What DEXA Scans Reveal About Your Health: 3 Lesser-Known Markers for Health Optimization

DEXA scans are often misunderstood as tools used exclusively for the elderly, and in some circles, bodybuilders. 

Many physicians learn about DEXA scans solely from the lens of assessing bone mineral density (BMD), especially in the context of frailty and compression fractures.  Other people first learn about them in the context of fitness and trying to measure levels of lean body mass and body fat with precision. To this day, it is known as the gold standard for body fat measurement (outside of MRIs, which are the real gold standard assessment of body composition).

But what exactly is a DEXA scan?

DEXA stands for Dual-Energy X-ray Absorptiometry. It is a quick, full-body scan typically performed at an imaging center that measures body composition, including fat mass, lean muscle mass, and bone mass. It allows for accurate interpretation of body fat percentage and reveals important information about various types of body fat and their location (more on this later).

There are simpler ways to estimate body fat percentage, such as skinfold calipers or digital body fat scales that run an electrical current through the body (not as crazy as it sounds). These home methods can be used daily for tracking purposes. A digital scale can be particularly useful for monitoring trends in body composition.

So, why get a DEXA scan?

Going beyond body fat percentage

Typical report from DEXA scan

The true value of a DEXA scan extends far beyond measuring body fat percentage.

At approximately $100 per scan, it provides exceptional value when you consider the comprehensive health data it offers. Annual DEXA scans can be an important part of proactive health monitoring.

Three critical measurements from DEXA scans besides body fat include:

1. Visceral fat, which is an underutilized predictor of cardiovascular risk

2. Android and gynoid fat, which together give the android to gynoid ratio, an important indicator of metabolic health

3. Bone mineral density, which becomes increasingly important to monitor as you age

Visceral fat

Visceral fat (also known as visceral adipose tissue or VAT) is stored within the abdominal cavity surrounding vital organs like the liver, pancreas, and intestines. Unlike subcutaneous fat that can be pinched under the skin, visceral fat lies deep inside the body.

Visceral fat poses greater health risks because:

• Higher visceral fat volume strongly correlates with increased cardiovascular risk

• It's metabolically active, releasing inflammatory substances that can increase insulin resistance, raise blood pressure, and contribute to abnormal blood lipid levels

• Even individuals with normal BMI but high visceral fat can have elevated cardiovascular risk

What to look for on your DEXA report:

VAT greater than 10% of total fat mass or VAT mass greater than 1 pound indicates higher cardiovascular risk for most.

Android to gynoid fat ratio

Android fat is distributed primarily in the abdominal area and upper body, creating an "apple-shaped" body type. This includes both visceral fat around internal organs and subcutaneous fat beneath the skin in the abdomen.

Gynoid fat is distributed mainly in the hips, thighs, and buttocks, creating a "pear-shaped" body type.

The android-to-gynoid ratio (A/G ratio) is important because lower ratios generally indicate better metabolic health:

1. Metabolic risk indicator: Higher ratios correlate with increased risk of metabolic disorders

2. Predictive value: Elevated ratios are associated with higher risks of Type 2 diabetes, cardiovascular disease, and metabolic syndrome

3. Hormonal implications: Android fat produces more inflammatory cytokines affecting insulin sensitivity

4. Clinical assessment: The A/G ratio provides more comprehensive health risk assessment than BMI alone

What to look for on your DEXA report:

An android to gynoid fat ratio greater than 1 is associated with increased metabolic and cardiovascular disease risks.

Bone mineral density

Bone mineral density (BMD) becomes increasingly important with age because:

• It helps assess risk for osteoporosis

• Lower BMD correlates with higher fracture risk

• Bone density naturally decreases with age, especially after menopause in women

• Early detection allows for preventive interventions

The Z-score on a DEXA report compares BMD to what's expected for someone of the same age, sex, and body size.

What to look for on your DEXA report:

• Z-score above 0: In great shape

• Z-score between -2.5 and -1: At risk with osteopenia

• Z-score below -2.5: Much lower than expected for your age group with osteoporosis

Taking action

If you've been considering a DEXA scan, this information may encourage you to take that first step. If you've had one before, you might consider monitoring your numbers more proactively.

Traditional medical doctors or PCPs might not recommend DEXA scans, especially for younger individuals in their 30s or 40s, typically only ordering them when they suspect a problem.

However, a partner like Velocity Health who is invested in your long-term health will not only encourage you to get a DEXA scan, but we will coordinate and track these over time.  We help interpret your results regardless of age, monitoring them over time to ensure positive trends. DEXA scans are included in Velocity Essential and Velocity One membership plans.

Without a care partner that understands and monitors this type of imaging, you are missing an important component of care. If you're interested in partnering with Velocity Health and learning what else we can do for you, fill out the form to schedule a free call.