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Assessment methods in human body composition
Open accessAbstract
PURPOSE OF REVIEW: The present study reviews the most recently developed and commonly used methods for the determination of human body composition in vivo with relevance for nutritional assessment. RECENT FINDINGS: Body composition measurement methods are continuously being perfected with the most commonly used methods being bioelectrical impedance analysis, dilution techniques, air displacement plethysmography, dual energy X-ray absorptiometry, and MRI or magnetic resonance spectroscopy. Recent developments include three-dimensional photonic scanning and quantitative magnetic resonance. Collectively, these techniques allow for the measurement of fat, fat-free mass, bone mineral content, total body water, extracellular water, total adipose tissue and its subdepots (visceral, subcutaneous, and intermuscular), skeletal muscle, select organs, and ectopic fat depots. SUMMARY: There is an ongoing need to perfect methods that provide information beyond mass and structure (static measures) to kinetic measures that yield information on metabolic and biological functions. On the basis of the wide range of measurable properties, analytical methods and known body composition models, clinicians and scientists can quantify a number of body components and with longitudinal assessment, can track changes in health and disease with implications for understanding efficacy of nutritional and clinical interventions, diagnosis, prevention, and treatment in clinical settings. With the greater need to understand precursors of health risk beginning in childhood, a gap exists in appropriate in-vivo measurement methods beginning at birth.
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“Additionally, incorporating blood variables such as lipid profile, glucose levels, and inflammatory markers can offer insights into metabolic health and obesity-related risks beyond what BMI alone can provide [62].”
From Advantages and Limitations of the Body Mass Index (BMI) to Assess Adult Obesity (2024) · cites this paper as [62]
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“However, DEXA represents a reliable alternative method, non-invasive, improved feasibility, lower cost, minimal radiation exposure, high accuracy, sensitive and reproducibility for measuring FM and FFM.(38,39) In addition, DEXA is a clinically accessible method that is widely used in bone mineral density measurement f…”
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BackgroundA comparison of three methods to assess body composition.
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“Other methodologies involve dilution with isotopically labeled water (12), measures of body volume by water displacement (13) or air plethysmography (14), and in vivo neutron activation (15).”
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“fat mass, not specifically AT quantities [33].”
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“Bioimpedance has emerged as a fast, noninvasive, and easy to use method for estimating body composition”
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“Furthermore, displacement methods such as air displacement and underwater weighing can not analyze the regional body fat distribution.(6) A very popular measurement technique for assessment of body composition is the measurement of the body impedance.”
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“Body composition was measuredby BIA, which while useful for larger cohort or populational studies, is less sensitive and accurate when compared with more established methods such as dual-energy X-ray absorptiometry (DXA) or magnetic resonance imaging (MRI) (Lee and Gallagher, 2008).”
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“172 BIA method can provide information about fat and muscle masses longitudinally, suggesting insights into various conditions.”
Validity of Leg-to-Leg Bioelectrical Impedance Analysis to Estimate Body Fat in Obesity
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“Bioelectrical impedance analysis (BIA) is a rapid, easy, and safe method of assessing body composition but is criticized for being inaccurate in comparison with reference measures, especially when applied to obese subjects [4, 5 , 8, 9]. Many interference effects may limit its validity: body geometry, underestimation…”
BackgroundMethodInfluentialQuantification of human body fat tissue percentage by MRI
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“The physical design and operating principle of this product have been described in detail previously with reliability and validity for body measurements confirmed (4,8,10,11).”
