Validation of a Skinfold Prediction Equation Based on Dual-Energy X-Ray Absorptiometry to Estimate Body Fat Percentage in Women

ABSTRACT

The purpose of this study was to validate an alternative skinfold equation for women created from dual-energy x-ray absorptiometry (DXA). Anthropometrics and a whole-body DXA scan were completed on 77 women (mean age: 28.0 ± 10.2 years). Four Jackson-Pollack (JP) skinfold prediction equations and the DXA criterion (DC) equation were compared to DXA-derived body fat percentage (%BF). One-way repeated measures ANOVA revealed significant differences (p ≤ .001) in the %BF with post hoc-comparisons revealing significant differences among JP7 (21.3 ± 5.7), JP4 (21.4 ± 5.7), JP3a (22.2 ± 5.9), and JP3b (22.6 ± 5.7) when compared to the DXA-derived %BF; no significant difference existed between DC %BF (26.5 ± 5.6) and DXA-derived %BF (26.5 ± 5.4) (p = 1.0). The DC equation more accurately predicted %BF in women volunteers compared to Jackson-Pollack equations.     

Body Composition Comparison: Bioelectric Impedance Analysis with Dual-Energy X-Ray Absorptiometry in Adult Athletes

The primary purpose of this study was to investigate the accuracy of the DF50 (ImpediMed Ltd, Eight Mile Plains, Queensland, Australia) bioelectrical impedance analysis device using dual-energy x-ray absorptiometry as the criterion in two groups: endurance athletes and power athletes. The secondary purpose was to develop accurate body fat percentage prediction equations for each group based on bioelectrical impedance analysis data and/or the combination of bioelectrical impedance analysis and anthropometric data.

Eighty male athletes (40 elite endurance athletes and 40 were power athletes), age 19–48 with body mass indexes ranging from 18.9 to 37.4 were recruited. Anthropometric measurements were taken. Body composition was assessed by dual-energy x-ray absorptiometry and bioelectrical impedance analysis. An athlete-specific bioelectrical impedance analysis prediction equation was developed by stepwise regression analysis using dual-energy x-ray absorptiometry as the criterion and bioelectrical impedance analysis data and anthropometric measurements as predictor variables.

The DF50 bioelectrical impedance analysis significantly overestimated body fat percentage by 6.4 ± 0.5 in the entire group (p < .001) and in both the endurance group (6.1 ± .6, p < .001) and the power group (6.7 ± 0.7, p < .001). The endurance and power group showed no significant difference in the error of estimation by bioelectrical impedance analysis (p = .554), indicating that bioelectrical impedance analysis has the same error in both groups. The final prediction equation incorporated both anthropometric variables as well as bioelectrical impedance analysis variables and produced an adjusted r² of .982 and a standard error of the estimate (SEE) of 1.98 for the entire group. This prediction equation used bioelectrical impedance analysis measurements and anthropometric measurements, specifically trunk measurements, to account for trunk size, a common source of error in bioelectrical impedance analysis equations. Follow-up validation studies are necessary to further validate the equations produced.     

Comparison of anthropometry to dual energy X-ray absorptiometry: a new prediction equation for women

The purpose of this study was to assess the accuracy of three recommended anthropometric equations for women and then develop an updated prediction equation using dual energy x-ray absorptiometry (DXA). The percentage of body fat (%BF) by anthropometry was significantly correlated (r = .896-.929; p < .01) with DXA, but each equation underestimated %BF (3.2-5.6 %BF; p < .01). The following DXA criterion (DC) equation was created: %BF= -6.40665 + 0.41946(S3SF) - 0.00126(S3SF)2 + 0.12515(hip) + 0.06473 (age); (S3SF = sum of triceps, suprailiac, thigh; hip = circumference in cm; age = years). The predicted residual sum of squares (PRESS) R2 was high (0.86), and the PRESS standard error of estimate (SEE) was low (2.5 %BF) for our sample of 150 women. The DC equation was further crosschecked on a separate sample of women (n = 25) and again showed excellent agreement. The DC equation appears to be a more accurate estimation of %BF in women.     

