Review Article

Nutrition and Health

1–15
Simple anthropometry-based calculations ª The Author(s) 2021
Article reuse guidelines:
to monitor body composition in athletes: sagepub.com/journals-permissions
DOI: 10.1177/02601060211002941

Scoping review and reference values journals.sagepub.com/home/nah

Diego A Bonilla1,2,3,4 , Lidia G De León5, Pedro Alexander-Cortez6,

Adrián Odriozola-Martı́nez4, Carlos A Herrera-Amante7,
Salvador Vargas-Molina8 and Jorge L Petro1,3

Abstract
Background: Kinanthropometry offers to exercise and health professionals a standardized procedure of acquiring surface
anatomical measurements that might be used to track changes in body composition. Aim: To describe simple anthro-
pometric indices to monitor body composition changes in amateur and elite athletes, and to provide reference values
during the competition phase. Methods: A search of articles indexed in PubMed/MEDLINE, ScienceDirect, Cochrane,
and SciELO databases using the string body composition AND (anthropometric OR skinfolds OR circumferences OR girth OR
estimation equation) AND “body fat”. Inclusion criteria were: quantitative and/or qualitative research published between
2009 and 2020, written in English or Spanish, reporting simple anthropometric indices that included skinfolds, girths, or
basic measures in amateur and elite athletes. Results: A total of 51 studies (Price’s index ¼ 66.4%) met all the inclusion
criteria and were included in this scoping review. Contrary to the frequent practice, the use of a regression equation might
not be accurate to evaluate bodyP composition. To avoid this, anthropometrists should base their analysis on the absolute
values of the sum of skinfolds ( S) and related variables, such as skinfold-corrected girths and lean mass index. While not
definitive, because further research is required, the practical recommendations and updated reference values in com-
petition phase Pprovided by this review would contribute to the accurate identification of body composition changes.
Conclusions: S and lean mass index have been shown to be valid for monitoring changes in fat mass and fat-free mass,
respectively. More research is needed to derive the lean mass index-specific coefficient for each sports population.

Keywords
Anthropometry, skinfold thickness, fat mass, physiological adaptation, physical fitness, sports nutrition sciences

