Evaluating body fat in girls and female adolescents: advantages and disadvantages of dual-energy X-ray absorptiometry

Wong, William W.; Hergenroeder, Albert C.; Stuff, Janice E.; Butte, Nancy F.; Smith, E O; Ellis, Kenneth J.

doi:10.1093/ajcn/76.2.384

Cited by 93 publications

(89 citation statements)

References 30 publications

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“…Previous studies have shown that DXA measures adiposity with variable bias, tending to overestimate fat mass in those who are fatter. 36,37 Despite such inaccuracy in absolute values, DXA tends to rank fatness consistently with other techniques, and the technique is unlikely to have generated erroneous associations in our analyses. Total fat mass by DXA was very strongly associated with 4-component values in this study (r ¼ 0.98).…”

Section: Discussionmentioning

confidence: 87%

Prenatal and postnatal programming of body composition in obese children and adolescents: evidence from anthropometry, DXA and the 4-component model

Wells¹,

Haroun²,

Levene³

et al. 2011

Int J Obes

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Background: Low-birth weight has been proposed to programme central adiposity in childhood. However, there is little information on associations between fetal weight gain and fat distribution within obese individuals. Objectives: To investigate associations between birth weight and postnatal weight gain with body composition in a sample of obese children and adolescents. Subjects and methods: Body composition was measured using anthropometry, dual-emission X-ray absorptiometry and the 4-component model in 45 male and 76 female obese individuals aged 5-22 years. General linear models were used to investigate associations between birth weight standard deviation score (SDS), or change in weight SDS between birth and follow-up, and body composition, adjusting for age, pubertal status, height and gender. Results: Birth weight SDS ranged from À1.86 to 3.46, and was inversely associated with current weight SDS after adjustment for height SDS. Birth weight SDS was weakly associated with waist and hip girths, but not waist-hip ratio or trunk fat, after adjusting for age, height, pubertal status and gender. Change in weight SDS was strongly associated with total and central adiposity. Conclusions: Despite incorporating substantial variability, birth weight SDS was only a weak predictor of tissue masses and their distribution in obese children. Variability in central adiposity was more strongly associated with the magnitude of postnatal growth, which in turn was weakly inversely associated with birth weight SDS. In a population uniformly characterised by excess body weight, postnatal weight gain exerted the dominant impact on adiposity and fat distribution.

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Section: Discussionmentioning

confidence: 87%

Prenatal and postnatal programming of body composition in obese children and adolescents: evidence from anthropometry, DXA and the 4-component model

Wells¹,

Haroun²,

Levene³

et al. 2011

Int J Obes

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“…Although DXA is considered a valid technique for %FM and FM analysis, it is not considered as the 'gold reference' method and it is not without limitations regarding both the accuracy and the reliability to estimate total body fatness. (Wong et al, 2002;Williams et al, 2006). However, of the available methods to measure body composition, DXA has a good performance criteria to measure %FM and FM when compared with multicompartment models (Lohman et al, 2000;Genton et al, 2002).…”

Section: Discussionmentioning

confidence: 99%

Changes in thoracic gas volume with air-displacement plethysmography after a weight loss program in overweight and obese women

et al. 2007

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Objective: This study was designed to compare measured and predicted thoracic gas volume (V TG ) after weight loss and to analyze the effect of body composition confounders such as waist circumference (WC) on measured V TG changes. Design: Prospective intervention study. Setting: Outpatient University Laboratory, Lisbon, Portugal. Subjects: Eighty-five overweight and obese women (body mass index ¼ 30.073.5 kg/m 2 ; age ¼ 39.075.7 years) participating in a 16-month university-based weight control program designed to increase physical activity and improve diet. Methods: Body weight (Wb), body volume (Vb), body density (Db), fat mass (FM), percent fat mass (%FM) and fat-free mass (FFM) were assessed by air-displacement plethysmography (ADP) at baseline and at post-intervention (16 months). The ADP assessment included a protocol to measure V TG and a software-based predicted V TG . Dual-energy X-ray absorptiometry (DXA) (Hologic QDR 1500) was also used to estimate FM, %FM and FFM. Maximal oxygen uptake (VO 2 max) was assessed with a modified Balke cardiopulmonary exercise testing protocol with a breath-by-breath gas analysis. Results: Significant differences between the baseline and post-weight loss intervention were observed for body weight and composition (Vb, Db, %FM, FM and FFM), and measures of V TG (measured: D ¼ 0.2 l, Po0.001; predicted: D ¼ 0.01 l, Po0.010) variables. Measured V TG change was negatively associated with the change in the WC (P ¼ 0.008), controlling for VO 2 max and age (P ¼ 0.007, P ¼ 0.511 and P ¼ 0.331). Linear regression analysis results indicated that %FM and FM using the measured and predicted V TG explained 72 and 76%, and 86 and 90% respectively, of the variance in %FM and FM changes using dual-energy x-ray absorptiometry. Conclusions: After weight loss, measured V TG increased significantly, which was partially attributed to changes is an indicator of body fat distribution such as WC. Consequently, measured and predicted V TG should not be used interchangeably when tracking changes in body composition. The mechanisms relating the reduction of an upper body fat distribution with an increase measured V TG are worthy of future investigation.

