Body composition assessment via 3-dimensional optical (3DO) scanning has emerged as a rapid and simple evaluation method. The aim of this study was to establish the precision of body composition ...estimates from four commercially available 3DO scanners and evaluate their validity as compared to a reference 4-component (4C) model.
The body composition of 171 participants was assessed using four commercially-available 3DO scanners (FIT3D®, Naked Labs®, Size Stream®, and Styku®) and a 4C model utilizing data from dual-energy x-ray absorptiometry, air displacement plethysmography, and bioimpedance spectroscopy. Body composition estimates were compared via equivalence testing, Deming regression, Bland–Altman analysis, concordance correlation coefficients (CCC), root mean square error (RMSE), and related metrics. Precision metrics, including the root mean square coefficient of variation (RMS-%CV), precision error, and intraclass correlation coefficient, were generated for duplicate scans in 139 participants.
All scanners produced reasonably reliable estimates, with RMS-%CV of 2.3–4.3% for body fat percentage (BF%), 2.5–4.3% for fat mass (FM), and 0.7–1.4% for fat-free mass (FFM). ICC values ranged from 0.975 to 0.996 for BF% and 0.990 to 0.999 for FM and FFM. All scanners except Styku® demonstrated equivalence with 4C, using 5% equivalence regions, and constant errors of <1% for BF% and ≤0.5 kg for FM and FFM. However, the slopes of regression lines differed from the line of identity for most scanners and variables. CCC values ranged from 0.74 to 0.90 for BF%, 0.85 to 0.95 for FM, and 0.93 to 0.97 for FFM. RMSE values ranged from 3.7 to 6.1% for BF% and 2.8–4.6 kg for FM and FFM. Bland–Altman analysis indicated proportional bias of varying magnitudes was present for all scanners.
Commercially available 3DO scanners produce relatively reliable body composition estimates. Three out of four scanners demonstrated equivalence with a 4C model for assessments of BF%, FM, and FFM, although other metrics of validity varied among scanners, and proportional bias was present for all scanners.
Segmental estimates add specificity to body composition evaluation and could potentially have greater health and function implications than whole-body estimates alone. The aim of this study was to ...quantify the level of agreement between total and segmental fat mass (FM) and lean soft tissue (LST) estimates from dual-energy x-ray absorptiometry (DXA) and single-frequency bioelectrical impedance analysis (SFBIA).
Assessments via DXA (GE® Lunar Prodigy) and SFBIA (RJL Systems® Quantum V) were performed in 179 adults (103 F, 76 M; 30% racial/ethnic minorities). Total and segmental FM and LST estimates were compared in the entire sample, females, and males using null hypothesis significance testing (NHST; via paired-samples t-tests), equivalence testing with 5% equivalence regions, Bland–Altman analysis with linear regression, and additional error metrics.
In females and the entire sample, all LST variables except LSTARMS exhibited equivalence between methods, despite statistically significant differences via NHST for most variables. In males, only estimates of LSTTOTAL and appendicular lean soft tissue (ALST) were equivalent between methods. LST variables exhibited minimal proportional bias. All FM variables failed to exhibit equivalence, and most FM variables were underestimated by SFBIA. The magnitude of relative errors for FM generally appeared larger in males than females. Proportional bias was observed for FMLEGS and FMARMS, as well as FMTOTAL in females only. ALST estimates were equivalent between DXA and SFBIA in all analyses, did not differ between methods based on NHST, exhibited relatively low errors, and displayed no proportional bias.
In the context of the present study, DXA and SFBIA LST estimates appear to exhibit better overall agreement than FM estimates. Additionally, overall agreement between SFBIA and DXA may be superior in females as compared to males. The relatively strong agreement between ALST estimates indicates potential utility of SFBIA for clinical applications, such as evaluation of sarcopenia. Further investigation into the explanatory physiological (e.g. hydration) and anthropometric (e.g. segment lengths, circumferences, and volumes) variables predicting individual discrepancies between DXA and BIA is warranted.
Automated visual anthropometrics produced by mobile applications are accessible and cost effective with the potential to assess clinically relevant anthropometrics without a trained technician ...present. Thus, the aim of this study was to evaluate the precision and agreement of smartphone-based automated anthropometrics against reference tape measurements. Waist and hip circumference (WC; HC), waist:hip ratio (WHR) and waist:height ratio (W:HT) were collected from 115 participants (69 F) using a tape measure and two smartphone applications (MeThreeSixty®, myBVI®) across multiple smartphone types. Precision metrics were used to assess test-retest precision of the automated measures. Agreement between the circumferences produced by each mobile application and the reference were assessed using equivalence testing and other validity metrics. All mobile applications across smartphone types produced reliable estimates for each variable with intraclass correlation coefficients ≥ 0·93 (all P < 0·001) and root mean square coefficient of variation between 0·5 and 2·5 %. Precision error for WC and HC was between 0·5 and 1·9 cm. WC, HC, and W:HT estimates produced by each mobile application demonstrated equivalence with the reference tape measurements using 5 % equivalence regions. Mean differences via paired t-tests were significant for all variables across each mobile application (all P < 0·050) showing slight underestimation for WC and slight overestimation for HC which resulted in a lack of equivalence for WHR compared with the reference tape measure. Overall, the results of our study support the use of WC and HC estimates produced from automated mobile applications, but also demonstrates the importance of accurate automation for WC and HC estimates given their influence on other anthropometric assessments and clinical health markers.
