Body Composition Techniques. DIRECT ASSESSMENT The only direct methods for body composition...
Transcript of Body Composition Techniques. DIRECT ASSESSMENT The only direct methods for body composition...
Body Composition Techniques
DIRECT ASSESSMENT
The only direct methods for body composition assessment are dissection or chemical analysis
Brussels Cadavre Study– 13 female and 12 male cadavers, age range 55–94 years, 12
embalmed and 13 unembalmed– After comprehensive anthropometry, each cadaver was
dissected into skin, adipose tissue, muscle, bones, organs and viscera.
– Volumes and densities of all tissues were determined by weighing the tissues underwater.
– A complete dissection lasted from 10 to 15 h and required a team of about 12 people.
Indirect or Doubly Indirect estimation of % Body Fat
All the techniques used routinely for % Body Fat estimation are either:– Indirect
% body fat is estimated using one or more assumptions e.g. Underwater Weighing
– Doubly Indirect% body fat is estimated by predicting the
results of an Indirect methodology from a related measure by regression analysis e.g. Skinfold prediction equations
Indirect Methods for the Estimation of % Body Fat
DENSITOMETRY
BODY DENSITY = MASS / VOLUME
Units: gm/ml
Any method that determines the volume of the body is a densitometric method
“GOLD STANDARD”
Densitometry via underwater weighing was the “gold standard” for determination of % body fat since the 1940’s. Since the late 1990’s a 4 compartment method is regarded as the best reference method.
Body Density can be determined accurately Unfortunately, % Body Fat can not because of
assumptions made in transforming density to % Fat
DENSITOMETRY
Volumetry by Water
Underwater (Hydrostatic) Weighing
Helium Dilution
BodPod – Whole Body Plethysmography
Predicting % Fat from Density
ASSUMPTIONS
Body can be divided into two components:
Fat & Non-Fat (Fat Free) Masses
Each has different, known and constant densities
Fat is not Adipose Tissue
FAT is ether extractable lipid molecules
ADIPOSE TISSUE is a tissue designed to store FAT (lipid) in adipocytes. Contains all the components of a tissue: cellular structures, extracellular matrix, water etc. as well as FAT (lipid) in the adipocytes. Adipose tissue is found subcutaneously and internally
SIRI EQUATION
Assumed Densities:
FAT MASS 0.9 gm/ml
NON-FAT (FAT FREE) MASS 1.1 gm/ml
Equation:
% Body Fat = (4.95/Density) - 4.5) x 100
Siri Equation: % Fat = (4.95/Density)-4.5) x 100
BROZEK EQUATION
Assumptions:
FAT MASS 0.9 gm/ml
LEAN BODY MASS 1.095 gm/ml
(some essential lipids in Lean Body Mass)
Equation:
% Fat = (4.57/Density)-4.142) x 100
DENSITOMETRYVolumetry by Water
Determine body volume by displacing water and directly measuring the change in water volume
DENSITOMETRYVolumetry by Water
Where:Wa = Body Weight in AirVwater displaced = Measured Volume of water displaced by the BodyRV = Residual VolumeC = Estimate of volume of entrapped intestinal gas
Archimedes (287-212 BC)
King Heiro of Syracuse summoned him to test the composition of a supposedly gold wreath
If assumed to be an alloy of only Gold and Silver he could use the laws of bouyancy to determine the fractional composition
Pure Gold and Silver have constant and different densities
use Archimedes’ principle to determine body volume by calculating weight of water displaced
DENSITOMETRYUnderwater Weighing
Small Tank or Open Swimming Pool
use Archimedes’ principle to determine body volume by calculating weight of water displaced
DENSITOMETRYUnderwater Weighing
Where:Wa = Body Weight in AirWw= Body Weight freely submerged in waterDw = Density of water RV = Residual VolumeC = Estimate of volume of entrapped intestinal gas
DENSITOMETRYHelium Dilution
Densitometry Volume determined using a sealed chamber into which
a known volume of Helium is introduced.– Volume of air in chamber determined from dilution of Helium.– Volume without subject determined (V1)– Volume with subject determined (V2)– Body Volume of Subject = V1 – V2
Density = Mass / Body Volume %Fat from Siri or Brozek equation Does not require Residual Volume calculation
DENSITOMETRYBODPOD - Whole Body Plethysmography
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 which results in bigger increase in pressure with injection of known volume of air
Advantages over hydrodensitometry– subject acceptability– precision (reliability not accuracy)
Limitations– costs: $25-30K– still assumes constant density of FFM and fat for prediction
of % Body Fat from whole body density
DENSITOMETRYBODPOD - Whole Body Plethysmography
DENSITOMETRYBODPOD - Whole Body Plethysmography
TOTAL BODY WATER (isotope dilution)
Determined by introducing a marker fluid that moves freely in body water and is not metabolized. – Isotopes of water - Deuterium Oxide, tritiated water– Marker introduced. – Following equilibriation period (eg 2 hrs) sample body fluid– apply conversion formulae to estimate TBW,