Tanvig, M. H. (2014) · PubMed · Cited by 59
Gupta, P., Lança, C., Gan, A. T. L., Soh, P., Thakur, S., Tao, Y., Neelam, K., Man, R. E. K., Fenwick, E., & Lamoureux, E. L. (2019) · Scientific Reports · doi:10.1038/s41598-019-49162-5 · Cited by 65
Kim, S. R., Lee, G., Choi, S., Oh, Y. H., Son, J. S., Park, M., & Park, S. M. (2022) · Journal of Cachexia Sarcopenia and Muscle · doi:10.1002/jcsm.12962 · Cited by 58
Fuchs, C. J., Kuipers, R., Rombouts, J. A., Brouwers, K., Schrauwen‐Hinderling, V. B., Wildberger, J. E., Verdijk, L. B., & van Loon, L. J. C. (2023) · Experimental Gerontology · doi:10.1016/j.exger.2023.112159 · Cited by 64
Dietary Protein Sources and Muscle Mass over the Life Course: The Lifelines Cohort Study
Alexandrov, N. V., Eelderink, C., Singh-Povel, C. M., Navis, G. J., Bakker, S. J. L., & Corpeleijn, E. (2018) · Nutrients · doi:10.3390/nu10101471 · Cited by 56
Huffman, D. M., Justice, J. N., Stout, M. B., Kirkland, J. L., Barzilai, N., & Austad, S. N. (2016) · The Journals of Gerontology Series A: Biological Sciences and Medical Sciences · doi:10.1093/gerona/glw106 · Cited by 52
“techniques comparable with human methods, including dual-energy x-ray absorptiometry (DXA), quantitative computed tomography (CT), isotope dilution, electrical conductance, and MRI (73).”
MethodInfluentialAgyapong‐Badu, S., Warner, M. B., Samuel, D., Narici, M. V., Cooper, C. C., & Stokes, M. J. (2014) · Physiological Measurement · doi:10.1088/0967-3334/35/10/2165 · Cited by 56
Smith, S., & Madden, A. M. (2016) · Journal of Human Nutrition and Dietetics · doi:10.1111/jhn.12372 · Cited by 67
Bazzocchi, A., Diano, D., Ponti, F., Salizzoni, E., Albisinni, U., Marchesini, G., & Battista, G. (2013) · Nutrition · doi:10.1016/j.nut.2013.11.013 · Cited by 54
“Numerous techniques are able to perform BC assessment at each level [4].”
BackgroundKoepke, N., Zwahlen, M., Wells, J. C. K., Bender, N., Henneberg, M., Rühli, F. J., & Staub, K. (2017) · PeerJ · doi:10.7717/peerj.2980 · Cited by 55
“The standard imaging methods used to precisely assess body composition and fat distribution (MRI, DEXA, CT) are either invasive or time-consuming, and expensive, and thus not suitable for large-scale monitoring studies (Machann et al., 2005; Lee & Gallagher, 2008).”
MethodFrailty, Sarcopenia, Cachexia, and Malnutrition in Heart Failure
Maeda, D., Fujimoto, Y., Nakade, T., Abe, T., Ishihara, S., Jujo, K., & Matsue, Y. (2024) · Korean Circulation Journal · doi:10.4070/kcj.2024.0089 · Cited by 57
“42) Regarding biomarkers, albumin or pre-albumin have been widely used in clinical practice; however, recent consensus statements do not recommend these markers to diagnose malnutrition because they do not change in response to changes in nutrient intake.”
BackgroundImaging of body composition in children
Simoni, P., Guglielmi, R., & Gómez, M. P. A. (2020) · Quantitative Imaging in Medicine and Surgery · doi:10.21037/qims.2020.04.06 · Cited by 52
“Several techniques are available to assess body composition at different escalating levels, from atomic to molecular and then cellular, to evolve into organ-tissue and finally whole-body assessment (11,12).”
BackgroundBioelectrical Impedance Analysis and Body Composition in Cardiovascular Diseases
Popiołek-Kalisz, J., & Szczygieł, K. (2023) · Current Problems in Cardiology · doi:10.1016/j.cpcardiol.2023.101911 · Cited by 51
Buehring, B., Krueger, D. C., Libber, J., Heiderscheit, B. C., Sanfilippo, J. L., Johnson, B., Haller, I. V., & Binkley, N. (2013) · Journal of Clinical Densitometry · doi:10.1016/j.jocd.2013.02.012 · Cited by 51
“This ability to evaluate not only total fat and lean mass but also mass in specific regions such as the extremities is a distinct advantage of DXA compared with other measures of body composition, such as bioelectrical impedance or hydrodensitometry (18,19).”
