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An overview of methods to assess body composition
Journal of Science and Medicine in Sport 20S (2017) 75–76
Contents lists available at ScienceDirect
Journal of Science and Medicine in Sport journal homepage: www.elsevier.com/locate/jsams
Best practice physique and body composition assessment
141
142
Best practice physique and body composition assessment
An overview of methods to assess body composition
P. Hume 1,∗ , L. Burke 2,3 , S. Keating 4
P. Hume
1
Sports Performance Research Institute New Zealand, Auckland University of Technology, New Zealand
Auckland University, Sport Performance Research Institute New Zealand, National Institute for Stroke and Applied Neurosciences, New Zealand 2 Australian Institute of Sport, Australia 3 Mary MacKillop Institute for Health Research, Australian Catholic University, Australia 4 University of Queensland, Australia Introduction: The accurate and valid measurement of physique is imperative to best practice sport and exercise science, medicine, nutrition and dietetics. While physique measurement is commonplace among many practitioners, debate exists around what constitutes best practice in measurement of physique and body composition for both research and clinical practice. Main body: The session begins with an introduction to the techniques utilised in body composition measurement and the requirements for accurate and valid results. Following, Paper 2 will look into dual X-ray absorptiometry (DXA) measurements in athletes and share experiences and research about the importance of optimising reliability of measurement. From there, the third and final paper will explore body composition assessment in adiposity-based chronic disease. The symposium will conclude with a discussion and time for questions. Paper 1: Professor Patria Hume; An overview of best practice methods for body composition assessment Paper 2: Professor Louise Burke: Dual X-ray absorptiometry (DXA) for measurement of body composition in athletes: experiences that underpin the importance of optimizing the reliability of measurement Paper 3: Dr Shelley Keating: Moving beyond the Body Mass Index: body composition assessment in adiposity-based chronic disease This session will conclude with 15 min of panel discussion. https://doi.org/10.1016/j.jsams.2017.09.344
1440-2440/
Scientific advancement has led to new technologies in the field of body composition assessment. Surface anthropometry has traditionally been used to assess body composition through the internationally recognised methodology of the International Society for the Advancement of Kinanthropometry (ISAK). However, the commercialisation of devices providing bioelectrical impedance analysis, dual energy X-ray absorptiometry, magnetic resonance imaging, three-dimensional photonic scanning (3DS), air-displacement plethysmography (i.e. Bod Pod), ultrasound techniques and dilution techniques (doubly-labelled water), has led to the adoption of new and often non-standardised, measurement techniques. Practitioners, all over the world, are employing these new technologies to measure and monitor change in body size, shape and composition for the purposes of health management, talent identification and development, optimising physique for sport performance, and enabling sports equipment design and fit. The accuracy and reliability of the technique measures are critical in a field where tracking small changes in an athlete’s physique is important. When athletes have their body composition measured across multiple technologies in a non-standardised manner, they often receive varying results which can be confusing and, in some cases, distressing. Currently, no reference or model exists for the standardisation of many of these new devices. There is a lack of awareness of standardisation of technique among both manufacturers & practitioners. There is often a lack of established protocols to ensure best practice in physique assessment. Different protocols can make large differences to the measurement value when they purport to measure the same thing – e.g. waist girth (up to 12% in females); Breathing cycle in 3D scan-derived % fat (15% for end tidal, rising to 28% on inspiration and reducing to 10% in expiration). These two examples underscore the importance of standardising protocols for body composition assessment. This presentation will outline considerations for current best practice to assess body composition. Examples for physique assessment in clinical practice using a selection of the technologies will be provided from the international team of co-authors in the Best Practice Protocols for Physique
76
Abstracts / Journal of Science and Medicine in Sport 20S (2017) 75–76
Assessment in Sport book (to be published by Springer International, November 2017).
layer of complexity to measurements and may reduce the practicality of a technique, they add value to the interpretation of the results in populations for whom small changes make a big difference.
