If, over the past two or three decades, you’ve visited your doctor or joined a gym, chances are, you’ve done a body composition ‘pinch test’ with calipers or maybe a measuring tape. That’s to get a rough approximation of how much of you was muscle, and how much wasn’t.

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While the pinch tests of the 90’s and 00’s weren’t, medically speaking, all that precise, they were a simple, inexpensive way to get an idea of one’s fat-to-muscle ratio without getting into more sophisticated methods, like the kinds usually reserved for elite athletes. But compared to the hi-tech, highly accurate options that are available now, all that pinching was the diagnostic equivalent of the rotary phone – it got the job done at a very rudimentary level.  

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Today, fortunately, our ability to determine more precisely the proportion of fat, lean muscle, bone and water in the body has vastly improved – so much so that digital body composition analysis has blossomed into a must-have tool for many of us in the wellness and longevity world. In fact, it’s now one of my favorite ways to identify a patient’s current state health and to call out what needs tending to in order to support their longevity and improve their ‘healthspans’ -- the length of time they’re able to stay vibrant and healthy. OK, so, you might wonder, how exactly does a high-tech test help you live longer and better? The road starts here:

Take a look under the hood.

Maybe your pants don’t quite fit like they used to, and maybe you could stand to lose a pound or two. But to really gain insight into your insides, you need to look at body composition and, more specifically, how much body fat you have. To do that, you can pick from any number of measurement techniques, for example, you might consider any one of the more common analog options or maybe a more high tech one outlined below, but I’ll tell you upfront, my preferred technique is BIA, or ‘bioelectrical impedance analysis.’ Among the options:

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1. Body Mass Index (BMI): Which involves a simple calculation that uses height and weight to determine if your body weight is healthy for a given height. Though it provides very general information about health, it doesn’t take muscle mass into account, so it can easily miscategorized a muscular person as overweight or obese, and on the flip side, may underestimate the body fat percentage of a non-muscular person.
2. Skinfold Measurements: The classic, old school ‘pinch test,’ mentioned above, that uses calipers to measure skinfold depth at specific points on the body. Results provide a general window into overall body fat percentage, but much depends on the skill of the person doing the measurements. And it can be less accurate when used on very lean or very obese people.
3. Dual-Energy X-Ray Absorptiometry (DEXA or DXA): This system provides highly accurate measurements using low-level X-rays to assess bone mass and density, lean muscle mass and fat mass – but it’s not for everyone. It’s an expensive option, requiring specialized equipment and also involves exposure to a small amount of radiation.
4. Bioelectrical Impedance Analysis (BIA):  I find this one the most helpful. I like the InBody testing device and use it in my practice just about every day. It takes just a minute or two and works by sending a small electrical current through the body, measuring the ‘resistance’ to the current to estimate body fat percentage, muscle mass, and body water content. Because water is reactive, and muscle tissue contains more water than fat tissue does, this digital approach can offer a more accurate estimate of fat mass and muscle mass than analog options.

But why bother looking under the (body fat) hood?

We humans come in an incalculable number of shapes and sizes, some big, some little and everywhere in between. But physical size isn’t always as obvious an indicator of health. For example, a tall, thin-looking person is often presumed healthier than someone who is short and curvy, but that may not actually reflect the reality.  The person who looks skinny on the outside may be carrying too much ‘visceral fat’ – i.e., the more troublesome stuff that collects around the organs and inside the muscles – to be considered healthy.

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In other words, looks can be deceiving, which is one reason why knowing what’s going on below the surface is so important. Regardless of your external shape, it’s what’s inside that counts, and a high amount of body fat, especially visceral fat, drives increased risk for life-shorteners like diabetes, heart disease and certain types of cancer, just to name a few. Simply put, the less visceral fat you’ve got, the better. ‘Subcutaneous fat, the jiggly stuff that lives just under the skin’s surface, is much less dangerous, although too much of it can put a strain on your heart, your joints and your overall quality of life. And when you’re significantly overweight, some of that extra fat will be visceral, no getting around it. 

Working towards a healthy body composition will turn your life, and your lifespan, around.

