Body Composition: How to Assess It and Why It Matters

Most of us have been there when trying to lose weight… following a diet to the T, only to get discouraged when the scale doesn't budge. But the truth is, weight can’t tell us everything about our health and can even be detrimental to our own body image. I know if I had let the traditional scale determine my own success, I would have stopped years ago.

While the diet and fitness world continue to be overly obsessed with weight, today we’re exploring why body composition, i.e. the breakdown of fat, bone, and muscle in your body, is actually a much better and more useful indicator of overall health. Join me as I encourage us to break free from the weight-centric mindset and learn how body composition tools can give us a more accurate picture of what’s really going on with our health.


References

InBody scale

Optimizing Fat Loss and Maintaining Muscle on a GLP 1 Mini-Course


Audio Stamps

01:56 - Dr. Rentea tells us about the limitations of the traditional scale and the need for deeper understanding when it comes to interpreting body composition testing.

06:20 - We learn some alternative methods for tracking body composition, including body measurements like the abdominal circumference.

08:30 - Dr. Rentea advises on interpreting body composition reports, emphasizing the importance of maintaining muscle mass, especially for individuals over 65. 

11:45 - Dr. Rentea challenges the idea that a lower number on the scale is always better and stresses why we need to understand body composition beyond traditional metrics like BMI.

17:52 - Our muscle mass has a significant impact on our metabolic health and so Dr. Rentea advises consulting with a knowledgeable clinician to help you accurately interpret body composition results.


Quotes

“If you're losing at a very rapid pace, there's likely going to be some amount of muscle that you're going to sacrifice.” - Matthea Rentea MD

“If you can't get the (InBody) scale, then I want you to do measurements. And you're going to do them once a month, not to be obsessive, but you're going to want to see progress with time.” - Matthea Rentea MD

“If the scale is not changing, but the inches are going down, this means you've lost fat and you've likely gained muscle. And that actually means you're healthier.” - Matthea Rentea MD

“It can help you out so much to step away from this understanding of, ‘Well, only the scale number going down is what's important.’ If I had let that determine success or not, I would have stopped years ago.” - Matthea Rentea MD

All of the information on this podcast is for general informational purposes only. Please talk to your physician and medical team about what is right for you. No medical advice is being on this podcast.

If you live in Indiana or Illinois and want to work with doctor Matthea Rentea, you can find out more on www.RenteaClinic.com

