Body composition and functional assessment of nutritional status in adults: a narrative review of imaging, impedance, strength and functional techniques

Smith, Sara; Madden, Angela

doi:10.1111/jhn.12372

Cited by 45 publications

(42 citation statements)

References 175 publications

(251 reference statements)

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“…The use of various imaging techniques, including DXA, CT, and MRI, could have led to differences in performance estimates. However, imaging techniques are currently considered to be the most accurate tools for body composition analysis because of their ability to accurately discriminate tissues 37 , 83 . We excluded all studies that used other reference standards, such as bioelectrical impedance analysis or dilution techniques, to increase homogeneity.…”

Section: Discussionmentioning

confidence: 99%

The performance of anthropometric tools to determine obesity: a systematic review and meta-analysis

Sommer

Teufer

Szelag

et al. 2020

Sci Rep

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the aim of this systematic review was to assess the performance of anthropometric tools to determine obesity in the general population (CRD42018086888). Our review included 32 studies. To detect obesity with body mass index (BMI), the meta-analyses rendered a sensitivity of 51.4% (95% CI 38.5-64.2%) and a specificity of 95.4% (95% CI 90.7-97.8%) in women, and 49.6% (95% CI 34.8-64.5%) and 97.3% (95% CI 92.1-99.1%), respectively, in men. For waist circumference (WC), the summary estimates for the sensitivity were 62.4% (95% CI 49.2-73.9%) and 88.1% for the specificity (95% CI 77.0-94.2%) in men, and 57.0% (95% CI 32.2-79.0%) and 94.8% (95% CI 85.8-98.2%), respectively, in women. The data were insufficient to pool the results for waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) but were similar to BMI and WC. In conclusion, BMI and WC have serious limitations for use as obesity screening tools in clinical practice despite their widespread use. No evidence supports that WHR and WHtR are more suitable than BMI or WC to assess body fat. However, due to the lack of more accurate and feasible alternatives, BMI and WC might still have a role as initial tools for assessing individuals for excess adiposity until new evidence emerges. Obesity is widely recognised as a pandemic public health problem. According to the World Health Organization (WHO), in 2016 more than 650 million adults worldwide were obese 1. These numbers have almost tripled since 1975 2. Obesity increases the risk for many chronic diseases, such as diabetes mellitus, cardiovascular diseases and cancers 3 , and is possibly associated with mental health disorders 4. Associations have been shown to be strongest between obesity and the incidence of diabetes mellitus, particularly in women (risk ratio [RR] 12.41, 95% confidence interval [CI] 9.03-17.06). Primary care is considered one of the main settings for the prevention, screening and management of obesity 5. Individual studies indicate that patients are more likely to lose weight when they receive recommendations for lifestyle changes from their primary care physicians 6. Because it can be difficult for physicians to accurately determine obesity solely through visually inspecting their patients 7 , they need a reliable, efficient screening tool in order to ensure that those who need management and treatment receive it. WHO conceptualises obesity as "abnormal or excessive fat accumulation that may impair health" 1. It is most commonly assessed using body mass index (BMI), a simple and quick anthropometric tool that has a low cost. Adults with a BMI greater than or equal to 30 are classified as being obese 1 (Table 1). However, several researchers and professional associations 8-14 consider the use of BMI as the primary clinical index of obesity insufficient. They have called for a new definition that fully accounts for the complexity of the disease relating to the quantity, distribution and secretory function of adipose tissue. A substantial body of evidence has shown that obesity (BMI ≥ 30) is ass...

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Section: Discussionmentioning

confidence: 99%

The performance of anthropometric tools to determine obesity: a systematic review and meta-analysis

Sommer

Teufer

Szelag

et al. 2020

Sci Rep

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“…However, caution is warranted because the different measurement techniques use different models and so there is likely to be a propagation of error from the measured component through to the last derived component . Also, BIA has previously shown variability in clinical populations and a lack of precision in longitudinal studies . BIA is also susceptible to error as a result of variations in internal fluid balances .…”

Section: Discussionmentioning

confidence: 99%

“…In comparison to BIA, ultrasound demonstrated far less agreement, particularly when measuring FM. A review of body composition using imaging techniques concluded that, even though the results from ultrasound scanning were promising, the accuracy of derived estimates of adiposity still needed to be examined against appropriate reference methods . It has also been demonstrated, in 47 healthy, young overweight/obese adults, that ultrasound predictions of body fat were significantly lower than fat percentage predicted by ADP .…”

