Assessment of Body

Composition
David L. Gee, PhD
FCSN 442 - Nutrition Assessment Laboratory

Body Composition Analysis vs.

Body Weight Assessment
Advantages

Direct assessment of body fatness

Overweight

Overmuscled or overfat
Athletes
Assessing need for weight loss

inadequate stores in patients

Monitor changes
weight loss quality
effect of medical therapy

Body Composition Analysis vs.

Body Weight Assessment
Disadvantages
relatively

limited database
all field methods are estimations
false assumptions in all field methods
errors by technicians
limited

understanding by clients

Nutrition and Athletic Performance

ACSM/ADA 2000 Position Paper

Body fat assessment techniques have inherent

variability, thus limiting the precision with which they
can be interpreted.
With carefully applied skin-fold or BIA,
relative body fat % error of 3% - 4%

15% (12-18%)

estimate fat-free mass within 2.5-3.5 kg

50kg (47.5-52.5kg)

Would you buy a bathroom scale with this type

of accuracy?
110 pounds + 7 pounds

Models of body composition

2

compartment models

Fat mass and Fat-free mass

Fat mass and Lean body mass

LBM includes cell membranes, TG in cells

assessment methods using this model

skinfold thickness
hydrodensitometry
bioelectric impedance

Models of body composition

4

compartment models

water, protein, fat , minerals

Assessment methods using this model
isotope dilution
dual emmision x-ray absorptiometry
(DEXA)
computed tomography (CT, CAT)

Research techniques
Not covered in this course

Skinfold Thickness
measures

double thickness of skin

and subcutaneous fat

Advantages:

inexpensive
fast
portable
large database

Skinfold Thickness
Assumptions:

predicts non-subcutaneous fat

>50% of fat is subcutaneous

sites selected represent average thickness

of all subcutaneous fat
compressibility of fat similar between
subjects
thickness of skin negligible

Skinfold Thickness
Limitations

Technician error
Skinfold thickness affected by factors
other than amount of fat

exercise increases skin thickness

dehydration reduces skin thickness
edema increases skin thickness
dermatitis increases skin thickness

Poorly predicts visceral fat

Single Site Measurements

Tricep skinfold thickness
Subscapular skinfold thickness
not for estimating body fat determination

for comparing against other reference data

NHANES II (1097-1980)

appendix O (p530-532) (TSF)

appendix P (p533-535) (SSF)

Two site measurements

Tricep

SF and Subscapular SF
correlated with body fatness in
children
fig. 6-32 (p192)
Tricep

SF and calf SF

fig. 6-33 (p 192)

Multiple Site Measurements

many sites
many equations
table 6-9 (p193) Jackson & Pollock
table 6-10 (p193) Durnin & Womersley
density and %body fat

Siri

% BF = (495/BD) 450

Brozek

% BF = (457/BD) - 414

Circumference Measurements
Katch and McArdle
Principle:

measure two fat sites

measure one muscle site
estimate fat and lean body mass.
Very

limited database
Easy to do

Hydrodensitometry

Hydrodensitometry
Principle:
two

compartment model
density related to relative amounts of
two compartments
D(fat) = 0.90 g/ml
D(lbm) = 1.10 g/ml
D(water) = 1.00 g/ml

Hydrodensitometry
Density = Body weight/Body volume
How does one estimate body volume?
Archimedes principles:

volume of submerged object = volume of

water displaced
weight in air - weight underwater = weight
of water displaced

Hydrodensitometry

wt of water displaced = vol of water displaced

Wt of water displaced = vol of body (BV)
Since weight of water displaced = weight in air - weight underwater

BV = BW-UBW
To calculate

body density

BD = BW / BV
calculate

%BF from BD

Hydrodensitometry Calculations

DATA

BW(air) = 180 lbs = 81.6 kg

BW(water) = UWW = 3.6 kg
RV = 1.30 L, est GI gas vol = 0.1 L
Density of water @ 77 deg = 0.997 kg/L

CALCULATIONS
BV = (BW-UWW)/.997 (RV +0.1)
BV = (81.6-3.6)/.997 (1.3+0.1)
BV = 78.23 1.4 = 76.83 L

Hydrodensitometry Calculations
BV = 76.83 L
BD = BW / BV = 81.6/76.83 = 1.062 kg/L
% BF = (495/BD)- 450 = (495/1.062)-450

