, of fat and muscle you need to lose/gain. You'll also see your projected change in weight - which might even be zero.
If you're better than the Bodyscan client average, you can set your targets to be the top quartile or top 10%.
The FMI and LMI targets come with a caveat - the Bodyscan client data does not represent a random sample of the UK population; they are self-selecting Bodyscan clients and they contain a range of ethnicities. Nevertheless, they are a very good starting point to set a tangible, achieveable target.
The opening episode of Doctor in the House airs at 9pm on Thursday 19th November and follows Sandeep and his family after his Bodyscan DEXA scan reveals he has high levels of visceral fat.
We have no idea what the final edit will look like but we hope it will raise awareness of the benefits of DEXA fat testing. The BBC programme guide is here (click 'show more' for the full description).
One of the questions I get asked most often (by men) following a DEXA scan is: “what percentage body fat do I have to be before I see my abs?”
One of the commonest rule-of-thumb responses is ten percent. But like a lot of stuff to do with the body, it depends.
Look at this scan report for Dave, who has put on both fat and muscle in 12 weeks and now stands at 17.2% fat (subtotal). Moreover, he is 17.5% fat in the trunk and 20% in the belly (android) region. But the photos above show he has respectable (certainly noticeable) abs at the front despite being able to pinch at least an inch at the side.
Compare that to Peter, whose progress we have charted before and whose DEXA fat figures are just 13.7% (subtotal), 13.1% (trunk) and 16.1% (belly) and whose abs remain elusive (sorry, we didn't take a photo).
Dave says he’s just blessed with good, thick abs and works them hard by adding weights to exercises such as hanging leg lifts and incline crunches. He's not in the camp that believes abs don’t need their own workout; he will usually train them hard twice a week.
A quick look at the pair’s respective lean mass index (lean mass divided by height squared in the Lean Indices table on the first page of each report) shows up significant lean mass/muscle differences: 23.6 for Dave, 21.5 for Peter. That 2.1 is a big difference for an index where 19.5 is average and 25 is steroid territory.
Further, relying on body fat percentage doesn’t really make much sense because it’s just an average over your entire body. You might carry your fat atypically. And you can have a low percentage (or proportion) of fat but still be carrying a lot of it in terms of kilos. That's what your fat mass index will make clear.
So it seems that to see your abs you need one or more of: a low FMI, low percentage fat, high LMI, a good ab routine and genetic luck!
Between January and August (2015), more than 350 men and 150 women came for a DEXA scan at Bodyscan’s London location.
The aggregated results are available here and show something quite interesting. The median value for fat mass is almost identical - 16.8kg for men and 17.3kg for women.
Of course, women are typically lighter than men so 17kg of fat will equate to a higher body fat percentage for women. Indeed, the median weight and fat percentage for Bodyscan clients turned out to be:
Men: 83kg weight, 21.8% fat*
Women: 63.1kg, 30.1% fat*
It’s important to remember that Bodyscan clients are not a random sample of the UK population; they have elected to have a DEXA scan for whatever reason (fitness or fat loss) and are probably geographically close to London. The data also include a broad range of ages (the median age is 36 (men) and 35 (women)).
However the approximate 17kg for median fat mass for both sexes is, if nothing else, quirky!
*Note: The data points in the data tables should be all read independently of each other - one should not expect to be in the same percentile for all data points. That’s why the median figures above (21.8% of 83kg for men and 30.1% of 63.1kg for women) do not produce the median fat mass figures of 16.8kg and 17.3kg.
Returning to Bodyscan after 13 weeks, Lee, 46, has lost an incredible 8.5kg of body fat with NO loss in lean mass - in fact he’s GAINED over a kilo of muscle!
Download the main pages of Lee's Bodyscan report here.
He did it all by himself, following Mike Matthews’s Bigger, Leaner, Stronger programme, which has him lifting five days a week, hitting each major muscle group for about an hour each day plus some high-intensity interval training (HIIT) on the two rest days. His diet was 45% protein, 45% carbs and 10% fat, a customised meal plan provided by Matthews’s Muscle for Life website.
Lee’s Bodyscan DEXA report reveals he has lost fat pretty evenly. Before, his body fat percentage was higher than that of three-quarters of men his age. Now, he's turned the tables and moved from the bottom quarter to the top quarter!
The highlights of Lee’s journey so far are:
If you want to see what your own body fat percentage would be if you lost 8.5kg or how much fat you have to lose to meet a specific fat percentage target, take a look at our body composition and calorie requirement calculators.