Implementation of an overnight fast is a pervasive recommendation prior to body composition assessment, but this is not always feasible. Previous research has indicated that for dual-energy X-ray absorptiometry (DXA) scans, the trunk region may be particularly susceptible to biological error induced by food and fluid intake. This analysis explored the potential utility of excluding the trunk region from nonfasted DXA scans. Recreationally active adults were assessed by DXA after an overnight fast and again after consumption of standardized high-carbohydrate and low-carbohydrate diets. The effects of food consumption on total and appendicular lean soft tissue (LST; ALST) and ALST-derived skeletal muscle mass (SMM) were evaluated via analysis of variance, and metrics of reliability were calculated. In both conditions, the constant error of nonfasted assessments was slightly lower when the trunk was excluded (ALST and SMM: 0.7–1.2%; LST: 1.5%). However, in both conditions, the total error, standard error of the estimate, and limits of agreement were higher for ALST and SMM (total error: 2.4–3.0%; standard error of the estimate: 2.2–2.8%; and limits of agreement: 4.5–5.6%) than LST (total error: 2.1%; standard error of the estimate: 1.3–1.4%; and limits of agreement: 2.5–2.8%) when expressed relative to mean values. The added technical error due to demarcation of body regions for ALST and SMM appears to outweigh the removal of biological error due to exclusion of the trunk. Although elimination of the trunk region is theoretically appealing for nonfasted DXA assessments, it is apparently an inferior method compared with utilizing whole-body LST.
Grant M. Tinsley and Brett S. Nickerson
Tori M. Stone, Jonathan E. Wingo, Brett S. Nickerson, and Michael R. Esco
The purpose of this study was to validate single-frequency hand-to-foot bioelectrical impedance analysis (HFBIA) for estimating bone mineral content (BMC) using dual-energy X-ray absorptiometry as the criterion measure in healthy men and women aged 18–40 years. A total of 80 men and women participated in this study. BMC was estimated on the same day using HFBIA and dual-energy X-ray absorptiometry. The HFBIA device provided higher mean BMC values in men and the entire sample, but not in women. A smaller standard error of estimate was observed in women (0.20, corresponding to 8% of the mean reference BMC values) compared with men (0.39, corresponding to 12% of the mean reference BMC values) and the combined sample (0.31). HFBIA provided a smaller constant error and individual estimation error indicated by the 95% limits of agreement in women (−0.05 ± 0.39) compared with men (−0.16 ± 0.78) and the entire sample (−0.10 ± 0.63). In conclusion, although BMC values were found to be more accurate in women, HFBIA overestimated BMC compared with dual-energy X-ray absorptiometry, especially in individuals with lower values. Given these results, using HFBIA to measure BMC would be inappropriate for diagnostic purposes.
Michael R. Esco, Brett S. Nickerson, Sara C. Bicard, Angela R. Russell, and Phillip A. Bishop
The purpose of this investigation was to evaluate measurements of body-fat percentage (BF%) in 4 body-mass-index- (BMI) -based equations and dual-energy X-ray absorptiometry (DXA) in individuals with Down syndrome (DS). Ten male and 10 female adults with DS volunteered for this study. Four regression equations for estimating BF% based on BMI previously developed by Deurenberg et al. (DEBMI-BF%), Gallagher et al. (GABMI-BF%), Womersley & Durnin (WOBMI-BF%), and Jackson et al. (JABMI-BF%) were compared with DXA. There was no significant difference (p = .659) in mean BF% values between JABMI-BF% (BF% = 40.80% ± 6.3%) and DXA (39.90% ± 11.1%), while DEBMI-BF% (34.40% ± 9.0%), WOBMI-BF% (35.10% ± 9.4%), and GABMI-BF% (35.10% ± 9.4%) were significantly (p < .001) lower. The limits of agreement (1.96 SD of the constant error) varied from 9.80% to 16.20%. Therefore, BMI-based BF% equations should not be used in individuals with DS.
Brett S. Nickerson, Michael R. Esco, Phillip A. Bishop, Brian M. Kliszczewicz, Kyung-Shin Park, and Henry N. Williford
The purpose of this study was twofold: 1) compare body volume (BV) estimated from dual energy X-ray absorptiometry (DXA) to BV from a criterion underwater weighing (UWW) with simultaneous residual lung volume (RLV), and 2) compare four-compartment (4C) model body fat percentage (BF%) values when deriving BV via DXA (4CDXA) and UWW (4CUWW) in physically active men and women. One hundred twenty-two adults (62 men and 60 women) who self-reported physical activity levels of at least 1,000 MET·min·wk-1 volunteered to participate (age = 22 ± 5 years). DXA BV was determined with the recent equation from Smith-Ryan et al. while criterion BV was determined from UWW with simultaneous RLV. The mean BV values for DXA were not significant compared with UWW in women (p = .80; constant error [CE] = 0.0L), but were significantly higher in the entire sample and men (both p < .05; CE = 0.3 and 0.7L, respectively). The mean BF% values for 4CDXA were not significant for women (p = .56; CE = –0.3%), but were significantly higher in the entire sample and men (both p < .05; CE = 0.9 and 2.0%, respectively). The standard error of estimate (SEE) ranged from 0.6–1.2L and 3.9–4.2% for BV and BF%, respectively, while the 95% limits of agreement (LOA) ranged from ±1.8–2.5L for BV and ±7.9–8.2% for BF%. 4CDXA can be used for determining group mean BF% in physically active men and women. However, due to the SEEs and 95% LOAs, the current study recommends using UWW with simultaneous RLV for BV in a criterion 4C model when high individual accuracy is desired.