The aim of this systematic review and meta-analysis was to summarize current evidence regarding body composition (BC) in SSc in order to gain new insights and improve clinical care in the context of ...the nutritional status of SSc patients.
The databases Web of Science, PubMed, Scopus and Cochrane Library were searched on 4 January 2023. Studies were included if they provided data regarding BC obtained by dual-energy X-ray absorptiometry (DXA) or bioelectrical impedance analysis (BIA) in patients with SSc and healthy controls (HC). The study design criteria for inclusion were cohort and observational studies. The risk of bias assessment was performed using the Newcastle-Ottawa scale. For meta-analysis, mean difference with a 95% confidence interval was obtained and all results were depicted as forest plots.
The number of retrieved publications was 593, of which nine were included in a random-effects meta-analysis totalling 489 SSc patients and 404 HC. Overall, significantly lower body mass index, lean mass (LM), fat mass (FM) and phase angle values were found in SSc patients when compared with HC. Furthermore, FM and LM were significantly lower in SSc patients when the DXA method was applied, whereas the same parameters were comparable between two groups of participants when BIA was applied.
Altered BC is characteristic of SSc patients indicating the need for regular nutritional status assessment in order to improve the quality of life and clinical care of patients with SSc.
Visual body composition (VBC) estimates produced from smartphone-based artificial intelligence represent a user-friendly and convenient way to automate body composition remotely and without the ...inherent geographical and monetary restrictions of other body composition methods. However, there are limited studies that have assessed the reliability and agreement of this method and thus, the aim of this study was to evaluate VBC estimates compared to a 4-compartment (4C) criterion model.
A variety of body composition assessments were conducted across 184 healthy adult participants (114 F, 70 M) including dual-energy X-ray absorptiometry and bioimpedance spectroscopy for utilization in the 4C model and automated assessments produced from two smartphone applications (Amazon Halo®, HALO; and myBVI®) using either Apple® or Samsung® phones. Body composition components were compared to a 4C model using equivalence testing, root mean square error (RMSE), and Bland–Altman analysis. Separate analyses by sex and racial/ethnic groups were conducted. Precision metrics were conducted for 183 participants using intraclass correlation coefficients (ICC), root mean squared coefficients of variation (RMS-%CV) and precision error (PE).
Only %fat produced from HALO devices demonstrated equivalence with the 4C model although mean differences for HALO were <±1.0 kg for FM and FFM. RMSEs ranged from 3.9% to 6.2% for %fat and 3.1–5.2 kg for FM and FFM. Proportional bias was apparent for %fat across all VBC applications but varied for FM and FFM. Validity metrics by sex and specific racial/ethnic groups varied across applications. All VBC applications were reliable for %fat, fat mass (FM), and fat-free mass (FFM) with ICCs ≥0.99, RMS-%CV between 0.7% and 4.3%, and PEs between 0.3% and 0.6% for %fat and 0.2–0.5 kg for FM and FFM including assessments between smartphone types.
Smartphone-based VBC estimates produce reliable body composition estimates but their equivalence with a 4C model varies by the body composition component being estimated and the VBC being employed. VBC estimates produced by HALO appear to have the lowest error, but proportional bias and estimates by sex and race vary across applications.
Position Statement: The International Society of Sports Nutrition (ISSN) bases the following position stand on a critical analysis of the literature regarding the effects of diet types (macronutrient ...composition; eating styles) and their influence on body composition. The ISSN has concluded the following. 1) There is a multitude of diet types and eating styles, whereby numerous subtypes fall under each major dietary archetype. 2) All body composition assessment methods have strengths and limitations. 3) Diets primarily focused on fat loss are driven by a sustained caloric deficit. The higher the baseline body fat level, the more aggressively the caloric deficit may be imposed. Slower rates of weight loss can better preserve lean mass (LM) in leaner subjects. 4) Diets focused primarily on accruing LM are driven by a sustained caloric surplus to facilitate anabolic processes and support increasing resistance-training demands. The composition and magnitude of the surplus, as well as training status of the subjects can influence the nature of the gains. 5) A wide range of dietary approaches (low-fat to low-carbohydrate/ketogenic, and all points between) can be similarly effective for improving body composition. 6) Increasing dietary protein to levels significantly beyond current recommendations for athletic populations may result in improved body composition. Higher protein intakes (2.3-3.1 g/kg FFM) may be required to maximize muscle retention in lean, resistance-trained subjects under hypocaloric conditions. Emerging research on very high protein intakes (>3 g/kg) has demonstrated that the known thermic, satiating, and LM-preserving effects of dietary protein might be amplified in resistance-training subjects. 7) The collective body of intermittent caloric restriction research demonstrates no significant advantage over daily caloric restriction for improving body composition. 8) The long-term success of a diet depends upon compliance and suppression or circumvention of mitigating factors such as adaptive thermogenesis. 9) There is a paucity of research on women and older populations, as well as a wide range of untapped permutations of feeding frequency and macronutrient distribution at various energetic balances combined with training. Behavioral and lifestyle modification strategies are still poorly researched areas of weight management.