Transcript

0:28

Welcome back to another episode of the podcast. How are you all feeling today? It is Monday morning, likely when you're listening to this. Hopefully on the day you're listening, it is, it is as beautiful outside right now, there is sun, I feel the spring energy where we're getting more daylight, we're able to get out more. It always makes me question, hey, have I been a little depressed over the winter? Because I think for me, I realize I really do well walking outside and having more hours of daylight. I have no idea how people do it in Alaska. You know, fun fact moment, little sidebar. So my clinic manager, Adrienne, she has actually worked for now for me and my business for over a year, but even before that she worked for us as a family. So I've known her a long time. Adrian is amazing, by the way, if you're one of my patients ever get to interact with her, we have on our website, rentierclinic. com, there's a meet the team. You can see kind of everyone that's on our team. And Adrian is actually from Alaska. And I often sit there and I think, wow, you know, periods when the day is so much shorter, I think about people living in different parts of the world where there are different circumstances. And I think about how resilient we all are, right, that we just figure out a way to make it work. But in any case, the circumstances change and we get more sunlight and I feel better. So today, if you're new to the podcast, this is definitely a 2. 0. This is definitely a next level podcast that we're going to do today. We're going to talk a lot today about body composition testing. And so Let me give you background here. Everyone has grown up with the traditional scale. So this was something that you hopped on and you just get the, what I say, the net number. You just get what you weighed, period. But you don't know everything that makes that up. And a lot of you think that, well, this really doesn't matter. And I want to talk you through a lot of the nuances today and why it very much so matters and who are the type of people where I strongly recommend that in some capacity, you get this body composition testing going hopefully under the supervision of a physician or. a provider that is able to help guide you because the interpretation can be very funky. This is something that I actually have a bonus section within my course, optimizing fat loss and maintaining muscle when on a GLP 1 because a lot of people are using body composition testing and they don't know how to interpret it. In fact, I have several people that once a month do a coaching session with me. I'm not their doctor. I don't prescribe medication to them, but we might go over things like body composition testing because seeing these numbers in a different way, it is incredibly helpful to them. So I want to go through today, if you're not doing this type of information, what you are likely missing and how it could really change things for you. Okay. So number one. We would use if you're not able to afford a body composition scale, they can be quite pricey. The one I personally like, again, there's no affiliate codes or anything used here. I'm not sponsored by any of them. I get no money back for any of this. I personally really like for my patients to use the InBody scale. It's I N B O D Y. It's all one word and we will put the link specifically in the show notes if you want a direct link to that on Amazon because people always say, well, there's several kinds of their scale. Which one do you mean? So we will link it. What's unique about these scales, so they're bioimpedance scales, means that they are going to be able to tell what percentage of your weight is coming from fat. So they call that fat mass, what percentage is going to be coming from muscle, from water. They're able to distinguish these different things. And so the reason that, the reason that this matters is that. As you're working on your metabolic health journey, people are so obsessed with the scale number going down. And a lot of people will do anything for that scale number to go down, including very much so not getting enough nutrition, which seems like it's working because they say, Oh, the scale's going down. But what they don't realize is that they're sacrificing a lot of muscle for that to be able to happen. And so you, if you were doing. a body composition scale, you would be able to tell, Oh, this is really not good. A huge percentage. I'm having muscle loss up to 10 percent can be acceptable when you are working on weight loss. None of my patients have 10 percent weight, uh, muscle loss. Now, if you look at some of the studies, People, right when GLP1s first came out, they said, look, it's 30, 40 percent muscle loss, and they said these ridiculous numbers. And I thought, but where are they getting this from? Because none of my patients where we're doing this, they're not experiencing that. Now I do understand I'm in a very unique privileged position with patients because we're very much so looking at their nutrition, their movement practices, their mindset, like we're their water, like we're just really working on all of it. Right. But just know that most people, if you're losing at a very rapid pace, likely there's going to be some amount of muscle that you're going to sacrifice. I will say for my patients, I see them maintain or gain. But it's because we're hyper focused on this. And the reason that I care so much about you maintaining your muscle. If we look at your basal metabolic rate, meaning let's say you do absolutely nothing and you lay in bed resting all day, you're still going to burn a lot of calories that day. And the majority of what is running that is going to be your muscle mass. And you holding onto that is incredibly important. For example, for a woman, Let's say she is really working on gaining muscle, which means you're likely in a calorie surplus, and you're really focusing on protein intake, things like that. Likely, you can maybe gain a half a pound per month, if not a little bit more, and