This past summer, when I set out on a personal journey to get into better shape--be more active, shed some pounds, and hopefully gain some muscle--I wasn’t prepared for this: the shock of my first body composition analysis.
InBody770Courtesy of InBody
I had considered myself to be in average shape—eating a relatively healthy diet, “exercising” when I found the time, while dealing life’s daily stressors. As an ER doctor, I lead a fairly hectic life and do shiftwork which can wreak havoc on your circadian rhythm, leading to weight gain, poor sleep, and elevated blood pressure.
After Tom Ram, a Tier 3+ trainer at Equinox Wall St., took my body measurements, performed some tests of flexibility, and then had me step on the InBody 770, an impedance-based scale, my state of health (and fitness) became clearer: I had excess body fat, which I already knew, but it was visceral body fat--inside the abdominal cavity—the bad kind that wraps around your organs and increases your risk of heart attacks and strokes.
“ InBody has been an incredible advance for me in evaluating the progress of my clients because it not only shows whether the training regimen that I am crafting is working--but working on the inside to effect changes in visceral body fat, skeletal muscle mass, and total body water,” said Ram. “It’s part of an integral approach that helps me motivate people to focus on their diet--intake of water, protein, fat and carbohydrates--in the context of preventing loss of muscle mass, which is indispensable to burning fat.”
While understanding your body composition may not seem like an important concept in a generic weight loss plan, it represents a clear measure of unseen risk. You see, as excess body fat accumulates around your organs, it begins to act as an independent endocrine organ secreting inflammatory compounds and increasing insulin resistance that may lead to metabolic syndrome, a constellation of elevated blood pressure, cholesterol, and a state of insulin resistance (diabetes).
“ Your waistline is important to your health with the fat around your waist being metabolically active ,” said Holly S. Andersen, M.D., Attending Cardiologist, Director of Education and Outreach at the Perelman Heart Institute, Clinical Associate Professor of Medicine (Cardiology) Joan and Sanford I. Weill Cornell Department of Medicine, New York Presbyterian Hospital. “This type of fat (visceral fat) makes your blood pressure and lipid (cholesterol) levels less favorable, makes you more prone to insulin resistance and diabetes, and is ‘pro-inflammatory’ with inflammation being the gateway to disease: brain disease, heart disease and cancer.”
“Anything you can do to make your waistline trimmer is healthy for you,” offered Andersen. “Ideally, you want your waistline to be less than half your height, but remember liposuction doesn’t count-- it’s not the fat under the skin that is bad for you, it’s the fat around your vital organs or visceral fat .”
“Generally speaking, the best way to trim your waistline is to be active and eat less sugar, explained Andersen. “That’s why your overall weight does not fully reflect your health.”
“A scale that estimates your body fat is more revealing. Women generally have more body fat than men, with ideal body fat in women at 25%, vs 15% in men,” added Andersen.
InBody is a treasure trove of information, not just a measurement of your body weight which you get from a traditional body scale. No calipers, immersion in water, or sitting into a pod, it simply involves stepping on the platform, holding both handles and placing your feet on the specially marked areas to measure body composition in your trunk and lower extremities.
“InBody’s accuracy for measuring percentage body fat is superb--within 2% accuracy of the result obtained by DEXA scanning (which has traditionally been the gold standard), but obviously quite difficult for people to access in the setting of a standard workout or weight loss program,” said Jeralyn Brossfeld, M.D., FACOG, an Obesity expert, Diplomate of the American Board of Obesity Medicine, and unpaid consultant for Inbody over the past several years, incorporating versions of the Inbody 770 in her own medical practice.
What InBody Reveals
Going way beyond your BMI–-a measure of your height and body weight--the scale calculates your percentage body fat, including your visceral fat area (VFA), which provides the most accurate measure of your risk for adverse cardiac events such as heart attack and stroke. BMI is not a true reflection risk of your cardiac risk since increased skeletal muscle mass in relation to height can elevate your BMI, falsely elevating cardiometabolic risk.
Other methods such as hydrostatic weighing (immersion), calipers, or even Bod Pod only measure fat and fat-free body mass, but are unable to arrive at the distribution of your fat and lean mass throughout your body. The advantage of DEXA scanning, is that is able to reliably distinguish between subcutaneous fat, (fat under the skin), and visceral body fat. While MRI and electron beam CT provide even greater accuracy and detail to evaluate visceral body fat, cost and availability limit their access for the general public.
