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Skeleton, muscle, fat make up 3 structural components of body

BODY COMPOSITION
Anthropometry measurement of body size and proportions including
skinfold thicknesses, circumferences, bony widths and lengths, height, and
body weight. quantitative measurements of human landmarks
Body composition - two-component model - the amount of fat and fat-free
mass of which the body is composed. Fat-free mass is primarily composed
of bone, muscle, vital organs, and connective tissue.
Four-component model - fat, protein, mineral, water
Why assess body composition?
Suitable body composition is important for health.
Establish reasonable fatness ranges for athletes in various sports
Accurate measures of body composition are needed to develop sound
weight reduction programs
Knowledge of bone mineral content in women and children is
important.
Monitor changes in body composition associated with disease.
Obesity complication --> Type II Diabetes mellitus, high inflammatory markers in body
Eating disorders --> Anorexia Nervosa, Bulimia Nervosa

I. Essential Fat vs. Storage Fat


Essential fat - fat that is required for normal physiological functioning structural components of cell membranes, required for the synthesis of
certain hormones, transport of fat-soluble vitamins,etc.
Storage fat - fat that is stored in adipose tissue for energy supply purposes. It
is located underneath the skin, in the abdominal cavity, and around certain
organs.

II. Body Composition of Males vs Females


The average male is taller, heavier, has a larger muscle mass, and a lower
total body fat content.
For reference male and female, age 20 - 24:
Storage fat - female = 15%
- male = 12%
Essential fat - female = 12%
- male = 3%
Female has sex specific fat depots in the breasts, pelvic and thigh regions,
and probably other areas.
The additional essential fat in females most likely serves biologically
important functions for childbearing and other hormone-related functions.
apple

"Male type" (android) obesity - excess fat is deposited on the upper torso and
around the abdomen apple shape. Male type obesity is associated with
higher health risks.
pear

"Female type" (gynoid) obesity - excess fat is deposited below the waist in
the thighs, hips, and buttocks (ie) pear shape. After menopause females
begin depositing more fat in the abdominal area
III. Obesity
The combination of diabetes and obesity is one of the largest epidemics the
world has faced. The prevalence of overweight and obesity is increasing
around the world and the obese are becoming more severely obese.
Obesity now ranks as the second leading cause of preventable deaths in the
USA about 330,000 deaths yearly. Deaths from tobacco use ranks first.
Obese individuals with a BMI of 30 or larger can expect about a 7 year
decrease in longevity. Survival rates progressively increase as BMI
decreases.
BMI = body mass in kg/height m^2
higher the body mass, more BMI

Obese children become obese adults. Obese children at ages 6 to 9 have a


55% chance of becoming obese as adults a risk 10 times that of children of
normal weight.
An obese child costs the health care system about three times more than a
child of normal weight.
In the past dozen years, scientists have discovered that adipose tissue is not
simply a passive storehouse for fat, but an endocrine organ that secretes
more than a dozen peptide and non-peptide compounds that trigger changes
throughout the body. When fat cells expand they release more of some of
these compounds and less of others. Examples leptin, adiponectin,
inflammatory proteins, etc.

Causes of the Obesity Epidemic


1. Weight gain and obesity occur when energy intake exceeds energy
expenditure too much food and too little activity. For most of human
history, survival meant avoiding starvation our bodies are set up to deal
with scarcity, not abundance. The average man and woman in the USA
now consumes an average of 445 more calories daily than in 1970.
2. Decreased physical activity automobiles, increased crowding, crime
patterns, technological advances and automation in the home and the
workplace, many hours spent watching TV, playing video games, sitting
at the computer
3. Increased consumption of calories consumption of large portion size
meals, high-fat diets, high sugar intake
4. Social environment advertising, pressure to consume, influence of
family and friends
5. Genetics the epidemic of obesity is occurring on genetic backgrounds
that have not changed, but it is now clear that genetics plays an important
role in the development of obesity. Ones genetic makeup doesnt
necessarily cause obesity, but instead lowers the threshold for its
development because of the impact of susceptibility genes.

Data from overfeeding experiments with identical twins demonstrate that


some individuals are more at risk than others to gain fat when energy
intake surplus is maintained at the same level for everyone and when all
subjects are confined to a sedentary lifestyle.
NEAT non-exercise activity thermogenesis. It is the energy expended
by physical activities other than planned exercise sitting, standing,
walking, fidgeting, etc. In a recent research study, obese participants were
seated for 164 minutes longer per day than were lean participants.
6. Role of viruses? Do some viruses play a role in the expansion of adipose
tissue mass? This is a new area of research.

IV. Common Techniques For Assessing Body Composition


Direct methods - chemical analysis of human cadavers
Indirect methods - noninvasive techniques used on living persons
A. Height - Weight Tables
Desirable weight with regard to the lowest death rates is predicted from
tables that have been developed by insurance actuaries.
Criticisms:
(1) These tables do not consider body composition.
(2) Most of the data in the 1983 Metropolitan Life Insurance Height-Weight
tables comes from white, middle-class, U.S. adults age 25 to 59 years.
This is not a representative sample of the general North American
population.
(3) No accepted method has been devised for determining frame size.