that's with really working on it. So the name of the game is really to maintain your muscle mass. Okay, so knowing that you want to maintain it. When you're losing weight, how do you keep an eye on that? So if you're not able to afford the scale because it can be quite pricey again, we'll link it in the show notes the Other version of doing this is doing measurements, body, like literally taking a tape measure and doing different body measurements. The one that I care the most about, it's the abdominal circumference. So it's going to be in the back where the top of the hip bone is, we call those the iliac crest. You're going to go back there, you're going to feel where that is, and you come around and it's at the end of you breathing out, the end of expiration. That is where you're going to get that abdominal circumference, that's the Measure all the way around so what I always say to patients is hey I want you to start off doing all these measurements and the reason being that I know that Not everybody is going to have access to getting the home in body, or not all of them will have a location near them. Again, I'll put that information down below if you want to search. They, there will be different testing places. What I've actually experienced is that a lot of the testing sites, I'll give you an example. The scale is anywhere from 300 to 350, depending on what sales going on. But the, the, the one at a specific location, I just had a patient tell me it was 80. But then subsequent, subsequent ones are going to be 25. But the point is you sometimes end up making a very big investment anyway, getting it done. And you might as well have just gotten the scale, and then you have it monthly to do the numbers. But anyway, let's say that you can't get the scale. It's not a problem. If you can't get the scale, then I want you to do measurements. And you're going to do them once a month, not to be obsessive, but you're going to want to see progress with time. So I just had someone tell me here recently, their blood sugar normalized, the cholesterol normalized, they lost inches in the abdomen. Obviously, all of that is amazing, right? That means their cardiometabolic risk has gone down. So if you can't do the scale, do the measurements, the abdominal one being the one that we care the most about. Again, I think it's fun to know the other ones as well, just because you can follow with time. If the scale stops moving, But you see inches going down, you know that fat takes up more room compared to muscle. Muscle is more dense, is the term we would use. And so even though the scale might not, if the scale is not changing, the number that you're seeing, but the inches are going down, this means you've lost fat and you've likely gained muscle. So you've replaced one with another. And that actually means you're healthier. Okay, but let's say you actually end up getting a scale or you have a body composition report. Let's talk a little bit, kind of, What you would do with this. So one thing is I would be following I would be tracking these numbers monthly and what I would be looking for is that you are maintaining your muscle mass or At the worst you're not losing more than 10 percent and if you are Thing number one that could change is your nutrition plan or your rate of weight loss We could change that based on what these results are. So I'll give you an example Let's say that you are losing a lot of muscle what this lets me know is that We either need to up the protein and carb or we need to up the calories, but we need to change something or we need to bring in strength training. We need to change something so that we remedy that situation. We don't just let you keep losing a bunch of muscle. And the people where this matters the most. It's going to be, and I hate this term, but we got to throw it out here. Any of my geriatric population, technically geriatrics, meaning in the adult category, it's going to be 65 and over. I hate the term geriatrics, but here's the reality. You are at increased risk of something called sarcopenia. Sarcopenic obesity is when. And so you're in a, you're in a, you're in the worst scenario because you are likely really weak with doing things. If anything happens where it puts you in the hospital, I'll give you the classic example I saw weekly when I was in primary care, I would have an elderly patient of mine that let's say was, you Let's say 70, 80. They would get a pneumonia. They would be in the hospital a day or two. Maybe they need oxygen for a day and then they'd get discharged a few days later and you think, okay, it's two, three days. Them getting an antibiotic, making sure that they're okay, they're back to home. And what they would do is some of them wouldn't be able to go back home. They would need to go to a subacute rehab for a few weeks to gain back their strength. Now, why is that two, three days sitting in a hospital, even where, trust me, they are trying their hardest physical therapy to get you up moving and do that. It's because they had so little muscle to begin with, they couldn't handle a period where they lost more. Every time we get sick, we're at increased risk for losing a bunch of muscle. And so, we need to care about this stuff. It is not just about losing weight and aesthetically looking different. We metabolically want you in a better place. If you're someone that is 65 and over, you need to care about this stuff even more. This is something that everyone needs to care about. Young people so that you can have the metabolism you want and be able to keep the weight off and be able to keep the blood sugars where you want it to be when you're older so you don't end up in the hospital, that you can't come home, that, that you can carry groceries, that you can play with your grandkids and get off the floor. These are the type of challenges that you start to have when you don't have enough muscle. So if you're following this monthly body composition report and you're losing muscle too quickly, I would really slow your pace way