DEXA Results Companion
Understand the key numbers on your Hologic DEXA report and how bone density, muscle mass, body fat, visceral fat, fracture risk, strength, nutrition, and metabolic health fit together.
A DEXA scan provides much more information than body weight or BMI alone. Depending on the study performed, a Hologic report may include bone mineral density, T-scores, Z-scores, body-fat percentage, visceral adipose tissue, lean-mass indices, fat distribution, and fracture-risk information.
No single DEXA number defines health. Bone density, muscle, visceral fat, body-fat distribution, strength, fitness, medical history, hormones, medications, nutrition, and metabolic health are most useful when considered together.
First: Find the Key Numbers on Your Hologic DEXA Report
The image below is based on the Hologic report format used at HormoneSynergy®. It shows where to look for the measurements discussed throughout this guide.
Educational locator based on a de-identified Hologic report. Patient-identifying information has been removed. Report appearance can vary somewhat by scanner, software version, sex, age, and the studies performed.
1. T-Score: What Does Your Bone Density Mean?
A T-score compares your bone mineral density with that of a healthy young adult. Hologic reports may provide T-scores for the lumbar spine, femoral neck, total hip, and other measured sites.
| T-Score | General Classification |
|---|---|
| -1.0 or higher | Normal bone density |
| Between -1.0 and -2.5 | Low bone mass, often called osteopenia |
| -2.5 or lower | Osteoporosis range |
2. Body Fat Percentage: Find “Total Body % Fat”
On a Hologic whole-body report, your total body-fat percentage may appear in the Body Composition Results table and again under Adipose Indices as Total Body % Fat.
Whole-body DEXA estimates the percentage of your total mass that is fat. These categories provide useful context, but they are not a diagnosis and should not be treated as the ideal target for every person.
| Classification | Women | Men |
|---|---|---|
| Essential fat / very low | Below 15% | Below 10% |
| Athlete | 15–19% | 10–14% |
| Fitness | 20–24% | 15–19% |
| Acceptable | 25–29% | 20–24% |
| Pre-obesity | 30–34% | 25–29% |
| Obesity | 35% or higher | 30% or higher |
3. Visceral Fat: Find “Est. VAT Area (cm²)”
Visceral adipose tissue, or VAT, is fat stored deep inside the abdomen around internal organs. On the Hologic report, look in the Adipose Indices table for Est. VAT Area (cm²).
You may also see estimated VAT mass in grams and VAT volume in cubic centimeters. For this guide, the VAT area in cm² is the most useful number to identify.
Higher visceral fat is associated with insulin resistance, fatty liver disease, cardiovascular risk, and other metabolic problems. Trends over time can be particularly useful.
4. ALMI: Find “Appen. Lean/Height²”
Appendicular Lean Mass Index, or ALMI, represents the lean mass in your arms and legs relative to your height.
The Hologic report may not use the abbreviation ALMI. Instead, look in the Lean Indices section for Appen. Lean/Height² (kg/m²). That is the measurement discussed here as ALMI.
| Reference | Approximate Low-ALMI Screening Level |
|---|---|
| Women | Below roughly 5.5 kg/m² |
| Men | Below roughly 7.0 kg/m² |
5. Z-Score: How Do You Compare With People Your Age?
A Z-score compares your bone density with the expected bone density of people of similar age and sex, with the reference population depending on the report.
This is different from a T-score, which compares bone density with a healthy young-adult reference population.
On Hologic lumbar-spine and hip reports, the T-score and Z-score columns generally appear next to one another in the DXA Results Summary.
6. Bone-Density Classification on the Hologic Report
Your bone-density report may also display a classification beneath the DXA Results Summary. Depending on your findings, this may read Normal, Osteopenia, or Osteoporosis.
Treat the classification as a starting point rather than the entire clinical picture. Fracture history, medications, falls, age, hormone status, and other risk factors can change what the result means for an individual patient.
7. FRAX®: Understanding 10-Year Fracture Risk
Some Hologic hip reports include a 10-Year Fracture Risk section using FRAX®. FRAX combines age, clinical risk factors, and usually femoral-neck bone mineral density to estimate:
- 10-year probability of a major osteoporotic fracture
- 10-year probability of a hip fracture
In the United States, a 10-year hip-fracture probability of 3% or more, or a major osteoporotic-fracture probability of 20% or more, is often used as one factor in treatment decisions. These thresholds do not replace clinical judgment.
8. Other Useful Numbers on Your Whole-Body DEXA
Your Hologic whole-body report contains additional measurements that can add useful context.
| Measurement | What It Adds |
|---|---|
| Fat Mass/Height² (FMI) | Fat mass adjusted for height. |
| Lean/Height² | Total lean mass adjusted for height. |
| Android/Gynoid Ratio | Compares abdominal fat distribution with hip and thigh fat distribution. |
| BMD | The measured bone mineral density from which T-scores and Z-scores are derived. |
These values can be useful, but they are best interpreted together rather than treated as separate health scores.
What Deserves Your Attention?
Your DEXA does not need to be “perfect.” The goal is to identify the areas most relevant to your long-term strength, mobility, metabolic health, and fracture prevention.