In practice, misunderstanding and technical errors are

Introduction
Currently, several socio-technological phenomena generate
confusion, malpractices, and problems in the development of
specialized knowledge and the communication of science in
exercise, sport, and health. Among these situations are
misinformation, biased professionals, monetary interests,
influencers and their thousands of followers (i.e. broscience/
pseudoscience), predatory journals, among others that are
categorized under the concepts of scienciness (Burke, 2017),
and junk science (Dadkhah et al., 2018; Fisher, 2019). In this
context, kinanthropometry (kine- movement, anthropos-
human, and metron- measurement), as a discipline for
analyzing the influence of several factors affecting the
morphological characteristics and body composition (BC) in
physically active individuals or athletes (training, recovery,
and nutrition; Figure 1), has been negatively affected by
each of the socio-technological factors mentioned above.
common not only when making measurements but also
during the data analysis process. Thus, the standardization
1
Research Division, DBSS International, Colombia
2
Research Group in Biochemistry and Molecular Biology, Universidad
Distrital Francisco José de Caldas, Colombia
3
Research Group in Physical Activity, Sports and Health Sciences
(GICAFS), Universidad de Córdoba, Colombia
4
kDNA Genomics®, University of the Basque Country UPV/EHU, Spain
5
Facultad de Ciencias de la Cultura Fı́sica, Universidad Autónoma de
Chihuahua, México
6
Universidad Nacional Experimental Politécnica, Venezuela
7
Division of Health Sciences, University of Guadalajara, México
8
EADE-University of Wales Trinity Saint David, Spain
Corresponding author:
Diego A. Bonilla, Research Division, Dynamical Business & Science Society
- DBSS International SAS, 110861 Bogotá, Colombia.
Email: dabonilla@dbss.pro
2 Nutrition and Health XX(X)
Figure 1. Factors affecting morphology and body composition.
Exercise, recovery, and nutrition promote physiological adapta-
tions by several mechanisms. Assessment of different variables,
including body composition, should be performed during the time
course of the athletes’ preparation or for aesthetic goals.
of the technique at the international level, following the
standards of the International Society for the Advancement
of Kinanthropometry (ISAK) (Esparza-Ros et al., 2019),
has contributed significantly: (a) to the reduction of the
technical error of measurement (TEM); (b) to the increase
in the reproducibility of studies; and (c) to the preservation
of professional ethics in nutrition, medicine, training, and
other disciplines that frequently collect kinanthropometric
data. Kinanthropometry offers to exercise and health pro-
fessionals a scientific procedure of acquiring surface ana-
tomical dimensional measurements, which in spite of its
limitations is easily accessible, inexpensive, short in
duration, mobile, and routinely used in many sports
(Zemski et al., 2018b). In the ISAK handbook for instruc-
tors (ISAK 3 and criterion/ISAK 4) and the reference
manual for technicians (ISAK 1 and 2), the international
anthropometric standards are described. These data not
only encompass basic measurements, such as body mass
(BM), stature (height), sitting height, and arm span, but also
three general categories that provide important information
about BC and morphology: skinfolds, as indicators of
subcutaneous body fat; girths, as indicators of muscle and
fat mass; and breadths and lengths, as indicators of bone
structure (Esparza-Ros et al., 2019). In fact, the Interna-
tional Olympic Committee research working group on
body composition, health, and performance recommends
the procedures established by the ISAK (Larson-Meyer
et al., 2018).
Anatomical landmarks correspond to body references
that can be easily identified with good technique and
practice. Special attention should be paid to obese parti-
cipants since it is more difficult to locate the marks,
although this is out of the scope of this review. In brief,
every anthropometrist must: (a) find these points of ref-
erence by palpation; (b) release the site; (c) relocate the
landmark; (d) mark the site using a dermographic pen
once it is verified; and (e) re-check the mark before
continuing with the measurement protocol. People inter-
ested in working with kinanthropometric data have to
follow the rule: all landmarks are identified before any
measurements are made (Norton and Eston, 2018). It is
important to highlight based on our experience that many
people doing anthropometry do not mark, which can
affect the TEM and validity of the data.
All anthropometrists or professionals interested in col-
lecting data are encouraged to follow the ISAK protocol
verbatim (Esparza-Ros et al., 2019) since, for instance,
measuring 1 cm away from a defined site produces sig-
nificant differences in the majority of obtained skinfold
values (Hume et al., 2018). Ensuring the skinfold caliper is
calibrated (e.g. using an engineer’s Vernier caliper or even
sponge as inner calibration), performing repeated mea-
surements (two or three per site), among other recom-
mendations, are within the reference manual of the
international anthropometric standards (Esparza-Ros et al.,
2019; Norton and Eston, 2018). Similar to the location of
landmarks, there are important features to highlight
throughout data collection and subsequent analysis for the
correct interpretation of the data and a consequent appli-
cation for the exerciser/athlete’s intervention. For example,
during the annotation of the anthropometric measurements,
there may be an error by number handling (human error)
when recording the data in the proforma. This error is very
common in the field of research when the investigator has a
recorder (e.g. beginner anthropometrist or student) who is
not focused/experienced in the correct way to register the
numbers that are dictated by the anthropometrist. The most
common mistakes when making the data registrations are
number mistyping (e.g. Ø is recommended instead of zero)
and mishearing. Additionally, in practice, a common issue
is the frequent reductionism due to both the argumentum ad
verecundiam and the wrong extrapolation of conclusions
from articles published in specialized journals, which
directly affects data analysis. Therefore, the analysis of the
recorded data is frequently often out of context, considering
the lack of preparation of professionals in matters of
descriptive, inferential, and/or estimation statistics and data
interpretation, even though there are easy-to-understand
materials in this regard (Cumming, 2013a, 2013b; Norton
and Olds, 2007). All aspects mentioned above make it
necessary to update recommendations when analyzing
anthropometric data with the aim to evaluate BC changes
over time in physically active individuals and athletes,
especially when a more valid methodology like dual-
energy X-ray absorptiometry (DXA) is inaccessible.
Objective
Thus, to identify gaps in the literature to aid the planning
and commissioning of future research and evidence-based
practices, this scoping review aims: (a) to describe simple
anthropometry-based calculations to track BC in amateur
and elite athletes, while we discuss the best practices to
Bonilla et al.
monitor these changes, and (b) to summarize findings in
several sports disciplines and provide reference values
among amateur and elite athletes.
Methods
Protocol and registration
This study employed the guidelines for Preferred Reporting
Items for Systematic reviews and Meta-Analyses extension
for Scoping Reviews (PRISMA-ScR) (Tricco et al., 2018).
The aim of this methodology was to synthesize the avail-
able evidence regarding simple anthropometric indices to
track BC in amateur and elite athletes, and provide refer-
ence values in sports populations. The scoping review
allows a more inclusive/heterogeneous sample of studies
that account for the different types of evidence or data
sources (e.g. quantitative and/or qualitative research) that
may be eligible as opposed to only studies. As this review
was not eligible to be registered on PROSPERO, the
summary information was uploaded to Figshare to make it
publicly accessible in order to avoid unnecessary duplica-
tion (https://doi.org/10.6084/m9.figshare.12618887).
Eligibility criteria
The inclusion criteria for this scoping review were as fol-
lows: (a) empirical or theoretical articles (quantitative,
qualitative, mixed methods studies); (b) studies published
between 2009 and 2020; (c) written in the English or
Spanish language; (d) reporting simple anthropometric
indices that include either skinfolds, girths or basic mea-
sures (body mass and stature); and (e) studies performed in
amateur and elite athletes. Additionally, data published in
studies with a sample size greater than or equal to 10 par-
ticipants were included to extract reference values. The
search excluded papers on participants of <15 or >45 years
old, on unhealthy population, commentaries, editorials,
letters to the editor, and books.
Search and sources of evidence
In order to summarize recently published data, we per-
formed a search of articles indexed in PubMed/MED-
LINE, ScienceDirect, Cochrane, and SciELO databases