%BF = 466.09-450 = 16.09% = 16%

Fat mass = 16% x 81.6kg = 13.1 kg

Lean mass = 81.6-13.1 = 68.5 kg

Hydrodensitometry:
Assumption
Density

of fat and lean are constant

bone density
muscle density
hydration status
GI

gas volume is constant

Hydrodensitometry:
Limitations
Measurement

of residual lung

volume
Precision of underwater weight
Cost
Non-portable
Limited types of subjects

Whole Body Pethysmography

Measures body volume by air displacement

actually measures pressure changes with
injection of known volume of air into closed
chamber

Large body volume displaces air volume in

chamber
results in bigger increase in pressure with
injection of known volume of air

Whole Body Pethysmography

Advantages

over hydrodensitometry

subject acceptability
precision
residual lung volume not factor
Limitations

costs: $25-30K
still assumes constant density of lean and fat

Bioelectrical Impedance
Analysis
1994

NIH Technology Assessment

Conference

BIA provides a reliable estimate of total

body water under most conditions.
It can be a useful technique for body
composition assessment in healthy
individuals

Bioelectrical Impedance
Analysis
BIA measures

impedance by body
tissues to the flow of a small (<1mA)
alternating electrical current (50kHz)
Impedance is a function of:
electrical resistance of tissue
electrical capacitance (storage) of
tissue (reactance)

BIA: basic theory

The body can be considered to be a

series of cylinders.

Resistance is proportional to the

length of the cylinder

Resistance is inversely proportional

to the cross-sectional area

BIA: basic theory

Volume is equal to length of the

cylinder times its area

Therefore, knowing the resistance and

the length, one can calculate volume.

Assuming that the current flows thru

the path of least resistance (water) ,
then the volume determined is that of
body water.

BIA: basic theory

Assume fat free mass has a constant

proportion of water (about 73%)
Then calculate fat free mass from body water

Assume BW = FFM + FM
Then calculate fat mass and %body fat

NHANES III
BIA Equations

Males
FFM = -10.68 + 0.65H2/R + 0.26W + 0.02R

Females
FFM = -9.53 + 0.69H2/R + 0.17W + 0.02R

Where

FFM = fat free mass (kg)

H = height (cm)
W = body weight (kg)
R resistance (ohms)

% BF = 100 x (BW-FFM)/BW

BIA Calculations

DATA
R = 520 ohms
BW = 170 lbs = 77.3 kg
H = 70 = 178 cm

CALCULATIONS
FFM = -10.68+(0.65H2/R)+0.26W+0.02R
FFM = -10.68+(0.65x1782/520)+0.26(77.3)+0.02(520)

FFM = -10.6 + 39.6 + 20.1 + 10.4 = 59.5 kg

FM = W FFM = 77.3 59.5 = 17.8 kg
%BF = (17.8/77.3)x100 = 23%

BIA: Advantages and

Limitations

Advantages

costs ($500-$2000)
portable
non-invasive
fast

Limitations
accuracy and precision
no better/worse than hydrodensitometry

Major types of BIA analyzers

BIA Protocol

Very sensitive to changes in body water

normal hydration

caffeine, dehydration, exercise, edema,

fed/fasted

Sensitive to body temperature

Avoid exercise

Sensitive to placement of electrodes

conductor length vs. height

What is a normal % body fat?

Classification

Males

Females

Unhealthy range
(too low)

< 5%

< 8%

Acceptable range
(lower end)

6-15%

9-23%

Acceptable range
(higher end)

16-24%

24-31%

Unhealthy (too
high)

> 25%

> 32%

Nieman, 1999 (p195)

Body Composition Data

NHANES III 1988-1994

All adults > 19 yrs

Mean % Body Fat
Men: 21.9% + 11.6% (SD)
Women: 32.4% + 17.8%

Mean BMI
Men: 26.5 + 7.8
Women: 26.4 + 11.7

Mean waist circumference

Men: 95.1 + 18.6 cm (cutpoint > 101.6 cm)
Women: 88.6 + 30.2 cm (> 89 cm)

Body Composition Data

NHANES III 1988-1994

Adults with BMI = 18.5-25

Mean % Body Fat
Men: 17.6% + 7.8% (SD)
Women: 26.7% + 8.9%

Mean BMI
Men: 22.7 + 3.2
Women: 22.0 + 2.2

Mean waist circumference

Men: 84.7 + 8.9 cm (cutpoint > 101.6 cm)
Women: 78.0 + 13.4 cm (> 89 cm)

Dual-Energy X-ray
Absorptiometry

DEXA, DXA

Two different energy level X-rays

Lean, fat, and bone mass each reduce (attenuate)
the X-ray signal in unique ways
Computer analyzes scan point by point to
determine body composition
Method
Low dose radiation
20-30 minutes
Applicable to young and old