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“…However, under-or overestimations of percent FM that should lead to critical interpretation of data have been reported in young children 12 and in girls. 14 Dramatic changes in body composition occur during adolescence and differ between boys and girls. We therefore conducted this study to examine the effects, in each sex, of diet combined with physical exercise training intervention on the total and segmental body composition in adolescents with severe obesity.…”

Section: Discussionmentioning

confidence: 99%

“…9 The dual-energy X-ray absorptiometry (DEXA) has been validated as an efficient tool to assess the total and regional body composition in vivo, 10 in adults 11 and in children. [12][13][14] Changes in body composition differs markedly between boys and girls during puberty. Hormonal changes that influence patterns in body fat accumulation and lean body mass leading to opposite trends in boys and girls have been well described in nonobese adolescents.…”

Section: Introductionmentioning

confidence: 99%

Effects of a multidisciplinary weight loss intervention on body composition in obese adolescents

et al. 2004

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OBJECTIVE:To investigate if a multidisciplinary weight loss program in adolescents suffering severe obesity allows adequate growth and development and avoid lean mass loss. DESIGN: A total of 55 adolescents (33 girls and 22 boys) suffering severe obesity were enrolled in an interdisciplinary weight reduction program lasting 6-12 months. Progressive submaximal physical activity was performed and national dietary allowances for adolescents with low levels of physical activity energy were provided. MEASUREMENTS: Total and segmental body composition was assessed by means of dual-energy X-ray absorptiometry. RESULTS: The mean height significantly increased (Po0.001). The mean body mass index (BMI) dropped in boys from 34.573.2 to 25.572.3 kg/m 2 and in girls from 38.474.1 to 28.474.1 kg/m 2 . Height increased according to the expected pattern (Po0.001). Total lean mass (LM) did not vary and was positively correlated to pubertal development in both sexes before and after weight loss. Steepest drop in fat mass (FM) was observed in the trunk (À63.2710.1% in boys and -51.5711.4% in girls). Decrease in BMI and FM was tightly correlated in both sexes. However, slopes significantly differed (Po0.0005) so that a decrease of 1 kg/m 2 in BMI corresponded to a decrease of 3.92 kg in FM in girls and of 5.44 kg in boys. In each sex, FM at baseline and duration of the treatment were the main determinants of the decrease in FM. CONCLUSION: During adolescence, despite a major weight loss, adequate growth and preservation of LM can be achieved. Weight loss kinetics markedly differs between boys and girls. Low-calorie diets are unnecessary to achieve a marked reduction of severe obesity during puberty. International Journal of Obesity (2004) 28, 290-299. doi:10.1038/sj.ijo.0802542Keywords: adolescents; diet; exercise; body composition IntroductionThe steep increase of obesity in children and adolescents is partly due to major changes in lifestyle in all industrialized countries. In France, the prevalence of obesity has doubled every 15 y since 1970 and reached 16% in 2000. 1 It has been extensively demonstrated that low physical activity levels are a cause and a consequence of overweight. 2 Obese children tend to remain obese in adulthood. 3 Many severe complications of adult obesity are embedded in childhood and adolescence. 4 So strategies are needed to prevent and to treat childhood obesity. 2,5 The treatment of obese children and adolescent should aim at decreasing fat mass (FM), avoiding loss of lean body mass, ensuring adequate growth and development and preventing cyclic weight regain. 2,6 Improving well-being is a second major aspect since psychological disturbances and social distress tend to be early features of obesity in the young. As such a multidisciplinary approach proves to be difficult to reach in the usual environment, in-patient units have been designed to help adolescents suffering the most severe forms of obesity. 7,8 Managing weight loss in obese adolescents actually requires paying special attention to potential...

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Evaluating body fat in girls and female adolescents: advantages and disadvantages of dual-energy X-ray absorptiometry

Cited by 93 publications

References 30 publications

Prenatal and postnatal programming of body composition in obese children and adolescents: evidence from anthropometry, DXA and the 4-component model

Prenatal and postnatal programming of body composition in obese children and adolescents: evidence from anthropometry, DXA and the 4-component model

Changes in thoracic gas volume with air-displacement plethysmography after a weight loss program in overweight and obese women

Effects of a multidisciplinary weight loss intervention on body composition in obese adolescents

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