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
- Leigh Perreault, MD
Leigh Perreault, MD
- Associate Professor of Medicine
- University of Colorado Anschutz Medical Campus
- Associate Professor of Epidemiology
- Colorado School of Public Health
Methods for determining body composition continue to improve, greatly increasing the accuracy and ease of making these measurements [1-4]. 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".)
WHY MEASURE BODY COMPOSITION?
When considering health and disease, body weight is not nearly as important as the composition of that weight. Body weight reflects the combined weight of all the body's tissues, while body composition measures the relative proportions of fat and lean mass in the body. Lean mass refers to bones, tissues, organs, and muscle.
Measurements of body composition are most commonly done for research purposes. However, body composition measurements may also be useful in a number of clinical settings to:
●Evaluate undernourished patients.To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information on subscription options, click below on the option that best describes you:
- 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.
- 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.
- Völgyi E, Tylavsky FA, Lyytikäinen A, et al. Assessing body composition with DXA and bioimpedance: effects of obesity, physical activity, and age. Obesity (Silver Spring) 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.
- Ginde SR, Geliebter A, Rubiano F, et al. Air displacement plethysmography: validation in overweight and obese subjects. Obes Res 2005; 13:1232.