BackgroundMethods for Body Composition Analysis in Adults
Ayvaz, G. (2011) · The Open Obesity Journal · doi:10.2174/1876823701103010062 · Cited by 57
“Radiation exposure from DEXA is considered small and is equivalent to 1-10% of a chest radiograph [21].”
BackgroundMethodInfluentialRangel Peniche, D. B., Raya Giorguli, G., & Alemán-Mateo, H. (2015) · Archives of Gerontology and Geriatrics · doi:10.1016/j.archger.2015.03.007 · Cited by 50
Patient physiology influences the MRI-based vertebral bone quality score
Aynaszyan, S., Devia, L. G., Udoeyo, I. F., Badve, S. A., & DelSole, E. M. (2022) · The Spine Journal · doi:10.1016/j.spinee.2022.06.003 · Cited by 50
Borggreve, A. S., den Boer, R. B., van Boxel, G. I., de Jong, P. A., Veldhuis, W. B., Steenhagen, E., van Hillegersberg, R., & Ruurda, J. P. H. (2020) · Journal of Clinical Medicine · doi:10.3390/jcm9010199 · Cited by 51
“However, studies reporting on accuracy of BIA have been inconsistent, limiting its application in clinical practice [39].”
BackgroundMoayyeri, A., Luben, R., Wareham, N. J., & Khaw, K. (2011) · Journal of Internal Medicine · doi:10.1111/j.1365-2796.2011.02443.x · Cited by 48
Dubin, R. L., Heymsfield, S. B., Ravussin, E., & Greenway, F. L. (2024) · Diabetes, Obesity and Metabolism · doi:10.1111/dom.15913 · Cited by 47
“60 61 – 63 An alternative method for estimating whole-body skeletal muscle mass is D3-creatine dilution.”
Imaging body composition in obesity and weight loss: challenges and opportunities
Silver, H. J., Welch, B. T., Avison, M. J., & Niswender, K. D. (2010) · Diabetes Metabolic Syndrome and Obesity · doi:10.2147/dmso.s9454 · Cited by 46
Imaging body composition in obesity and weight loss: challenges and opportunities
Silver, H. J., Welch, E. B., Avison, M. J., & Niswender, K. D. (2010) · Diabetes Metabolic Syndrome and Obesity · doi:10.2147/dmsott.s9454 · Cited by 46
“Further, all methods contribute some form of error or bias that is usually related to assumptions about body composition that may not hold across different population groups and clinical scenarios.(54) The pros and cons of the three common state-of-the-art imaging techniques for whole body measurement, ie, DEXA, CT, a…”
MethodNovel Approaches to the Diagnosis of Sarcopenia
Edwards, M. H., & Buehring, B. (2015) · Journal of Clinical Densitometry · doi:10.1016/j.jocd.2015.04.010 · Cited by 45
Hart, N. H., Nimphius, S., Spiteri, T., Wilkie, J. C., & Newton, R. U. (2015) · Europe PMC (PubMed Central) · Cited by 45
Military nutrition: maintaining health and rebuilding injured tissue
Hill, N. E., Fallowfield, J. L., Price, S., & Wilson, D. R. (2010) · Philosophical Transactions of the Royal Society B Biological Sciences · doi:10.1098/rstb.2010.0213 · Cited by 45
Whole‐body MRI‐based fat quantification: A comparison to air displacement plethysmography
Ludwig, U., Klausmann, F., Baumann, S., Honal, M., Hövener, J., König, D., Deibert, P., & Büchert, M. (2014) · Journal of Magnetic Resonance Imaging · doi:10.1002/jmri.24509 · Cited by 44
Alexandrou, M. E., Balafa, O. C., & Sarafidis, P. A. (2020) · American Journal of Nephrology · doi:10.1159/000509115 · Cited by 44
Palacios, C. S., Pérez, C. M., Guzmán, M., Ortiz, A. P., Ayala‐Marín, A. M., & Suarez, E. L. (2011) · Public Health Nutrition · doi:10.1017/s1368980011000796 · Cited by 43
“Although computed tomography and MRI are considered the gold standard measurements for abdominal fat((2,3)), and dual-energy X-ray absorptiometry is considered a very reliable alternative((3,4)), these are not feasible to use in large epidemiological studies; therefore, BMI and other indices have been used.”
