Body Composition Analysis

1. Body Composition

2. What is body composition?
The proportion of fat and fat-free mass (muscle,
bone, organs, and water) in the body.
Healthy body composition involves a high
proportion of fat-free mass and an acceptably
low level of body fat, adjusted for age and
gender.
How to lose fat?
Through a lifestyle that includes a sensible diet and
exercise.
How to add muscle mass?
Through resistance training/strength training.

3. What Is Body Composition?
Body composition = the body’s relative amounts
of fat mass and fat-free mass (bone, water,
muscle, connective and organ tissues, teeth)
Essential fat = crucial for normal body
functioning
3–5% of total body weight in males
8–12% of total body weight in females
Nonessential fat = adipose tissue

4. The Spectrum of Body Size,
Shape and Composition

5. We All Change in Many Ways

6. What are the different ways
to look at human body
composition?
 Medical (health)
 Anthropological
 Performance
 Appearance

7. Why is knowledge of body
composition so important?
 Health and Disease
 Performance
 Appearance
 Longevity

8. Typical Body Composition

9. What are fat-free mass, essential fat, and
non-essential fat, and what are their
functions in the body?
 Fat Free mass
 The non-fat component of the human body consisting of skeletal muscle,
bone, organs, and water.
 Essential fat
 The fat in the body necessary for normal body function
 Includes lipids incorporated into nerves, brain, heart, lungs, liver and
mammary glands.
 These fat deposits are crucial for normal body functioning
 3% for Men, and 12% for women.
 Non-essential fat (Storage Fat)
 Extra fat or fat reserves stored in the body.
 Adipose tissue (fat cells) exists primarily just below the skin (subcutaneous)
and around major organs (visceral).
 The amount of storage fat varies from person to person based on many
factors:
 Gender, age, heredity, metabolism, diet, and activity level

10. Genetics and Body Composition

11. Different Levels of BC Measurement

12. Compartment Model
FAT MASS
FAT-FREE
MASS
Mineral
Protein
Water
Body
Weight

13. Reference Female

14. Reference Female

15. Reference Male

16. (note
differences in
fat and muscle
content )
Male
vs
Female

17. What is Essential Fat?
 Consists of fat stored in major organs, muscles, and
central nervous system
 Important for childbearing and
hormone-related functions
 Required for normal physiological
functioning: reducing essential fat below
some minimal amount can impair
overall health. Extremes in dieting (and
exercise) can reduce essential fat stores)

18. Sex Differences in Essential Fat
Men
3%
Women
12%
Of this amount, 5 to 9%
is called sex-specific,
reserve storage fat
contained in breast and
genital regions, lower
body subcutaneous fat,
and intramuscular
depots

19. Sex Differences in Storage Fat
Storage fat accumulates mainly in adipose tissues.
This fat depot includes visceral fatty tissues and
adipose tissue deposited beneath the skin’s
surface called subcutaneous fat
Women
15%
Men
12%
The common anatomic sites for subcutaneous
fat include the triceps, subscapula, iliac ,mid-
abdomen, and upper thigh

20. Distribution of Adipose Tissue

21. Fat Distribution and Assessment of Fat Distribution
 Men and women and regional fat distribution:
 Men often carry their excess fat in the abdominal region (apple
shape/android obesity).
 Women often carry excess fat in the hips, thighs, and buttocks
(pear shape/gynoid obesity).
 Assessment of Fat Distribution
 Two simplest forms are waist circumference measurement, and
waist-to-hip calculation.
Waist circumference—simply measure your waist. Right at the
umbilicus (belly button) and top of the iliac crest (top of the hip
bone).
Waist-to-hip calculation—take you waist measurement divided by
your hip measurement.

22. Fat-Free Body Mass (FFM)
Defined as body mass devoid of
all extractable fat
Fat mass = Body mass * % body fat
Body mass = 75.1 kg Body fat = 23.6%
FFM = Body mass - fat mass
What is the FFM for this person?
Answer: 57.4 kg

23. Lean Body Mass (LBM)
In men, FFM includes 3% essential fat
In females, FFM includes 12% essential fat
LBM is an in vivo concept essential for normal
physiological functioning throughout the life span
When you compute LBM (body mass minus fat
mass), the LBM component includes the “lipid-
rich” essential fat stores in bone marrow, brain,
spinal cord, and internal organs. LBM and FFM
yield the same result, but the interpretation of
their tissue composition distinguishes between
the two concepts

24. The Concept of Minimal Weight
Lowest you can weigh before compromising FFM stores
Males: Includes about 3% essential body
fat (marathon runner; gymnasts;
jockeys; others
Females: Includes about 4%-7% essential
fat + sex-specific fat (5%-9%) = 12%
[probably around 48.5 kg (105 lbs) for
reference female]

25. How Lean is Too Lean?
In males, the lower limit of leanness equals about about
3% body fat. Long distance runners typically have such
low values. This level of fatness is compatible with
efficient heat dissipation during intense prolonged
aerobic exercise.
In females, the lowest values for body fat correspond to
the essential fat content (about 12%). This level of
fatness is extremely low—in fact, females rarely go
below this amount and still remain in “good” health. A
woman who appears “skinny” or thin does not
necessarily mean she has a low body fat content.