using the following Boolean algorithm: body composition
AND (anthropometric OR skinfolds OR circumferences
OR girth OR estimation equation) AND “body fat”. The
data search was enriched by using the string NOT obesity
NOT overweight NOT disease in all databases, besides the
free language terms related to “skinfolds, anthropometric,
circumferences, equation or body fat percentage” in
Google Scholar. To capture relevant articles for the
review, the search of the databases took place during the
first week of July 2020.
3
Data charting process and items
Databases were evaluated for articles that met the inclusion
criteria. Those publications that met all the requirements
went on to the next phase of data analysis and synthesis. In
brief, simple anthropometric indices used for tracking
changes in BC were summarized and discussed. Further-
more, a table with the population characteristics (sport,
sample size, sex, region, age, stature, and study year) and
relevant anthropometric indices to track changes in the
percentage of body fat (%BF) was developed. Discrepancies
were identified and resolved through discussion between
authors where necessary.
Results
Selection of sources of evidence
The first search, solely with the Boolean algorithm, resul-
ted in 6311, 14,569, 1141 and 51 references from the
PubMed/MEDLINE, ScienceDirect, Cochrane, and
SciELO databases, respectively. After activation of the
filter options of the databases, it resulted in 722 publica-
tions although after the removal of duplicates and the
screening of articles to meet the inclusion criteria (a to c)
we found 280 potential studies. However, after reviewing
the abstracts, 184 were excluded due to ineligibility. From
the remaining publications, 45 articles were excluded since
they had low sample size (<10), had low homogeneity to
extract reference values, were focused on BC changes after
a certain nutritional or supplementation intervention, or had
data missing. A total of 51 studies (Price’s index ¼ 66.4%)
met all the inclusion criteria and were included in this
scoping review. Figure 2 represents a flow chart of the
article selection process.
Characteristics of sources of evidence
Table 1 shows the characteristics of the obtained studies,
with useful information regarding BC during the compe-
tition phase in different sport populations. While P not
definitive, these values of sum of skinfolds ( S) and
estimated/quantified %BF will provide helpful guidance
for athletes’ preparation, but further research is needed to
have reference values in each country and to evaluate the
validity of lean mass index (LMI) in other sports. More-
over, the high between-study heterogeneity whenP report-
ing anthropometric variables (e.g. number of S) is itself
informative as it might be seen as an opportunity to
standardize and explore missing data that contribute to the
literature.
In the following sections, we discuss several anthropo-
metric indices found in the reviewed articles in order to
improve anthropometrists’ praxis (beginners and inter-
mediate experience).
4 Nutrition and Health XX(X)
Figure 2. PRISMA flow chart of the scoping review.
Equations to estimate percentage of fat mass
Kinanthropometry is considered a doubly indirect method
when the aim is to evaluate BC, or more specifically to
estimate the %BF based on a two-component model
(Wang et al., 2000). This is because from the recorded
data (skinfolds and sometimes girths) it is possible to
estimate body density by applying regression equations
that have been developed by different authors using a
“gold standard” comparison (e.g. DXA, nuclear magnetic
resonance), which in turn indirectly estimates the BC of
an individual. Consequently, there are more than 100
available equations in the scientific literature that use
anthropometric measurements for the prediction of body
density and %BF. In this process, the use of additional
formulas is required, such as Siri (1956), Brozek et al.
(1963), or Willmore and Benkhe (1969, 1970). However,
there are differences in the accuracy level of using any of
these equations to estimate the %BF from body density in
certain populations (Guerra et al., 2010). This might be
due in part to the lack of comparable experimental data to
support the initial conclusions in the human body (i.e.
Siri), given they have been demonstrated extensively in
animal models, such as the guinea pig (Pitts, 1956).
Unfortunately, in an attempt to fulfill the insistent
feedback demands of exercisers/athletes in regards to %BF,
many professionals in exercise, sport or health sciences
incorrectly choose the estimation equation to track changes
in BC. Generally, the most commonly used equations are
(a) Durnin and Womersley (1974) for sedentary popula-
tion; (b) Jackson and Pollock (1978), Jackson et al. (1980),
Harbin et al. (2017) for physically active men and women;
and (c) Yuhasz (1962) or Faulkner (1968) for sub-elite and
elite athletes. However, anthropometrists should be aware
of the recent validation studies (compared to DXA), which
have revealed new equations for different populations, such
as Caucasian young male and female football players
(Lozano-Berges et al., 2019), international soccer players
of the Italian Serie-A (Nunez et al., 2019), professional
Mexican male soccer players (Gonzalez-Mendoza et al.,
2019), Spanish elite youth male soccer players (Munguı́a-
Izquierdo et al., 2018), Japanese male athletes (Takai et al.,
2018), Colombian adult women (Aristizabal et al., 2018),
physically active women and men (Lahav et al., 2018),
southern Brazilian adolescents (Ripka et al., 2017), Italian
female handball players (Cavedon et al., 2018), and young
Iranian wrestlers (Riyahi-Alam et al., 2017). In “fitness”
and bodybuilding, the success and achievement of goals
can be accounted for in large part by easily obtained
physical variables, as Fry and colleagues (Fry et al., 1991)
demonstrated after they analyzed anthropometric features
as discriminators of success in North American body-
builders. It has been established that the Lohman equation
(Lohman, 1981) might be particularly appropriate for the
 Table 1. Fat percentage and/or sum of skinfolds in different female and male sports populations in competition phase.
P
Sport n Sex Region Age (years) Stature (cm) Body mass (kg) %BF SS (mm) Study and year
a
Alpinism 42 7 F Spain NA NA NA 13.0 + 1.1 79.0 + 11.1 y (Garrido-Chamorro et al., 2012)
35 M 11.1 + 2.0 a 53.1 + 21.7 y
19 9 F Spain 28.6 + 3.6 162 + 0.03 52.9 + 3.6 25.2 + 3.6 * NA (Espana Romero et al., 2009)
10 M 31.2 + 5.0 172 + 0.04 65.5 + 4.5 13.3 + 3.3 *
Athletics 98 sprinters 98 M Italy 23.1 + 6.3 177.9 + 7.1 73.0 + 7.5 7.7 + 2.9 b NA (Barbieri et al., 2017)
62 general 32 F Portugal 21.8 + 4.1 166.3 + 2.2 59.1 + 2.3 NA 71.4 + 10.3 z (Santos et al., 2014)
30 M 21.6 + 3.5 182.1 + 2.1 73.9 + 2.4 46.6 + 5.0 z
188 general 89 F Spain NA NA NA 14.6 + 3.8a 94.8 + 36.7y (Garrido-Chamorro et al., 2012)
99 M 11.4 + 3.5a 56.9 + 35.2y
Badminton 15 15 M France 22.6 + 4.9 182 + 6.2 74.4 + 6.0 15.4 + 4.2 j NA (Phomsoupha and Laffaye, 2020)
9 9 M Poland 26.7 + 5.6 185.0 + 5.1 82.7 + 4.6 82.7 + 4.6 j NA (Tomaszewski et al., 2018)
a
155 66 F Spain NA NA NA 14.3 + 1.7 93.9 + 16.6 y (Garrido-Chamorro et al., 2012)
89 M 11.3 + 1.6 a 56.3 + 14.6 y
Basketball 1160 1160 M USA 20.6 + 1.4 197.6 + 4.5 98.1 + 7.4 7.28 + 2.4 c NA (Cui et al., 2019)
30 14 F USA 20.6 + 1.6 180.5 + 7.0 76.3 + 12.6 23.6 + 7.5 * NA (Sanfilippo et al., 2019)
16 M 20.1 + 1.5 192.9 + 8.9 92.1 + 11.9 12.2 + 2.0 *
41 41 F Spain 25.4 + 4.1 177.6 + 8.3 72.1 + 9.7 15.4 + 4.2 j 122.3 + 32 ~ (Garcia-Gil et al., 2018)
10 10 M Mexico 22.2 + 1.3 192.8 + 10.2 82.9 + 17.7 26.1 + 4.4 * 92.6 + 53.0 ~ (Sosa, 2016)
90 43 F Portugal 17.3 + 2.7 176.7 + 2.5 68.9 + 2.9 NA 126.8 + 12.0 z (Santos et al., 2014)
47 M 16.8 + 0.7 190.6 + 2.9 81.9 + 3.1 73.3 + 7.0 z
412 137 F Spain NA NA NA 16.0 + 3.4 110.9 + 31.9y (Garrido-Chamorro et al., 2012)
275 M 11.3 + 1.6 56.3 + 14.6y
Cycling 50 50 M India 22.4 + 3.1 171 + 5.1 76.71 + 5.15 14.02 + 1.0 c 44.2 + 1.43  (Kumar and Singh, 2019)
21 21 M International 29.0 + 4.0 NA 68.8 + 5.9 NA 41.8 + 8.4 z (Saw et al., 2018)
19 1 F Spain NA NA NA 13.2 a 82.8 y (Garrido-Chamorro et al., 2012)
a
18 M 11.7 + 2.4 60.5 + 4.7 y
Frontenis 31 5 F Spain NA NA NA 14.5 + 2.8 a 98.3 + 31.7 y (Garrido-Chamorro et al., 2012)
26 M 13.4 + 2.7 a 79.3 + 26.7 y
Hockey 37 37 M Canada 22.86 + 1.5 181.69 + 6.1 87.21 + 6.52 16.0 + 3.9 * NA (Chiarlitti et al., 2018)
48 22 F USA 20.1 + 1.1 168.0 + 5.3 69.8 + 5.8 25.0 + 3.8 * NA (Sanfilippo et al., 2019)
26 M 21.7 + 1.7 181.1 + 6.8 85.9 + 7.5 15.2 + 2.6 *
17 4 F Spain NA NA NA 13.4 + 5.0 a 78.9 + 40.2 y (Garrido-Chamorro et al., 2012)
13 M 15.1 + 4.9 a 91.7 + 45.8 y
Handball 85 85 F Italy 22.1 + 5.7 167.4 + 6.2 64.9 + 10.7 25.4 + 5.6 * 120.2 + 33.7 D (Cavedon et al., 2018)
41 4 F Portugal 25.3 + 2.5 167.3 + 2.5 67.9 + 4.9 NA 128.1 + 28.0 z (Santos et al., 2014)
37 M 21.4 + 4.8 183.4 + 2.0 83.7 + 3.6 86.7 + 14.7 z
a
125 15 F Spain NA NA NA 16.7 + 3.6 113.0 + 32.0 y (Garrido-Chamorro et al., 2012)
110 M 14.1 + 3.1 a 77.2 + 27.5 y
32 32 M Serbia 20.4 + 1.1 190.7 + 5.2 88.4 + 8.9 13.6 + 5.8 d NA (Ilic et al., 2015)
Jiu-Jitsu 25 25 M Brazil 26.3 + 5.5 174.2 + 6.8 75.5 + 10.6 19.3 + 2.5 * 45.5 + 16.9 y (Báez et al., 2014)

