Chapter 17: Body Composition Status and Assessment

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1 Chapter 17: Body Composition Status and Assessment American College of Sports Medicine. (2010). ACSM's resource manual for guidelines for exercise testing and prescription (6th ed.). New York: Lippincott, Williams and Wilkins

2 Rationale for Body Composition Assessment Many benefits in children, adolescents and teenagers, adults, and elderly populations Provides information concerning health and fitness Excess body fat is related to poor health and risk of diseases/conditions including: Type 2 diabetes mellitus Hypertension Hyperlipidemia Cardiovascular disease (CVD) Certain types of cancer Premature death Low body fat can be detrimental to health (malnutrition, eating disorders) Assessments of bone structure and muscle mass are related to several potentially serious conditions including: Osteoporosis Osteopenia Sarcopenia

3 Levels of Body Composition There are five levels of body composition: Atomic Molecular Cellular Tissue Whole body Most body composition assessments for health and administered by exercise professionals are at the wholebody level.

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5 Body Composition Models Property-based methods involve the measurement of specific properties, such as body volume, decay properties of specific isotopes, or electrical resistance, e.g., estimation of total body water (TBW) from tritium dilution Component-based methods depend on well-established models, usually ratios of measurable quantities to components that are assumed to be constant, both within and between individuals Two-compartment (2C) model partitions body mass into fat mass and fat-free mass (FFM) and has the widest application to body composition analysis. Easy to perform and convenient Multicompartment models have been developed because of violation of the inherent assumptions of the 2C model. These models divide the body into more than two compartments and require fewer assumptions about the composition of the FFM and may provide more accurate results. Require more measures such as total body water and bone mineral content, thus making it more difficult to assess than the 2C model

6 Methodologies in Body Composition Assessment Height, body weight, and body mass index (BMI) Waist-to-hip ratio See Box 17-1 for standards of height, weight, and waist-to-hip ratio measurements. BMI = weight in kg divided by height in meters squared kg m -2 = normal kg m -2 = overweight kg m -2 = obese 40 kg m -2 = morbidly obese Hydrodensitometry (underwater or hydrostatic weighing) 2C model Special equipment required; and the skill of the technician and effort of the subject are key to accuracy Body density determined, and following equations, convert to body fat %: Siri equation: % Body fat [(4.95 BD -1 ) ] 100 Brozek equation: % Body fat [(4.57 BD -1 ) ] 100 Skinfold measurement Theory that subcutaneous fat is directly related to total body fat Use a Lange or Harpenden caliper Need to use population-specific equation

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8 Methodologies in Body Composition Assessment Bioelectrical impedance 3C model A small electrical current is sent through the body (from ankle to wrist), and the impedance to that current is measured. The theory underlying BIA is that lean tissue (i.e., mostly water and electrolytes) is a good electrical conductor (low impedance), whereas fat is a poor electrical conductor and acts as impedance to electrical current. Near-infrared interactance Principles of light absorption and reflection using near-infrared spectroscopy to provide information about the chemical composition of the body Light wand is positioned perpendicularly on a body part and infrared light is emitted and absorption is subsequently measured via a silicon-based detector. Equations estimate percent body fat via optical density, sex, height, and body weight. Air displacement plethysmography Alternative to hydrostatic weighing Only device available = BOD POD Effective for assessing changes over time Computed tomography and magnetic resonance imaging Cross-sectional imaging of the whole body available for body composition analysis All major organs and tissues can be viewed Total body assessment possible via slicing imaging

9 Methodologies in Body Composition Assessment Ultrasound Pattern depends on wavelength (frequency) and the density of the tissues. Part of the energy is reflected, while the rest is refracted where the tissue density dictates the magnitude of reflection. Total percent body fat predicted via regression equations using various sites of subcutaneous fat measurements that estimate body density similar to skinfold analyses. Isotopic dilution Isotopic dilution enables measurement of TBW and estimation of FFM and percent body fat. Common tracers used in isotopic dilution are D 2 O, 18 O, and tritiated water ( 3 H 2 O). Dual x-ray absorptiometry (DXA) 3C model Based on exponential attenuation of x-rays at two energies as they pass through the body DXA provides the masses (g) of fat, lean tissue, and bone mineral content and density (g/cm 2 ) for the total body and for specific regions, e.g., the head, trunk, and limbs

10 Figure Skinfold Measures

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14 Body Composition Assessment in Children and Adolescents Important because many children are overweight or obese Must select child-specific equations for optimal validity Skinfolds, DXA, and air displacement are typically used. Underwater weighing is difficult to perform. BIA tends to be less accurate versus other methods.

15 Body Fat Prediction Equation Selection When selecting a method and equation, one needs to ask: To whom is the specific percent body fat equation applicable? Was an appropriate compartment model used to develop the equation? Was a representative sample of the population studied? How were the predictor variables measured? Was the equation cross-validated in another sample of the population? Does the equation give accurate estimates of percent body fat?

16 Interpretation of Body Fat Percentage Estimates When interpreting, consider that: There are no universal standards for percent body fat that have been established and accepted. All methods of measurement are indirect, so error needs to be considered. There is no universally accepted criterion measurement method. Body fat percent standards National standards exist for BMI and waist circumference. There are no national standards for estimates of percent body fat. The Institute for Aerobics Research has published norms that provide percentiles that differ by sex and age (ranging from 20 to 60 years).

17 Figure Percent Body Fat Standards for Men and Women

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