26. Leanness, Exercise, and
Menstrual Irregularity
Society places an extreme focus on body weight and need for weight loss
through dieting. The effects are felt in the general adult population, many
athletic endeavors, and unfortunately in grade school. For example, 55% of
8th grade girls and 28% of 8th grade boys believed they were too fat and
required dieting. The facts revealed the contrary. Only 13% of both
populations needed to reduce. Sadly, 50% of the 8th grade girls and 15% of
the boys had already begun dieting regimens.
And it’s not just teenagers who are possessed about
losing weight. Professional models, role models for
children and teenagers, today weigh 23% less than the
reference woman, many with disordered eating
conditions

27.  Ammenorrhea (completion cessation of menses) occurs in 2 to 5% of
women of reproductive age, and 40% of female athletic groups such as
dancers, skaters, cheerleaders, gymnasts, cross-country runners
 Oligomenorrhea (irregular menstrual cycles) or amenorrhea increases the
risk of bone loss and musculoskeletal injury in premenopausal women
Health Consequences of “Thinness”
Leanness is not the only factor to play a role in
menstrual irregularities. Many physically active females
fall below critical fat levels (about 17% body fat), yet
still have normal menstrual cycles. Some amenorrheic
athletes have normal body fat percentage

28. Overweight and Obesity
The most important consideration in
evaluating body weight and composition
is the proportion of total body weight
that is fat (percent body fat)
Overweight = total body weight above a
recommended range for good health
Obesity = severely overweight and
overfat; characterized by excessive
accumulation of body fat

29. Prevalence of Overweight and Obesity

30. Obesity Trends* Among U.S. Adults
1990
No Data <10% 10%–14%
(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)
Source: Behavioral Risk Factor Surveillance System, CDC

31. Source: Behavioral Risk Factor Surveillance System, CDC
(*BMI 30, or ~ 30 lbs overweight for 5’4” person)
No Data <10% 10%–14% 15%–19% 20%–24% ≥25%
(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)
Obesity Trends* Among U.S. Adults
2002

32. Excess Body Fat and Wellness
Increased risk of chronic disease and premature
death; associated health problems include
 Unhealthy blood fat levels
 Impaired heart function
 Heart disease and hypertension
 Cancer
 Impaired immune function
 Gallbladder disease
 Kidney disease
 Skin problems
 Sleeping problems

33. Body Composition and Cancer
Mortality

34. Physical Activity, Overweight, and Risk of
Death

35. Body Mass Index
 A rough assessment based on the concept that a person’s weight should
be proportional to height
 Body weight in kilograms is divided by the square of height in meters
 Elevated BMI is linked to increased risk of disease, especially if associated
with large waist circumference

36. Body Mass Index and Risk of Type 2
Diabetes

37. Assessment Results
You are at high risk for disease if you fall
above these ranges:
Men—Waist Circumference: > 40 in
Waist-to-Hip Measurement: > 0.94
Women—Waist Circumference: > 35 in
Waist-to-Hip Measurement: > 0.82
Try this out with your tape measure.
Partner up and calculate on your handout.

38. How does body composition affect
wellness?
 Think about this…
 Two women who are 5’5” and weigh 130 lbs. One woman is a runner and has
15% body fat. The second woman is sedentary who has 33% body fat. Although
both women are not overweight by many standards, the second woman is
overfat.
 Measuring body weight is not an accurate way to assess body composition
because it does not differentiate between muscle weight and fat weight.
 Remember that muscle is more dense that fat. A fit person can easily weigh
more than an unfit person.

39.  Overweight: characterized by a body weight above a recommended
range for good health; ranges are set through large scale population
surveys.
 Obesity: severely overweight, characterized by an excessive
accumulation of body fat 25% of body weight or more as fat in men,
and 32% or more as fat in women. Obesity may also be defined in
terms of some measure of total body weight.
 Percent Body Fat Standards for men and women
Men Women
At risk < 5% < 8%
Below average 6-14% 9-22%
Average 15% 23%
Above average 16-24% 24-31%
At risk > 25% > 32%
*These vary on age and gender, please follow the healthy standards emailed to you for your age and
gender.