(continued)

5
6
Table 1. (continued)
P
Sport n Sex Region Age (years) Stature (cm) Body mass (kg) %BF SS (mm) Study and year

Judo 61 26 F Austria 19.9 + 4.2 167.8 + 6.0 64.7 + 7.7 NA 115 + 35.0 ~ (Sengeis et al., 2019)
35 M 22.5 + 6.1 176.9 + 8.0 83.7 + 19.8 92.5 + 60.0 ~
e
51 29 F Spain >18 165.5 + 10.6 66.1 + 20.0 16.9 + 6.3 81.0 + 6.5 z (Casals et al., 2017)
f
22 M 176.5 + 15.2 79.7 + 29.9 7.5 + 3.5 53.0 + 8.3 z
93 24 F Portugal 20.4 + 5.3 162.1 + 2.9 59.4 + 3.8 NA 123.0 + 19 z (Santos et al., 2014)
69 M 21.0 + 5.0 172.7 + 1.6 71.5 + 2.3 59.4 + 5.8 z
58 39 F Spain NA NA NA 12.7 + 2.1 a 77.1 + 17.3 y (Garrido-Chamorro et al., 2012)
19 M 11.7 + 4.4 a 58.7 + 38.3 y
Kayaking 11 11 M Spain 43.4 + 11.9 178.3 + 7.9 85.4 + 10.7 11.8 + 2.9 72.6 + 26.3 y (Almagro Blázquez et al., 2019)
MMA 13 13 M Brazil 30.0 + 4.4 176.0 + 0.05 82.1 + 10.9 11.8 + 5.1 i NA (Marinho et al., 2011)
11 11 M USA 26.5 + 4.7 176.7 + 6.8 80.3 + 7.1 12.3 + 5.8 * NA (Siqueido, 2010)
Mountain bike 51 51 M International 30.1 + 3.9 175.1 + 3.9 68.1 + 4.0 10.2 + 2.9 c 46.1 + 10.9 ~ (Sanchez-Munoz et al., 2018)
Orienteering 89 30 F Spain NA NA NA 14.1 + 1.6 a 91.2 + 15.1 y (Garrido-Chamorro et al., 2012)
59 M 10.8 + 1.3 a 52.0 + 13.9 y
Padel 35 35 M Spain 31.1 + 5.7 177.7 + 7.3 77.2 + 9.9 18.4 + 4.8 c 95.3 + 33.3 ~ (Sanchez-Munoz et al., 2020)
Rhythmic gymnastics 15 15 F Venezuela 17.4 + 3.4 158.5 + 5.1 49.4 + 5.1 23.6 + 5.7 c NA (Palacios de Espig and Sánchez Jaeger,
2016)
76 76 F Spain NA NA NA 10.2 + 1.2 a 50.2 + 13.2 y (Garrido-Chamorro et al., 2012)
Rowing 21 6 F Chile 18.6 + 2.5 170.0 + 4.6 62.9 + 5.6 27.0 + 3.6 * 58.1 + 16.8 y (Gutiérrez-Leyton et al., 2020)
16 M 22.0 + 4.7 182.0 + 4.4 81.5 + 7.6 19.3 + 1.5 * 42.3 + 10.1 y
20 20 M Spain 29.3 + 3.6 182.5 + 5.2 80.4 + 6.3 10.9 + 1.1 a 67.3 + 15.6 ~ (León Guereño et al., 2018)
35 8 F Portugal 23.4 + 6.7 169.9 + 4.7 66.1 + 5.2 NA 104.5 + 17.4 z (Santos et al., 2014)
27 M 21.1 + 4.5 183.0 + 2.2 78.5 + 3.5 60.5 + 7.6 z
a
86 21 F Spain NA NA NA 15.6 + 1.9 100.5 + 16.5 y (Garrido-Chamorro et al., 2012)
a
65 M 14.0 + 3.2 81.6 + 29.3 y
Rugby 43 43 M Australia 25.5 + 3.1 188.0 + 7.8 104.2 + 11.9 13.2 + 2.9 * 68.8 + 22.5 (Zemski et al., 2018a)
g
x ¼ 0.13 for forwards 362 362 M Italy 25.0 + 4.0 183.0 + 6.5 97.0 + 5.5 15.75 + 5.2 NA (Fontana et al., 2015)
x ¼ 0.14 for backs 44 44 M Europe 26.0 + 3.3 186.0 + 5.5 101.1 + 6.5 NA 75.5 + 20.7 (Bradley et al., 2015)
45 45 M UK 21.8 + 5.4 180.6 + 6.8 90.8 + 10.8 19.2 + 4.4 * NA (Barlow et al., 2015)
62 62 M Portugal 20.4 + 4.0 182.8 + 1.9 92.2 + 4.1 NA 110.5 + 14.5 z (Santos et al., 2014)
b
Snowboarding 10 10 M Italy 23.5 + 4.3 181.0 + 4.9 77.2 + 9.2 11.9 + 3.5 70.1 + 21.1 z (Vernillo et al., 2016)
Football/soccer 17 17 M International 29.3 + 3.1 184.0 + 6.0 78.8 + 4.7 13.6 + 1.8 * 50.7 + 9.3 ~ (Nunez et al., 2019)
56 26 F USA 19.8 + 1.1 167.3 + 6.8 65.3 + 7.8 24.5 + 3.7 * NA (Sanfilippo et al., 2019)
30 M 21.0 + 1.9 179.4 + 2.3 76.7 + 9.0 13.7 + 2.6 *
64 22 F Portugal 22.5 + 5.7 164.1 + 2.6 59.7 + 2.9 NA 105.5 + 11.9 z (Santos et al., 2014)
42 M 19.7 + 4.1 176.6 + 1.8 73.8 + 2.4 58.1 + 6.1 z
72 72 M Peru 27.4 + 4.9 179.0 + 4.6 77.4 + 6.4 NA 57.3 + 14.14 y (Cossio-Bolaños et al., 2013)
749 106 F Spain NA NA NA 14.9 + 2.9a 100.0 + 8.5 y (Garrido-Chamorro et al., 2012)
643 M 11.3 + 1.6a 53.7 + 15.2 y
30 30 M France 24.4 + 4.1 182.1 + 5.8 76.8 + 5.8 10.8 + 1.7 c NA (Carling and Orhant, 2010)
145 16 F Spain NA NA NA 13.0 + 2.1 a 79.2 + 19.4 y (Garrido-Chamorro et al., 2012)
Indoor players 129 M 15.1 + 3.1 a 87.1 + 27.7 y

