What's On Your Mind: An Inside Look at DEXA Scans

Ram Ahluwalia [00:00:02] Hey, Justin. How are you?

Justin Guilder [00:00:03] Hey, Ram. I'm doing well. How are you?

Ram Ahluwalia [00:00:06] Doing all right? Doing all right. We got so many degrees here in late October, so it's a good day. Halloween is coming soon, so I'm going to overload on sugar to protect my kids from the sugar. I'm going to do my part as a dad. Teach them tactics, that's all. I'm teaching them taxes as well. I provide security and protection for them rule of law shelter basic care and a lot of services. And the method of payment for that is the taxation of the hard-earned chocolate that they're going to collect.

Justin Guilder [00:00:40] Absolutely. Do you have a favorite candy?

Ram Ahluwalia [00:00:42] Oh, yeah. Of course. I like 100 grand. I know that's going out of style, but I think that's great. I like Kit-Kat. I like Reese's peanut butter chocolate cups. those are my fave. How about you?

Justin Guilder [00:00:55] Yeah. Milky Way dark. Oh, I love that. okay. Um. And, take five, take five.

Ram Ahluwalia [00:01:05] Eclectic decision here. Okay.

Justin Guilder [00:01:08] And, uh. As a child. I loved Baby Ruth. Still do.

Ram Ahluwalia [00:01:14] Oh, yeah. Baby Ruth hasn't had that in a long time.

Justin Guilder [00:01:17] Uh. All right. I will also impose a tax.

Ram Ahluwalia [00:01:21] Of course. So, look, this is a great set-up for decks of scans. You, I believe, completed a Dexa scan.

Justin Guilder [00:01:31] Good. I did one this week. The first one I've ever done.

Ram Ahluwalia [00:01:35] Okay. Great. So let's focus on that here today. But why don't you just introduce what a Dexa scan is? What was your motivation? and we can get into what you learned, the cost and any side effects one should consider.

Justin Guilder [00:01:49] Yeah. So, a Dexa scan, it's like a low-dose radiation full body scan, and it gives you a detailed view of your bone density as well as your, lean muscle mass and fat percentage. It breaks it up over your body so it can give you a total body view, but it also can break it down to like, each arm, each leg, trunk, sections of your torso, etc. So it's a very detailed view that, enables you to understand in granular, specific detail how much fat, lean muscle and, the density of your bones.

Ram Ahluwalia [00:02:36] Got it. And what's the price of this procedure?

Justin Guilder [00:02:40] So it was not expensive. It was $90.

Ram Ahluwalia [00:02:44] That's with insurance or just of pocket purchase.

Justin Guilder [00:02:46] Oh, I didn't even consider whether insurance could cover it, but I like that did it. Yeah, I didn't think so. So, like insurance and such a headache on some of these things. I'm like a cash payment sometimes because it's like a headache. It's not worth it.

Ram Ahluwalia [00:03:04] Totally. Yeah. If it had insurance eligibility, I probably would not have done it. So your point. So walk us through the experience from preparation to walk through what sensations you might have experienced or not. How long did it take?

Justin Guilder [00:03:20] So I did no prep work whatsoever besides obviously just scheduling it. It was at a gym, kind of like a private gym that offers physical training in the summer. and then they had the machine there, and I'm sure it's available at similar types of gyms and other places in the country. And the procedure was very fast. You went in, I was assuming I was going to have to get down into like workout clothes or shorts or something like that, but it just took all the metal out of your pockets so, you know, took off belt, took everything else off, slipped off my shoes and then laid down. And you. Captain lay still, but only for a couple of minutes. It probably took. She said it was going to take six. I don't think it took six minutes, but you're able to still talk through it, just not. You're advised to not move your arms, move your legs, etc.

Ram Ahluwalia [00:04:18] So you're laying down. Do you enter like a tube, like an fMRI or there's a scan that passes overhead?

Justin Guilder [00:04:25] Good question. Yeah. No, not like a tube, like an MRI. You're just laying down. And then there's a scanning arm that okay, scans down your head body and then goes all the way down. You can see it scanning left to right as it kind of passes over each section of your body.

Ram Ahluwalia [00:04:43] Got it. Okay. Very cool. So that takes just a couple of minutes or so and then you're done.

Justin Guilder [00:04:49] A couple of minutes immediately read out the results pop up on the screen right away. And then I think different machines and different software have some different capabilities. Now that I know that, I may search for a different location to provide this because one of the things I was looking for was a measure of what's called visceral fat, which is the fat around your organs. Right? So you can be deceptively lean and still have visceral fat, which would indicate that you're having fat accumulate around your organs, which is problematic. This one had, the ability to kind of make some assumptions about that based on a segment of your body, but it did not have a defined visceral fat number. Now, that may be other places that use the same number and just say, oh, that's visceral fat. Or this place may have been and this place may have been honest or it may be a deficiency, the woman who read this and other stuff.

