Cited by 27Body Composition Measurement TechniquesObesity, Physical Activity, DietDiabetes, Cardiovascular Risks, and Lipoproteins

Comparison of Body Composition Methods in Obese African‐American Women

Open access
Newton, Robert L., Alfonso, Anthony, York‐Crowe, Emily, Walden, Heather, White, Marney A., Ryan, Donna, Williamson, Donald A.·2006·Obesity

Abstract

Objective: To compare the accuracy of percentage body fat (%BF) estimates between bioelectrical impedance analysis (BIA) and DXA in obese African‐American women. Research Methods and Procedures: Fifty‐five obese African‐American women (mean age, 45 years; mean BMI, 38; mean %BF, 48%) were studied. BF was assessed by both BIA (RJL Systems BIA 101Q; RJL Systems, Clinton Township, MI) and DXA (Hologic QDR‐2000 Bone Densitometer; Hologic Inc., Bedford, MA). Generalized and ethnicity‐ and obese‐specific equations were used to calculate %BF from the BIA. Bland‐Altman analyses were used to compare the agreement between the BIA and the DXA, with the DXA serving as the criterion measure. Results: Two of the generalized equations provided consistent estimates across the weight range in comparison with the DXA estimates, whereas most of the other equations increasingly underestimated %BF as BF increased. One of the generalized and one of the ethnicity‐specific equations had mean differences that were not significantly different from the DXA value. Discussion: The findings show that the Lukaski equation provided the most precise and accurate estimates of %BF in comparison with the QDR 2000 and provide preliminary support for the use of this equation for obese African‐American women.

Integrity signals

Registry

Crossref · 10.1038/oby.2006.55

Cites

41 of 41 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

4 of 46 cited sources checked · 2 supported · 0 flagged · accuracy not yet measured

  • Interpretationcitation

    Differences in body properties related to obesity and ethnicity may prevent a single BIA equation from being best for all.

    “mounting evidence suggests that the differences in the properties of the body, such as those related to obesity (3) and ethnicity (6,9,33), may prevent this from becoming a reality.”
    Quote in the paperSubstantial claim1 of 4 sources checked
    • cites [3] source
    • cites [6] source
    • cites [9] source
    • cites [33] source
  • Findingown data

    Jakicic's equation provided biased estimates.

    “It is also somewhat surprising that Jakicic's equation (4) provided biased estimates because it was developed on a similar sample of obese African-American adult women.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [4] source
  • Findingown data

    In the sample, mean %BF by DXA was 48.5% (SD 6.2).

    “According to the DXA, on average, the women had 48% BF (Table 3).”
    • Also stated in: § Discussion · plain
      “DXA | 48.5 | (6.2) | 30.8 to 63.6”
    Quote in the paperNot a substantial claim
  • Findingown data

    All BIA equations except Segal 2 had significant negative slopes, indicating increasing underestimation of %BF as BF increased.

    “All of the other equations (except Segal 2) had significant negative slopes, meaning that they increasingly underestimated %BF as BF increased.”
    Quote in the paperSubstantial claim
  • Findingown data

    The Sun equation was significantly biased and underestimated %BF in this sample.

    “Of note, the equation developed by Sun was significantly biased and underestimated %BF.”
    Quote in the paperSubstantial claim
  • May combine two claims. 18
  • Classified as probably not a substantial claim. 6
  • The quote only partly states this claim. 1
  • May combine two claims.

    Study design and conductcitation

    In the authors' laboratory, DXA coefficients of variation were 0.25% for weight, 1.0% for lean mass, 1.6% for fat mass, and 1.5% for percentage fat.

    “Data from our laboratory show that the coefficient of variation for weight was 0.25%, lean mass was 1.0%, 1.6% for fat mass, and 1.5% for percentage fat (18).”
    Quote in the paperNot a substantial claim1 of 1 sources checked
  • May combine two claims.

    Premisecitation

    In the same sample, the Lukaski equation significantly underestimated fat-free mass, but its estimates were unaffected by body weight in obese women.

    “In this same sample, the Lukaski equation provided estimates that significantly underestimated fat-free mass, but estimates were unaffected by body weight in obese women.”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [29] source

      The Discussion states that the Lukaski equation significantly underestimated fat-free mass, and the Results say it failed to cross-validate in every subgroup, including obese women. The paper reports that its discrepancy was not influenced by obesity and that a trend with fat mass was significant only in the full sample (Results, p. 534); it does not establish that estimates were unaffected by body weight within obese women. (LLM, conf=0.84)

      Experimental — accuracy not yet measured
  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    In a study of normal and overweight adults, the Kushner equation accurately predicted fat-free mass in overweight women but tended to overestimate fat-free mass as fat mass increased.

