Dexascan + RMR results - Now what?

BodyTemple23

I got a Dexascan and have 40% body fat. My RMR is 978. Yes, I have always had a low metabolism and energy, so the scientific RMR test results didn't surprise me. The Dexascan results did. I thought I was about 30% body fat based on online calculators. It was an eye-opener. Also, my body uses carbs as a fuel source versus fat based on RMR results.

I'm 5'4, 137 pounds, F. It's my body composition, not weight. I have about 16% body fat to lose to be in the fit range.

I work out six days a week—a mix of 4x weekly strength training and 3x cardio. I feel the definition/toning of my muscles now. I was loving the process until I got these tests.

I was eating about 1400-1500 calories, including exercise calories, based on a prior MFP goal before the test before I knew my RMR. The testing center has now advised me to eat 1200 calories for fat loss and 100 grams of protein. I'm a vegetarian, and getting 100 grams of protein and eating adequate fats of 45 grams within 1300 calories is tough.

My goal is to reduce body fat by 16% and increase my RMR to at least 1200 calories.

My plan is to maintain a daily calorie intake of about 1300 calories and be consistent with daily steps of 5K. I will continue with my exercise routine because it's working, and I'm lifting heavy with guidance from experts here. Additionally, I intend to incorporate a weekly water-only fast as a strategy to achieve my fat loss goal.

Please advise how you would proceed.

Corina1143

I was in a similar situation once upon a time. My dietitian told me to eat what I wanted, not ALL that I wanted, but just forget diet and exercise for 2 weeks. Eat what looked good within reason and be active. Sleep as much as I could. Log during those 2 weeks, but with no calorie limit. At the end of 2 weeks, I averaged my calories, subtracted a few, I don't remember how many. She told me eating healthy was more important than hitting goals. Both were important, and I should work toward goals. We decided together that I could probably take exercise classes about 5-6 days a week. It worked well for me. My
Tdee went up significantly. I was working towards a goal, but without the stress I had before.

Lietchi

I personally would steer clear of the water only fasting. You're working hard to build muscle, I wouldn't jeopardize that by regularly depriving yourself of food (specifically a regular supply of protein to rebuild muscle after exercising).

kshama2001

While DEXA is the gold standard for body fat, they're not infallible. If you felt comfortable with your results with your prior regimen, perhaps it makes more sense to continue that rather than to make things unnecessarily hard on yourself with a routine geared for a goal that might not be accurate.

Would you be comfortable posting current pictures? There's at least one trainer here who is very good at assessing BF visually.

I agree with the previous poster that water fasting is counter productive to your goal of gaining muscle.

Paging @AnnPT77, a long time vegetarian, who has no problem hitting her protein goal, and likely has other words of wisdom as well.

BodyTemple23

Thank you for your response, all. Appreciate it. I don't have suitable pictures to post that can help with the assessment, but I can click a couple and post later.

Meanwhile, I just now happened to stumble upon this video that talks about insulin and how the body will turn down your RMR to maintain your body fat at high insulin levels. My insulin level was 5.7, and I'm working on lowering it (it was 5.2 when I last checked). That explains the low RMR and high body fat. I'm seeing the muscle tone, but I'm not losing weight.

https://www.youtube.com/watch?v=1XSJY3eS-C0&t=1225s

I will continue to eat healthily and sensibly.

AnnPT77

To get 100g of good-quality protein on 1200-1300 calories as an ovo-lacto vegetarian, I'd need to eat substantially more soy foods than I prefer (taste preference, not health aversion), and possibly use a protein powder (also against my taste preference).

I do typically get well over 100g daily, but it's on 1850+exercise calories. I did eat 1200+exercise briefly while losing weight, but it was way too few calories, and I lost weight too fast (when only about 20 pounds heavier than you are now, an inch taller, and 59F). I was probably getting 80s-90s grams on that 1200+exercise calories.

To improve protein intake, the general routine I'd suggest is to eat at least one big protein source at every meal (20-30g), plus get at least a small amount of protein from nearly all other foods. (Those little extra bits through the day will add up.)

What I did was regularly review my diary, reduce portions or frequency of calorie-dense foods that had little/no protein, and replace them with other foods I like eating that had more protein, making those new food choices part of my routine autopilot habits. That gradually bumped up my protein intake without needing to micromanage it daily. I found this thread helpful:

https://community.myfitnesspal.com/en/discussion/10247171/carbs-and-fats-are-cheap-heres-a-guide-to-getting-your-proteins-worth-fiber-also

If you're willing to eat protein-dense foods heavily at every meal, plus use protein supplements, I'd guess you can get to 100g on 1300 calories as a vegetarian. The protein-dense foods should be complete (all essential amino acids (EAAs) in reasonable proportions), and highly bioavailable. (I'm suggesting that so that those very limited calories aren't spent on less-effective sources, not because I think that it's essential to be that strict in all cases.)