Assessing Body Composition of Children and Adolescents Using Dual-Energy X-Ray Absorptiometry,Skinfolds, and Electrical Impedance

To determine the validity and reliability of percent body fat estimates in 177 boys and 154 girls between 12–17 years of age, percent body fat was assessed once using dual-energy X-ray absorptiometry and twice using the sum of two skinfolds and three bioelectrical impedance analysis devices. The assessments were repeated on 79 participants on a second day. The agreement between the percent body fat estimates from the four prediction methods and dual-energy X-ray absorptiometry was evaluated using Bland–Altman analyses and a mixed linear model. All methods were reliable within and between days. The sum of two skinfolds (±6.8% body fat), OMRON (OMRON Healthcare Inc., Vernon Hills, Illinois, USA) bioelectrical impedance analysis (0 ± 7.3% body fat), and TANITA 521 (TANITA Corporation, Tokyo, Japan) bioelectrical impedance analysis (±7.6% body fat) had wide prediction intervals and are acceptable for use in large population-based studies. The TANITA 300A bioelectrical impedance analysis is not recommended for use in children and adolescents due to its wide prediction interval (±8.1% body fat) and large bias. A criterion method should be used when the accurate assessment of body composition of an individual is critical.     

Nutritional practices associated with low energy availability in Division I female soccer players

Abstract

The purpose of this study was to examine macronutrient intake, energy density and energy intake distribution that may be associated with low energy availability (EA) in Division I female soccer players. The energy intake, exercise energy expenditure and EA of 19 participants (18–21 years) was assessed during the pre-, mid- and postseasons. Repeated measures analysis of variance was performed to examine the changes across the season. Chi-square analysis was performed to examine the distribution of participants meeting the American College of Sports Medicine recommendations for carbohydrate and protein consumption. Independent t-tests were used to compare differences between groups. The proportion of athletes who did not meet the American College of Sports Medicine recommendations for carbohydrate intake (6–10 g . kg^–1 BW) was significantly greater in the low (<30 kcal . kg^–1 LBM) than higher (≥30 kcal . kg^–1 LBM) EA group (χ² (1) = 7.5; P = 0.006). Participants with low compared to higher EA consumed a lower energy dense dinner (0.8 ± 0.1 vs. 1.4 ± 0.1 kcal . g^–1; P = 0.004) after a soccer match during midseason. No differences in the percentage (%) of kilocalories from food (84.5 ± 2.0% vs. 84.7 ± 2.6%), sports drinks (7.3 ± 1.4% vs. 6.0 ± 3.2%), other drinks (7.6 ± 1.5 % vs. 6.0 ± 1.5%) or bars/gels/beans (1.7 ± 0.6 vs. 3.0 ± 1.5) were observed in participants with low compared to higher EA (P > 0.05) during the pre- and midseasons. Identifying inadequate carbohydrate intake and the practice of consuming lower energy dense meals may be important in preventing low EA conditions and consequently the Female Athlete Triad.     

Book review of Measurement by the Physical Educator: Why and How

Although not perfect, skinfolds (SK), or the measurement of fat under the skin, remains the most popular and practical method available to assess body composition on a large scale (Kuczmarski, Flegal, Campbell, &; Johnson, 1994). Even for practitioners who have been using SK for years and are highly proficient at locating the correct anatomical sites and pinching the skin, the question remains—how accurate are the results? Creation of new SK equations using Dual Energy X-Ray Absorptiometry (DXA)technology as the criterion have improved the estimation accuracy achieved by SK. Practitioners are asked to recognize that the equations currently recommended by the American College of Sports Medicine underestimate body fatness by about 3% in both men and women. New equations, developed using DXA as the criterion, are prompting fitness and health professionals to reinterpret the meaning of the percentage of body fat standards for their clients. In summary, the accuracy of various SK assessments are reviewed and various principles of application are presented for the practitioner.     