% FAT predicted from TBW– Assume a constant for the fraction of water in the Fat Free
Mass or at least FFM (73.8%, 72,3% etc.)– Even if no technical error in Body Water, there would still be
S.E.E. = 3.6% Body Fat associated with biological variability
K40 - Whole Body Counting
K40 emits gamma radiation Using whole body counters the amount of
radiation emitted can be determined Fat Free Mass (Non-fat Mass) estimated
Assumptions:– Constant fraction of K40 in potassium– Constant fraction of potassium in non-fat
mass
Doubly Indirect Methods for the Estimation of % Body Fat
Doubly Indirect Methodsfor Estimating % Body Fat
Skinfold predictions Ultrasound Radiography Bioelectrical Impedance Analysis (BIA) Near-infrared Spectrophotometry (NIR) DEXA
General Research Approachfor Doubly Indirect Methodologies
Selected subject sample Determine body density or % fat using an
accepted methodology; often underwater weighing
Measure subjects with other technique Produce regression equations to best predict
density or % fat from new technique
Regression Equationsto Predict % Body Fat
d
Y
X
Y = mX + c
Y = % Body Fat
X = Anthropometric measure (Skinfolds etc)
Correlation Coefficient (r)
Standard Error of Estimate (SEE)
Anthropometric (skinfolds)prediction of % Fat
Adipose Tissue not Fat Equations predict % Fat (Lipid) Over 100 equations available for the prediction of percentage body
fat or body density All are sample specific Specific for age, gender, activity level, nutrition etc.
Adipose Tissue
Assumptions inherent in prediction of % Fat from Skinfolds
Based upon densitometry
“Which is better UW Weighing or Skinfold predictions?”
%fat from skinfolds is predicted using equations developed from UW Weighing of subjects.
UW Weighing: S.E.E. = 2.77% Fat Skinfolds: S.E.E. = 3.7% Fat
Assumptions inherent in prediction of % Fat from Skinfolds
Constant Skinfold Patterning
Constant Skinfold Compressibility
Constant Tissue Densities
Constant Ratio of external/internal adipose tissue
Constant Fat (lipid) content of adipose tissue
YUHASZ
Male: % Fat = 0.1051(Sum 6 SF) + 2.585
Female: % Fat = 0.1548(Sum 6 SF) + 3.580
Canadian University Students
Can never give a negative answer.
What if weight alone changes or is different?
Durnin & Womersley
Density = a (log10Sum 4 SF) + c Overpredicts by 3 - 5% Fat British (left side) Age and gender specific equations Upper body sites Electronic Skinfold Caliper
Ultrasound
High Frequency Sound (6 MHz)
Some sound reflected at tissue interfaces
Time taken for return of sound used to estimate distance based upon assumed speed of sound in that tissue
% Fat prediction from Ultrasound
Regression equations predicting densitometrically determined % Fat
S.E.E.’s comparable to skinfold predictions
Beware of “predict anything from anything” once it is in a computer
RADIOGRAPHY
Measurements from radiographs– uncompressed tissue thicknesses
Regression equations predicting densitometrically determined % Fat
BIOELECTRICAL IMPEDANCE ANALYSIS (BIA)
BIA measured by passing a microcurrent through the body
% Fat predicted from sex, age, height, weight & activity level + BIA
Influenced by hydration level Claims that you can guess %
fat more accurately
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
Typical 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: Advantages and Limitations
Advantages– costs ($500-$2000)– portable– non-invasive– fast
Limitations– accuracy and precision– no better, usually worse than hydrodensitometry
Major types of BIA analyzers
Client Friendly
Site Specific?
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
Near Infra-Red Spectrophotometry (NIR)FUTREX
Near Infra-Red light emitted from probe
Reflected light monitored Changes due to differing
optical densities Influenced by hydration Relative fat may be useful
Dual-Energy X-ray Absorptiometry
DEXA, DXADual Energy X-ray Absorptiometry
Two different energy level X-rays Lean, fat, and bone mass each reduce
(attenuate) the X-ray signal in unique ways Whole body Regional Osteoporosis
X-Ray Measurement System
Dual energy attenuation values are measured for each point in the image
Calibration standards (acrylic, aluminum, delrin) are measured
The fat and lean mass of each point in the image is calculated by direct comparison to the standards
BMI = 12.6%Fat = 3.2%
BMI = 23.7%Fat = 48.1%
BMI = 18.1%Fat = 23.1%
What DEXA Measures
Fat and fat-free mass (based upon the standards)
Bone Mineral Mass Regional results for the above
DEXA Cannot Measure...
Protein Mass 3-D Fat Distribution Hydration Status Tissue inside bone (brain, marrow,
blood)
Next generation of Body Composition Models
Two compartment plus– Water– Bone mineral– Protein
3 or 4 compartment models now regarded as the reference standard rather than underwater weighing