(continued)
 Table 1. (continued)
P
Sport n Sex Region Age (years) Stature (cm) Body mass (kg) %BF SS (mm) Study and year

Stand-up paddle 31 31 M International 24.6 + 2.0 175.0 + 4.2 74.6 + 6.6 11.3 + 3.5 a 57.8 + 22.2 ~ (Castañeda Babarro et al., 2020)
Swimming 15 7 F International 23.3 + 4.0 169.6 + 8.3 62.2 + 6.9 17.8 + 4.4j 82.9 + 25.5z (Shaw and Mujika, 2018)
x ¼ 0.16 for female 8 M 22.9 + 3.2 183.7 + 4.9 77.9 + 8.6 10.8 + 2.6j 61.3 + 15.1z
x ¼ 0.15 for male 13 13 F International 21.0 + 4.0 NA 65.0 + 5.1 NA 67.1 + 9.9 z (Saw et al., 2018)
70 26 F Portugal 17.2 + 1.3 167.7 + 2.4 59.3 + 2.2 NA 93.1 + 10.5 z (Santos et al., 2014)
44 M 19.6 + 3.4 179.9 + 2.1 72.0 + 2.6 56.6 + 6.2 z
Tennis 34 11 F Portugal 18.0 + 2.7 168.5 + 3.5 64.2 + 4.3 NA 141.0 + 17.6 z (Santos et al., 2014)
23 M 20.4 + 5.2 177.4 + 2.6 71.3 + 4.2 67.7 + 8.4 z
62 31 F Spain NA NA NA 14.2 + 2.1a 92.0 + 19.9 y (Garrido-Chamorro et al., 2012)
31 M 12.5 + 2.6a 69.7 + 23.7 y
Triathlon 52 11 F Portugal 21.0 + 3.5 168.4 + 4.6 57.9 + 4.4 NA 86.3 + 40.2 z (Santos et al., 2014)
41 M 23.0 + 5.4 175.8 + 1.8 65.9 + 1.3 49.6 + 4.0 z
24 24 M Portugal 21.4 + 4.8 176.6 + 5.1 66.4 + 4.2 9.1 + 1.7 h 38.4 + 11.2 # (Silva et al., 2012)
46 6 F Spain NA NA NA 11.5 + 1.2 a 72.8 + 13.7 y (Garrido-Chamorro et al., 2012)
40 M 11.0 + 1.7 a 49.9 + 15.7 y
Ultra-runners 65 65 M Spain 21.0 + 3.0 177.0 + 5.0 64.97 + 7.36 NA 46.97 + 9.3 y (Barrientos et al., 2020)
22 22 M Spain 41.4 + 4.1 177.8 + 5.1 80.6 + 9.2 10.5 + 1.73 92.9 + 22.8 ~ (Vaquero-Cristóbal et al., 2019)
19 19 M Colombia 28.2 + 6.9 170.6 + 8.3 69.1 + 12.7 13.3 + 3.2 b 67.8 + 32.0 y (Ramı́rez-Vélez et al., 2015)
Volleyball 16 16 F USA 20.1 + 1.3 178.0 + 10.1 73.6 + 7.9 24.8 + 3.5 * NA (Sanfilippo et al., 2019)
11 11 M México 23.2 + 2.69 186.4 + 9.6 82.9 + 17.7 26.1 + 4.4 * 92.6 + 53.0 ~ (Sosa, 2016)
42 42 F International 27.2 + 5.4 177.0 + 5.2 67.8 + 5.3 NA 73.6 + 15.2 c (Mielgo-Ayuso et al., 2015)
33 16 F Portugal 25.9 + 5.9 174.5 + 5.2 67.7 + 6.1 NA 118.0 + 18.9 z (Santos et al., 2014)
17 M 27.8 + 2.5 195.0 + 3.5 90.1 + 3.8 70.0 + 10.2 z
P
Means + SD. The means represent the entire sample of participants of the study with no distinction of player position. x: constant for the lean mass index calculation; %BF: percentage of body fat; S: sum of
a b c
skinfolds; F: female; M: male; NA: not available; Yuhasz equation P modified by Faulkner; Jackson and PPollock equation for body density
P and Siri equation for
P %BF; Durnin and Womersley equation for body density
and Siri equation for %BF; d Matiegka equation for %BF; e %BF ¼ ( 6 S x 0.1548) þ 3.58; f %BF ¼ ( 6 S x 0.1051) þ 2.58; g (0.22  6 S) – 0.00029  [ 6S2 þ (0.133  age)] – 5.73; h Petroski equation for body
density and Siri equation for %BF; i Lohman equation D ¼ 1.0982  0.000815X þ 0.0000084 X2, where X ¼ sum of triceps, abdomen and subscapular skinfolds, and Siri equation for %BF; j Withers et al .(1987a) for
P
* Dual energy X-ray absorptiometry (DXA); * Ross and Kerr

males and Withers et al. (1987b) for females;P P (1991) five-component model; j bioelectrical impedance using
P commercial device; # 4 S ¼ triceps,
subscapular, supraespinale, and medial calf;
P 5 S ¼ biceps, triceps, subscapular, iliac crest and calf; c 5 S ¼ triceps, subscapular,
P abdominal, mid-thigh and calf; y 6 S ¼ triceps, subscapular, supraespinale,
abdominal, front thigh and medial calf; z 7 S ¼ triceps, biceps, subscapular, supraespinale, abdominal, front thigh and medial calf; D 8 S ¼ skinfolds of the Lohman’s protocol (triceps, subscapular, thorax, axillary,
P
abdominal, suprailiac, thigh and calf); ~ 8 S ¼ all skinfolds of the ISAK protocol.