So, for the sake of laying the groundwork for a longer and healthier life, I recommend you get your body composition measurements taken and reviewed.  The information gleaned will help you and your practitioner develop a plan to help improve your health, so expect a plan that will include a combination of lifestyle upgrades, including movement, nutrition, stress reduction and of course, body fat reduction (a very positive ‘side effect’ of all those upgrades). By focusing on improving your body composition, you’ll also stimulate numerous longevity-boosting effects throughout the body, including:

1. Metabolic Efficiency:
   • Basal Metabolic Rate (BMR): More muscle mass means a higher BMR, in other words, the body burns more calories at rest. That means avoiding weight gain is that much easier which means your risk of prediabetes or type 2 diabetes drops. 
   • Insulin Sensitivity: More muscle mass also improves insulin sensitivity. Your muscles take in the glucose they need to function with less insulin, again lowering the risk of metabolic disease. 
2. Physical Performance and Functionality:
   • Strength and Stamina: If you’ve got a healthy amount of muscles, you simply live stronger. You’ve got what you need to power through your day, as well as do more demanding physical activities, whether that’s working out in a gym or having the endurance to go for a long, restorative walk.
   • Mobility and Balance: Having healthy muscle and bone is a boost to your mobility, balance, and coordination. It’s your best insurance against taking a fall, which for older adults especially can be very dangerous (think, hip fractures). 
3. Hormonal Balance:
   • Hormone Production: Fat tissue plays a role in the production of hormones like estrogen. Having a healthy amount of body fat, not too much and not too little, is what we’re shooting for, to maintain optimal hormonal balance and reproductive health, not to mention mood and energy levels.
4. Mental Health:
   • Body Image: A body composition that you’re happy with can be great self-esteem booster. 
   • Mental Well-being: Having a healthier body composition makes regular physical activity that much more inviting which further improves body composition and protects against anxiety, depression and other mental health issues.
5. Longevity and Quality of Life:
   • Aging Process: Keeping your muscle healthy is absolutely crucial in your senior years. Sarcopenia, the loss of muscle mass that occurs with age, leads directly to frailty and a decreased quality of life.
   • Chronic Disease Prevention: The better your balance of muscle to fat, the less risk of chronic disease. That’s the secret to enhanced longevity and a better quality of life.
6. Immune Function:
   • Inflammation: One important way excess body fat, particularly visceral fat, hurts us is by upping levels of chronic inflammation, which weakens the immune system and increases our susceptibility to illness.
   • Immune Response: Having enough muscle mass and feeding it with the right food (adequate protein consumption becomes more and more important as we get older) safeguards our immune response.

Age slower and better – by monitoring your body composition.

We all have a pretty decent idea of the kinds of behaviors and habits that will quickly age a body – think the usual suspects like smoking, alcohol, sedentary living, poor diet, poor sleep hygiene, poor mental health and so on. But no matter your age, muscle mass is an extremely important part of maintaining your vitality, particularly when it comes to the essential youth-preservers mentioned above (i.e., healthy metabolism, strong physical performance, hormonal balance, mental health, longevity and immune response).

Focus on hanging onto your muscles too!

What most people don’t realize though is that as they get older, especially as they approach 40, they lose muscle mass, more rapidly than they did in their 20’s. So, if you’re coming up on a birthday milestone (and even if you’re not), now’s the time to work on building muscle and minimizing fat (in a healthy way) to help you hold the line. It really is, never too late.

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Beyond the natural aging process though, there is another muscle underminer to be aware of and that is the very popular diabetes/weight loss drugs like Ozempic, Wegovy and Mounjaro. If you’ve been prescribed one of them, be it to help lower your A1C or to lose weight (or both) keep in mind that one not-so-welcome and very common side effect of these types of drugs is muscle loss, which can be considerable, in addition to the fat loss many patients are after. So, it’s extremely important for people on these drugs pay extra attention to doing more strength training – and closely monitoring body composition at frequent intervals along the way.

Scanning – and seeing is believing.

With an accurate, high-tech body composition scan, like the InBody device I use in my practice, I can show patients both young and old where the trouble spots are (I’m looking at you visceral fat) and help them identify the exercise and strength training tweaks they need to incorporate to start chipping away at those potentially life-shortening stores of visceral fat. If warranted, we can also add more specialized elements to their program -- like reducing carbs, increasing protein, adding supplements like creatine, peptides and even hormones like testosterone -- for additional support and to help hold the line against muscle loss. 

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What’s more is that by tracking and monitoring a patient’s muscle mass, we can clearly see what’s working, and what may need a few more tweaks – making the prospect of muscle-building and maintenance a much more engaging and tangible process. Patients do the work and over time, with each 2-minute scan on the InBody machine, they can see the payoff not only on the outside, but more importantly, on the inside right now, and ideally for decades to come.