DEXA Scan + Dietitian
Feb. 10th, 2022 05:45 pm![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
taz_39After a series of bizarre, awful scheduling decisions by Fitnescity, I finally did actually get to take the DEXA scan in Des Moines.
Here is the machine. Neato!
There was only one technician in the facility, she was probably a bit younger than me and very upbeat and cheerful.
We chatted amicably about nutrition and how interesting x-rays are; this must all have been very routine for her, but she seemed like one of those optimistic types who gets excited because you're excited.
And I was excited!
Scans and tests can be fun and interesting when there's not something wrong, some dire diagnosis pending.
This is preventative medicine, and I find it fascinating.
After checking that I didn't have any metal or buttons on my clothes, the technician instructed me to lie on the machine's purple mat.
She then positioned my limbs a little bit to get them close to equally centered, and advised me to point my toes inward, to stay as still as possible, and to keep breathing.
The machine arm moved around me, up and down and around on both sides, for a total of three passes.
My paperwork had said that the scan would take 20 minutes, but it only took about three!
Once the scan was done I put my shoes back on and sat across from the technician, who printed my results right away.
This was the top page, containing the majority of information.
There are an awful lot of numbers here.
(You can click on the picture to make it bigger, btw)
The tech said that she will send a copy to Fitnescity, and they are the ones who are supposed to review the results with me and tell me what it all means. But she also said that if they don't get in touch with me or if I have any questions, I'm welcome to reach out to her as well.
I badly wanted to ask her about All The Things right then and there, but since she implied that wasn't her part in this, didn't.
Waiting is hard!
So I took my results home to Google about them.
Everyone admire my guts.
Yellow is fat, the redder it gets the more lean the guts are (muscle, connective tissue), and the blue are the bones.
Here's the best resource that I was able to find about interpreting DEXA results: (CLICK HERE, it's a pdf).
I am using this document to self-interpret while I wait.
According to that reference document, my bone density is pretty well average.
My overall body fat percentage, which is 26%, seems to be within a good range.
However I was interested to see that my Fat Mass is 14701, which is 14.7kg, which the reference document says is "athletic".
I am NOT an athlete; I barely make 10,000 steps per day on most days.
This is why I'm enlisting medical professionals to help interpret what I'm seeing here about my body.
Clearly I don't understand what I'm looking at!
Anyway looking at the Adipose Indices box, this shows how much subcutaneous fat I have.
It also gives an estimate of visceral fat (harder to see because it's huddled around your organs).
The Result columns are in kg, g, or percentages depending on what line you're looking at.
The Percentile columns are comparing your results to averages for Young Normal (YN) people, and Age Matched (AM) people.
In other words it's placing your measurements on a bell curve of averages taken at some point in the past ten years or so.
So then, for my Total Body Fat, it is showing that I'm in the 7th percentile for the Young Normal average, and 4th percentile for the Age Matched average.
I think that's good? But again, I don't know. "Lean" doesn't equal "good".
The reference documents suggests that a lower number in this category is "good".
In the smaller Lean Indices box, kind of similar stats going on except in this case you want your percentile to be higher, because that would indicate high lean mass.
According to the reference sheet, my "Appen. Lean/Height" number seems to be just scraping the criteria for having Low Muscle Mass.
That is surprising to me. I consider myself stronger than average, and appearance-wise more muscular than most others too.
But, maybe not. Definitely need to remember to ask about this.
And I suspect, again, someone is going to suggest weight training.
And it would be GREAT if, along with that, I got to eat more calories! Yum yum.
Here's a graph of my Total Body Fat.
Reference sheet says, "If your circle is below the middle of the three lines, your % fat is below the average % fat of people the same age and gender as you."
I guess that lines up with the YN and AM averages presented earlier.
Wait...am I "skinny fat"?
That's kind of what it's looking like to me...
I am taking these results to a dietitian tomorrow, and will also get feedback from Fitnescity, so probably by the end of this post I will know more.
But at time of writing, I Know Nothing John Snow, and am just trying to understand at a basic level what the numbers mean.
Whether things are "good" or "bad" or "needs improvement" I will leave up to the professionals.
This is fun and interesting!
