Body composition measurement tools

Correspondence to: Dana L. Duren, Ph. This article has been cited by other articles in PMC. Abstract The incidence of obesity in the United States and other developed countries is epidemic.

Keywords: anthropometry, body composition, obesity, type 2 diabetes. Introduction The recent rise in prevalence of type 2 diabetes is concomitant with the sharp rise in obesity in the United States and other developed countries. Indirect Methods Anthropometry Anthropometric measurements are the most basic method of assessing body composition. Abdominal Circumference Obesity is commonly associated with increased amounts of intra-abdominal fat.

Skinfolds Skinfold measurements are used to characterize subcutaneous fat thickness at various regions of the body, but it should be noted that they have limited utility in the overweight or obese adult. Bioelectric Impedance Analysis The analysis of body composition by bioelectrical impedance produces estimates of total body water TBW , fat-free mass FFM , and fat mass by measuring the resistance of the body as a conductor to a very small alternating electrical current.

Direct Methods Total Body Water Total body water is easy to measure because it does not require undressing or any real physical participation. Dual-Energy X-ray Absorptiometry Dual energy X-ray absorptiometry is the most popular method for quantifying fat, lean, and bone tissues. Computed Tomography and Magnetic Resonance Imaging The other imaging modalities, such as CT and MRI, are gaining in popularity and represent important new techniques for body composition assessment.

Conclusion The ability to monitor, diagnose, and treat obesity and associated comorbidities such as type 2 diabetes is an important aspect of both research endeavors and clinical patient care. References 1. The emerging pandemic of obesity and diabetes: are we doing enough to prevent a disaster?

Int J Clin Pract. Seidell JC. Obesity, insulin resistance and diabetes—a worldwide epidemic. Br J Nutr. Adipocyte dysfunctions linking obesity to insulin resistance and type 2 diabetes. Nat Rev Mol Cell Biol. Roche A. Anthropometry and ultrasound. Human body composition. Assessment and prevalence of obesity: application of new methods to a major problem. Lohman TG. Advances in body composition assessment. Moore FD. The body cell mass and its supporting environment. London: W. Saunders Company; Comparison of methods to assess body composition changes during a period of weight loss.

Obes Res. Anthropometric standardization reference manual. Measurement and standardization protocols for anthropometry used in the construction of a new international growth reference. Food Nutr Bull. J Gerontol. The prediction of stature from knee height for black and white adults and children, with application to the mobility-impaired.

J Am Diet Assoc. Physical status: the use and interpretation of anthropometry. Geneva: WHO; Obesity: preventing and managing the global epidemic. Chumlea WM, Guo S. Predicting overweight and obesity in adulthood from body mass index values in childhood and adolescence. Am J Clin Nutr. Body mass index during childhood, adolescence, and young adulthood in relation to adult overweight and adiposity: the Fels Longitudinal Study.

Contributions of total body fat, abdominal subcutaneous adipose tissue compartments, and visceral adipose tissue to the metabolic complications of obesity. Waist circumference and abdominal sagittal diameter: best simple anthropometric indexes of abdominal visceral adipose tissue accumulation and related cardiovascular risk in men and women.

Am J Cardiol. Estimation of deep abdominal adipose-tissue accumulation from simple anthropometric measurements in men. Bray obesity. Present knowledge in nutrition.

Health, Aging and Body Composition Study. Association of visceral adipose tissue with incident myocardial infarction in older men and women: the Health, Aging and Body Composition Study. Am J Epidemiol. Abdominal adiposity in U. Prev Med. Body size, subcutaneous fatness and total body fat in older adults. Int J Obes. Relat Metab Disord. Fat distribution and blood lipids in a sample of healthy elderly people. Assessment of intra-abdominal and subcutaneous abdominal fat: relation between anthropometry and computed tomography.

Malina RM, Bouchard C. Fat distribution during growth and later health outcomes. New York: Wiley-Liss; Subcutaneous fat distribution during growth; p. Peripheral and abdominal adiposity in childhood obesity. Grading body fatness from limited anthropometric data. Chumlea WC, Guo S. Bioelectrical impedance and body composition: present status and future direction—reply. Nutr Rev. Assessment of fat-free mass using bioelectrical impedance measurements of the human body.

Bioelectric impedance for body composition. In: Pandolf KB, editor. Exercise and sports sciences reviews. New York: MacMillan; Bioelectrical impedance analysis. Statistical methods for the development and testing of body composition prediction equations. Effect of obesity on bioelectrical impedance. Validation of bioelectrical impedance analysis as a measurement of change in body composition in obesity.

In summary, although there is increased functionality of the most recently developed BIA technologies, BIA is not as yet a reference method due to reliance on specific assumptions, the most important being a constant hydration.

The introduction of segmental and MF-BIA has greatly improved limitations related to differences across individuals in the length of limbs and trunk and differences in body shape. The measurement is acquired with the participant in a supine position and the measurement acquisition time is 2—4 min. This technique does not require the participant to be absolutely still, a significant advantage when assessing infants and children. Reported precision is high, with test—retest coefficient of variation for fat mass 0.