My bone density needs attention
Bone responds to mechanical loading, nutrition, hormones, medications, and overall health. Resistance exercise, appropriate weight-bearing activity, adequate protein, calcium, magnesium, vitamins D and K, fall prevention, and medical evaluation may all play a role.
When dietary intake or individual needs warrant additional nutritional support, some patients may discuss options such as Bone Support, OsteoStrength MK-7, or UltraMag Plus Calcium. The need for supplemental calcium, magnesium, vitamin D, vitamin K, or other nutrients should be considered in the context of diet, laboratory findings, medications, kidney function, and individual risk.
Exercise should be individualized if you have osteoporosis, a prior fracture, significant balance problems, or pain.
My muscle mass or strength needs attention
Resistance training is the foundation for maintaining and building muscle. Adequate protein, sufficient calories, sleep, recovery, and medical factors that influence muscle should be considered together.
Strength and physical function remain important even when measured lean mass appears adequate.
My visceral fat needs attention
Visceral fat is closely tied to metabolic health. Nutrition, aerobic activity, resistance training, sleep, insulin sensitivity, and preservation of muscle are all part of the picture.
The goal is not simply to lower body weight. Improving body composition while preserving muscle is generally more useful.
I am trying to lose fat without losing muscle
Preserving lean mass should remain a central priority during weight loss. Resistance training, adequate protein, appropriate calorie intake, recovery, and repeated body-composition measurements can help distinguish fat loss from unwanted muscle loss.
Protein & Muscle Preservation
Protein needs often increase with age. For many healthy older adults, approximately 1.2 g/kg/day is a reasonable starting point. People actively working to build or preserve muscle may benefit from closer to 1.6 g/kg/day when medically appropriate.
Food remains the foundation. When appetite, convenience, or training demands make it difficult to meet protein needs consistently, UltraMeal Advanced Protein is one option that may help close a protein gap. RetzlerRx® Creatine Monohydrate may also be considered alongside resistance training to support strength and muscle performance. Collagen Peptides can provide amino acids used in connective tissue, but collagen should complement rather than replace complete dietary protein.
The table below gives approximate daily amounts by body weight.
| Body Weight | 1.2 g/kg/day | 1.6 g/kg/day |
|---|---|---|
| 120 lb | 65 g | 87 g |
| 140 lb | 76 g | 102 g |
| 160 lb | 87 g | 116 g |
| 180 lb | 98 g | 131 g |
| 200 lb | 109 g | 145 g |
| 220 lb | 120 g | 160 g |
These are general educational ranges, not individualized prescriptions. Kidney disease and some other medical conditions may require a different protein target.
A Useful Exercise Baseline
A general healthy-aging baseline is at least 150 minutes of moderate-intensity aerobic activity per week, or 75 minutes of vigorous activity, plus muscle-strengthening exercise at least two days per week.
Bone density, joint health, balance, pain, fitness, prior fractures, and medical conditions should influence the type and intensity of exercise you choose.
Joint comfort can influence how consistently someone is able to train. When appropriate, some patients may discuss supportive options such as RetzlerRx® Joint Support or Cartigenix HP. These do not replace evaluation of persistent joint pain, injury, swelling, or limitations in movement.
The Goal Is Better Body Composition, Not Just a Lower Number on the Scale
Bone, muscle, and body fat change at different rates. Muscle strength and performance can improve within weeks to months. Bone-density changes generally occur much more slowly.
A long-term healthy-aging strategy combines resistance training, appropriate weight-bearing activity, adequate protein and micronutrients, recovery, and attention to hormone and metabolic health.
Repeating body-composition measurements over time can help show whether you are maintaining muscle, reducing visceral fat, and moving in the direction you want.
DEXA Results Companion FAQ
Where do I find ALMI on my Hologic report?
Look under Lean Indices for Appen. Lean/Height² (kg/m²). Hologic may not label the measurement “ALMI,” but this is the appendicular lean-mass index used in this guide.
Where do I find visceral fat on my Hologic report?
Look under Adipose Indices for Est. VAT Area (cm²). The report may also list estimated VAT mass and estimated VAT volume.
Is DEXA body-fat percentage more useful than BMI?
They measure different things. BMI relates body weight to height but does not distinguish fat from lean tissue. Whole-body DEXA estimates fat and lean mass and also provides information about fat distribution.
Is a VAT measurement below 100 cm² always healthy?
No single cutoff defines health. A VAT area below about 100 cm² is a useful target, but trends, metabolic markers, lean mass, fitness, age, and overall health still matter.
Does low ALMI mean I have sarcopenia?
Not by itself. ALMI can help identify low appendicular lean mass, but sarcopenia assessment also considers strength, physical function, body size, and clinical context.
What is the difference between a T-score and a Z-score?
A T-score compares your bone density with a healthy young-adult reference population. A Z-score compares your bone density with an age- and sex-matched reference population.
What is FRAX?
FRAX is a fracture-risk assessment tool that estimates the 10-year probability of a major osteoporotic fracture and hip fracture using clinical risk factors and usually femoral-neck bone mineral density.
How often should I repeat my DEXA?
The appropriate interval depends on why the test was performed, baseline findings, treatment or lifestyle changes, age, fracture risk, and medical history. Discuss timing with your clinician.