    “In a study of normal and overweight adults (29), the Kushner equation accurately predicted fat-free mass in overweight women, although it also tended to overestimate fat-free mass with increasing fat mass.”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [29] source

      The Results (Table 3) say the Kushner equation cross-validated in obese women, supporting that part of the claim, though the paper calls this group obese rather than overweight. The Results (p. 534) also report overestimation with increasing fat mass, but only in women; the citing sentence leaves that restriction unstated. (LLM, conf=0.84)

      Experimental — accuracy not yet measured
  • May combine two claims.

    Findingown data

    Limits of agreement for all equations ranged from 5.4% to 10.2%, with most about 6.5% above and below the mean difference.

    “The limits of agreement for all of the equations were between 5.4% and 10.2%, with the majority lying ϳ6.5% above and below the mean difference.”
    Quote in the paperSubstantial claim
  • Classified as probably not a substantial claim.

    Findingown data

    The study enrolled 55 obese African-American women.

    “Fifty-five obese African-American women (mean age, 45 years; mean BMI, 38; mean %BF, 48%) were studied.”
    • Also stated in: § Participants · plain
      “The 55 African-American women who volunteered for the current study were recruited as part of a study that tested the efficacy of a weight-loss program (17).”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Findingown data

    All BIA equations except Wang produced lower mean %BF than DXA; Wang's mean equaled DXA.

    “Table 3 also shows that all of the BIA equations resulted in mean %BF estimates that were lower than the estimates determined by DXA, except the Wang equation, whose estimates were equal to the DXA.”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Premisecitation

    DXA estimates of %BF are accurate, but values can differ by DXA instrumentation.

    “Estimates of %BF are also accurate (11)(12)(13), but values can differ based on the DXA instrumentation utilized (e.g., Lunar, Hologic, Norland).”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [11] source
    • cites [12] source
    • cites [13] source
  • May combine two claims. The quote only partly states this claim.

    Interpretationown data

    The findings support the hypothesis that the Sun equation would be inaccurate at higher body weights and would estimate better for whites than African Americans, in middle-aged obese African-American women.

    “The findings of the current study support this hypothesis for middle-aged, obese African-American adult women.”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Interpretationown data

    The Lukaski and Kushner equations gave estimates unaffected by body weight, but only Lukaski gave unbiased estimates.

    “The Lukaski (22) and Kushner (21) equations provided estimates that were unaffected by the participants' body weight, but only the Lukaski equation ( 22) provided unbiased estimates.”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [22] source
    • cites [21] source
  • May combine two claims.

    Interpretationown data

    Neither ethnicity-specific nor obese-specific equations provided better estimates than two generalized equations.

    “Our findings show that neither ethnicity-specific [Jakicic (4) and Wang (9)] nor obese-specific [Segal (3) and Jakicic (4)] equations provided better estimates than two generalized equations (21,22).”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [4] source
    • cites [9] source
    • cites [3] source
  • May combine two claims.

    Premisecitation

    DXA provides accurate estimates of bone mineral content and bone mineral density.

    “The DXA method has been shown to provide accurate estimates of bone mineral content and bone mineral density (11).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [11] source
  • Classified as probably not a substantial claim.

    Interpretationreasoning

    The study's conclusions should not be generalized to other ethnic or age groups, genders, or non-obese samples.

    “Therefore, conclusions should not be generalized to other ethnic or age groups, genders, or to non-obese samples.”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Premisecitation

    In a sample of obese women, the Kushner equation overestimated %BF by 1% to 2%, while the Lukaski equation underestimated %BF by 3.7% to 4.0%, compared with densitometry, deuterium dilution, and the three-component model.

    “In a sample of obese women (1), the Kushner equation overestimated %BF between 1% and 2%, whereas the Lukaski equation underestimated %BF between 3.7% and 4.0%, in comparison with densitometry, deuterium dilution, and the three-component model.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [1]
  • May combine two claims.

    Premisecitation

    Sparling et al. showed the average estimate was 29% different from densitometrically determined fat-free mass in normal weight African-American women but only 5% different in white women.

    “Sparling et al. (30) showed that the average estimate was 29% different than the densitometrically determined fat-free mass value in normal weight African-American women but only 5% different in white women.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [30] source
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Some studies have shown DXA measurement differences are less than 2%.

    “Some have shown that the measurement differences are Ͻ2% (36 -38).”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [36] source
    • cites [37] source
    • cites [38] source
  • May combine two claims.

    Interpretationreasoning

    It is difficult to predict how the BIA equations used here will perform with different DXA instruments, but differences are likely about 3%.

    “Therefore, it is difficult to predict exactly how the BIA equations used in the present study will perform when used with different DXA instruments, but it is likely that the differences will be ϳ3%.”
    Quote in the paperNot a substantial claim
  • Classified as probably not a substantial claim. May combine two claims.

    Premisecitation

    Sun noted their generalized equation better estimated body composition in the white sample and would likely underestimate %BF in African Americans.