If you prefer plant sources, the EAA complete bioavailable sources are pretty much going to be the less caloric soy foods (tofu, tempeh, and that sort of thing). If you eat dairy, nonfat or lowfat dairy foods qualify, such as cottage cheese, plain Greek yogurt, skim milk, possibly other calorie-efficient (reduced fat) cheeses. If you eat eggs . . . well, eggs.

IMO, there's nothing major wrong nutritionally with using EAA-complete, bioavailable protein powders/drinks as a supplement on top of whatever protein level a person can reasonably accomplish from food. (Personally, I don't use them because I don't find them tasty or filling, and I don't need them to reach my protein goals.)

Here's the thing, though: If your RMR is low because your body fat is high, then that just adds to the many reasons I'd suggest you mainly try to add muscle, a thing that's less likely to happen alongside fat loss. I know that's slow. But you're not massively overweight. In your circumstances, with your aims, I'd be putting muscle gains at top priority (eating at maintenance, with ample protein and good overall nutrition) for a while, and focusing on an excellent progressive weight lifting regimen. Just my opinion, though.

To get to 24% body fat purely through fat loss, you'd need to get down around 115 pounds at 5'4" if I do the arithmetic correctly. That's pretty thin (BMI 19.7 for rough reference, not because BMI is gospel!). Fat loss limits muscle gain. That makes faster fat loss be at cross-purposes with muscle gain goals.

I feel certain that a weekly water fast is antithetical to your body composition goals. If you feel you must run a weekly calorie deficit for fat loss, if it were me with your goals I'd maybe consider something like 5:2 IF, i.e., eating at maintenance 5 days a week, and a very low amount (500 calories is common) 2 days a week, planning the low days around strength training (to get good nutrition on workout days and usually the day after). Probably some kind of vegetarian meal replacement shake(s) (not just protein shakes) would be a good thing on the low days. That's still not great, but not IMO as bad as a water fast.

BTW: Did you have the Dexafit RMR test, or some similar one where you you wear a mask that monitors exhaled gases as you sit still? If so, that should be reasonably reliable, though point in time. If the RMR figure came from your DEXA scan per se (not an exhaled gases test) that would still be an estimate.

This next is going to get me in trouble: I don't believe a single thing Dr. Fung says. Sure, there may be some truth here and there, but it's like hunting for wild strawberries in a field full of cow pies. He's had some clinical successes in a specific range of cases, but his science has been debunked by his profession at large over and over again.

If by "insulin level" you mean A1C (since those numbers sound like results of an a1C test), then 5.7 is Straight up blood insulin level is usually measured in mIU/L or pmol/L, which yields a very different range of numbers than things like 5.2 or 5.7. A1C of 5.7 is at the low end of the prediabetes range, so worth action. I have to admit, I'm curious what has changed in your life since the 5.2: Body weight, dietary composition, exercise, something else?

Please note: I'm not personally a credentialed expert in any of this, just an interested amateur who's done a bunch of reading out of interest in my own goals, which differ from yours. The only official nutrition education I've had was a tiny bit along the way to my (sport-specific) coaching certification. It's not a credential at all, but I do have substantially higher lean mass (lower body fat) than average for my demographic, probably mid-20s percent someplace, at a height/weight close to yours, and have a substantially higher than predicted TDEE for my demographics and activity level. (I haven't had my RMR measured by any method I'd trust.) Maybe that implies that I made some good choices along the way, I don't know.

Sincere best wishes for success, whatever route you choose!

BodyTemple23

@AnnPT77, you are amazing, and thanks for the sage advice, as always!

I have been working out consistently and not losing weight, so I decided to get a Dexascan and RMR test. Yes, the RMR was Dexascan RMR. I did them both at the same facility. I can feel my muscles when I run my hand against them. The skin isn't soft and squishy like it used to be. I know that isn't much, but it is something. I know I have a long way to go. The thing is, I lost 35 pounds 6-7 years ago, and that makes me wonder, if I have 40% body fat now, how much fat did I have back then?! Like 60%?! So, I'm a bit skeptical about the results, and I have been reading that Dexascan results can be incorrect. Currently, I'm eating at maintenance (without realizing my RMR was that low - 978) and lifting heavy, so it's possible my muscles have been responding. Which is what you are suggesting I believe, Ann.

When I was at 5.2 HbA1C last year, I consistently worked out and ate good protein, and I lost 11 pounds from 151 to 139. However, I traveled for 3 months and took a bit to pick up where I left off. I also have a sweet tooth and indulge in sweets, which I believe is the cause for the insulin spike, coupled with a more carby diet and less focus on protein. But I have been back on the horse for over 2-3 months and have had no success.

