From calipers to magnetic resonance imaging (MRI), we have come a long way in our ability to analyze body composition. Some historical milestones are a reminder that many concepts in muscle and fat metabolism, and their measurement, have stood the test of time. However, newer imaging technology has improved our understanding of population heterogeneity in body composition, and the potential health problems associated with certain body composition phenotypes. Imaging analyses, such as dual energy X-ray absorptiometry, computed tomography, and MRI, have provided detailed characterization of the type and amount of fat deposited centrally (abdominal adipose tissue), the trajectory of losses in muscle tissue (sarcopenia), and the combination of low muscle mass/high fat mass (sarcopenic obesity). The last is a new emerging health concern because the presence of these two disproportionate tissue depots may have an additive effect on increasing morbidity. Ongoing measurement of body composition is needed, and preliminary research suggests this may have important nutritional implications.