Two DEXA scans eleven months apart: down 24kg total, of which the scan says 6kg was lean. I want to know whether that ratio is bad, normal, or simply what happens.
So the question, as narrowly as I can put it: what fraction of loss being lean mass is actually normal, because the numbers quoted here range from 10% to 40% and cannot all be right.
Practical detail welcome, however dull — the duller the better.
Short answer first, then the reasoning. The intervention that works is boring and well evidenced: resistance training two to three times a week at a genuine effort, protein at 1.4 to 2.0 g/kg of reference body weight, and not making the deficit larger than the training can support. Cardio does not protect lean mass and in a deep deficit competes with recovery.
Dr.SleepRoch said:The intervention that works is boring and well evidenced: resistance training two to three times a week at a genuine effort, protein at 1.4 to 2.0…
Agreed on the ranges, with the condition that a single DEXA is not a measurement, it is one draw from a distribution. Hydration status moves the lean compartment by a kilogram or more between scans, so any comparison of scans done at different times of day or different hydration states is noise.
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Browse GL Biochemrachel_ABQ said:Two DEXA scans eleven months apart: down 24kg total, of which the scan says 6kg was lean.
Same position here, arrived at the long way round. The honest range is roughly 20 to 40% of total loss as lean mass without deliberate resistance training, and roughly 10 to 20% with it plus adequate protein. Both numbers need a caveat that matters: "lean mass" on a DEXA is not muscle. It includes water, glycogen and the lean fraction of organs, and glycogen alone carries about three grams of water per gram. A large early lean drop is mostly the glycogen and water going, which is why the first scan flatters and the second is the honest one.
Happy to go further on any of that.
Clinical perspective, offered as context rather than as advice.
OMG yes. lean mass + resistance training is the combo. Can confirm.