Either way, I'm determined to eat healthy and not stress about the Dexascan results. I'll craft my diet around the good things you listed and go from there. You nailed it when you said 100 grams within 1300 calories. It's the low calories that are making it complicated. Otherwise, I should be good. I eat eggs and Greek Yogurt, and I've been following a balanced diet with a focus on protein and healthy fats. I will also continue with my workouts, which include a mix of strength training and cardio. I so love the process now. That wasn't always the case. Exercise was to lose weight, and now it's because it makes me feel better. I don't want to ever lose that perspective.

I will research more on a good way to fast. I have been following Dr. Mindy Pelz's Fast Like a Girl, a fasting program designed specifically for women (I'm 44Y F, so hormones are a consideration). I've found it interesting, and it seems to have some potential benefits, but I'm yet to conclude on fasting. I want to make sure I fully understand its effects on my body before I commit to it as a regular practice.

Thank you, all. I deeply appreciate your support and insightful responses. Your encouragement means a lot to me.

AnnPT77

BodyTemple23 wrote: »

@AnnPT77, you are amazing, and thanks for the sage advice, as always!

I have been working out consistently and not losing weight, so I decided to get a Dexascan and RMR test. Yes, the RMR was Dexascan RMR. I did them both at the same facility. I can feel my muscles when I run my hand against them. The skin isn't soft and squishy like it used to be. I know that isn't much, but it is something. I know I have a long way to go. The thing is, I lost 35 pounds 6-7 years ago, and that makes me wonder, if I have 40% body fat now, how much fat did I have back then?! Like 60%?! So, I'm a bit skeptical about the results, and I have been reading that Dexascan results can be incorrect.

For body composition, Dexa is about as accurate as you're going to get non-invasively, if it was done properly. But yeah, there's still an error factor. Posting a photo here and asking for estimates would be a double-check method.

For RMR, the exhaled gases test (with a mask) is about as accurate as that's going to get. That's why I asked whether you did the mask test while resting, rather than just getting an RMR estimate from the Dexa scan of your body composition.
[quote}
Currently, I'm eating at maintenance (without realizing my RMR was that low - 978) and lifting heavy, so it's possible my muscles have been responding. Which is what you are suggesting I believe, Ann.

When I was at 5.2 HbA1C last year, I consistently worked out and ate good protein, and I lost 11 pounds from 151 to 139. However, I traveled for 3 months and took a bit to pick up where I left off. I also have a sweet tooth and indulge in sweets, which I believe is the cause for the insulin spike, coupled with a more carby diet and less focus on protein. But I have been back on the horse for over 2-3 months and have had no success.

Either way, I'm determined to eat healthy and not stress about the Dexascan results. I'll craft my diet around the good things you listed and go from there. You nailed it when you said 100 grams within 1300 calories. It's the low calories that are making it complicated. Otherwise, I should be good. I eat eggs and Greek Yogurt, and I've been following a balanced diet with a focus on protein and healthy fats. I will also continue with my workouts, which include a mix of strength training and cardio. I so love the process now. That wasn't always the case. Exercise was to lose weight, and now it's because it makes me feel better. I don't want to ever lose that perspective.

I will research more on a good way to fast. I have been following Dr. Mindy Pelz's Fast Like a Girl, a fasting program designed specifically for women (I'm 44Y F, so hormones are a consideration). I've found it interesting, and it seems to have some potential benefits, but I'm yet to conclude on fasting. I want to make sure I fully understand its effects on my body before I commit to it as a regular practice.
[/quote]

I'd suggest that you also seek out and read critiques of whatever fasting method you're considering, ones that are written by people with solid credentials (for example, registered dietitians). I'm not saying that because I think fasting is always wrong. I'm saying that because I think it's the best way to evaluate anything about which there's controversy. It's the approach I strive to take myself, not that I'm a perfect being in that or any other way.

Personally, for me as an individual and with my goals, I don't see myself fasting at all for any reason, at the current levels of evidence of its benefits. That has at least as much (maybe more) to do with me being a hedonist as it does with any rationally justifiable balanced objective reasoning. I'd find fasting unpleasant. I don't do things that are unpleasant to me, unless there's a really, really, really persuasive reason.

Thank you, all. I deeply appreciate your support and insightful responses. Your encouragement means a lot to me.

You're doing fine. I hear your frustration. I think avoiding doing something extreme is a really good plan, but figuring out exactly what to do is a more nuanced question.

If you feel up to it, come back here and let us know how it's going. Other people can learn from your perspectives and experience.

Best wishes for success with your goals!