7
8 Nutrition and Health XX(X)

Table 2. Anthropometry-based calculations to monitor fat mass and/or fat-free mass.

Name Description Calculation

Relative fat mass (RFM) Regression equation based on waist girth RFM (%BF) ¼ 64  (20  (height/waist)) þ (12  sex)
Takai’s equation (male athletes) Regression equation based on waist girth FFM (kg) ¼ 0.883  BM/waist (kg/m) þ 43.674
 waist/H (cm/cm)  41.480
Aktiven Körpersubstanz (AKS) Index to monitor lean and bone mass AKS Index ¼ FFM (kg) x 103 x 100 / H3 (cm)
index Male athletes (Parizkova and Buzkova, % FM ¼ 2.745 þ 0.008  T þ 0.002  Sb þ 0.637
1971)  Sp þ 0.809  B
Female athletes (Durnin and Rahaman, D ¼ 1.1581  0.0720  log  (T þ Sp þ B þ IC)
P 1967) P FM ¼ [(4.95/D)  4.50]  100
%
Sum of skinfolds ( S) Index to determine adiposity and local fat S (mm) ¼ sum of absolute values of skinfolds (mm)
Corrected girth (CG) Index to determine musculoskeletal size CG ¼ girth – (p x skinfold
P thickness at the site)
Lean mass index (LMI) Index to monitor FFM LMI ¼ log10 BM / (log10 7 S) x
P
In RFM, sex is zero for male and one for female. % FM ¼ fat mass percentage; 7 S ¼ sum of triceps, subscapular, biceps, supraespinale, abdominal, front
thigh, and medial calf skinfolds (mm); D ¼ body density; FFM ¼ fat-free mass; FM ¼ fat mass; BM ¼ body mass; H ¼ height; T ¼ triceps skinfold; Sb ¼
subscapular skinfoldl Sp ¼ supraespinale skinfold; B ¼ biceps skinfold; IC ¼ iliac crest skinfold; x ¼ this is a sport- and sex-specific estimated constant.