-------------------------------------------------------------------------------------------
The next morning I went to the dietitian.
Her name was Anne, and she was awesome!
So attentive and actually listening to what I was saying!
So passionate about her work and the information that she was sharing with me!
That alone made this visit very worthwhile.
But on top of her wonderful refreshing demeanor, Anne provided me with all of the information and advice that I could have hoped for.
Prior to our visit, I had sent her copies of some sample MyFitnessPal entries, and a link to my food diary so she could see what I eat on average.
I also sent her the results of my DEXA scan, some bloodwork that I had done in 2020, and the Fit360 scan that my gym did for me in 2021.
We started off with the DEXA results.
Anne was not totally familiar with interpreting DEXA, but she did clarify for me that I am NOT "skinny fat", that my fat is well-distributed meaning less risk of cardiac and other diseases, and that while I should try to improve my lean mass it was just something I can work on.
Overall she saw nothing that indicated any problems, and commended me for taking initiative to try and maintain the health that I enjoy now.
Next she went over my bloodwork.
Can you believe that no one has EVER explained my bloodwork to me before??
I have always gotten bloodwork done for employment purposes, so my pcp would receive it but never went over it with me.
I knew that my cholesterol was a little high, but Anne explained that the ratio between my good and bad cholesterol was very good, so if both the good and bad are high yet well balanced that is a Good Thing.
She pointed out that my glucose reading was a little high, around 90, and that I should keep an eye on this because if it drifts above 100 I could end up in pre-diabetes land.
And then she segued from that into "I notice that you don't monitor your sugar intake as much as some of your other macros."
Aah, crud. I've been caught!
The carbs, the sugars. I had a feeling I'd be told to tone those down.
Here is the nutritional outline that Anne made for me based on all of the information that I shared with her:
THIS, right here, is exactly what I wanted help with.
Am I eating enough calories? Can I have more?
If I start exercising, how many more can I have?
Do my macros need to be adjusted?
What could be improved?
This answers ALL of those questions.
I was very pleased to see that the calorie limits I have set for myself line up with what Anne suggests. Yay! Phew!
I set my limit at 1500, but as we all know calorie counting online is not very accurate, so I am most certainly already eating between 1500-1700 calorie range on any given day. No change needed there (keeping in mind that I still have a Resting Metabolic Test to take next week).
Self-guided it turns out I did a good job up to this point both with my macros and my calorie levels.
Anne was VERY emphatic about that.
This consultation with her allows me to tweak and hone in on improvements going forward.
And I am THRILLED for the knowledge and the guidance!
Here are the changes based on Anne's suggestions:
1 - My macros were previously set at 50/25/25 (that's 50% carbs, 25% proteins and fat).
Anne suggests changing them to 45/30/25 (5% reduction in carbs, 5% increase in protein, leave fats alone).
I already eat quite a lot of protein and was worried about how the heck I'm going to get more.
Anne suggested that if I continue eating like I've been doing, but add ONE protein shake per day, I will hit 126g per day.
She suggested the Fairlife "Core Power" shake, which is lactose free and has 20g protein, or the Chobani Complete shakes, which are also lactose free with 25g protein. Both are low in sugar and fat.
The Chobani needs to be refrigerated, so I will probably have that one less often while on tour.
2 - I will work on reducing my sugar intake below 45g overall, with 25g of that coming from added sugars.
Anne emphasized that I am not expected to hit those numbers every single day.
She suggested no more than three servings of fruit per day (and or eating more berries), and of course very limited treats to try and reach this goal. It will probably take a while, but if I eventually get to where I can do five days a week below 45g of sugar, I'll be pleased!
3 - Include more and more varied fiber.
I thought I was doing well in the fiber department, but Anne thinks I need more, especially after I described some digestive issues to her.
A lot of my digestive issues have to do with nerves, anxiety, and traveling. Some of them are hereditary.
And some of them may be due to not enough or the wrong kinds of fiber.
Anne suggested switching up what veggies I eat each week to try and give my body new forms of fiber.
And she gave me a digestive enzyme to take when I want to eat foods that I know will cause digestive upset, like beans or dairy.
Incorporating the protein shakes will also help, as they have good fiber content.