BodyTemple23

@AnnPT77 Yes, I will post once I learn more about fasting and what I would like to do. I think getting different perspectives may be helpful. To your point about fasting, I don't always do things that are unpleasant either, but I'm doing them right now by avoiding rice, roti, and grains (carb-heavy food because in 1300 calories, I can't accommodate grains and eat 100 grams of protein and fats). This was the wrong way of eating anyway. That has been my staple since childhood, so giving them up and overhauling my diet is a journey. The very idea was unpleasant, but I'm doing it. I will treat fasting the same way if I find health benefits, and I'll admit that I'm more convinced, but I want to do it right without hurting my progress.

I had one question: How did you calculate 115 pounds for 24% body fat? What is the math?

P.S. I will also post pictures once I have them, so I can get an assessment of body fat.

AnnPT77

BodyTemple23 wrote: »

@AnnPT77 Yes, I will post once I learn more about fasting and what I would like to do. I think getting different perspectives may be helpful. To your point about fasting, I don't always do things that are unpleasant either, but I'm doing them right now by avoiding rice, roti, and grains (carb-heavy food because in 1300 calories, I can't accommodate grains and eat 100 grams of protein and fats). This was the wrong way of eating anyway. That has been my staple since childhood, so giving them up and overhauling my diet is a journey. The very idea was unpleasant, but I'm doing it. I will treat fasting the same way if I find health benefits, and I'll admit that I'm more convinced, but I want to do it right without hurting my progress.

I had one question: How did you calculate 115 pounds for 24% body fat? What is the math?

The math is simplistic, veryVery rough, and there are multiple ways to look at it. (And I now think did it wrong above, besides. ) A better answer is more like 108, which would be technically at the border of underweight at 5'4" (BMI 18.5). (That's using the formula according to @ninerbuff in this thread: https://community.myfitnesspal.com/en/discussion/304029/a-quick-way-to-figure-out-your-ideal-weight/p1)

If you know your lean body mass (in pounds or kg), the formula Ninerbuff suggested is (body fat in pounds or kg) divided by (one minus the desired body fat percent expressed as a decimal value).

You mentioned weighing 137 pounds, and being 40% body fat. You wanted to reduce your BF% by 16%, which would be 24%. So:

Current body fat in pounds: 137 times 0.4, which is 54.8
Current lean mass in pounds: 137 minus 54.8, which is 82.2
Target weight to be at 24% body fat: 82.2 divided by (one minus 0.24), so 82.2 divided by 0.76, which is 108 pounds, rounded to the whole number.

Note that when I wrote what I did, I said "To get to 24% body fat purely through fat loss", i.e., without considering muscle mass increase.

If you gained muscle mass, you could weigh more and still be at 24% body fat . . . but that's a more complicated thing to figure out, not to mention that - more importantly - predicting the timeline for doing that is magical crystal ball territory. I don't have a crystal ball!

Best wishes!

BodyTemple23

@AnnPT77 My lean body mass is 78 pounds, and I have 4-5 pounds of bone weight.

Thanks for the math. Interesting!

I'm not focused on a certain number on the weighing scales, but I'll stay the course. I have been advised to add about 15 pounds of muscle. With a consistent diet, exercise, and sleep, that will likely take about a year.

AnnPT77

BodyTemple23 wrote: »

@AnnPT77 My lean body mass is 78 pounds, and I have 4-5 pounds of bone weight.

For an estimate like the one in the formula, bone counts as part of lean mass. Bone mass doesn't change very rapidly, except perhaps in really dire health conditions that deplete it.
The formula's really using everything-but-fat mass, pretty much, but that's long to type.

Thanks for the math. Interesting!

I'm not focused on a certain number on the weighing scales, but I'll stay the course. I have been advised to add about 15 pounds of muscle. With a consistent diet, exercise, and sleep, that will likely take about a year.

BodyTemple23

@AnnPT77

I have a question. What would I be doing differently if I focused on eating at maintenance, which is around 1375-1450 calories for me, and continued focusing on building muscle rather than losing fat?

I'm kinda doing that by eating protein, healthy fats, weight training, lifting heavy, and sleep, but I was just checking to see if I'm missing anything? Should I think about any supplements?

AnnPT77

Maybe you wouldn't be doing anything different, just not chasing (worrying about) losing weight - mindset shift?

I'm not a lifting expert, including lifting supplements. If you optimize nutrition from foods (macros, micros, fiber, pre- and probiotics, etc.), then supplements may not be meaningful. One to consider would be creatine monohydrate, especially as a vegetarian. I do mean "consider": Read about it. See what you think. I do use it, and I don't even lift much.

PAV8888

Don't forget that creatine will ADD WATER WEIGHT non fat mass = lean mass which is not actually muscle. This doesn't suggest not taking it. It is just alerting to a fact that may otherwise bother.

I would also consider your RMR results in the context of what you have been doing this past while.

if you've been eating minimal calories for a while now, then it would not be unexpected to have reduced RMR at this point of time. This doesn't mean that your RMR won't recover after a non trivial length of time of eating at maintenance.