40. At Risk…What does that mean?
Negative Health Consequences of Obesity
 Early death
 Death from CVD
 Hypertension
 Diabetes and insulin resistance
 Gallbladder disease
 Cancer of the colon, prostate,
esophogus, gallbladder, ovaries,
endometrium, breast, and cervix
 Arthritis and gout
 Back Pain
 Complications during pregnancy
 Menstrual abnormalities
 Shortness of breath
 Sleep apnea
 Increased LDL and triglycerides
 Decreased HDL levels
 Impaired heart function
 Impaired immune function

41.  A healthy body composition is vital for wellness
throughout life. Strong scientific evidence suggests that
controlling your weight will increase your life span;
reduce the risk of heart disease, cancer, diabetes, insulin
resistance, and back pain; increase your energy level, and
improve your self-esteem

42. How are body composition and fat
distribution measured?
 Body Mass Index—also known as height and weight
charting. These are of limited value for athletes because
they make no distinction between fat and fat-free mass.
However the average person, BMI are of value to predict risk
in the general population.
 BMI = (weight x 703)/(height in inches)²
 Normal: 18-24.99; Overweight: 25-29.99; Obese: 30 +
 Using this criteria, 64.5 % of American adults are considered overweight or obese.
 Again, BMI should not be used for athletic /highly muscular individuals as it may
falsely identify them as being overweight.
 Waist Circumference—use of tape measure. With a tape
measure you can measure anything on your body that you
are wanting to lose inches. As seen before, and what we did
in our assessments.
 Skinfold Method—a practical and inexpensive method.
Only measure subcutaneous fat. Available at the RWC if
you are a member.

43. Other Forms of Assessments
 Hydrostatic Weighing-water displacement
 Bod Pod—Air displacement
 Bioelectrical Impedance—Our scale is a form of this method
 Ultrasound—sound waves to measure adipose tissue thickness.
 Infrared
 Creatine Excretion
 Total Body Potassium
 3-Methylhistidine Excretion
 Measurement of Total Body Water
 Dual Energy X-ray Absorbiometry (DEXA); also used for bone density

44. Estimating Percent Body Fat
Skinfold measurements:
Folds of skin are measured
with a caliper. The
measurements are used in
equations that link the
thickness of skinfolds to
percent body fat
calculations made from
more precise experiments.

45. Estimating Percent Body Fat
Underwater weighing: An individual is submerged
and weighed under water. Percentages of fat and
fat-free weight are calculated from body density.
The Bod Pod: The amount of air displaced by a
person in a small chamber is measured by
computerized sensors.
Bioelectrical impedance analysis (BIA): A small
electrical current is sent through the body, and the
resistance of the body to it is recorded. The
resulting estimates of how much water is in the
body can be used to determine body composition.

46. Assessing Body Fat Distribution
Disease risk increases with total waist
measurement of more than
40 inches for men
35 inches for women
Disease risk increases with total waist-
to-hip measurement above
0.94 for young men
0.82 for young women

47. Setting Body Composition Goals
If fat loss would benefit your health,
set a realistic goal in terms of percent
body fat or BMI
If you have underlying health issues,
check with your physician before
setting a goal
A little weight loss at a time can be
very beneficial; focus on a healthy
lifestyle including proper diet and
exercise

48. Making Changes in Body Composition
Lifestyle should focus on:
Regular physical activity, endurance exercise, and
strength training

49. Making Changes in Body Composition
 Lifestyle should focus on:
 Moderate energy intake
 Physical activity is the key to long-term success

50. BODY COMPARTMENTS
 TBW: Total Body Water
 ECW: Extracellular
Water
 ICW: Intracellular Water
 BF: Body Fat
 FFM: Fat-free Mass
 FM: Fat Mass

51. Methods for Body Composition
Assessment
 Diluition Techniques – Reference method
 2H, 3H, 18O, NaBr;
 Dual Energy X-ray Absorptiometry (DEXA)- Reference
method
 Computed Tomography and Magnetic Resonance Imaging
 Site Specific images - IAAT
 Densitometry –
 Hydrostatic Weighing, BodPod
 Electrical Impedance Techniques
 BIA (single & multi- frequency)
 BIS – Cole-Cole Model
 Skinfolds & Anthropometric
 Body Mass or Weight

52. References Methods
 Dilution Techniques
 Deuterium (2H) exchanges with H2O –
reference method for Total Body Water
 NaBr (sodium-bromide) dilution doesn’t
cross cell membrane – ECF space
 Requires pre- and post- dilution specimen
(serum, urine) and mass spectrometer
 Dual Energy X-ray Absortiometry
(DXA)
 X-ray
 Measures Bone Mineral Content (BMC)
 Bone Free Soft Tissue (BFST)
 BMC + BFST = FFM
 Distribution of Fat and Lean Tissue