4 - Reduce the carbs.
Listen, she's only asking me to reduce carbohydrates by 5%.
By reducing sugar, I think this will happen naturally.
The somewhat-excessive bread that I eat currently is a tour-only, temporary indulgence.
I'm not going to promise to give that up; either I'll choose to reduce it on tour to fit my new macros, or it'll end when the tour ends in June.
5 - Lift weights 3x per week for at least 15 minutes per session.
This is NOT a big ask. I am lazy and don't like to exercise, but 15 minutes of weights for three days is truly not going to break my butt.
Plus, as Anne gently nudges in her final bullet point: "More movement, more calories!"
Maybe this is the incentive I need to exercise for 15 minutes before my next decadent meal :)
That's it!
Anne is not asking me to change very much at all.
And all of this I suspected, but wanted to be sure.
Oh, the bullet point about alcohol was just for her to remember to bring it up.
At maximum I have 2 glasses of wine per week, so I am not much of a drinker at all.
Alcohol is an empty sugar, contributes to fat storage, etc etc, so Anne said she makes a point to mention it.
I will start making these changes as soon as I can, though it'll probably take a week or two to really kick in.
----------------------------------------------------------------------------
For those in the Peanut Gallery who wonder why I'm doing all of this,
or to whom it all seems unnecessary because I was doing a good job on my own:
I can Google and Wiki and net-reference all I want, and it will never be equal to a degree in dietary science.
Most of us are just fine going about our day eating whatever and not thinking twice about it.
And I'd be fine with it too! No really, trust me. I'm from a town where we ate whatever was provided and finished what was on our plates.
So why am I doing all this?
Because it's interesting. I'm interested.
And because I'm turning 40 soon.
The age at which many women start to experience hormonal shifts, and muscle loss, and body changes.
My mother died of pancreatic cancer at the age of 42.
In four years, I'll be 42.
There's a lot that I can't control, like whether I get cancer, or whether I get hit by a bus tomorrow.
What I CAN control is how well I take care of the body I was given.
Which can be massively, massively helpful in preventing serious chronic diseases as I get older.
So I am interested, and I want to learn and understand and get advice.
There you have it!
Next week I'll take an RMR, and will post about what that's like, and the results!
Here is the machine. Neato!
There was only one technician in the facility, she was probably a bit younger than me and very upbeat and cheerful.
We chatted amicably about nutrition and how interesting x-rays are; this must all have been very routine for her, but she seemed like one of those optimistic types who gets excited because you're excited.
And I was excited!
Scans and tests can be fun and interesting when there's not something wrong, some dire diagnosis pending.
This is preventative medicine, and I find it fascinating.
After checking that I didn't have any metal or buttons on my clothes, the technician instructed me to lie on the machine's purple mat.
She then positioned my limbs a little bit to get them close to equally centered, and advised me to point my toes inward, to stay as still as possible, and to keep breathing.
The machine arm moved around me, up and down and around on both sides, for a total of three passes.
My paperwork had said that the scan would take 20 minutes, but it only took about three!
Once the scan was done I put my shoes back on and sat across from the technician, who printed my results right away.
This was the top page, containing the majority of information.
There are an awful lot of numbers here.
(You can click on the picture to make it bigger, btw)
The tech said that she will send a copy to Fitnescity, and they are the ones who are supposed to review the results with me and tell me what it all means. But she also said that if they don't get in touch with me or if I have any questions, I'm welcome to reach out to her as well.
I badly wanted to ask her about All The Things right then and there, but since she implied that wasn't her part in this, didn't.
Waiting is hard!
So I took my results home to Google about them.
Everyone admire my guts.
Yellow is fat, the redder it gets the more lean the guts are (muscle, connective tissue), and the blue are the bones.
Here's the best resource that I was able to find about interpreting DEXA results: (CLICK HERE, it's a pdf).
I am using this document to self-interpret while I wait.
According to that reference document, my bone density is pretty well average.
My overall body fat percentage, which is 26%, seems to be within a good range.
However I was interested to see that my Fat Mass is 14701, which is 14.7kg, which the reference document says is "athletic".
I am NOT an athlete; I barely make 10,000 steps per day on most days.