BackgroundHuang, R., Prescott, S. L., Godfrey, K. M., & Davis, E. A. (2015) · Journal of Nutritional Science · doi:10.1017/jns.2014.69 · Cited by 43
Raymond‐Pope, C. J., Dengel, D. R., & Bosch, T. A. (2017) · The Journal of Strength and Conditioning Research · doi:10.1519/jsc.0000000000002320 · Cited by 43
“Therefore, DXA is considered the gold standard body composition assessment method within research settings (19,25,28).”
MethodBioimpedance analysis of vascular tissue and fluid flow in human and plant body: A review
Prasad, A., & Roy, M. (2020) · Biosystems Engineering · doi:10.1016/j.biosystemseng.2020.06.006 · Cited by 44
The Effect of Gender-Affirming Hormone Therapy on Serum Creatinine in Transgender Individuals
Maheshwari, A., Dines, V. A., Saul, D., Nippoldt, T. B., Kattah, A. G., & Davidge-Pitts, C. J. (2021) · Endocrine Practice · doi:10.1016/j.eprac.2021.08.009 · Cited by 43
Measurement of Sarcopenia in Head and Neck Cancer Patients and Its Association With Frailty
de Bree, R., Meerkerk, C. D. A., Halmos, G. B., Mäkitie, A. A., Homma, A., Rodrigo, J. P., López, F., Takes, R. P., Vermorken, J. B., & Ferlito, A. (2022) · Frontiers in Oncology · doi:10.3389/fonc.2022.884988 · Cited by 44
Metadata
- Authors
- Lee, S. Y., & Gallagher, D.
- Affiliations
- Inje University (KR)
- Columbia University (US)
- Corresponding author
- Gallagher, Dympna
- Venue
- Current Opinion in Clinical Nutrition & Metabolic Care
- Published
- 2008-09
- Volume
- 11
- Issue
- 5
- Pages
- 566-572
- ISSN
- 1363-1950 (ISSN-L)
- PMC
- PMC2741386
- OpenAlex
- W2044952536
- Cited by
- 694
- References
- 49
- Citations by year
- 2026: 10 · 2025: 33 · 2024: 44 · 2023: 43 · 2022: 55 · 2021: 54 · 2020: 53 · 2019: 57 · 2018: 55 · 2017: 52 · 2016: 35 · 2015: 36 · 2014: 42 · 2013: 39 · 2012: 27
- FWCI
- 2.13
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Current Opinion in Clinical Nutrition & Metabolic Care (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Diabetes and Digestive and Kidney Diseases (R01DK072507, DK72507)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD042187, HD42187)
- Topics
- Health Sciences › Medicine › Physiology (medical) › Body Composition Measurement Techniques
- Health Sciences › Medicine › Physiology (medical) › Nutrition and Health in Aging
- Health Sciences › Medicine › Infectious Diseases › HIV-related health complications and treatments
- Keywords
- body composition, nutritional assessment, bioelectrical impedance analysis, dilution method, air displacement plethysmography, dual-energy X-ray absorptiometry, magnetic resonance spectroscopy, quantitative MRI, fat-free mass, bone mineral content, total body water, extracellular water, adipose tissue depots, visceral fat, subcutaneous adipose tissue, intermuscular fat, ectopic fat, skeletal muscle
- MeSH terms
- Body Composition, Diagnostic Imaging, Female, Humans, Male, Nutrition Assessment, Electric Impedance
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