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Dr. Peter Attia's Longevity DEXA Metrics | Muscle Mass | DEXA Body Scan (UK)

Welcome to the third and final video in our Outlive series, looking at the DEXA scan metrics of most interest to the book’s author, Dr Peter Attia. Our first two videos looked at the DEXA metrics of visceral fat and bone density. But it is Attia’s third DEXA measurement that causes him the most concern, and that is muscle mass. The word ‘muscle’ appears over 200 times in the book (four or five times more than the other two metrics combined), and two of them are in this emphatic statement: “Continued muscle loss and inactivity literally puts our lives at risk,” he says. “Seniors with the least muscle mass are at the greatest risk of dying from all causes.” In an interview he says that muscle mass is a “highly, highly predictive metric of how long you’re going to live.” As with bone density, Attia quotes a staggering statistic, this time from a Chilean study of 1400 people with an average age of 74. Of those in the lowest quartile for muscle mass, after 12 years about half of them were dead, compared to just 20 percent in the highest quartile. Let’s now look at muscle mass as measured by a DEXA scan. DEXA breaks body composition into three compartments - fat, bone and what is called ‘lean mass’. Because your lean mass is everything that is not fat or bone, it includes not just your muscles, but also your organs, ligaments, connective tissue, skin and so on. It is standard practice, as Attia does, to read lean mass as if it were muscle. For one thing, about half or more of your lean mass actually is muscle, and for another, the lean mass that isn’t muscle (like skin and organs, etc) we don’t expect to change. Now, a technical point – Attia often interchanges Lean Mass and Fat-Free Mass. They are similar but not quite the same. Lean Mass is just your non-fat soft tissue (mainly muscle and organs), whereas fat-free mass includes your bones. As you can see from this Bodyscan report, because your bone weight is small (typically between 1.5-3.5kg), lean mass and fat-free mass are quite close. That said, fat-free mass is typically about 5% more than your lean mass. At Bodyscan we use lean mass, which is closer to muscle mass. Your DEXA scan then calculates two indices for muscle, and it is these datapoints that Attia homes in on. They are known as your Lean Mass Index (LMI) and your Appendicular Lean Mass Index (ALMI) and appear on page 1 of your DEXA report. Your Lean Mass Index is your total lean body mass (essentially muscle and organs) divided by your height-squared. You could say it’s your “BMI for muscle”. Because it is normalised for height, your LMI is a very good index for putting your total muscle mass into perspective and comparing it to the broader population. Attia’s second datapoint, your Appendicular Lean Mass Index is the same as LMI but for your limbs only – that is, it excludes your torso. He uses both LMI and ALMI to “triangulate” overall muscle mass but he puts more emphasis on ALMI and regards it as a “purer” measure of muscle mass because it’s not skewed by the lean mass of your organs. In one interview, Attia despairs about our ignorance of the metric: “Most people don’t know their ALMI,” he says. “They don’t actually know how much muscle they have. They don’t know where they stack up for other people their age and sex.” As for ALMI being a purer measure of muscle mass than LMI (total body lean), Attia has a point, but ALMI is the lean mass of all your limbs, so it too has its own limitation in that it doesn’t separate arms from legs. At Bodyscan, we go a step beyond ALMI because we reveal your muscle distribution across arms, legs and trunk separately. ✅ Get 10% off your DEXA scan with code YT10 ✅ Visit https://www.bodyscanuk.com Bodyscan is the UK's only company dedicated to accurately measuring body composition with DEXA scans. Since 2015 we have performed over 17,000 scans! Bodyscan will tell you exactly how much fat you have now, how much you need to lose, the amount of food you should eat every day and how long it will take to get there. DEXA body composition scan at Bodyscan (UK) is the best solution for you. Bodyscan Ltd © 2023