down, maybe even you stop losing weight and you worry about am I getting enough protein and then you figure out how can I create the deficit in such a way where I'm not sitting there wasting away a bunch of muscle. It can be done, usually it's that the protein is not high enough. Okay, so that's the first thing that I would look at. The other thing that I would do is, the second way that this can be incredibly helpful for you, everyone always assumes that a lower number on the scale is better. And the time when you really start to run into problems, it's when that BMI starts to be, and again, we know it's not a perfect measure if you're new. No, we don't focus on the BMI, but I'm just giving you general references, because that's conventionally the way a lot of people think. So if your body mass index is under 30, and let's say that you're someone that you are actually working out a lot, You might not need to get your BMI into that normal range and you are actually incredibly healthy. I want to give a big example of this that just blew my socks off the other day. So I have patients, they will tell me their body composition reports, and this patient of mine, so just know in this example, I have to tell you gender just because otherwise it makes no sense. So my husband had got our in body scale because he wanted to know his skeletal muscle mass. So we knew his, we knew the body fat percentage, all of that. Okay, so I had that information. To give you reference, my husband is this thin guy, BMI 22, 23, I forget the exact number, you know, all of this. Okay, then I had a patient that is over 100 pounds more than him, same height, everything. Okay, and so you think, oh, that person's got a ton of weight to lose. Wrong. This person had double the muscle mass of my husband, the same body fat composition, like the same percentage body fat. And the message here is, if I only went based on what the number is, I would just think that that person needed to lose another hundred pounds. You can't go based on that. You have to go based on what is the muscle mass compared to what is the fat mass, and a doctor can walk you through that. And so you don't know, I can't tell you how often I am shocked by this. That some people genetically have a lot more muscle compared to others. Now is it something you can work on? Of course! Of course you can work on it. But the reality is, if you're sitting there with a ton of muscle, and you keep thinking that you want this lower scale number, and so you keep kind of being in a deficit, Yeah, you can get the scale to go down and you might lose a lot of muscle in the process because you've gotten to a place actually where you have optimized your body. You have more muscle compared to fat, the ratios, everything is looking great. Everything is good. And you actually don't need to lose more but you want to keep pushing it because in your mind you're like, I want to fit in that like made up category with the BMI. Remember that these categories are made up. Remember the drug industry with fen phen decided to lower What like they decided they wanted to lower the BMI what was normal so that more people fit in the overweight category and qualified. So keep in mind you're trying to fit yourself into some artificial category, a BMI thing that was made up by a mathematician in a shipping yard. You are trying to fit into that and what's happening is you're losing a ton of muscle. So what ends up happening? Sure, you're conventionally the scale number goes down But you've lost a bunch of muscle. Now your basal metabolic rate doesn't support it. Now you, you tell me, I can't keep the weight off. I'm constantly struggling. I'm constantly hungry. It's like, yeah. Because you lost the engine that was fueling your ability to be able to stay strong. Your ability to be able to support a metabolism. And now you've got this recovery work in the opposite direction that is so much harder. than doing it right the first time. So I know that this is a little bit I'm telling you this is like the the 2. 0 version because most people only care about the scale but I'm telling you that it does matter what your skeletal muscle is. It does matter what the fat mass is and it does matter because we all have different ratios and you can never tell until someone actually steps on a scale. The other thing too is that if you're someone like you're in my camp where I hate this word, this, oh, losing slower. I always used to think that was a bad thing with me. And then once I started to bring body composition testing in, I suddenly realized, wow, I'm actually in this. This gifted percentage where we're putting on muscle as we're losing weight, that's very, that's incredibly rare. When I go through this with patients, that's usually not the norm because usually when you're losing weight, it's incredibly tough to hold on to your muscle. So if you're doing that, you're already doing amazing. But if you're putting on muscle as you're losing weight, Again, really incredible, because that's not everybody. And so I stopped judging myself because when I really did the math, and I want to just like tell you the data from these past three months for me, it's been fascinating. So when I look back these past three months, the net scale went down five pounds. But really, I put on three pounds of muscle as well. So it was much more than five pounds of fat that I lost. And that's why if you only stay, Oh, I'm doing all this work. I mean, I'm working out and I'm really watching nutrition. Like, I'm doing all these things, right? And if I thought to myself, Oh, I've only lost five pounds. That's not the real story. The real story is a lot more fat left my body. I created muscle, three pounds of muscle, which is phenomenal, right? I did all those changes and if I stay in the lane of, Oh, it's only one and a half per month or, you know, whatever kind of like garbage scenario. Do you see how it's very different looking at trends of what's going on being like, This is working. And then you get to look at, Do I