This is why I'm enlisting medical professionals to help interpret what I'm seeing here about my body.
Clearly I don't understand what I'm looking at!
Anyway looking at the Adipose Indices box, this shows how much subcutaneous fat I have.
It also gives an estimate of visceral fat (harder to see because it's huddled around your organs).
The Result columns are in kg, g, or percentages depending on what line you're looking at.
The Percentile columns are comparing your results to averages for Young Normal (YN) people, and Age Matched (AM) people.
In other words it's placing your measurements on a bell curve of averages taken at some point in the past ten years or so.
So then, for my Total Body Fat, it is showing that I'm in the 7th percentile for the Young Normal average, and 4th percentile for the Age Matched average.
I think that's good? But again, I don't know. "Lean" doesn't equal "good".
The reference documents suggests that a lower number in this category is "good".
In the smaller Lean Indices box, kind of similar stats going on except in this case you want your percentile to be higher, because that would indicate high lean mass.
According to the reference sheet, my "Appen. Lean/Height" number seems to be just scraping the criteria for having Low Muscle Mass.
That is surprising to me. I consider myself stronger than average, and appearance-wise more muscular than most others too.
But, maybe not. Definitely need to remember to ask about this.
And I suspect, again, someone is going to suggest weight training.
And it would be GREAT if, along with that, I got to eat more calories! Yum yum.
Here's a graph of my Total Body Fat.
Reference sheet says, "If your circle is below the middle of the three lines, your % fat is below the average % fat of people the same age and gender as you."
I guess that lines up with the YN and AM averages presented earlier.
Wait...am I "skinny fat"?
That's kind of what it's looking like to me...
I am taking these results to a dietitian tomorrow, and will also get feedback from Fitnescity, so probably by the end of this post I will know more.
But at time of writing, I Know Nothing John Snow, and am just trying to understand at a basic level what the numbers mean.
Whether things are "good" or "bad" or "needs improvement" I will leave up to the professionals.
This is fun and interesting!
-------------------------------------------------------------------------------------------
The next morning I went to the dietitian.
Her name was Anne, and she was awesome!
So attentive and actually listening to what I was saying!
So passionate about her work and the information that she was sharing with me!
That alone made this visit very worthwhile.
But on top of her wonderful refreshing demeanor, Anne provided me with all of the information and advice that I could have hoped for.
Prior to our visit, I had sent her copies of some sample MyFitnessPal entries, and a link to my food diary so she could see what I eat on average.
I also sent her the results of my DEXA scan, some bloodwork that I had done in 2020, and the Fit360 scan that my gym did for me in 2021.
We started off with the DEXA results.
Anne was not totally familiar with interpreting DEXA, but she did clarify for me that I am NOT "skinny fat", that my fat is well-distributed meaning less risk of cardiac and other diseases, and that while I should try to improve my lean mass it was just something I can work on.
Overall she saw nothing that indicated any problems, and commended me for taking initiative to try and maintain the health that I enjoy now.
Next she went over my bloodwork.
Can you believe that no one has EVER explained my bloodwork to me before??
I have always gotten bloodwork done for employment purposes, so my pcp would receive it but never went over it with me.
I knew that my cholesterol was a little high, but Anne explained that the ratio between my good and bad cholesterol was very good, so if both the good and bad are high yet well balanced that is a Good Thing.
She pointed out that my glucose reading was a little high, around 90, and that I should keep an eye on this because if it drifts above 100 I could end up in pre-diabetes land.
And then she segued from that into "I notice that you don't monitor your sugar intake as much as some of your other macros."
Aah, crud. I've been caught!
The carbs, the sugars. I had a feeling I'd be told to tone those down.
Here is the nutritional outline that Anne made for me based on all of the information that I shared with her:
THIS, right here, is exactly what I wanted help with.
Am I eating enough calories? Can I have more?
If I start exercising, how many more can I have?
Do my macros need to be adjusted?
What could be improved?
This answers ALL of those questions.
I was very pleased to see that the calorie limits I have set for myself line up with what Anne suggests. Yay! Phew!
I set my limit at 1500, but as we all know calorie counting online is not very accurate, so I am most certainly already eating between 1500-1700 calorie range on any given day. No change needed there (keeping in mind that I still have a Resting Metabolic Test to take next week).
