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Alisa Nana, Gary J. Slater, Arthur D. Stewart and Louise M. Burke

Dual energy X-ray absorptiometry (DXA) is rapidly becoming more accessible and popular as a technique to monitor body composition, especially in athletic populations. Although studies in sedentary populations have investigated the validity of DXA assessment of body composition, few studies have examined the issues of reliability in athletic populations and most studies which involve DXA measurements of body composition provide little information on their scanning protocols. This review presents a summary of the sources of error and variability in the measurement of body composition by DXA, and develops a theoretical model of best practice to standardize the conduct and analysis of a DXA scan. Components of this protocol include standardization of subject presentation (subjects rested, overnight-fasted and in minimal clothing) and positioning on the scanning bed (centrally aligned in a standard position using custom-made positioning aids) as well as manipulation of the automatic segmentation of regional areas of the scan results. Body composition assessment implemented with such protocol ensures a high level of precision, while still being practical in an athletic setting. This ensures that any small changes in body composition are confidently detected and correctly interpreted. The reporting requirements for studies involving DXA scans of body composition include details of the DXA machine and software, subject presentation and positioning protocols, and analysis protocols.

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Adam J. Zemski, Elizabeth M. Broad and Gary J. Slater

body composition are surface anthropometry and dual-energy X-ray absorptiometry (DXA) ( Ackland et al., 2012 ; Zemski et al., 2015 ). Surface anthropometry, which includes the indirect assessment of subcutaneous fat, is an easily accessible, inexpensive, mobile, and robust method of assessment. The

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Ana Torres-Costoso, Dimitris Vlachopoulos, Esther Ubago-Guisado, Asunción Ferri-Morales, Iván Cavero-Redondo, Vicente Martínez-Vizcaino and Luis Gracia-Marco

skeletal growth related to PA may be important for the prevention of osteoporosis in later life. It is well known that certain sports induce osteogenic responses in the growing skeleton ( 36 ,41 ). However, monitoring osseous changes over time is not an easy task. Dual-energy X-ray absorptiometry (DXA) is

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Erik Sesbreno, Gary Slater, Margo Mountjoy and Stuart D.R. Galloway

performance in the field. Dual-energy X-ray absorptiometry (DXA) is increasingly integrated into the monitoring of athletic populations to provide timely information on both absolute and relative whole-body and regional body composition, plus bone health ( Meyer et al., 2013 ). However, without careful

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Flinn Shiel, Carl Persson, Vini Simas, James Furness, Mike Climstein, Rod Pope and Ben Schram

Dual energy X-ray absorptiometry (DXA) uses a machine originally developed to provide information about bone mineral density, with the additional capability to assess and analyze body composition (BC) while imparting only low levels of radiation (less than a thousandth of the maximum recommended

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Asunción Ferri-Morales, Marcus Vinicius Nascimento-Ferreira, Dimitris Vlachopoulos, Esther Ubago-Guisado, Ana Torres-Costoso, Augusto Cesar F. De Moraes, Alan R. Barker, Luis A. Moreno, Vicente Martínez-Vizcaino and Luis Gracia-Marco

estimate fat mass accurately and with minimal bias in 9- to 14-year-old children. Other methods such as bioelectrical impedance analysis (BIA) or dual-energy X-ray absorptiometry (DXA) are commonly used as field and laboratory methods to assess body composition, respectively. The feasibility of the foot

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Adam J. Zemski, Shelley E. Keating, Elizabeth M. Broad and Gary J. Slater

measures are unable to accurately quantify absolute ( Doran et al., 2014 ; Reilly et al., 2009 ; Zemski et al., 2018 ), or changes in, FFM and FM ( Silva et al., 2009 ). Given this limitation, anthropometric data are increasingly being complemented by other measures. Dual-energy X-ray absorptiometry (DXA

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Grant M. Tinsley and Brett S. Nickerson

of common methods, including dual-energy X-ray absorptiometry (DXA). However, the requirement of an overnight fasting period imposes limitations for when and how many assessments can be conducted. Nonetheless, the importance of an overnight fast prior to DXA assessment has been confirmed by reports

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Gabriel Lozano-Berges, Ángel Matute-Llorente, Alejandro Gómez-Bruton, Alejandro González-Agüero, Germán Vicente-Rodríguez and José A. Casajús

). International standards for anthropometric assessment . Adelaida, CA : International Society for the Advancement of Kinanthropometry . Nana , A. , Slater , G.J. , Stewart , A.D. , & Burke , L.M. ( 2015 ). Methodology review: Using dual-energy X-ray absorptiometry (DXA) for the assessment of body

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Disa J. Smee, Anthony Walker, Ben Rattray, Julie A. Cooke, Ben G. Serpell and Kate L. Pumpa

), and instead relies on overall weight changes ( Walker et al., 2014 ). Given the previously stated limitations of BMI as a tool to assess the body composition of firefighters, researchers have utilized dual-energy X-ray absorptiometry (DXA) ( Bilzon et al., 2001 ); hydrostatic densitometry ( Donovan et