like this pace? Do I want to see if I can kind of clip it up a little bit? For me, it really works in my life right now the way it's going. I'm not overly hungry. I'm not in the gym all the time. It just works what I'm doing, right? And so it's like, I don't feel the need to make big changes at this moment because I know I will continue to get toward my goals. I'm loving the way in which it's going. But it might be different. Now, again, remember, I've been at this for years. So like I'm not necessarily like day one starting this, right? So it's a little bit more of like a body recomposition that I'm working on. But I just want to tell you, like, you know, never take my numbers and compare and within the mini course that I have, I give. A patient let me use anonymously their data from one month to the other, and I kind of give examples of how if you just look at the net scale, you think nothing's happened, but then you really see what's happened with fat and muscle, and I kind of walk through this, right? We go through it in detail, but I just want to let you know if you're someone that You are worried that you're either not eating enough or you're worried that you're losing too fast or you feel like the scale Oh, it's never I mean, I have to tell you like I'll think oh my gosh I've done all this work and one pound has changed and then I will do the once a month in body for myself and I see the changes and I realize wow, that's incredible. I'm sitting here next to me. I'm looking I'm looking at a one pound I'm looking at one pound of muscle if you saw how big this is for your body to have created that and obvious Obviously, like, it's not all in one spot, right? It's not like, oh, my calf is suddenly three inches bigger, right? But it's kind of a little bit all over the body. But, but the point is, it's incredible, the amount of energy for you to create muscle, or for you to preserve that muscle as you're asking your body, release these stores, these stores of fat that you think are so important, and that your mind still thinks is going to keep you from a famine. Remember, we're in this modern world, but Ancient brain thinks you're going to die when you're letting go of these things. That's incredibly tough. And so these scales help you, help that analytical part of your brain to see what is actually happening because it is not the truth. I could have you at the beginning of the year and the end of the year be the same weight and maybe you've let go of six pounds of fat and you put on six pounds of muscle. You are radically different at the end of that year. You are metabolically in a very different place. And so if you can, if this speaks to you, I would see if this is a tool that maybe you and your clinician that you want to incorporate. And hopefully they know how to read these because I have to tell you that there actually were not good resources for me when I first got into this area to understand how to use these reports. A lot of people are just using like what the normal ranges are. Which is fine, but knowing how to interpret these, what to do, I actually had to work with colleagues where this is what they do all day long, and I had to understand what is normal for a man, for a woman. What can I expect? I started to learn different genetic patterns. I always thought, oh, like before I got into this area, I thought anyone can just like work out and put on a bunch of muscle. Really not true. There's different genetic body types and so some will be able to put on muscle it like very easily and it's just everything you do is amazing and others they're doing all the things and not much is happening and so knowing that you want to get the right help on these type of things. So again, work with the clinician. that is familiar with doing this type of body, this type of body composition testing. And then if you're going to do it again, monthly, monthly, you want to hop on and look at the differences. This is not something where day to day, there's going to be fluctuations, right? And again, in my course, I really get into, okay, you should be hydrated, should be once a week, you know, here's how to look at it. These are all things that you can really get in the weeds and it can help you out so much to step away from this understanding of, well, only the scale number going down is what's important. If I let that determine success or not, I would have stopped years ago. I would not, I would not continue to be here. But knowing that all these other things impact our health so much more, knowing that it does matter when I'm doing walks. We see the data behind how longevity increases when you exercise and when you do these things. This is but one other tool to be able to see what internally is actually changing. And not just this one number. Alright, so I know that this can be a confusing topic. I am, I welcome you if you're on my email list. You can always hit reply if you have questions to that email that we send out on Monday morning. If you're not on our list, again I want to encourage you, it's rentiaclinic. com forward slash blog. Right on the right hand side you can subscribe to our weekly email that goes out. We don't spam you with a bunch of stuff. I, it's like this type of information where you might have really been wanting to learn about, Hey, is that even worth it? Why? Like, why would it matter? I literally had a physician colleague of mine. I went to medical school with this person and they sent me a direct message on Facebook recently about this. Like, Hey, is it worth it? What would it tell me that this other scale doesn't? And I literally went through some of this with them. So if that person is a physician and has these questions. know that we all have these questions and I even had to go in and specialize learn a lot of this. So if you have questions, let me know. Otherwise, I'm glad that we just got to at least skim the surface that there are other tools that you could use on this path. Okay. I hope you have a great rest of the week and we'll talk soon.