    “Furthermore, Sun (7) noted that their generalized equation (developed on a sample across a wide range of body weights) better estimated body composition in the white sample and that the equation would likely underestimate percentage BF (%BF) in African Americans.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [7] source
  • May combine two claims.

    Premisecitation

    Sun developed one equation intended for use across ethnic groups, while other equations are ethnicity-specific.

    “Sun (7) developed one equation that could be used across ethnic groups, whereas the other equations are separate based on ethnicity.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [7] source
  • May combine two claims.

    Premisecitation

    At least two studies, one using QDR 2000, have shown QDR overestimates Lunar.

    “However, at least two studies (14,35), one of which was conducted with the QDR 2000 (14), have shown that the QDR overestimates Lunar.”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [14] source
    • cites [35] source
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    DPX instruments overestimate %BF compared with QDR instruments by 3% to 8%.

    “Several researchers have shown that DPX instruments overestimate %BF values in comparison with QDR instruments from 3% to 8% (16,34).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [16]
    • cites [34]
  • May combine two claims.

    Premisecitation

    Body composition differences exist between ethnic groups and could affect BIA accuracy.

    “Studies have shown that body composition differ-ences exist between ethnic groups (5) that could affect the accuracy of BIA measurement.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [5] source
  • May combine two claims.

    Premisecitation

    Sun, Ainsworth, and Wang equations included individuals from all weight ranges; Jakicic's sample was exclusively obese; Hortobagyi included college athletes.

    “In addition, the Sun (7), Ainsworth (8), and Wang (9) equations included individuals from all weight ranges, whereas Jakicic's (4) sample was exclusively obese, and Hortobagyi (10) included college athletes.”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [7] source
    • cites [8] source
    • cites [9] source
22 of 22
  • The paper relies on this without support.

    BIA becomes less accurate as body fat increases.

    “Studies have found that BIA becomes less accurate as body fat (BF) increases.”
  • The paper relies on this without support.

    No additional obese populations beyond the original validation sample have been used to test the Jakicic equation.

    “the Jakicic equation ( 4) has not been tested on additional obese populations outside the original validation sample.”
  • The paper relies on this without support.

    Compared with whites, African Americans have differences in bone mineral content within fat-free mass, in fat distribution and body shape, and in limb length proportions.

    “For example, African Americans differ from whites with respect to fat-free mass (bone mineral content), body shape (fat distribution), and body proportion (length of limbs).”
  • The paper relies on this without support.

    Sun's hypothesis that their generalized equation would underestimate %BF in African Americans has not been directly tested.

    “However, this hypothesis has not been directly tested.”
  • The paper relies on this without support.

    Results from different DXA scanners vary somewhat because of software, scanner generation, and scan mode.

    “Although DXA is commonly used as a reference method, differences between DXA scanners yield slightly different results due to differences in software, generation of DXA instrument, and scan mode.”
  • The paper relies on this without support.

    The majority of BIA equations were derived using white participants and later used with people of other ethnicities.

    “Most BIA equations have been developed on white samples and then applied to individuals from other ethnic groups.”
6 of 6

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Abstract and Table 2 give different mean ages

    Minor

    The abstract reports a mean age of 45 years, whereas Table 2 reports 43.1 years for the participants. Rounding 43.1 to a whole year gives 43, not 45.

  • BIA table cites the wrong reference number for Deurenberg

    Minor

    Table 3 labels the Deurenberg equation as reference 13, but the reference list assigns Deurenberg to reference 20. Reference 13 is a different paper.

2 of 2

Cites

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Authors
Newton, R. L., Alfonso, A., York‐Crowe, E., Walden, H., White, M. A., Ryan, D., & Williamson, D. A.
Affiliations
  • Pennington Biomedical Research Center (US)
  • Yale University (US)
Corresponding author
Williamson, Donald A.
Venue
Obesity
Publisher
Wiley
Published
2006-03
Volume
14
Issue
3
Pages
415-422
ISSN
  • 1930-7381 (ISSN-L)
  • 1930-739X
OpenAlex
W2061041983
Cited by
27
References
38
Citations by year
2026: 1 · 2025: 1 · 2024: 1 · 2022: 1 · 2020: 1 · 2019: 2 · 2018: 1 · 2017: 2 · 2016: 1 · 2015: 1 · 2014: 1 · 2013: 1
FWCI
1.57
Type
journal article
Language
en
Open access
Locations
  • Obesity (publishedVersion)
  • PubMed (publishedVersion)
  • Civil War Book Review (submittedVersion)
Topics
  • Health Sciences › Medicine › Physiology › Body Composition Measurement Techniques
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Keywords
body composition, body fat percentage, bioelectrical impedance analysis, dual-energy X-ray absorptiometry, African American women, measurement agreement, underestimation of body fat
MeSH terms
Adult, Anthropometry, Black or African American, Body Composition, Female, Humans, Middle Aged, Models, Theoretical, Obesity

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