estimation of body density in extremely muscular and lean
bodybuilders, which may also be appropriate in male ath-
letes with similar physical characteristics (Fry et al., 1987).
It should be noted that the Yuhasz equation has been also
used to track changes in bodybuilding competitors (Manore
et al., 1993). Furthermore, Sesbreno et al. (2020) not only
reported a new equation that could be useful for tracking
BC changes across a range of physiques if an accepted
methodology like DXA is inaccessible, but also showed
that equations incorporating skinfolds and limb girths were
more effective at explaining the variance in DXA estimates
of lean tissue.
A simple recent anthropometric linear equation, designed
as relative fat mass (RFM), was proposed as an alternative
for body mass index to correlate with whole-body fat in
healthy adult Mexican-Americans, European-Americans,
and African-Americans (Woolcott and Bergman, 2018).
This equation was developed considering the height-to-waist
ratio, with height and waist girth expressed in meters (Table
2). Although we already discussed considerable limitations
when estimating %BF from conventional anthropometric
indices, the external validation of the RFM has shown a
strong correlation with DXA in north-west Mexican popu-
lation (Guzmán-León et al., 2019), and in adolescents from
15 to 19 years (Woolcott and Bergman, 2019); notwith-
standing, most of the current research in terms of validation
and usefulness of the RFM has been carried out in gen-
eralized non-athletic and/or obese populations (Ferrinho
et al., 2019; Kobo et al., 2019; Machado et al., 2020;
Woolcott and Bergman, 2020). Interestingly, in an athletic
population, Takai et al. (2018) demonstrated that an equation
with body mass-to-waist circumference and waist
circumference-to-body height as independent variables was
applicable for predicting whole-body fat-free mass in male
athletes, which might reinforce the potential of RFM in an
athletic population. Future research might focus on the
external validation of this simple anthropometric formula in
amateur and elite athletes, since it represents an even faster
in-field procedure.
In general, equations for estimating body density or %BF
vary considerably depending on the unique characteristics of
each study population, the equipment used, the measurement
technique or protocol, and the degree of experience and
preparation of the researchers. Interestingly, sex has an
important effect on influencing the correlations between
DXA and anthropometric indices (Salamat et al., 2015).
Based on the aforementioned discussion some authors infer
that analyzing the BC of an individual through the values
obtained by a kinanthropometric assessment lacks reliability
and presents considerable variation (Moreira et al., 2015).
Hence, the use of popular and “recommended” equations for
certain populations do not seem to have sufficient accuracy
when compared to other methods. In the sports field, several
studies have also shown that prediction equations developed
for non-athletes do not offer good validity for athletes, and
should be avoided (Fonseca et al., 2007; Fonseca-Junior
et al., 2017; López-Taylor et al., 2018; McLester et al.,
2019). Therefore, further studies are needed in order to
investigate other valid, reliable, affordable, easily accessible,
and safe methods or equations that could replace DXA in the
evaluation of %BF in specific populations.
Considering the aforementioned, before using any given
equation, it is mandatory for the registered dietitian, sports
nutritionist or sports science specialist to perform a pre-
liminary search in different databases to determine the
suitability of the equation for predicting body density or
%BF, considering it is necessary to map the population in
which these prediction equations were developed with the
working participants to determine the suitability and avoid
misinterpretation. A systematic search strategy proposed
by Umapathysivam et al. (2017) is available for guidance in
using Boolean terms and the algorithm construction in this
regard. Parameters to be considered in the selection of the
equation should include the following: (a) the assessed
Bonilla et al.
exercisers/athletes should be similar to the ones used to
develop the original equation; (b) similarities in age and
sex; (c) average adiposity and physical activity levels of
both populations; (d) the technique or protocol used in the
study; and (e) the equipment used.
Anthropometrists are expected to be aware of the errors
involved in the use of regression equations and we, there-
fore, emphasize the paradigm shift, considering that there
are better indices to track the changes in BC during/after
nutrition and/or exercise interventions.
Aktiven Körpersubstanz index
The Aktiven Körpersubstanz (AKS) index was first defined
by Tittel and Wutscherk (1972), and originally applied to
the evaluation of muscle development in athletes and used
for anthropometric nutritional assessment. It represents the
amount of fat-free mass (FFM) existing in a volume of BM
represented by a cube, whose edges have the length of the
stature (Henriquez-Pérez et al., 2009). The AKS index is
calculated by applying the formula shown in Table 2. This
table also shows the regression equations that must be used,
according to the sex population, to derive the FFM value
from fat mass (FM) calculation.
Arencibia-Moreno et al. (2017) reported that the AKS
index is a sensitive parameter for assessing increases in lean
body mass and bone mass, since positive variations were
found from the physical conditioning phase to competition
phase in highly competitive Ecuadorian rugby players, while
no significant changes were seen on muscle mass or %BF,
both calculated by the Mosteller’s formula (Mosteller,
1987). It has been shown that the greater the muscle and
bone mass, the higher the AKS index and the greater the
mesomorphism in Colombian karate fighters (Chow-Siado,
2017). Furthermore, this index has been shown to serve as an
indicator of the proportion of muscle mass in professional
Colombian soccer players (Castillo-Vanegas, 2012) and has
been used to track changes in Venezuelan amateur mar-
athoners (Fuenmayor et al., 2018), German shot-putters and
javelin throwers (Raschka et al., 2015), and Cuban elite
kayakers (Orta Miranda and Torres López, 2020). Thus, the
AKS index allows the analysis of musculoskeletal devel-
opment according to the modality and the training period of
an athlete, although care should be taken when using it to
compare populations considering that its value depends on
the mean stature of the participants.
Sum of skinfolds and related indices
Although the use of regression equations might be rec-
ommended for the estimation of %BF in large population
studies (where the errors may be due to the sample size)
(Fosbol and Zerahn, 2015), if a smaller sample size is
available or the aim is to evaluate the P
exerciser/athlete’s
progression, it is advisable to use the S (Reilly et al.,
1996). This absolute measurement (expressed in milli-
meters) not only gives information concerning local fat
9
distribution in the body but also provides an index to
determine adiposity, since subcutaneous fat reflects the
amount of fat present in the adipose tissue (Ballard P et al.,
2014; Garrido-Chamorro et al., 2012). In fact, the S may
avoid errors and help to increase the accuracy and con-
sistency of the measurements obtained by the anthropo-
metric method (Moreira et al., 2015). A P very recent study
by Gomes
P et al. (2020) reported that the 8 S (r ¼ 0.959)
and 7 S (r ¼ 0.911) are very accurate anthropometric
tools for tracking changes in BC as compared to the DXA
measure of FM, in well-trained Australian female (n ¼ 29)
and male (n ¼ 27) athletes from various sports. Therefore,
we recommend evaluating changes in FM during a nutri- P
tion and/or exercise intervention via variations in S.
Importantly,Pincluding
P sites from both the upper and lower-
limbs (e.g. 8 S, 7 S) is worthwhile; however, it should
be noted that this kind of anthropometric data is always
complemented by other measures (Zemski et al., 2018a).
On the other hand, anthropometric girths might be cor-
rected for the skinfold at the measurement sites using the
expression shown in Table 2 (Martin et al., 1990). These
skinfold-corrected limb circumferences have been shown to
be reliable indicators of musculoskeletal size at each
anthropometric location. Several studies have included them
as estimators of skeletal muscle mass throughout a time
course (Garcı́a et al., 2018; Idrizovic et al., 2018; Kerr et al.,
2007; Mielgo-Ayuso et al., 2015; Ramos-Campo et al.,
2016; Vaquero-Cristóbal et al., 2019). Interestingly,
Bahamondes-Avila et al. (2018) established a predictive
model of jumping performance with simple anthropometric
measures (including the corrected middle thigh girth),
achieving between 74 and 90% of security for squat and
countermovement jump in Chilean adolescent athletes.
Additionally, in 2020, a cross-sectional study which aimed
to develop a novel equation to estimate appendicular muscle
mass in young soccer players showed that the best predictor
model (r2 ¼ 0.83, compared with measurements by DXA)
was the corrected middle thigh girth. The authors concluded
that this predictive equation was valid (Bland-Altman
analysis showed a mean difference of 0.049 kg and 95%
CI from 1.481 to 1.578 kg), easy to calculate, and a low-
cost tool to estimate lower-limbs muscle mass in Chilean
athletes (Zapata-Gómez et al., 2020).
Similarly, changes in FFM can be monitored via fluc-