InBody 770 provides a clear breakdown of the composition of your two body compartments: lean body mass and body fat mass, two important measurements which together constitute your true body weight. Dry lean mass, the component of body mass without water, is another component of your weight, simply not apparent from a standard body scale.
InBody 770 also provides valuable information about your state of hydration by analyzing what is known as extracellular water, or water content outside of cells, (ECW) as well as total body water (TBW). These values provide important information that allows careful assessment of the healthy makeup of various body compartments, and how the water content varies between them. Increasing water intake is essential in elevating basal metabolic rate (BMR), which serves as a way to reduce body fat and increase lean body mass.
Your lean body mass is a measure of your skeletal muscle mass. Skeletal muscle mass is integral to accelerating weight loss because building muscle can allow you to burn fat more efficiently. Workouts that employ strength training (using weights and resistance) not only enhance cardiovascular fitness, they build muscle.
Building muscle is based on 3 important principles, in the context of beginning a training program, according to Ram. “Attention to the mechanics of movement, sound nutrition, and a focus on regeneration are essential to success when evaluating the merits of any particular program,” he emphasized.
“From a movement perspective, it’s vital to develop a solid core in order to build the foundation for a good strength training program. The use of a heart rate monitor is also essential for monitoring the intensity of workouts in order to stay in the ‘fat burning zone’.”
“Training in different planes of motion also helps to increase your range of motion and is complemented with additional mobility training,” added Ram.
The Summer Challenge
I started my journey this summer with 19% body fat, at the upper range of what would be considered acceptable for percentage body fat. The measurement is based on the principle of impedance, the transmission of electrical current through various body tissues, with fat creating the most resistance and muscle the least, based on its higher water content.
Based on my age and starting weight, the machine calculated my visceral fat area (VFA measured in cm2) as 88.1, which placed me just 12 cm2 beneath the ‘at-risk’ level of 100, and estimated that I would need to lose 9.7 pounds of body weight to reduce my cardiac risks.
Starting out, my segmental fat analysis revealed that 38.4 pounds of my total body weight constituted body fat mass. Armed with this information, my workouts were tailored to focus on flexibility, strength training and cardiovascular fitness with a goal to build up my core, legs, as well as upper body uniformly.
Over the 3 month period, my visceral fat area (VFA) dropped to 60.2 from 88.1, (with percentage body fat falling to 14.5 % from 19.1%), reflecting a healthier measurement and reduced cardiac risk. My skeletal or lean muscle mass remained constant at 92 pounds, in light of continued fat loss, reflecting the success of my workout regimen. My body fat mass dropped to 27 pounds reflecting a decrease in visceral fat, while total body water (TBW) increased by nearly 3%, reflecting a focus on hydration.
But another important deficiency revealed by InBody 770 was the lack of muscular development in my right leg, likely the result of a prior knee injury and ensuing patellofemoral syndrome over the years which likely limited by ability to get into better shape over the past several years.
In my view, the ability to break down body compartments to perform analysis of muscular development helped me as well as my trainer better understand my deficiencies and limitations as I embarked on my workouts and continued over the 3 month period.
Focus on building up my hamstrings, gluteus, and quadriceps muscles alongside core development using the TRX system proved beneficial in helping to improve muscle strength and cardiovascular endurance.
But an unexpected part of my journey was the introduction to the awareness and importance of breathing and the influence of intra-abdominal pressure and muscular stabilization as part of an integrated approach to weight loss, which Ram emphasized in my workouts.
Learning to breath properly and rhythmically during weight training and aerobic conditioning can enhance standard efforts to strengthen and develop truncal and abdominal musculature, which in turn influence the shape and contour of the body.
Otherwise known as Dynamic Neuromuscular Stabilization (DNS), the technique helps one focus on spinal stabilization, intra-abdominal pressure regulation (IAP) and purposeful movement by using positions of optimal function determined by developmental kinesiology.
DNS can be part of your training regimen because it helps to serve as a “re-set” for the positions of your joints and muscles, by aiming to recreate the way your body functioned as an infant. Focused deep abdominal breathing targets IAP by focus on the diaphragm, pelvic floor and transversus abdominal musculature.
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