Accuracy of DXA in estimating body composition changes in elite athletes using a four compartment model as the reference method
Open accessAbstract
Background: Dual-energy x-ray absorptiometry (DXA) provides an affordable and practical assessment of multiple whole body and regional body composition. However, little information is available on the assessment of changes in body composition in top-level athletes using DXA. The present study aimed to assess the accuracy of DXA in tracking body composition changes (relative fat mass [%FM], absolute fat mass [FM], and fat-free mass [FFM]) of elite male judo athletes from a period of weight stability to prior to a competition, compared to a four compartment model (4C model), as the criterion method. Methods: A total of 27 elite male judo athletes (age, 22.2 ± 2.8 yrs) athletes were evaluated. Measures of body volume by air displacement plethysmography, bone mineral content assessed by DXA, and total-body water assessed by deuterium dilution were used in a 4C model. Statistical analyses included examination of the coefficient of determinant (r 2), standard error of estimation (SEE), slope, intercept, and agreement between models. Results: At a group level analysis, changes in %FM, FM, and FFM estimates by DXA were not significantly different from those by the 4C model. Though the regression between DXA and the 4C model did not differ from the line of identity DXA %FM, FM, and FFM changes only explained 29%, 36%, and 38% of the 4C reference values, respectively. Individual results showed that the 95% limits of agreement were -3.7 to 5.3 for %FM, -2.6 to 3.7 for FM, and -3.7 to 2.7 for FFM. The relation between the difference and the mean of the methods indicated a significant trend for %FM and FM changes with DXA overestimating at the lower ends and underestimating at the upper ends of FM changes. Conclusions: Our data indicate that both at group and individual levels DXA did not present an expected accuracy in tracking changes in adiposity in elite male judo athletes.
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Compared with other reference methods, DXA has been reported to overestimate FM.
“Furthermore, compared with other reference methods, DXA has been reported to overestimate FM (Santos et al., 2010).”
From External validation of bioelectrical impedance analysis equations for body composition against dual-energy X-ray absorptiometry in Mexican recreational runners (2025) · cites this paper as Santos et al., 2010
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STATISTICAL METHODS FOR ASSESSING AGREEMENT BETWEEN TWO METHODS OF CLINICAL MEASUREMENT
Martin Bland, J., & Altman, D. (1986) · The Lancet · doi:10.1016/s0140-6736(86)90837-8 · Cited by 47,965 · see citing works
Human Body Composition: Advances in Models and Methods
B. Heymsfield, S., Wang, Z., Baumgartner, R. N., & Ross, R. (1997) · Annual Review of Nutrition · doi:10.1146/annurev.nutr.17.1.527 · Cited by 527 · see citing works
Casa, D. J., Clarkson, P. M., & Roberts, W. O. (2005) · Current Sports Medicine Reports · doi:10.1097/01.csmr.0000306194.67241.76 · Cited by 236 · see citing works
Body fat measurement in adolescent athletes: multicompartment molecular model comparison.
Silva, A. M., Minderico, C. S., Teixeira, P. J., Pietrobelli, A., & Sardinha, L. B. (2006) · European Journal of Clinical Nutrition · doi:10.1038/sj.ejcn.1602405 · Cited by 72 · see citing works
Flagged first, then by citations
Research works printed but not linked: 35
- Prouteau S Benhamou L Courteix D Relationships between serum leptin and bone markers during stable weight, weight reduction and weight regain in male and female judoists Eur J Endocrinol 2006 154 389 395 10.1530/eje.1.02103 16498051 · DOI
- Utter AC Goss FL Swan PD Harris GS Robertson RJ Trone GA Evaluation of air displacement for assessing body composition of collegiate wrestlers Med Sci Sports Exerc 2003 35 500 505 10.1249/01.MSS.0000053726.16625.D5 12618582 · DOI
- Utter AC Nieman DC Mulford GJ Tobin R Schumm S McInnis T Monk JR Evaluation of leg-to-leg BIA in assessing body composition of high-school wrestlers Med Sci Sports Exerc 2005 37 1395 1400 10.1249/01.mss.0000174901.05353.f2 16118588 · DOI
- Callister R Callister RJ Staron RS Fleck SJ Tesch P Dudley GA Physiological characteristics of elite judo athletes Int J Sports Med 1991 12 196 203 10.1055/s-2007-1024667 1860744 · DOI