tuations in the LMI, which assesses within-athlete P propor-
tional changes in BM controlled for changes in S (Slater
et al., 2006). P
LMI is a function of log-transformed values of
BM and the 7 S as shown in Table 2, and an estimated
constant called x (which depends on the athletic population
and sex) (Duthie et al., 2006; Pyne et al., 2006). The log
transformation is a widely used method to address skewed
data to approximately conform to normality (Feng et al.,
2014). This empirical measure of LMI has been validated
(r ¼ 0.97 related to DXA) and represents an inexpensive,
non-invasive, safe, and in-field methodology (Delaney et al.,
2016) that can be used to obtain measures during training or
competition; however, more research is needed to assess
10
accuracy (Mitchell et al., 2020) and to derive the specific
coefficients for each sports population.PBased on reviewed
articles, the use of these indicators ( S, corrected girths,
and LMI) might be part of the set of variables to be mon-
itored by a professional during an exercise or nutrition
program in different athletic populations (Ackland et al.,
2012; Aslan et al., 2019), as an alternative to avoid the use of
equations to estimate the %BF.
Technical error of measurement (coefficient of
variation)
TEM refers to individual precision measurement and tech-
nical variation. As described by Perini et al. (2005), the TEM
index allows anthropometrists to verify the precision degree
when performing and repeating anthropometrical measure-
ments (intra-tester) and accuracy when comparing their
measurements with data from other expert anthropometrists
(inter-tester).
pP The absolute TEM is calculated with the
equation d2/2n, where d is the difference between two
measurements and n is the number of pairs of measurements.
This absolute value can be transformed in the relative TEM
in order to obtain the error, expressed as a percentage, cor-
responding to the total average of the variables analyzed.
ISAK has established reference values of intra-TEM for
beginner (skinfolds ¼ 7.5%, other measures ¼ 1.5%)
and skillful anthropometrists (skinfolds ¼ 5.0%, other
measures ¼ 1.0%). Refer to Perini et al. (2005) and Norton
and Olds (2007) for a comprehensive systematic explanation
for the TEM calculation.
Exploring changes over time
Anthropometrists should perform the kinanthropometry
assessment twice, considering as valid repeat measures
when the calculated intra-tester is lower than the TEM
(Esparza-Ros et al., 2019). Awareness of the percentage of
error and the confidence intervals of analyzed data is
important to establish real changes over time (i.e. a sig-
nificant change in BC after several weeks of nutrition and/
or exercise intervention) and should help ensure quality in
improving the validity of anthropometric measurements
(Mony et al., 2016).
Notwithstanding, there are several technical factors that
can affect the analysis of anthropometric data and subse-
quent interpretation. The most frequent and important
errors are briefly described below:
 The biological variation of the individual: time of day,
day of the week, menstrual period, hydration (post-
exercise, after a shower, etc.), and compressibility of
skinfolds (Lohman, 1971).
 Technique: there are different protocols for carrying out
anthropometric measurements; however, the most fre-
quently used and accepted in scientific research is the
ISAK protocol (Norton and Eston, 2018).
Nutrition and Health XX(X)
 Metrological conditions and equipment: it is recom-
mended to perform measurements with instruments
calibrated and certified by metrology laboratories that
are validated for use in kinanthropometry (Mony et al.,
2016; Norton and Olds, 2007).
 Error by number handling (human error) when record-
ing the data in the proforma.
Statistically speaking, the calculation of the confidence
intervals for the true score is a much more useful procedure
for interpreting a dataset, rather than overemphasizing
hypothesis-assessment tests and the use of P-values to
differentiate significant from non-significant results
(Nakagawa and Cuthill, 2007). In fact, according to
Gardner and Altman (1986), in medical research, authors
are often interested in the magnitude of the difference of an
outcome measured in two different groups or in data taken
before and after an intervention, not in a simple indication
of whether or not that difference is statistically significant.
Thus, the true score confidence intervals present a range of
values, based on the sample result and typical error, in
which the population difference can be found, and the
effect size represents the magnitude of a significant differ-
ence. The calculation of the TEM and the true score con-
fidence intervals allow us to verify if the changes detected
in repeated measurements are a result of a given exercise/
nutrition intervention or a result of the method’s relative
variation/anthropometrist’s error (Mony et al., 2016; Perini
et al., 2005). We recommend that anthropometrists express
in their routine reports if the intervention has been success-
ful or not based on whether confidence intervals for change
lie to the desired side of the zero line (smallest worthwhile
change) (Swinton et al., 2018). As a more objective deter-
mination of the smallest worthwhile change to evaluate
clinical significance, we also recommend the calculation
of the effect size (e.g. unbiased
P Cohen’s d). This must be
applied specifically to the S, as a valid proxy measure-
ment of adiposity (Marfell-Jones, 2001). On the other hand,
for reporting results of an investigation, it is advisable to
give complete statistical information including statistics
power, sample estimates, confidence intervals, test statis-
tics P-values, and effect size (assuming that basic details
such as sample size and standard errors have already been
given in the text) (Gardner and Altman, 1986), whilst the
public awareness of artificial intelligence’s practical bene-
fits in kinanthropometry is raised (Bonilla et al., 2020). See
a comprehensive step-by-step explanation of these statisti-
cal calculations, with anthropometric data examples, for a
personalized approach to evaluating progress and effective-
ness of exercise and sports nutrition interventions in Swin-
ton et al. (2018).
Conclusions
Recent, partially valid and simple anthropometry-based
calculations to monitor changes in BC in amateur and
elite athletes have been examined in this scoping review.
Bonilla et al.
We emphasize the importance of following international
anthropometric standards (i.e. ISAK protocol) to reduce
TEM, and improve reproducibility between the studies.
Special attention should be paid when the aim is to evaluate
the %BF since there are several sources of error in kinan-
thropometry and the use of a regression equation might not
be accurate. To avoid this, anthropometrists
P should base
their analysis on the absolute values of S, which gives
information concerning local fat distribution in the body
and also provides an index to determine adiposity. Com-
plementary, corrected girths are limb circumferences that
are adjusted for skinfold thickness, with good reliability as
indicators of musculoskeletal size. Furthermore, the LMI
appears to be valid for monitoring moderate to large
changes in the lean mass of athletes, but more research is
needed to derive the specific coefficients
P for each sports
population. In conclusion, the S, skinfold-corrected
girths, and LMI can be easily obtained/derived using cali-
pers and the information provided might be quickly inter-
preted, represent normative data, and allow comparing
between different groups. We invite anthropometrists to be
familiar with basic statistical procedures (e.g. TEM, true
score confidence intervals, smallest worthwhile change,
and effect size) and to be very cautious of using the ref-
erence values reported in this review, in order to analyze
and interpret correctly the exerciser/athlete’s changes in
BC. Proper identification of changes before both delivering
the anthropometric report and modifying the dietary/exer-
cise intervention is part of the comprehensive work of a
qualified professional.
Acknowledgements
The authors would like to thank all DBSS International
fellows (with special mention to Professor Alexandra
Pérez-Idárraga for her comments on this manuscript),
invited speakers, and attendees at the Ibero-American Sym-
posium in Sports and Physical Activity: Nutrition and
Training SIDANE where this topic was fully covered.
Moreover, we would like to thank the practicum student
of Universidad Santo Tomás (Brayan Pulido) who collabo-
rated as research assistant at DBSS International with the
first version of the drafted manuscript.
Author contributions
Conceptualization, DAB; Methodology, DAB; Search and
data extraction: DAB; Writing—original draft preparation,
DAB; writing—review and editing, JLP, SV, CAH-A, PA-
C, AO, GD-L; project administration, DAB.
Consent for publication
All authors have read and consent for publication of this
manuscript.
Ethical approval
Ethical approval was not required for this research because
it did not involve human participants.
11
Declaration of conflicting interests
The authors declared no potential conflicts of interest with
respect to the research, authorship, and/or publication of
this article.
Funding
The authors received no financial support for the research,
authorship, and/or publication of this article.
ORCID iD
Diego A Bonilla https://orcid.org/0000-0002-2634-1220
Jorge L Petro https://orcid.org/0000-0001-5678-1000
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