Great review thank you!

I’m a family doc in Philadephia, land of soft pretzels, great sandwiches, Italian pasta, and an impressive pizza scene... not to mention all the sugary treats like cannoli.

Your proxies for visceral fat estimates are spot on... I might add high triglycerides, low HDL, fatty infiltration of the liver, elevated HBA1c, low reported exercise, high carb and processed food intake reported, elevated CRP, and higher alcohol intake especially beer it seems (aka the beer gut).

I also give an intuitive answer to the goal body weight question, factoring in body frame, muscle mass, and fat distribution of pear v apple.

Unfortunately here in the states, the answer to the question of what you weighed at age 21 is increasingly overweight and obese already, but for middle age and older, it still works.

Cheers and thanks again, had never heard of VAT scoring with DEXA, will call radiology and see if they have this capability. Nice to have found another quality substack!

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I can fit in my 18 year old suit pants, but the vest won't fit around my rib cage anymore.

Thank you for another interesting and useful article!

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