In a study of adults, whereas QMR fat mass measurements were highly correlated with 4-compartment estimates, systematic differences were noted between the sexes [ 17 ]. The latter is a positive finding as it suggests that the QMR may be capable of accurately assessing changes in fat under conditions of both weight loss and weight gain. Collectively, these studies reinforce Napolitano et al. The gold standard method for TBW assessment is D 2 O, a stable isotope, which requires a fasting blood draw saliva sampling is frequently employed in children , ingestion of the isotope, followed by an equilibration period and a second blood draw at min.

Air displacement plethysmography ADP measures body volume through air displacement inside a sealed chamber. This is a noninvasive and fast technique that does not require extensive training of technicians. The adult ADP requires participant cooperation to follow instructions.

Currently, the PEA POD is the only commercially available technology that allows for accurate body composition assessment of newborns. However, there remains a gap for use in children from 6 months to about 5 years of age. Crook et al. If FFM is dehydrated, the opposite occurs. Indeed, underestimation of fat mass and overestimating FFM by ADP has been reported in male athletes [ 24 , 25 ] and overestimation of fat mass and underestimation of FFM has been reported in neonates [ 26 ].

DXA is one of the most widely used techniques for body composition research. The advantages of DXA are its use across the entire age range and at relatively low-cost. A whole-body scan output provides values for fat, bone, and bone-free lean for each limb and the trunk. This is currently the only available technique that measures bone mineral density and content. The limitations of DXA are the requirement of a certified radiology technician or physician to administer a test that involves a low dose of radiation.

Accordingly, this technique is not suitable for pregnant women and, although safe, is not always accepted by parents for use in young children. MRI is the only available nonradiation technique that allows for the in-vivo quantification of total adipose tissue and its subdepots, subcutaneous, intramuscular, and VAT.

MRI also allows for the quantification of important FFM components, skeletal muscle mass arms, legs, and trunk , and specific organ mass. Organs such as heart, liver, and brain have high resting metabolic rates relative to their masses which is highly relevant to investigations of the effects of weight perturbations gain and loss on resting energy expenditure. MRI can also provide estimates of bone marrow adipose tissue [ 30 ].

Andersen et al. A single slice cross-sectional area at mid-femur has also been proposed to be used in clinical practice for a fast and noninvasive diagnosis of sarcopenia in older adults [ 33 ]. Collectively, these studies highlight the increased sensitivity of MRI to assess regional or depot-specific tissues with relevance for prognosis of health outcomes. MRI is most valuable for clinical research studies due to its ability to quantify body compartments not measurable by any other technique, and allows for the assessment of change over time either through designed interventions e.

Limitations of MRI include high cost to acquire the scan, specialized postprocessing software required for tissue volume analysis by a highly trained analyst, participant required to remain completely motionless during scan making it difficult for young children and not feasible for persons with claustrophobia.

NMR is a noninvasive technique and the standard noninvasive technique for measurement of intrahepatic lipid [ 34 ] and intramyocellular lipid IMCL and extramyocellular lipid EMCL in muscle fibers. NMR is a surrogate for liver biopsies to detect fat content in liver [ 35 ].

Hasegawa et al. In the PET, a tracer usually 18F-fluorodeoxyglocose is introduced in the body and accumulate in clusters of high glucose metabolism, that can be visualized in the PET scan [alone or, more commonly combined with computed tomography CT ]. PET scans are used to identify highly metabolically active areas in the body. Thus, BAT has been proposed to be protective against obesity or obesity-related complications [ 39 — 42 ].

There is large interest in better understanding how to activate BAT, as well as how to induce transformation or browning of white adipose tissue WAT into BAT naturally or through the use of pharmacological therapies. Therefore, accurate and safe tools for assessing BAT are needed. A range of techniques are available to safely and accurately assess body composition in living humans from birth through senescence.

Research efforts should concentrate on developing new or tailoring available techniques for simple, inexpensive, safe, and accurate assessments across the lifespan.

Moreover, techniques should be accurate and adequate for use both at the cross-sectional level that is, single measure as well as for monitoring the effects of interventions behavioral, pharmacological, and surgical aimed at promoting a healthy weight and a healthy body composition include longitudinal measurement of changes in body weight. There are several available accurate techniques for the assessment of body composition both at the clinical and research level.

A new technique that can be safely assess body composition across the lifespan and that can be easily reproduced at the clinical and research level needs to be developed. Papers of particular interest, published within the annual period of review, have been highlighted as:.

National Center for Biotechnology Information , U. Curr Opin Endocrinol Diabetes Obes. Author manuscript; available in PMC Oct 1. Thaisa Lemos a and Dympna Gallagher b. Author information Copyright and License information Disclaimer. Copyright notice. The publisher's final edited version of this article is available at Curr Opin Endocrinol Diabetes Obes. See other articles in PMC that cite the published article. Abstract Purpose of review The current article reviews the most innovative and precise, available methods for quantification of in-vivo human body composition.

Recent findings Body composition measurement methods are continuously being perfected. Summary There is an ongoing need for methods that yield information on metabolic and biological functions.

Keywords: assessment method, human, human phenotyping, in vivo. Summary: This review highlights some of the basic challenges faced by researchers and clinicians when conducting body composition assessments in severely obese patients.

A simple three-compartment model that is accurate and easy to perform appears to be promising for use in this population. Further research is needed, however, on this and other feasible methods of body composition assessment in a diverse group of severely obese people.