Ram Ahluwalia [00:05:51] So when you call in, you should check for a particular metric. So now you get a visual readout and they walk you through the hand, this to you, and then you interpret the statistics.

Justin Guilder [00:06:01] They walked me through it. So spent a little bit of time kind of talking through the different, outcomes and showing me how it breaks down across your body and then how you compare to. Others. Now, the interesting thing in the comparison set for this provider is that they'll compare you against BMI, which is like everybody, right? BMI is not very useful if you are if you lift weights and you have a lot of muscle. even if you have a little bit of muscle, it's not that useful. And then the analysis ranks you, across the cohort of people who have used their machine.

Ram Ahluwalia [00:06:47] 4% you've got. You've got a population panel that comes from a broader sample and then the local machine itself. But does a local machine control for age, gender, etc?

Justin Guilder [00:07:01] Good question. So there are quite some age and gender controls. bone density gets you an age against your comparable age and gender. And then they do an analysis of how you compare to 20 to 40-year-olds. Oh, that'd be standard. I'd be looking.

Ram Ahluwalia [00:07:19] At that versus 20-year-old right.

Justin Guilder [00:07:21] Away. Yeah. 20 to 40. Got it on density and then on the fat percentage. It is a comparison against the people who have used their machine. So it's in their software. And the challenge there is that she's like, look, there are people who are bodybuilders who are coming in here and doing these machines. And so it's a self-selecting set of people. They are getting an excess scan.

Ram Ahluwalia [00:07:50] Right. This is called a healthy user of bias. This is the flaw with asking or measuring vegans about their health traits versus non-vegans. Vegans might have a healthy user bias. You get that selection effect and it's not a real control. So now you get these metrics that are reported out and what are the stats? So it's like percentages like visceral fat BMI etc.

Justin Guilder [00:08:14] Yeah. So got it right. So you can double-check uh the dense the bone density is a score that ranges from kind of, uh. 0.696, which is like danger territory up to 1.604 and that's. That's the phone measure density. so that's what they're looking for. The higher the better. And, you know, over time bone density can decrease. And so you have risk of things like osteoporosis if your bone density is, low and typically in kind of the traditional medicines and still test, I think women at 65 men and 70 something late. So you probably won't have much time to do anything about it if you have low bone density. I'm fortunate I don't. my bone density was quite good.

Ram Ahluwalia [00:09:17] So quite good, quite good. We're talking like 90th percentile plus here. You feel proud of, uh.

Justin Guilder [00:09:23] Yeah. No, it was, they said. Scoring against young adults was 120%, so I'm 120% above. Oh, wow. I'm above the score they want for young adults.

Ram Ahluwalia [00:09:40] Oh that's amazing. That's good. Yeah. Perfect. You're in good shape there.

Justin Guilder [00:09:44] I think it's like, you know, you just. If you lift enough weight over time, your bone density just increases. Eat calcium. Drink milk. Right. Right. Ice cream helps, too.

Ram Ahluwalia [00:09:53] Maybe a little here and there. Right. cool. So what are the other metrics you pick up, then?

Justin Guilder [00:09:58] Yeah. Then the other ones are really, total lean body mass. lean muscle mass. Your, total fat percentage, and then, you know, other tissue, it's just like everything else. And then it gives you a percentage of your fat, and then it breaks your body down. So it tells you how much your fat percentage is per area as well. And muscle. So right arm or left arm or total right leg, left leg likes total trunk. And then a couple of regions as they call it and Noid and the guy Noid. Okay. Like kind of like your abs and then your hips but it's the guy.

Ram Ahluwalia [00:10:43] Got it. And so what matters? Like where should one focus when you get that result? Where did your eyes go?

Justin Guilder [00:10:48] Uh, so I thought there were for me. There were a couple of interesting takeaways. I've had a few minor injuries here and there that have impacted me, and they've always been on the right side of my body, whether it was like a right ankle or a right knee or, back pain. And it came out in the symmetry of my muscle mass. So I'm a right-hand dominant person, yet my left leg had, almost a pound more muscle in my right leg. Right. And my left trunk had more muscle than my right trunk and my left arm very slightly. But my left arm also, had more muscle, am I right? I think that was very surprising to see that.

Ram Ahluwalia [00:11:37] That happens often. Did they give you any guidance on that?

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