https://doi.org/10.1016/j.jsams.2017.09.345 143 Dual X-Ray Absorptiometry (DXA) for measurement of body composition in athletes: Experiences that underpin the importance of optimising the reliability of measurement
https://doi.org/10.1016/j.jsams.2017.09.346 144 Moving beyond the Body Mass Index: Body composition assessment in adiposity-based chronic disease
L. Burke 1,2
S. Keating
1
School of Human Movement and Nutrition Sciences, The University of Queensland, Australia
Sports Nutrition, Australian Institute of Sport, Australia 2 Mary MacKillop Institute for Health Research, Australian Catholic University, Australia Over the past decade, DXA has become a “gold standard” for the assessment of body composition in sports nutrition, offering a reasonably precise and practical tool to monitor fat mass and fat free mass, and its changes, in athletic populations. On deciding to invest in such a tool, AIS Sports Nutrition undertook an assessment of the reliability of such measurements, with interest in identifying and minimising the sources of machine, technician and biological error involved. From this, the AIS “Best Practice Protocol” was devised, involving standardisation of athlete presentation (overnight fasted and rested, euhydrated, standard dress), placement on the scanning bed (use of position aids, protocols to address tall and wide athletes), and technician precision. The value of the implementation of this protocol was demonstrated in a research project involving overtraining and recovery in cyclists, where differences in the effects on body composition between the treatment and control groups were detectable from DXA scans using this protocol, but not from additional scans collected randomly over the day. In this case, the reduction in typical error of measurement with the standardised protocol allowed the detection of small but meaningful changes in body composition that were otherwise obscured by the measurement error associated with the intake of food and/or fluid shifts associated with exercise. More recently, we have developed a “correction” factor that can account for the artefact in measurement of fat-free mass which occurs due to changes in muscle glycogen and water content. This allowed us to detect a change in Resting Metabolic Rate, relative to fat free mass, following a low carbohydrate, high fat (LCHF) diet that was otherwise masked by the artefact introduced by the depletion of muscle glycogen and water associated with this diet. Although Best Practice Protocols add a
It is well established that the location of excess body fat is more important than the total quantity of adipose tissue when predicting the cardiometabolic consequences of obesity. In particular, excess fat stored as visceral adipose tissue and as intrahepatic lipid is strongly linked to cardiovascular disease and type 2 diabetes. The gold-standard method for the assessment of these ectopic fat depots is via magnetic resonance imaging (MRI) and spectroscopy (1 H-MRS), respectively. Using these methods, we have established that aerobic exercise can significantly reduce visceral and liver fat in adults with obesity, in the absence of clinically meaningful weight loss. However, a current limitation to the translation of research into clinical practice is that MRI/MRS is expensive and not readily available outside of research settings. To address this issue, novel anthropometric- and biochemistry-based biomarkers (such as the Visceral Adiposity Index and the Fatty Liver Index) have been proposed for clinical use. We have recently examined the suitability of these novel biomarkers for detecting changes in visceral and liver fat with lifestyle intervention. Using a case-based approach, this presentation will outline the importance of assessing body composition in the management of adiposity-based chronic disease, and current limitations and considerations for best practice in assessing body composition using MRI, dual-energy X-ray absorptiometry, and novel biomarkers in adults with high levels of adiposity. Given that the prevalence of adiposity-based chronic disease is increasing worldwide, and that it carries a significant economic and disease burden, this presentation is appropriate for practicing exercise professionals who play a central role in chronic disease management. https://doi.org/10.1016/j.jsams.2017.09.347
Contents lists available at ScienceDirect
Journal of Science and Medicine in Sport journal homepage: www.elsevier.com/locate/jsams
Best practice physique and body composition assessment
141
142
Best practice physique and body composition assessment
An overview of methods to assess body composition
P. Hume 1,∗ , L. Burke 2,3 , S. Keating 4
P. Hume
1
Sports Performance Research Institute New Zealand, Auckland University of Technology, New Zealand
Auckland University, Sport Performance Research Institute New Zealand, National Institute for Stroke and Applied Neurosciences, New Zealand 2 Australian Institute of Sport, Australia 3 Mary MacKillop Institute for Health Research, Australian Catholic University, Australia 4 University of Queensland, Australia Introduction: The accurate and valid measurement of physique is imperative to best practice sport and exercise science, medicine, nutrition and dietetics. While physique measurement is commonplace among many practitioners, debate exists around what constitutes best practice in measurement of physique and body composition for both research and clinical practice. Main body: The session begins with an introduction to the techniques utilised in body composition measurement and the requirements for accurate and valid results. Following, Paper 2 will look into dual X-ray absorptiometry (DXA) measurements in athletes and share experiences and research about the importance of optimising reliability of measurement. From there, the third and final paper will explore body composition assessment in adiposity-based chronic disease. The symposium will conclude with a discussion and time for questions. Paper 1: Professor Patria Hume; An overview of best practice methods for body composition assessment Paper 2: Professor Louise Burke: Dual X-ray absorptiometry (DXA) for measurement of body composition in athletes: experiences that underpin the importance of optimizing the reliability of measurement Paper 3: Dr Shelley Keating: Moving beyond the Body Mass Index: body composition assessment in adiposity-based chronic disease This session will conclude with 15 min of panel discussion. https://doi.org/10.1016/j.jsams.2017.09.344
1440-2440/
Scientific advancement has led to new technologies in the field of body composition assessment. Surface anthropometry has traditionally been used to assess body composition through the internationally recognised methodology of the International Society for the Advancement of Kinanthropometry (ISAK). However, the commercialisation of devices providing bioelectrical impedance analysis, dual energy X-ray absorptiometry, magnetic resonance imaging, three-dimensional photonic scanning (3DS), air-displacement plethysmography (i.e. Bod Pod), ultrasound techniques and dilution techniques (doubly-labelled water), has led to the adoption of new and often non-standardised, measurement techniques. Practitioners, all over the world, are employing these new technologies to measure and monitor change in body size, shape and composition for the purposes of health management, talent identification and development, optimising physique for sport performance, and enabling sports equipment design and fit. The accuracy and reliability of the technique measures are critical in a field where tracking small changes in an athlete’s physique is important. When athletes have their body composition measured across multiple technologies in a non-standardised manner, they often receive varying results which can be confusing and, in some cases, distressing. Currently, no reference or model exists for the standardisation of many of these new devices. There is a lack of awareness of standardisation of technique among both manufacturers & practitioners. There is often a lack of established protocols to ensure best practice in physique assessment. Different protocols can make large differences to the measurement value when they purport to measure the same thing – e.g. waist girth (up to 12% in females); Breathing cycle in 3D scan-derived % fat (15% for end tidal, rising to 28% on inspiration and reducing to 10% in expiration). These two examples underscore the importance of standardising protocols for body composition assessment. This presentation will outline considerations for current best practice to assess body composition. Examples for physique assessment in clinical practice using a selection of the technologies will be provided from the international team of co-authors in the Best Practice Protocols for Physique
76
Abstracts / Journal of Science and Medicine in Sport 20S (2017) 75–76
Assessment in Sport book (to be published by Springer International, November 2017).