Classification of obesity varies between body mass index and direct measures of body fat in boys and girls of Asian and European ancestry

Body mass index is a common proxy for proportion of body fat. However, body mass index may not classify youth similarly across ages and ethnicities. We used sex- and ethnic-specific receiver operating characteristic curves to determine how obesity classifications compared between body mass index and dual energy x-ray absorptiometry-based body fat percent. Male and female participants 9- to 18-years-old (n = 944; 487 female) were measured 1 to 13 times (1999–2012; 4,411 observations). Body mass index identified < 50% of those classified as obese from body fat percent. Specificity was 99.7%, and sensitivity was 35.8%. Using area under the curve and standard error values, body mass index performed significantly better for: Male versus female at 10 years, Asian versus European female except at 13-, 15-, and 16-years-old, Asian female versus male except at 10- and 15-years-old, and for European male versus female, 9- to 11-years-old (p < .05). Our findings provide evidence that users of body mass index should use caution when comparing body mass index across age, sex, and ethnicity.     

Relationship between peak oxygen uptake and regional body composition in Japanese subjects

PurposeTo investigate the link between peak oxygen uptake and regional body composition by dual energy X-ray absorptiometry (DEXA) in Japanese subjects.MethodsA total of 93 men (42.2 ± 12.3 years old) and 106 women (43.5 ± 12.3 years old) were enrolled in this cross-sectional investigation study. Peak oxygen uptake was measured by the breath-by-breath method. Regional body composition i.e., body fat mass, lean body mass, and body fat percentage was evaluated using DEXA. In addition, metabolic risk parameters were also evaluated.ResultsPeak oxygen uptake was 37.6 ± 8.7 mL/kg/min in men and 31.1 ± 6.4 mL/kg/min in women, and decreased with age in both genders. Peak oxygen uptake was significantly correlated with total body fat percentage (men: r = −0.684, p < 0.0001; women: r = −0.681, p < 0.0001). These associations remained even after adjusting for age and total lean body mass. However, peak work rate was positively and significantly correlated with leg lean body mass.ConclusionPeak oxygen uptake was closely correlated with total body fat percentage in both genders. Aerobic exercise as well as leg resistance training might be useful for improving peak oxygen uptake in Japanese subjects.     

Body fat measurement in elite sport climbers: Comparison of skinfold thickness equations with dual energy X-ray absorptiometry

Abstract

The aim of this study was to compare equations for estimating percentage body fat from skinfold thickness in elite sport climbers by assessing their agreement with percentage body fat measured using dual-energy X-ray absorptiometry (DXA). Skinfold thickness was measured in a convenience sample of 19 elite sport climbers [9 women and 10 men; mean age 31.2 years (s = 5.0) and 28.6 years (s = 3.6), respectively]. Percentage body fat was estimated using 17 different equations, and it was also measured by DXA. A significant inter-methods difference was observed for all equations, except for Durnin's equation in men (inter-methods difference: ?0.57% and ?0.29%; 1.96 s: 5.56 and 5.23 for Siri's and Brozek's equation, respectively) and women (inter-methods difference: ?0.67% and ?1.29% for Siri's and Brozek's equation, respectively), and for Wilmore's equation using Siri's body fat equation in women (inter-methods difference: ?1.86%). In women, the limits of agreement were lower when using Durnin's equation compared with Wilmore's equation (1.96 s: 3.86% and 5.13%, respectively). In conclusion, of the 17 studied equations, Durnin's equation was the most accurate in estimating percentage body fat in both male and female elite climbers. Therefore, Durnin's equation could be used to assess percentage body fat in elite sport climbers if more accurate methods are not available. The generalizability of the results is limited by the fact that the sample was not selected at random.     

