Determining body composition in adults
- George A Bray, MD
George A Bray, MD
- Boyd Professor Emeritus, Pennington Biomedical Research Center/Louisiana State University
- Professor of Medicine Emeritus, Louisiana State University Health Science Center
Methods for determining body composition continue to improve, greatly increasing the accuracy and ease of making these measurements [1-4]. Body composition measurements may be useful in undernourished patients, or for identifying patients who do not have an increase in overall body fat, but who have an increase in visceral fat. This latter circumstance is associated with a substantially increased risk of heart disease and diabetes. Measurement of body composition is also instructive for assessing body changes associated with growth and development, aging (sarcopenia), and in certain disease states (eg, human immunodeficiency virus [HIV], diabetes) [5-11].
Certain measurements, such as height, weight (to calculate body mass index [BMI]), and waist circumference are the minimal clinical criteria for evaluating the overweight patient. This topic will review body composition and critique most methods available for its measurement. Other considerations when evaluating the overweight patient are discussed elsewhere. (See "Obesity in adults: Prevalence, screening, and evaluation".)
MODELS OF BODY COMPOSITION
- Heymsfield SB, Shen W, Wang Z, et al. Evaluation of Total and Regional Adiposity. In: Handbook of Obesity, Bray GA, Bouchard C (Eds), Marcel Dekker, New York 2004. p.33.
- Jebb SA, Johnstone AM, Warren J, et al. Key Methodologies in Obesity Research and Practice. In: Obesity: Science to Practice, Williams G, Fruhbeck G (Eds), Wiley-Blackwell, Chichester, UK 2009. p.45.
- Levitt DG, Heymsfield SB, Pierson RN Jr, et al. Physiological models of body composition and human obesity. Nutr Metab (Lond) 2007; 4:19.
- Lee SY, Gallagher D. Assessment methods in human body composition. Curr Opin Clin Nutr Metab Care 2008; 11:566.
- Chomtho S, Wells JC, Williams JE, et al. Associations between birth weight and later body composition: evidence from the 4-component model. Am J Clin Nutr 2008; 88:1040.
- Loomba-Albrecht LA, Styne DM. Effect of puberty on body composition. Curr Opin Endocrinol Diabetes Obes 2009; 16:10.
- Dey DK, Bosaeus I, Lissner L, Steen B. Changes in body composition and its relation to muscle strength in 75-year-old men and women: a 5-year prospective follow-up study of the NORA cohort in Göteborg, Sweden. Nutrition 2009; 25:613.
- Gallagher D, Kelley DE, Yim JE, et al. Adipose tissue distribution is different in type 2 diabetes. Am J Clin Nutr 2009; 89:807.
- Heshka S, Ruggiero A, Bray GA, et al. Altered body composition in type 2 diabetes mellitus. Int J Obes (Lond) 2008; 32:780.
- Scherzer R, Shen W, Bacchetti P, et al. Comparison of dual-energy X-ray absorptiometry and magnetic resonance imaging-measured adipose tissue depots in HIV-infected and control subjects. Am J Clin Nutr 2008; 88:1088.
- Newman AB, Lee JS, Visser M, et al. Weight change and the conservation of lean mass in old age: the Health, Aging and Body Composition Study. Am J Clin Nutr 2005; 82:872.
- Wang ZM, Pierson RN Jr, Heymsfield SB. The five-level model: a new approach to organizing body-composition research. Am J Clin Nutr 1992; 56:19.
- Gallagher D, Kuznia P, Heshka S, et al. Adipose tissue in muscle: a novel depot similar in size to visceral adipose tissue. Am J Clin Nutr 2005; 81:903.
- Bray GA, DeLany JP, Volaufova J, et al. Prediction of body fat in 12-y-old African American and white children: evaluation of methods. Am J Clin Nutr 2002; 76:980.
- LaForgia J, Dollman J, Dale MJ, et al. Validation of DXA body composition estimates in obese men and women. Obesity (Silver Spring) 2009; 17:821.
- National Institutes of Health. National Heart, Lung, and Blood Institute. North American Association for the Study of Obesity. The Practical Guide: Identification, Evaluation and Treatment of Overweight and Obesity in Adults. NIH Publication Number 00-4084, October 2000. http://www.nhlbi.nih.gov/guidelines/obesity/prctgd_c.pdf (Accessed on November 16, 2011).
- Gallagher D, Heymsfield SB, Heo M, et al. Healthy percentage body fat ranges: an approach for developing guidelines based on body mass index. Am J Clin Nutr 2000; 72:694.
- Ginde SR, Geliebter A, Rubiano F, et al. Air displacement plethysmography: validation in overweight and obese subjects. Obes Res 2005; 13:1232.
- Völgyi, E, Tylavsky, FA, Lyytikäinen, A, et al. Assessing body composition with DXA and bioimpedance: effects of obesity, physical activity, and age. Obesity 2008; 16:700.
- Fakhrawi DH, Beeson L, Libanati C, et al. Comparison of body composition by bioelectrical impedance and dual-energy x-ray absorptiometry in overweight/obese postmenopausal women. J Clin Densitom 2009; 12:238.
- Shen W, Punyanitya M, Wang Z, et al. Visceral adipose tissue: relations between single-slice areas and total volume. Am J Clin Nutr 2004; 80:271.
- Machann J, Thamer C, Stefan N, et al. Follow-up whole-body assessment of adipose tissue compartments during a lifestyle intervention in a large cohort at increased risk for type 2 diabetes. Radiology 2010; 257:353.
- Bray GA, Jablonski KA, Fujimoto WY, et al. Relation of central adiposity and body mass index to the development of diabetes in the Diabetes Prevention Program. Am J Clin Nutr 2008; 87:1212.
- MODELS OF BODY COMPOSITION
- Atomic composition
- Molecular composition
- Cellular composition
- Tissue and organ components
- Whole body
- METHODS OF MEASURING BODY COMPOSITION
- Anthropometric measurements
- Dual-energy x-ray absorptiometry
- Isotopic measurement of body water
- Body density and whole-body plethysmography
- Impedance measurement
- Imaging techniques