- Thomas SG Cox MH LeGal YM Verde TJ Smith HK Physiological profiles of the Canadian National Judo Team Can J Sport Sci 1989 14 142 147 2819609
- Kukidome T Shirai K Kubo J Matsushima Y Yanagisawa O Homma T Aizawa K MRI evaluation of body composition changes in wrestlers undergoing rapid weight loss Br J Sports Med 2008 42 814 818 10.1136/bjsm.2007.044081 18385191 · DOI
- Brozek J Grande F Anderson JT Keys A Densitometric Analysis of Body Composition: Revision of Some Quantitative Assumptions Ann N Y Acad Sci 1963 110 113 140 10.1111/j.1749-6632.1963.tb17079.x 14062375 · DOI
- Baumgartner RN Heymsfield SB Lichtman S Wang J Pierson RN Jr Body composition in elderly people: effect of criterion estimates on predictive equations Am J Clin Nutr 1991 53 1345 1353 2035461
- Heymsfield SB Waki M Body composition in humans: Advances in the development of multicompartment chemical models Nutrition Reviews 1991 49 97 108 2046977
- Modlesky CM Cureton KJ Lewis RD Prior BM Sloniger MA Rowe DA Density of the fat-free mass and estimates of body composition in male weight trainers J Appl Physiol 1996 80 2085 2096 8806917
- Wang Z Pi-Sunyer FX Kotler DP Wielopolski L Withers RT Pierson RN Jr Heymsfield SB Multicomponent methods: evaluation of new and traditional soft tissue mineral models by in vivo neutron activation analysis Am J Clin Nutr 2002 76 968 974 12399267
- Silva AM Fields DA Quiterio AL Sardinha LB Are skinfold-based models accurate and suitable for assessing changes in body composition in highly trained athletes? J Strength Cond Res 2009 23 1688 1696 19675495
- Tothill P Dual-energy X-ray absorptiometry for the measurement of bone and soft tissue composition Clin Nutr 1995 14 263 268 10.1016/S0261-5614(95)80062-X 16843941 · DOI
- Heymsfield SB Smith R Aulet M Bensen B Lichtman S Wang J Pierson RN Jr Appendicular skeletal muscle mass: measurement by dual-photon absorptiometry Am J Clin Nutr 1990 52 214 218 2375286
- Pietrobelli A Formica C Wang Z Heymsfield SB Dual-energy X-ray absorptiometry body composition model: review of physical concepts Am J Physiol 1996 271 E941 951 8997211
- Heymsfield SB Wang J Lichtman S Kamen Y Kehayias J Pierson RN Jr Body composition in elderly subjects: A critical appraisal of clinical methodology Am J Clin Nutr 1989 50 1167 1175 2683725
- Dempster P Aitkens S A new air displacement method for the determination of human body composition Med Sci Sports Exerc 1995 27 1692 1697 8614327
- McCrory MA Gomez TD Bernauer EM Molé PA Evaluation of a new air displacement plethysmograph for measuring human body composition Med Sci Sports Exerc 1995 27 1686 1691 8614326
- Prosser SJ Scrimgeour CM High-Precision Determination of 2H/1H in H2 and H2O by continuous-flow isotope ratio mass spectrometry Anal Chem 1995 67 1992 1997 10.1021/ac00109a014 · DOI
- Schoeller DA van Santen E Peterson DW Dietz W Jaspan J Klein PD Total body water measurement in humans with 18O and 2H labeled water Am J Clin Nutr 1980 33 2686 2693 6776801
- Clark RR Bartok C Sullivan JC Schoeller DA Minimum weight prediction methods cross-validated by the four-component model Med Sci Sports Exerc 2004 36 639 647 10.1249/01.MSS.0000121942.84630.6C 15064592 · DOI
- Mahon AK Flynn MG Iglay HB Stewart LK Johnson CA McFarlin BK Campbell WW Measurement of body composition changes with weight loss in postmenopausal women: comparison of methods J Nutr Health Aging 2007 11 203 213 17508096 PMC2495082
- Evans EM Saunders MJ Spano MA Arngrimsson SA Lewis RD Cureton KJ Body-composition changes with diet and exercise in obese women: a comparison of estimates from clinical methods and a 4-component model Am J Clin Nutr 1999 70 5 12 10393132
- Fogelholm GM Sievanen HT van Marken Lichtenbelt WD Westerterp KR Assessment of fat-mass loss during weight reduction in obese women Metabolism 1997 46 968 975 10.1016/S0026-0495(97)90089-5 9258284 · DOI
- Minderico CS Silva AM Keller K Branco TL Martins SS Palmeira AL Barata JT Carnero EA Rocha PM Teixeira PJ Sardinha LB Usefulness of different techniques for measuring body composition changes during weight loss in overweight and obese women Br J Nutr 2008 99 432 441 10.1017/S0007114507815789 17894918 · DOI
- Houtkooper LB Going SB Sproul J Blew RM Lohman TG Comparison of methods for assessing body-composition changes over 1 y in postmenopausal women Am J Clin Nutr 2000 72 401 406 10919934
