A recently standardized ultrasound technique for measuring subcutaneous adipose tissue (SAT) was applied to normal-weight, overweight and obese persons. Eight measurement sites were used: upper abdomen, lower abdomen, erector spinae, distal triceps, brachioradialis, lateral thigh, front thigh and medial calf. Fat compression was avoided. Fat patterning in 38 participants (body mass index: 18.6-40.3 kgm; SAT thickness sums from eight sites: 12-245 mm) was evaluated using a software specifically designed for semi-automatic multiple thickness measurements in SAT (sound speed: 1450 m/s) that also quantifies embedded fibrous structures. With respect to ultrasound intra-observer results, the correlation coefficient ρ = 0.999 (p < 0.01), standard error of the estimate = 1.1 mm and 95% of measurements were within ±2.2 mm. For the normal-weight subgroup, the median measurement deviation was 0.43 mm (1.1% of mean thickness), and for the obese/overweight subgroup it was 0.89 mm (0.5%). The eight sites used here are suggested to represent inter-individual differences in SAT patterning. High measurement accuracy and reliability can be obtained in all groups, from lean to overweight and obese, provided that measurers are trained appropriately.

Ultrasound (US) provides the most accurate technique for thickness measurements of subcutaneous adipose tissue (SAT) layers. This US method was recently standardised using eight sites to capture SAT patterning and allows distinguishing between fat and embedded fibrous structures. These eight sites chosen for fat patterning studies do not represent the mean SAT thickness measured all over the body that is necessary for determining subcutaneous fat mass. This was obtained by SAT measurements at 216 sites distributed randomly all over the body. Ten participants with BMI below 28.5kgm−2 and SAT means (from eight sites) ranging from 3 mm to 10 mm were selected. The means from eight sites overestimated the means obtained from 216 sites (i.e. 2160 US measurements in the ten participants); the calibration factor of 0.65 corrects this; standard deviation (SD) was 0.05, i.e. 8%. The SD of the calibration factor transforms linearly when estimating the error range of the whole body’s SAT volume (body surface area times the calibrated mean SAT thickness). The SAT masses ranged from 3.2 to 12.4 kg in this group. The standard deviations resulting from solely the calibration factor uncertainty were ±0.3 and ±1.0 kg, respectively. For these examples, the SAT percentages were 4.9(±0.4)% and 13.3(±1.0)%.

Body weight and fat are major performance variables in many sports. Extreme weight reduction can lead to severe medical problems. Accurate body composition measurements are fundamental for both medical and performance optimization. Relative body weight in terms of mass index (MI1 = 0.53 M/(hs)), and in terms of body mass index (BMI = M/h 2) were determined (h:stature, s:sitting height, M:body mass). Subcutaneous adipose tissue (SAT) was measured using a recently standardized ultrasound (US) method. US thickness sums from eight body sites were measured in 26 female and 35 male judokas of various weight classes. Comparisons of US and skinfold results indicate that the latter can be severely misleading in competitive judokas. Mean MI1 of females was 22.8 kg m−2 (BMI:22.9 kg m−2), males: 26.7 kg m−2 (BMI:26.5 kg m−2), but individual differences MI1‐BMI were larger than 0.5 kg m−2 in 13 and larger than 1.0 kg m−2 in three cases. Medians of SAT thickness sums D I were three‐times higher in females (66.1 mm) than in males (21.8 mm), and the fat patterning differed significantly. Females had 8.6% (median) fibrous structures embedded in SAT, and males 20.2%. Both MI and BMI were not correlated with SAT. Mean pre‐competition weight loss was 4.3% (ie, 3.0 kg), and maximum was 9.2% (7.4 kg), indicating that modifications of weigh‐in procedures are urgently needed. DI‐values mirror the athletes' potential to reduce ballast fat instead of short‐term weight reduction by dehydration; however, weight loss and SAT measured some weeks before the competitions were not correlated. Further, US measurements and medical longitudinal observations are required for discussing the large individual variations and possible fat minimum demands.