B. Body Density and Volume Measurements


Density = mass/volume. Body density will vary with the amount of body
fat.
Use underwater weighing or volumetry to measure body volume. In recent
years the UWW technique has begun to be replaced by air- displacement
plethysmography (BOD POD method) where the subject is immersed not in
water but in a closed air-filled chamber (plethysmograph). Measure the
volume of air displaced inside the closed chamber.
After body density has been determined using one of the above methods, use
an equation, such as the equation developed by Siri, to determine percent
body fat.
These equations make two basic assumptions:
(1) The human body has two compartments - fat and nonfat
(2) Each of these compartments has densities which are known constants.
Assume that fat has a density of 0.90 g/ml and nonfat a density of 1.10
g/ml.
For decades hydrostatic weighing has been used as a universal method for
validating skinfold caliper formulae and all other methods (ie) it has been
used as the "gold standard".
Problems:- cadaver studies (Brussels cadaver study, 1984) have shown that
the density of the nonfat compartment varies as a function of age, sex, and
racial group.
Therefore, a nonfat density value of 1.10 g/ml is not universally applicable.
Conclusion - densitometry should not be used as a universal criterion for
prediction of percent fat. Equations based on four component models are
preferred over equations based on a two component model.

C. Weight - Height Indices


Body Mass Index (BMI) - used as an indicator of obesity. This index uses
the body mass (kg) divided by the height (meters) squared.
Classification system for adults (20-70 years old):
BMI less than 18.5 = underweight
BMI of 25.0 to 29.9 = overweight
BMI of 30 or higher = obese

BMI = Weight (kg)/ Height (m^2)

The absolute value of BMI is not used to classify weight status in children
because change in BMI is normal and expected as children grow and
develop. In children, 2 to 19 years of age, a BMI between the 5th and 84th
percentiles is healthy, between the 85th and 94th percentiles is overweight, and
at or above the 95th percentile is obese.
Recent research evidence indicates that these BMI cut-off points may need
revision because the relationship between BMI and body composition, and
between indices of fat distribution and the actual amount of visceral fat,
differs across ethnic groups. For example, Asian populations have a higher
body fat percentage at a lower BMI compared to Caucasians. Change the
definition for overweight for Asian populations from 25 to 23?
A 2007 study in Vancouver found that, for the same amount of total body fat,
Chinese and South Asian people had a far greater concentration in their inner
abdomen, where it poses the greatest risk for diabetes and heart disease.
The main assumption of BMI guidelines is that BMI is closely associated
with body fatness and consequent morbidity and mortality. However, some
individuals who are overweight are not over-fat.
Criticism - BMI does not differentiate body composition.
BMI of NFL football players: Marshawn Lynch = 32.1, Ray Lewis = 33,
Nick Mangold = 36.6
BMI of NHL hockey players: Sidney Crosby = 27.8, Alexander Ovechkin =
28.8
Accumulating research evidence shows that waist circumference and/or
waist-to-hip ratio may be a better predictor of obesity related health risks
than BMI.

The prevalence of overweight and obesity amongst Canadian children and


adults has increased significantly in the past 20 years.
D. Waist Circumference
WC has been shown to be a simple and inexpensive, yet effective way to
assess for central obesity, with excellent correlation with abdominal imaging
(CT and MRI), and high association with CVD risk and mortality.
One problem is that different research studies have used up to 8 different
locations for measuring WC. North American agencies now recommend
performing the WC measurement at the iliac crest.
E. Skinfold Measurements
Read pages 4-1 to 4-3 in Laboratory Manual
Rationale - a relationship exists between the fat located in the depots directly
beneath the skin and internal body fat and body density.
There are basically two ways to use skinfolds:
(1) Use the sum of a number of skinfolds as an indication of relative fatness
among individuals. Also compare "before" and "after" in the same
individual.
(2) Use skinfolds in conjunction with equations or tables to predict percent
body fat.
Skinfold caliper formulae to predict percent fat are site and sample specific.
Assumptions in using skinfold measurements to predict percent fat:
(1) Constant densities in a two-compartment model
(2) Proper identification of measurement site and proper measurement
technique