layer of complexity to measurements and may reduce the practicality of a technique, they add value to the interpretation of the results in populations for whom small changes make a big difference.
https://doi.org/10.1016/j.jsams.2017.09.345 143 Dual X-Ray Absorptiometry (DXA) for measurement of body composition in athletes: Experiences that underpin the importance of optimising the reliability of measurement
https://doi.org/10.1016/j.jsams.2017.09.346 144 Moving beyond the Body Mass Index: Body composition assessment in adiposity-based chronic disease
L. Burke 1,2
S. Keating
1
School of Human Movement and Nutrition Sciences, The University of Queensland, Australia
Sports Nutrition, Australian Institute of Sport, Australia 2 Mary MacKillop Institute for Health Research, Australian Catholic University, Australia Over the past decade, DXA has become a “gold standard” for the assessment of body composition in sports nutrition, offering a reasonably precise and practical tool to monitor fat mass and fat free mass, and its changes, in athletic populations. On deciding to invest in such a tool, AIS Sports Nutrition undertook an assessment of the reliability of such measurements, with interest in identifying and minimising the sources of machine, technician and biological error involved. From this, the AIS “Best Practice Protocol” was devised, involving standardisation of athlete presentation (overnight fasted and rested, euhydrated, standard dress), placement on the scanning bed (use of position aids, protocols to address tall and wide athletes), and technician precision. The value of the implementation of this protocol was demonstrated in a research project involving overtraining and recovery in cyclists, where differences in the effects on body composition between the treatment and control groups were detectable from DXA scans using this protocol, but not from additional scans collected randomly over the day. In this case, the reduction in typical error of measurement with the standardised protocol allowed the detection of small but meaningful changes in body composition that were otherwise obscured by the measurement error associated with the intake of food and/or fluid shifts associated with exercise. More recently, we have developed a “correction” factor that can account for the artefact in measurement of fat-free mass which occurs due to changes in muscle glycogen and water content. This allowed us to detect a change in Resting Metabolic Rate, relative to fat free mass, following a low carbohydrate, high fat (LCHF) diet that was otherwise masked by the artefact introduced by the depletion of muscle glycogen and water associated with this diet. Although Best Practice Protocols add a
It is well established that the location of excess body fat is more important than the total quantity of adipose tissue when predicting the cardiometabolic consequences of obesity. In particular, excess fat stored as visceral adipose tissue and as intrahepatic lipid is strongly linked to cardiovascular disease and type 2 diabetes. The gold-standard method for the assessment of these ectopic fat depots is via magnetic resonance imaging (MRI) and spectroscopy (1 H-MRS), respectively. Using these methods, we have established that aerobic exercise can significantly reduce visceral and liver fat in adults with obesity, in the absence of clinically meaningful weight loss. However, a current limitation to the translation of research into clinical practice is that MRI/MRS is expensive and not readily available outside of research settings. To address this issue, novel anthropometric- and biochemistry-based biomarkers (such as the Visceral Adiposity Index and the Fatty Liver Index) have been proposed for clinical use. We have recently examined the suitability of these novel biomarkers for detecting changes in visceral and liver fat with lifestyle intervention. Using a case-based approach, this presentation will outline the importance of assessing body composition in the management of adiposity-based chronic disease, and current limitations and considerations for best practice in assessing body composition using MRI, dual-energy X-ray absorptiometry, and novel biomarkers in adults with high levels of adiposity. Given that the prevalence of adiposity-based chronic disease is increasing worldwide, and that it carries a significant economic and disease burden, this presentation is appropriate for practicing exercise professionals who play a central role in chronic disease management. https://doi.org/10.1016/j.jsams.2017.09.347