Undoubtedly, ultrasound measurement of fat thickness and A/G ratio could provide a practical solution in places where DXA is unavailable. Still, it possesses several challenges due to diverse ...corporal compositions, especially in the measure of fat thickness in overweight or obese patients. In addition, those patients tend to have a sizeable abdominal diameter, so visualizing the aorta could be challenging; despite this technical factor, ultrasound often results be accurate and reliable, as should be expected from a suitable measurement technique for abdominal subcutaneous fat. It would be interesting to compare other body composition assessment techniques, such as MRI, which has excellent agreement with DXA without the ionizing radiation or compare it to computed tomography that can accurately determine fat in skeletal muscle tissue and the liver.
Low muscle mass is the most critical consequence of malnutrition as it reduces immunity, increases the risk of infection, and significantly decreases physical function and quality of life, which ...persists for years. A team was created to detect changes in body composition and muscle quality in hospitalized patients to provide better management of their nutritional status.
A body composition assessment team comprising specialist nutritionists who measure handgrip strength and use bioimpedance or anthropometry in hospitalized patients with nutritional risk was created. Using specific protocols, the body composition assessment team conducts an individualized nutritional intervention.
Superficial and subjective assessments may overlook risk and nutritional status. Nutritional intervention based on objective body composition assessments contributes to the reversal of lean mass loss, even in critically ill patients with inflammation and comorbidities.
Assessment of body composition through protocol contributes to the stratification of nutritional risk and the development of early interventions. Moreover, the systematization of care generates data for the continuous monitoring of the quality of nutritional assistance.
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Two, three and four compartment (2C, 3C and 4C) models of body composition are popular methods to measure fat mass (FM) and fat-free mass (FFM) in athletes. However, the impact of food and fluid ...intake on measurement error has not been established. The purpose of this study was to evaluate standardised (overnight fasted, rested and hydrated) v. non-standardised (afternoon and non-fasted) presentation on technical and biological error on surface anthropometry (SA), 2C, 3C and 4C models. In thirty-two athletic males, measures of SA, dual-energy X-ray absorptiometry (DXA), bioelectrical impedance spectroscopy (BIS) and air displacement plethysmography (BOD POD) were taken to establish 2C, 3C and 4C models. Tests were conducted after an overnight fast (duplicate), about 7 h later after ad libitum food and fluid intake, and repeated 24 h later before and after ingestion of a specified meal. Magnitudes of changes in the mean and typical errors of measurement were determined. Mean change scores for non-standardised presentation and post meal tests for FM were substantially large in BIS, SA, 3C and 4C models. For FFM, mean change scores for non-standardised conditions produced large changes for BIS, 3C and 4C models, small for DXA, trivial for BOD POD and SA. Models that included a total body water (TBW) value from BIS (3C and 4C) were more sensitive to TBW changes in non-standardised conditions than 2C models. Biological error is minimised in all models with standardised presentation but DXA and BOD POD are acceptable if acute food and fluid intake remains below 500 g.
Lipedema is a chronic and progressive disease associated with lymphatic impairment at later stages. The aim of our study was to describe the functional status and anatomy of lower limb superficial ...lymphatic system using indocyanine green (ICG) lymphography in patients with lipedema.
Following ICG injection at the dorsum of the foot, distance (cm) covered by the dye at 10 (T10′) and 25 min (T25′) was measured and normalized for limb length. If the dye did not reach the groin within 25 min, patients were classified as “drainage-needing” group (DNG). Values of fat and lean distribution assessed by dual-energy X-ray absorptiometry were extracted, and correlation analysis was performed. Furthermore, anatomical patterns of superficial lymphatics were assessed.
Overall, 45 women were included, 25 (56%) of whom were classified as DNG. Symptoms duration was significantly associated with DNG status at multivariate analysis (odds ratio 1.07; 95% CI 1.01–1.14; p = 0.047). Moreover, Spearman's analysis showed a negative correlation between symptoms duration and T25′ dye migration (r = −0.469; p = 0.037). Overall, no major anatomical lymphatic changes were found.
Present study suggests that lymphatic functioning in patients with lipedema correlates with symptoms duration. Further research on larger cohorts should verify our findings and clarify their potential therapeutic implications. Overall, ICG lymphography may be promising technique to assess both lymphatic anatomy and functioning in patients with lipedema.
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•Lipedema can be associated with lymphatic overload and consequent overt lymphedema.•ICG lymphography was used to assess lymphatic functioning in patients with lipedema.•Lymphatic functioning seems to be independent of degree of regional fat accumulation.•We found negative correlation with duration of symptomatic disease.•Our study emphasizes the importance of early detection of symptomatic lipedema.
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