(3) Constant compressibility of the skinfold


(4) Fixed adipose tissue patterning
(5) Fixed proportion of internal to external fat
There are two types of body composition prediction equations:
(1) Population specific equations - developed from relatively small,
homogeneous (age, sex, state of training, fatness) samples. Their
application is limited to that subsample.
Example Yuhasz
(2) Generalized equations - developed from large, heterogeneous samples.
These equations have a wider application in terms of age, and fatness.
However, these equations should be used cautiously with unique
populations such as extremely obese individuals and professional football
players.
Example - Jackson and Pollock, Durnin & Womersley, Peterson, Wang
With advancing age, proportionately more fat deposits internally rather than
subcutaneously. The same skinfold score reflects a greater total percentage
of body fat as one ages. For this reason, age-adjusted percent fat prediction
equations are needed.
Even when the correct equation is used and the measurements are performed
correctly, prediction of percent fat from skinfold measurements has an error
of approximately 3-4 %.
F. CSEP-PATH Body Composition Assessment
Refer to Unit 6 in Lab Manual
In the 2013 CSEP-PATH body composition assessment procedures, as
compared to the 2003 CPAFLA body composition assessment procedures,
the Sum of Five Skinfolds has been removed in favour of the combined use

of Body Mass Index (BMI) and Waist Circumference (WC) to provide an


assessment of an individuals health risks associated with body composition.
The 2013 procedure first determines whether or not the subject is overweight
or obese via a BMI calculation, then via the waist circumference
measurement, if there is excess body fat deposited in the abdominal area.
G. O-Scale System
Refer to Unit 5 in Lab Manual
Adiposity rating, proportional weight rating, stanine scale
H. Bioelectrical Impedance Analysis
Electrical impedance units are used to measure the electrical resistance of the
body.
Impedance is greater in adipose tissue (14 - 22% water) than in bone and
muscle (71 - 75% water).
Attach electrodes to the subject. A low level electrical current (500 to 800
microamps at 50 kHz) is passed through the subjects body. The higher the
electrical resistance, the fatter the subject.
The daily fluctuations in water content from exercise, dehydration, eating and
drinking all need to be standardized to obtain optimum impedance results.
Clients must adhere to strict pretest guidelines in order to yield valid
estimates of their body composition.
The prediction equations that estimate fat free mass are validated using
underwater weighing.
These equations tend to overestimate fat mass in the lean and underestimate
fat mass in the obese
Must use equations specific to given populations sex, age, race, ethnicity
Error in percent fat estimation - approx. 3-5% body fat

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I. Near-Infrared Interactance (NIR)


Principle a fiber optic probe emits a low energy beam of near-infrared light
into the anterior surface of the biceps brachii muscle. The intensity of the
infrared light reflected is related to the composition of the tissues. The
theory is that optical densities are linearly related to subcutaneous and total
body fat.
In general, research does not support NIR as a valid method to assess human
body composition across a broad range of ages, sexes, and racial and athletic
categories.
J. Other Procedures
1. Dual energy X-ray absorptiometry (DXA) widely used for performing
bone mineral density measurements. It can also reliably and accurately
quantify fat and regional lean body mass
2. Total body water - hydrometry
3. Ultrasound
4. Magnetic resonance imaging (MRI)
5. Computerized tomography (CT) the radiation dose is not insignificant.
Do the ends justify the means?
6. Total body potassium
CT, MRI and DEXA are now frequently being considered as gold standards
for calibration of field methods designed to measure adipose tissue and lean
body mass.
CT and MRI have the advantage of distinguishing between subcutaneous
adipose tissue (SAT) and adipose tissue located in the abdominal cavity
visceral adipose tissue (VAT). Although waist circumference is generally a
good predictor of abdominal adiposity, it cannot distinguish between SAT
and VAT.
These laboratory/research methods are accurate but they are expensive,
cumbersome, and require highly trained technicians.
Conclusion - results of estimation of body composition should be interpreted
cautiously.

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V. Body Composition and Aging


Changes associated with aging in a prosperous, industrialized society:
increased fat mass
decreased muscle mass - sarcopenia
decreased bone mass
These changes can be slowed down by a regular exercise program and proper
dietary habits.
Evidence indicates that skeletal fragility in elderly women is related to failure
to obtain an optimal level of bone mass during childhood.

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Co-morbidities/Complications Associated With Obesity


Type II diabetes mellitus
Hypertension
Coronary artery disease, and heart failure
Higher incidence of certain cancers breast, colon, esophagus, prostate,
kidney, and uterus. Up to one-third of common cancers in industrialized
nations are related to excess weight and diminished physical activity.
Dyslipidemia
Higher levels of inflammatory markers in the body
Stroke
Sleep apnea
Gallbladder disease
Nonalcoholic fatty liver disease
Osteoarthritis of the weight-bearing joints
Gout
Reduced fertility
Impaired obstetric performance
Reduced physical agility

Co-morbidities/Complications Associated With Excessive Thinness


Fluid-electrolyte imbalances
Osteoporosis
Bone fractures
Muscle wasting
Cardiac arrhythmias and sudden death
Peripheral edema
Renal disorders
Reproductive disorders
The prevalence of anorexia nervosa is estimated at 0.5% of the population in
the western industrialized countries. 90% of people with anorexia are
female, with females between 15 and 19 years old making up 40% of all
cases.

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