Self-guided it turns out I did a good job up to this point both with my macros and my calorie levels.
Anne was VERY emphatic about that.
This consultation with her allows me to tweak and hone in on improvements going forward.
And I am THRILLED for the knowledge and the guidance!
Here are the changes based on Anne's suggestions:
1 - My macros were previously set at 50/25/25 (that's 50% carbs, 25% proteins and fat).
Anne suggests changing them to 45/30/25 (5% reduction in carbs, 5% increase in protein, leave fats alone).
I already eat quite a lot of protein and was worried about how the heck I'm going to get more.
Anne suggested that if I continue eating like I've been doing, but add ONE protein shake per day, I will hit 126g per day.
She suggested the Fairlife "Core Power" shake, which is lactose free and has 20g protein, or the Chobani Complete shakes, which are also lactose free with 25g protein. Both are low in sugar and fat.
The Chobani needs to be refrigerated, so I will probably have that one less often while on tour.
2 - I will work on reducing my sugar intake below 45g overall, with 25g of that coming from added sugars.
Anne emphasized that I am not expected to hit those numbers every single day.
She suggested no more than three servings of fruit per day (and or eating more berries), and of course very limited treats to try and reach this goal. It will probably take a while, but if I eventually get to where I can do five days a week below 45g of sugar, I'll be pleased!
3 - Include more and more varied fiber.
I thought I was doing well in the fiber department, but Anne thinks I need more, especially after I described some digestive issues to her.
A lot of my digestive issues have to do with nerves, anxiety, and traveling. Some of them are hereditary.
And some of them may be due to not enough or the wrong kinds of fiber.
Anne suggested switching up what veggies I eat each week to try and give my body new forms of fiber.
And she gave me a digestive enzyme to take when I want to eat foods that I know will cause digestive upset, like beans or dairy.
Incorporating the protein shakes will also help, as they have good fiber content.
4 - Reduce the carbs.
Listen, she's only asking me to reduce carbohydrates by 5%.
By reducing sugar, I think this will happen naturally.
The somewhat-excessive bread that I eat currently is a tour-only, temporary indulgence.
I'm not going to promise to give that up; either I'll choose to reduce it on tour to fit my new macros, or it'll end when the tour ends in June.
5 - Lift weights 3x per week for at least 15 minutes per session.
This is NOT a big ask. I am lazy and don't like to exercise, but 15 minutes of weights for three days is truly not going to break my butt.
Plus, as Anne gently nudges in her final bullet point: "More movement, more calories!"
Maybe this is the incentive I need to exercise for 15 minutes before my next decadent meal :)
That's it!
Anne is not asking me to change very much at all.
And all of this I suspected, but wanted to be sure.
Oh, the bullet point about alcohol was just for her to remember to bring it up.
At maximum I have 2 glasses of wine per week, so I am not much of a drinker at all.
Alcohol is an empty sugar, contributes to fat storage, etc etc, so Anne said she makes a point to mention it.
I will start making these changes as soon as I can, though it'll probably take a week or two to really kick in.
----------------------------------------------------------------------------
For those in the Peanut Gallery who wonder why I'm doing all of this,
or to whom it all seems unnecessary because I was doing a good job on my own:
I can Google and Wiki and net-reference all I want, and it will never be equal to a degree in dietary science.
Most of us are just fine going about our day eating whatever and not thinking twice about it.
And I'd be fine with it too! No really, trust me. I'm from a town where we ate whatever was provided and finished what was on our plates.
So why am I doing all this?
Because it's interesting. I'm interested.
And because I'm turning 40 soon.
The age at which many women start to experience hormonal shifts, and muscle loss, and body changes.
My mother died of pancreatic cancer at the age of 42.
In four years, I'll be 42.
There's a lot that I can't control, like whether I get cancer, or whether I get hit by a bus tomorrow.
What I CAN control is how well I take care of the body I was given.
Which can be massively, massively helpful in preventing serious chronic diseases as I get older.
So I am interested, and I want to learn and understand and get advice.
There you have it!
Next week I'll take an RMR, and will post about what that's like, and the results!