Validity of equations for estimating aerobic fitness in Mexican youth

The purpose of this study was to evaluate the validity of prediction equations for estimating maximal oxygen uptake (VO_2peak) based on the PACER test and different adiposity indicators in Mexican youth. A convenience sample of youth aged 9–18 years from schools in Mexico City was recruited. VO_2peak was evaluated with a laboratory exercise test on a treadmill and using a gas analyser and with the 20-m PACER test guidelines. The sample was randomly divided to develop new equations (n = 220) and to evaluate their validity (n = 106). Prediction equations of VO_2peak were developed using multiple linear regression models. The adiposity indicators were BMI, waist circumference and body fat. The validity of the new and previously published equations was evaluated based on linear regression models, intra-class coefficient, Akaike’s information criterion, mean absolute percentage error and Bland-Altman graphs. Equations with waist circumference and body fat performed better than those with BMI and without any anthropometric indicator. The accuracy of the developed equations (R² = 57.0%–59.50%) was higher than that of previously published equations (R² = 24.1%–56.0%). The new equations had lower bias in estimating VO_2peak. In Mexican youth, the estimation of VO_2peak from the 20-m PACER test is more accurate after including waist circumference or body fat than with BMI.     

The effects of resistance training volume on osteosarcopenic obesity in older women

The aim of this study was to analyze the effects of resistance training (RT) performed with 1 or 3 sets per exercise on osteosarcopenic obesity (OSO) syndrome parameters in older women. Sixty-two older women (68.0 ± 4.3 years, 26.8 ± 4.4 kg/m²) participated in a 12-week RT program. Participants were randomly assigned into one of the three groups: two training groups that performed either 1 set (G1S, n = 21) or 3 sets (G3S, n = 20) 3 times weekly, or a control group (CG, n = 21). Body composition was assessed by dual X-ray absorptiometry, strength was evaluated by 1 repetition maximum testing. The G3S presented significantly higher strength changes than G1S. The changes for percentage of body fat were higher for G3S compared to G1S. There was no difference in skeletal muscle mass between G3S and G1S, however both training groups displayed greater increases in this outcome compared to CG. There was no effect for bone mineral density. The overall analysis indicated higher (P < 0.05) positive changes for G3S than G1S (composed Z-score: G3S = 0.62 ± 0.40; G1S = 0.11 ± 0.48). The results suggest that a 12-week RT period is effective to improve the risk factors of OSO, and that 3 sets induce higher improvements than a single set.     

Validity of “Generalized” Equations for Body Composition Analysis in Women Athletes

Abstract

Equations by Jackson, Pollock, and Ward (1980) and by Durnin and Womersly (1974) for estimating body density (BD) from skinfolds (SF) purportedly overcome the criticism of “population specificity” by taking into account age and the curvilinear relationship between SFs and BD. Selected equations were validated on 79 women athletes against %fat and fat(kg) measured by underwater weighing. Equations by Sloan, Burt, and Blyth (1962), Wilmore and Behnke (1970), and Katch and McArdle (1973) were also evaluated to compare the newer equations to older ones. The mean estimate of %fat by one equation by Jackson et al. utilizing the sum of triceps, abdomen, suprailiac and thigh SF was the same as the true value (20.1%) and correlated .795 (SEE ± 3.27 total error 3.23). Regression analysis showed it to have acceptable accuracy over the range of sample values (10.3–34.0%). The Durnin-Womersly equations overestimated %fat by 3.9 to 4.4% and were not acceptable. For the older equations, the mean Sloan et al. estimate (20.8 %Fat) was not significantly different from the true value and correlated .779 (SEE ± 3.37 total error 3.47). Regression analysis showed it to overestimate fat in leaner subjects and to underestimate it in fatter ones, making it unacceptable. The Wilmore-Behnke equation overestimated %fat by 4.3%. Equations by Jackson et al., using the sum of triceps, suprailiac and thigh skinfolds, and by Katch and McArdle were shown to be acceptable if the ordinate values were adjusted (1.0994921 to 1.1074921 and 1.08347 to 1.09147 respectively) to account for the higher density of women athletes.     