No abstract

Background: A procedure to measure subcutaneous adipose (SAT) using brightness-mode ultrasound has recently been standardized and applied to various groups of adults including underweight, overweight and obese adults. High reliability of this procedure was found in each of the examined groups. The purpose of this study was to determine inter-observer reliability of the standardized brightness-mode ultrasound measurement of uncompressed SAT in three to six-year-old children. Methods: Three experienced observers independently captured the ultrasound images at the eight standardized measurement sites in each of the 20 children and evaluated their images using an interactive software that detects the SAT contour and automatically measures multiple thicknesses in each image; the mean of these represents SAT thickness at a given site. The children were aged 4.9 ± 1.0 years; their body mass index ranged from 13.6-17.7 kgm − 2. Sound speed was set to 1450 ms − 1 for SAT. Results: SAT thickness sums with fibrous structures included (D I) ranged from 25.7-86.4 mm, mean D I was 48.1 ± 15.5 mm. For D I , resulting from 160 measurements by each observer, the intra-class correlation coefficient was 0.998 (95% confidence interval 0.980-0.999), standard error of the estimate was 1.1 mm, and 95% limits of agreement were within ±2.1 mm. The median difference in D I was 0.8 mm, i.e. about 1.9% of mean D I. Conclusions: Inter-observer results in children are comparable to previously described high reliability in adults. This method, which provides a technical thickness measurement accuracy of about 0.1 to 0.2 mm, enables monitoring of subcutaneous adipose tissue in children with a similarly high reliability as was obtained in adults previously.

Monitoring of children at heightened risk of cardio–metabolic diseases raises the need for accurate assessment of obesity. A standardized approach for measuring subcutaneous adipose tissue (SAT) by bright-mode ultrasound was evaluated in relation to body indices and anthropometry in a cross-sectional sample of 76 South African children (7–10 years) and 86 adolescents (13–17 years) to assess cardio–metabolic risk. SAT was higher in girls as compared to boys (children: 50.0 ± 21.7 mm > 34.42 ± 15.8 mm, adolescents: 140.9 ± 59.4 mm > 79.5 ± 75.6 mm, p < 0.001) and up to four times higher in adolescents than in children. In children, measures of relative body weight showed only a poor correlation to SAT (BMI: r = 0.607, p < 0.001), while in adolescents, BMI correlated high with SAT (r = 0.906, p < 0.001) based on high rates of overweight and obesity (41.8%). Children with identical BMIs may have large differences (>2–3-fold) in their amount of SAT. The moderate association to systolic (r = 0.534, r = 0.550, p < 0.001) and diastolic blood pressure (r = 0.402, r = 0.262, p < 0.001) further substantiates that SAT measured by ultrasound provides an accurate, safe and easy applicable approach for monitoring in children and adolescents at cardio–metabolic risk.

Body fat values obtained with various measurement methods deviate substantially in many cases. The standardised brightness-mode ultrasound method was used in 32 Kenyan elite long-distance runners to measure subcutaneous adipose tissue thicknesses at an accuracy and reliability level not reached by any other method. Subcutaneous adipose tissue forms the dominating part of body fat. Additionally, body mass (m), height (h), sitting height (s), leg length, and the mass index MI1 =0.53m/(hs) were determined. MI1 considers leg length, which the body mass index ignores. MI1 values of all participants were higher than their body mass indices. Both indices for relative body weight were within narrow ranges, although thickness sums of subcutaneous adipose tissue deviated strongly (women: 20–82 mm; men: 3–36 mm). Men had 2.1 times more embedded fasciae in the subcutaneous adipose tissue. In the subgroup with personal best times below world record time plus 10%, no correlation between performance and body mass index was found, and there was also no correlation with sums of subcutaneous adipose tissue thicknesses. Within the data ranges found here, extremely low relative body weight or low body fat were no criteria for the level of performance, therefore, pressure towards too low values may be disadvantageous.

No abstract