Body composition indices of a load-capacity model: gender- and BMI-specific reference curves
Open accessAbstract
Objective: Fat mass (FM) and fat-free mass (FFM) are frequently measured to define body composition phenotypes. The load–capacity model integrates the effects of both FM and FFM to improve disease-risk prediction. We aimed to derive age-, gender- and BMI-specific reference curves of load–capacity model indices in an adult population (≥18 years). Design: Cross-sectional study. Dual-energy X-ray absorptiometry was used to measure FM, FFM, appendicular skeletal muscle mass (ASM) and truncal fat mass (TrFM). Two metabolic load–capacity indices were calculated: ratio of FM (kg) to FFM (kg) and ratio of TrFM (kg) to ASM (kg). Age-standardised reference curves, stratified by gender and BMI (<25·0 kg/m 2, 25·0–29·9 kg/m 2, ≥30·0 kg/m 2), were constructed using an LMS approach. Percentiles of the reference curves were 5th, 15th, 25th, 50th, 75th, 85th and 95th. Setting: Secondary analysis of data from the 1999–2004 National Health and Nutrition Examination Survey (NHANES). Subjects: The population included 6580 females and 6656 males. Results: The unweighted proportions of obesity in males and females were 25·5 % and 34·7 %, respectively. The average values of both FM:FFM and TrFM:ASM were greater in female and obese subjects. Gender and BMI influenced the shape of the association of age with FM:FFM and TrFM:ASM, as a curvilinear relationship was observed in female and obese subjects. Menopause appeared to modify the steepness of the reference curves of both indices. Conclusions: This is a novel risk-stratification approach integrating the effects of high adiposity and low muscle mass which may be particularly useful to identify cases of sarcopenic obesity and improve disease-risk prediction.
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Studies by Siervo et al. showed that the ratio of visceral fat mass to appendicular skeletal muscle index is a better predictor of mortality and diabetes risk than the simple fat mass to fat-free mass ratio.
“Among available examples, studies conducted by Siervo et al [6,108] have shown that the ratio of visceral FM/ASMI is a better predictor of mortality and diabetes risk compared to the more simple FM/FFM ratio.”
From Critical appraisal of definitions and diagnostic criteria for sarcopenic obesity based on a systematic review (2020) · cites this paper as [6]
In sarcopenic obesity, this adaptive process can fail, leading to adipose accumulation without corresponding muscle mass and function increase.
“However, in individuals with sarcopenic obesity, this adaptive physiological process can falter, leading to excessive adipose tissue accumulation (‘load’) without a corresponding increase in muscle mass and functionality (‘capacity’)12,13.”
From Sarcopenic obesity in older adults: a clinical overview (2024) · cites this paper as [12]
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- Authors
- Siervo, M., Prado, C. M., Mire, E., Broyles, S., Wells, J. C., Heymsfield, S., & Katzmarzyk, P. T.
- Affiliations
- Newcastle University (GB)
- University of Alberta (CA)
- Pennington Biomedical Research Center (US)
- University College London (GB)
- Corresponding author
- Siervo, Mario
- ORCID
- Venue
- Public Health Nutrition
- Publisher
- Cambridge University Press (CUP)
- Published
- 2014-09-15
- Volume
- 18
- Issue
- 7
- Pages
- 1245-1254
- ISSN
- 1368-9800 (ISSN-L)
- 1475-2727
- PMC
- PMC10272998
- OpenAlex
- W2060484010
- Semantic Scholar
- bb7332716765b6f06e044d6f93f01e473d37845e
- Cited by
- 86
- References
- 37
- Citations by year
- 2026: 11 · 2025: 8 · 2024: 10 · 2023: 6 · 2022: 5 · 2021: 15 · 2020: 3 · 2019: 6 · 2018: 5 · 2017: 9 · 2016: 5 · 2015: 2
- FWCI
- 3.55
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Public Health Nutrition (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Newcastle University ePrints (Newcastle Univesity)
- Topics
- Health Sciences › Medicine › Physiology › Body Composition Measurement Techniques
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Keywords
- body composition, fat mass, fat-free mass, appendicular skeletal muscle mass, reference curves, obesity, sarcopenic obesity, menopause, sex differences, body mass index, disease risk prediction
- MeSH terms
- Adult, Algorithms, Cross-Sectional Studies, Female, Humans, Male, Models, Biological, Nutrition Surveys, Obesity, Sex Factors, United States, Cohort Studies, Absorptiometry, Photon, Body Mass Index, Prevalence, Weight-Bearing, Muscle, Skeletal, Risk Assessment, Adiposity, Overweight, Whole Body Imaging, Sarcopenia
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