Bone mass,bone mineral density and muscle mass in professional golfers

The aim of this study was to determine the effects of long-term professional golf participation on whole-body and regional bone mass and density. Dual-energy X-ray absorptiometry was performed on 15 male professional golfers and 18 sedentary individuals, matched for sex, race, age (29 ± and 25 ± 1 years, respectively), body mass (79 ± 2 and 74 ± 2 kg), height (1.78 ± 0.01 and 1.77 ± 0.02 m) and percent body fat (20 ± 2 and 21 ± 2%; mean ± s _χ). We found that long-term professional golf participation is not associated with significant increments in regional or whole-body bone mass or density. Neither the lumbar spine nor the femoral neck showed any noticeable enhancement of bone mass in professional golfers compared with controls from the same population. The only effect of professional golf participation on regional body composition was a 9% increase in muscle mass in the dominant arm (P ? 0.05).     

Upper and lower thresholds of fat-free mass index in a large cohort of female collegiate athletes

ABSTRACT

Fat-free mass index (FFMI) is a height-adjusted metric of fat-free mass which has been suggested as a useful method of body composition assessment in athletic populations. The purpose of this study was to determine sport-specific FFMI values and the natural upper threshold of FFMI in female athletes. 372 female collegiate athletes (Mean±SD; 20.03±1.55 years, 167.55±7.50 cm, 69.46±13.04 kg, 24.18±5.48% bodyfat) underwent body composition assessment via dual-energy x-ray absorptiometry. FFMI was adjusted to height via linear regression and sport-specific reference values were determined. Between-sport differences were identified using one-way ANOVA with Tukey post-hoc tests. Average FFMI was 18.82±2.08 kg/m²; height-adjusted values were not significantly different (p<0.05) than unadjusted values. FFMI in rugby athletes (20.09±2.23 kg/m²) was found to be significantly higher (p<0.05) than in gymnastics (18.62±1.12 kg/m²), ice hockey (17.96±1.04 kg/m²), lacrosse (18.58±1.84 kg/m²), swim & dive (18.16±1.67 kg/m²), and volleyball (18.04±1.13 kg/m²). FFMI in cross country (16.56±1.14 kg/m²) and synchronized swimming (17.27±1.47 kg/m²) was significantly lower (p<0.05) than in Olympic weightlifting (19.69±1.98 kg/m²), wrestling (19.15±2.47 kg/m²), and rugby. The upper threshold for FFMI in female athletes (97.5^th percentile) was 23.90 kg/m². These results can be used to guide personnel decisions and assist with long-term body composition, training, and nutritional goals.     

Body Composition of Olympic Speed Skating Candidates

Abstract

The purpose of this investigation was to quantify the body composition of speed skaters who were candidates for the 1980 United States Olympic Team. Subjects were 19 males between 16 and 27 years of age. Most subjects had just completed three months of intensive dry-land training. Seven skinfold fat, 11 circumference, and seven diameter sites were measured. Body density was determined by underwater weighing. Study of the speed skaters (mean ± standard deviation) gave the following results: height, 176 ± 8 cm; body weight, 69.6 ± 7.0 kg; body density, 1.081 ± 0.006 g/ml; and relative fat, 7.6 ± 2.6%. The eight speed skaters who were selected for the Olympic Team were significantly older, taller, and heavier in total body weight and fat free weight (FFW) than the non-Olympians. Thus, years of training and greater FFW may help differentiate international caliber male speed skaters. Data on Olympic speed skating candidates from 1968 showed them to be of similar age (20.1 yr) and height (176 cm), but greater in body weight (73.9 kg). Relative fat was not determined but the body mass index (Wt/ht²) showed that the present speed skaters may be leaner (24.0 vs 22.2). These differences in body composition were thought to be, in part, a result of the more rigorous training program currently used by speed skaters. The body composition of the speed skaters was also compared to that of other athletic groups.     

