Percent body fat via DEXA: comparison with a four-compartment model
Abstract
This study compared body composition by dual-energy X-ray absorptiometry (DEXA; Lunar DPX-L) with that via a four-compartment (4C; water, bone mineral mass, fat, and residual) model. Relative body fat was determined for 152 healthy adults [30.0 ± 11.1 (SD) yr; 75.10 ± 14.88 kg; 176.3 ± 8.7 cm] aged from 18 to 59 yr. The 4C approach [20.7% body fat (%BF)] resulted in a significantly ( P < 0.001) higher mean %BF compared with DEXA (18.9% BF), with intraindividual variations ranging from −2.6 to 7.3% BF. Linear regression and a Bland and Altman plot demonstrated the tendency for DEXA to progressively underestimate the %BF of leaner individuals compared with the criterion 4C model (4C %BF = 0.862 × DEXA %BF + 4.417; r 2 = 0.952, standard error of estimate = 1.6% BF). This bias was not attributable to variations in fat-free mass hydration but may have been due to beam-hardening errors that resulted from differences in anterior-posterior tissue thickness.
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DXA is a reliable method for assessing BMD and estimating fat and lean masses, provided standard test protocols are used.
“Though costlier, DXA is a reliable method for assessing BMD and estimating fat and lean masses, provided standard test protocols are used.[138][139][140]”
From 2023 international olympic committee's (IOC) consensus statement on relative energy deficiency in sport (REDs) (2023) · cites this paper as [139]
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- Authors
- van der Ploeg, G. E., Withers, R. T., & Laforgia, J.
- Affiliations
- Exercise Physiology Laboratory, School of Education, Flinders University, and
- Flinders University (AU)
- University of South Australia (AU)
- Venue
- Journal of Applied Physiology
- Publisher
- American Physiological Society
- Published
- 2003-02-01
- Volume
- 94
- Issue
- 2
- Pages
- 499-506
- ISSN
- 0161-7567 (ISSN-L)
- 8750-7587
- 1522-1601
- OpenAlex
- W2100004116
- Cited by
- 163
- References
- 4
- Citations by year
- 2026: 1 · 2025: 4 · 2024: 8 · 2023: 3 · 2022: 3 · 2021: 4 · 2020: 7 · 2019: 7 · 2018: 10 · 2017: 13 · 2016: 10 · 2015: 12 · 2014: 11 · 2013: 15 · 2012: 17
- FWCI
- 2.30
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Applied Physiology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Body Composition Measurement Techniques
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
- Health Sciences › Medicine › Emergency Medicine › HIV-related health complications and treatments
- Keywords
- body fat percentage, dual-energy X-ray absorptiometry, four-compartment model, body composition, method comparison, measurement bias, beam hardening, tissue thickness, healthy adults
- MeSH terms
- Adipose Tissue, Adult, Female, Humans, Male, Middle Aged, Models, Anatomic, Absorptiometry, Photon
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