53. PRINCIPLES OF BIA
The resistance (R) of an of homogeneous material of uniform
cross-sectional area is proportional to its length (L) and inversely
proportional to its cross sectional area (A).
The body offers two types of R to an electrical
current: capacitative R (Reactance), and resistive R (simply called
Resistance).
Reactance (Re or X): Capacitative R CELL MEMBRANES
Reactance (R): Extra and Intracellular FLUIDS
Impedance (Z): Relation between X and R
Phase Angle (PA): Lower phase angles: decreased cell integrity
A basic assumption of BIA is that the sum of the arm,
trunk and leg volumes can be modeled as a cylinder with uniform
conductivity.

54. CLASSIFICATION
 BIA: Bioelectrical Impedance Analysis
 SF-BIA: Single Frequency Bioelectrical Impedance
Analysis
 MF-BIA: Multi Frequency Bioelectrical Impedance
Analysis
 BIS: Bioelectrical Impedance Spectroscopy
 BIVA: Bioelectrical Impedance Vector Analysis
 W-BIA: Whole Body Bioelectrical Impedance Analysis
 S-BIA: Segmental Bioelectrical Impedance analysis

55. MACHINES FOR BIOIMPEDANCE ANALYSIS
 Quantum II (RLJ System)
 SC-331 S (Tanita Corporation)
 ElectroFluidGraph (Akern s.r.l.)
 SFB7 (Impedimed Ltd.)
 Bioscan 916S (Maltron Ltd.
 Body Composition Monitor (Fresenius Medical Care)

56. Methods for Body Composition
Assessment
IN VIVO Neutron Activation Analysis
Elemental Analysis
Computed Tomography
Site Specific images - IAAT
Magnetic Resonance Imaging
Site Specific images - IAAT
Densitometry – reference method
Hydrostatic Weighing, BodPod
Dual Energy X-ray Absorptiometry (DXA)

57. Methods for Body Composition
Assessment
 Tracer Techniques – reference method
 2H, 3H, 18O, NaBr
 Electrical Techniques
 BIA (single & multi- frequency)
 BIS – Cole-Cole Model
 Skinfolds & Anthropometric
 Body Mass or Weight

58. Principles of Methods
 Bod Pod – body density
 Archimedes
 Density of the body is determined – reference method
 Equations are used to convert body density to body fat
 Size Limitations – 450 pounds
 Dilution Techniques
 Deuterium (2H) exchanges with H2O – reference method
 NaBr dilution doesn’t cross cell membrane – ECF space
 Requires pre- and post- dilution specimen (serum, urine)
 C1 x V1 = C2 x V2

59. Principles of Methods
Bioelectrical Impedance (BIA)
Water and electrolytes are conductors
Fixed frequency (50kHz) transmitted through body
Measures Resistance, Capacitance, Phase Angle
Phase = cellular health and/or cellular death
Equations are used to convert resistance measures to
estimates of fat-free mass (FFM)
Multiple Frequency Impedance (MFBIA)
Frequencies vary from 5 kHz – 1MHz
Use of prediction equations - not independent of TBW
Cole-Cole model

60. BIA Measurement

61. Principles of Methods
Dual Energy X-ray Absortiometry (DXA)
X-ray is filtered into 2 energies
Measures Bone Mineral Content (BMC)
Bone Free Soft Tissue (BFST)
BMC + BST = FFM
Distribution of Fat and Lean Tissue
Special Region Of Interest (ROI) for Specific Sites
Size Limitations

62. DXA Lumbar Spine
Measurement

63. DXA for Whole Body Composition

64. Clinical Use of Body
Composition
Anorexia & Obesity
Renal Failure
Liver Disorders: Ascites
Chronic Obstructive Pulmonary Disease
Cancer & AIDS associated wasting
Burns & Trauma
Congestive Heart Failure
Spinal Cord Injuries
Osteoporosis

65. Potential Uses on Methods
Found in Literature
Bod Pod
FFM & FM
Adults
Infant model – tested
DXA
BMC, BMD, FFM,and FM
Tissue Distribution
CT and MRI
Site specific tissue analysis

66. Potential Uses on Methods
Found in Literature
 BIA
 FFM & FM
 Adult and Pediatric
 Dialysis
 Survival
 Cancer, peritoneal dialysis, malnutrition, obesity
 Congestive Heart failure
 MFBIA or BIS
 FFM, FM, TBW, ECF
 Pregnancy, HIV+ wasting