Reliability and agreement between DXA-derived body volumes and their usage in 4-compartment body composition models produced from DXA and BIA values

Two research groups recently produced equations for estimation of body volume from dual-energy x-ray absorptiometry (DXA) scans. These body volume estimates can be used for body composition evaluation in modified 4-compartment models. In the present analysis, the reliability of body volume calculations, as well as their usage in 4-compartment models, was explored while employing precise scheduling of assessments and dietary standardization. Forty-eight recreationally active males and females completed two pairs of identical assessments, which included a DXA scan and single-frequency bioelectrical impedance analysis. Each assessment within a pair was separated by 24 hours, during which participants were provided a standardized diet. Body volume and 4-compartment equations were applied to the data, and metrics of reliability and agreement were calculated for body volume and 4-compartment components. While both body volume equations demonstrated excellent reliability individually, substantial disagreement between equations was present when utilized in 4-compartment equations. The magnitude of this disagreement was 4.3 kg for lean mass and fat mass and 6.9% for body fat percentage. At present, the large discrepancies in body composition components when using existing body volume equations preclude their interchangeability and demonstrate the need for continued exploration of the utility of body volume estimates.     

Low energy availability and low body fat of female gymnasts before an international competition

Abstract

The purpose of the present study was to evaluate dietary intake and body composition of elite rhythmic gymnastics (RG) athletes prior to a competition event. Sixty-seven rhythmic gymnasts (18.7 ± 2.9 years old) of high performance level, with 36.6 ± 7.6 h of training/week were evaluated in order to collect training and competition data, medical and gynaecological history, detailed dietary intake and body composition before an international competition. The majority of the participants (n = 40; 59.7%) had already menstruated, but age of menarche was delayed (15.3 ± 1.3 years) and all revealed menstrual irregularities. Gymnasts' body mass (48.4 ± 4.9 kg) and body mass index (BMI; 17.4 ± 1.1 kg/m²) were below the normal for age, and height (1.66 ± 0.05 m) was normal or even slightly above normal for age. Body fat was 9.0 ± 2.0% with no significant differences between age strata. Gymnasts exhibited low energy availability (EA; 31.5 ± 11.9 kcal/kg fat-free mass (FFM)/day). The average carbohydrate and protein intakes were 5.1 ± 2.3 g/kg/day and 1.6 ± 04 g/kg/day, which correspond to 51.4 ± 7.2% and 16.9 ± 3.4% of total energy intakes, respectively; average fat contribution was 33.0 ± 5.3%. Low intakes of pantothenic acid, folate and vitamins D, E and K and of minerals, including calcium, iron and magnesium were reported. Intakes of thiamine, riboflavin, niacin, vitamins A, B-6, B-12, C and manganese and zinc were above-adequate (P < 0.05). Low EA, low body fat and micronutrient deficiencies are common among RG.     

Nutritional intake and body composition changes in a UCI World Tour cycling team during the Tour of Spain

Abstract

The aim of this study was to quantify the food intake of an International Cyclist Union (UCI) World Tour professional cyclist team and to analyse changes in body composition during the Tour of Spain. Nine male professional road cyclists (31.3?±?3.0 years) volunteered to participate in the study. Nutritional data were collected each day throughout the 3-week Tour by two trained investigators who weighed the food ingested by the cyclists. Mean nutritional intake of the cyclists was as follows: carbohydrate, 12.5?±?1.8?g/kg/day of body weight (BW) (65.0?±?5.9%); fat, 1.5?±?0.5 g/kg/day BW (17.9?±?5.6%); and protein, 3.3?±?0.3?g/kg/day BW (17.1?±?1.6%). Intake of all micronutrients, except for folate, vitamin D and potassium (which were 78.7%, 46% and 84% of Recommended Dietary Allowances (RDA), respectively), exceeded the RDA. Height, weight, skinfolds, circumferences and diameters were taken following the guidelines outlined by the International Society for the Advancement of Kinanthropometry. Body density, body fat percentage, muscle mass, total muscle mass and fat mass of the arms and thighs were calculated. Percentage body fat, fat mass and upper arm fat mass significantly decreased (p < .05) after the Tour independent of the equation method used in the calculations. Total muscle mass remained unchanged. Generally, this sample of cyclists consumed more protein and less fat than the recommended amount and had low weight, BMI and fat mass. It is suggested that sports nutritionists design personalised diets in order to maintain a correct proportion of nutrients as well as controlling possible anthropometrical changes that could affect performance.