Section: Discussionmentioning

confidence: 99%

Practical measurement of body composition using bioelectrical impedance, air displacement plethysmography and ultrasound in stable outpatients with short bowel syndrome receiving home parenteral nutrition: comparison of agreement between the methods

Jones

Lal

Gittins

et al. 2018

J Human Nutrition Diet

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Background People diagnosed with intestinal failure ( IF ) as a result of short bowel syndrome are dependent on home parenteral nutrition ( HPN ). Measuring nutritional status is essential for monitoring treatment. The present study aimed to determine the agreement and feasibility of three methods bioelectrical impedance analysis ( BIA ), ultrasound and air displacement plethysmography ( ADP ) for measuring body composition in people receiving HPN . Methods Body composition data were collected from patients attending an IF clinic. Results There were 50 participants recruited and data were collected for BIA ( n = 46), ultrasound ( n = 49) and ADP ( n = 9). Numbers for ADP were much lower because of a lack of participant uptake. Fat‐free mass ( FFM ) measured by BIA and ultrasound in comparison to ADP was found to have good intraclass correlation ( ICC ) 0.791 (95% confidence interval (CI) CI −0.21 to 0.96) and a moderate ICC 0.659 [95% ( CI) −0.27 to 0.92], respectively. Fat mass ( FM ) measured by both BIA and ultrasound in comparison to ADP was found to have moderate ICC 0.660 (95% CI −0.28 to 0.92) and poor ICC −0.005 (95% CI −0.73 to 0.65), respectively. Conclusions Compared to ADP , BIA indicated moderate to good agreement for measuring body composition, whereas ultrasound indicated far less agreement, particularly when measuring FM . The lack of uptake of ADP suggests that participants found the Bodpod (COSMED Srl, Shepperton, UK) unfavourable. Considering that ultrasound has limited agreement and ADP was not the preferred option for participants, BIA shows some potential. However, the difference between ADP and BIA was larger for FM compared to FFM , which needs to be considered in the clinical setting.

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“…Body composition constitutes a key component of individuals' and populations' health status and is determinant in selecting which patients undergo the procedure. The procedures mostly utilized to assess body composition for research purposes include densitometry, single‐cut imaging of the abdomen using computed tomography, magnetic resonance imaging or dual‐energy X‐ray absorptiometry (Smith & Madden, ). However, the high cost of these procedures has led to the use of single measures, such as the BMI (defined as weight in kilograms divided by height in meters squared, kg/m 2 ).…”

Section: Introductionmentioning

confidence: 99%

Weight Loss Trajectories in Bariatric Surgery Patients and Psychopathological Correlates

García-Ruiz-de-Gordejuela

Agüera

Granero

et al. 2017

Euro Eating Disorders Rev

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This study aimed to explore the empirical trajectories of body mass index (BMI) 1 year following bariatric surgery (BS) and to identify the risk factors for each trajectory. The study included 115 patients with severe obesity who underwent BS. Assessment included metabolic variables, psychopathological and personality measures. Growth mixture modelling identified four separated trajectories for the percentage of total weight loss course shape (namely, T1 'good-fast', T2 'good', T3 'low' and T4 'low-slow'). After adjusting for BS subtype and metabolic baseline state, T1 and T2 registered less eating and general psychopathology. T1 was characterized by the lowest scores in novelty seeking and self-transcendence, whereas T4 was defined by the highest scores in novelty seeking and the lowest scores in persistence. Our findings suggest that psychological state prior to BS is predictive of BMI trajectories during the 12 months following BS. These results could be useful in developing more efficient interventions for these patients. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.

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Body composition and functional assessment of nutritional status in adults: a narrative review of imaging, impedance, strength and functional techniques

Cited by 45 publications

References 175 publications

The performance of anthropometric tools to determine obesity: a systematic review and meta-analysis

The performance of anthropometric tools to determine obesity: a systematic review and meta-analysis

Practical measurement of body composition using bioelectrical impedance, air displacement plethysmography and ultrasound in stable outpatients with short bowel syndrome receiving home parenteral nutrition: comparison of agreement between the methods

Weight Loss Trajectories in Bariatric Surgery Patients and Psychopathological Correlates

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