- Schoeller DA Tylavsky FA Baer DJ Chumlea WC Earthman CP Fuerst T Harris TB Heymsfield SB Horlick M Lohman TG Lukaski HC Shepherd J Siervogel RM Borrud LG QDR 4500A dual-energy X-ray absorptiometer underestimates fat mass in comparison with criterion methods in adults Am J Clin Nutr 2005 81 1018 1025 15883424
- Pietrobelli A Wang Z Formica C Heymsfield SB Dual-energy X-ray absorptiometry: fat estimation errors due to variation in soft tissue hydration Am J Physiol 1998 274 E808 816 9612238
- Mazess RB Barden HS Bisek JP Hanson J Dual-energy x-ray absorptiometry for total-body and regional bone-mineral and soft-tissue composition Am J Clin Nutr 1990 51 1106 1112 2349926
- Goodsitt MM Evaluation of a new set of calibration standards for the measurement of fat content via DPA and DXA Med Phys 1992 19 35 44 10.1118/1.596890 1620056 · DOI
- Going SB Massett MP Hall MC Bare LA Root PA Williams DP Lohman TG Detection of small changes in body composition by dual-energy x-ray absorptiometry Am J Clin Nutr 1993 57 845 850 8503351
- Roubenoff R Kehayias JJ Dawson-Hughes B Heymsfield SB Use of dual-energy x-ray absorptiometry in body-composition studies: not yet a "gold standard" Am J Clin Nutr 1993 58 161 162 8237861
- Kiebzak GM Leamy LJ Pierson LM Nord RH Zhang ZY Measurement precision of body composition variables using the lunar DPX-L densitometer J Clin Densitom 2000 3 35 41 10.1385/JCD:3:1:035 10745300 · DOI
- Wang Z Pierson RN Jr Heymsfield SB The five-level model: a new approach to organizing body-composition research Am J Clin Nutr 1992 56 19 28 1609756
- Snyder WS Cook MJ Nasset ES Karhausen LR Howells PG Tipton IH Report of the Task Group on Reference Man 1975 Oxford, Pergamon Press
Cited by
Sorted by citations
Nana, A., Slater, G. J., Stewart, A. D., & Burke, L. M. (2015) · International Journal of Sport Nutrition and Exercise Metabolism · doi:10.1123/ijsnem.2013-0228 · Cited by 372 · see citing works
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Santos, D. A., Dawson, J. A., Matias, C. N., Rocha, P. M., Minderico, C. S., Allison, D. B., Sardinha, L. B., & Silva, A. M. (2014) · PLoS ONE · doi:10.1371/journal.pone.0097846 · Cited by 282 · see citing works
Self-citationCampa, F., Gobbo, L. A., Stagi, S., Cyrino, L. T., Toselli, S., Marini, E., & Coratella, G. (2022) · European Journal of Applied Physiology · doi:10.1007/s00421-021-04879-y · Cited by 115 · see citing works
Matias, C. N., Campa, F., Santos, D. A., Lukaski, H., Sardinha, L. B., & Silva, A. M. (2021) · International Journal of Sports Medicine · doi:10.1055/a-1179-6236 · Cited by 54 · see citing works
Self-citationFrancisco, R., Jesus, F., Nunes, C. L., Cioffi, I., Alvim, M., Mendonca, G. V., Lukaski, H., Sardinha, L. B., & Silva, A. M. (2023) · Scandinavian Journal of Medicine & Science in Sports · doi:10.1111/sms.14355 · Cited by 20 · see citing works
Self-citationVázquez-Bautista, M. A., Robles-Sardin, A. E., Reséndiz-Sandoval, M., Navarro-Ibarra, M. J., Hernández López, J., & Caire-Juvera, G. (2025) · BIOtecnia · doi:10.18633/biotecnia.v27.2512
“Furthermore, compared with other reference methods, DXA has been reported to overestimate FM (Santos et al. , 2010).”
- Authors
- Santos, D. A., Silva, A. M., Matias, C. N., Fields, D. A., Heymsfield, S. B., & Sardinha, L. B.
- Affiliations
- Universidade Técnica de Lisboa (PT)
- University of Oklahoma Health Sciences Center (US)
- Merck & Co., Inc., Rahway, NJ, USA (United States) (US)
- Corresponding author
- Silva, Analiza M
- ORCID
- Venue
- Nutrition & Metabolism
- Published
- 2010-03-22
- Volume
- 7
- Issue
- 1
- Pages
- 22-22
- ISSN
- 1743-7075 (ISSN-L)
- PMC
- PMC2850896
- OpenAlex
- W2168984469
- Cited by
- 91
- References
- 4
- Citations by year
- 2026: 2 · 2025: 7 · 2024: 6 · 2023: 7 · 2022: 6 · 2021: 3 · 2020: 6 · 2019: 5 · 2018: 7 · 2017: 4 · 2016: 6 · 2015: 4 · 2014: 7 · 2013: 12 · 2012: 3
- FWCI
- 4.55
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- Nutrition & Metabolism (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Medicine › Physiology › Body Composition Measurement Techniques
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Sports Performance and Training
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
- Keywords
- dual-energy X-ray absorptiometry, body composition, four-compartment model, judo athletes, fat mass, fat-free mass, adiposity, measurement agreement, air displacement plethysmography, deuterium dilution, bone mineral content, elite athletes
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