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{{about|fat, bone, water and muscle molecules content of the human body|the body's chemical composition|Composition of the human body|the general composition of all organisms|Biological organisation}}
{{about|fat, bone, water and muscle molecules content of the human body|the body's chemical composition|Composition of the human body|the general composition of all organisms|Biological organisation}}
{{more citations needed|date=August 2016}}
{{more citations needed|date=August 2016}}
In [[physical fitness]], '''body composition''' is used to describe the percentages of [[fat]], [[bone]], [[water]], and [[muscle]] in [[human bodies]].<ref>{{Cite web|title = composition of the body – FREE composition of the body information {{!}} Encyclopedia.com: Find composition of the body research|url = http://www.encyclopedia.com/doc/1O128-compositionofthebody.html|website = www.encyclopedia.com|access-date = 2016-01-10}}</ref> Because muscular [[Tissue (biology)|tissue]] takes up less space in the body than fat tissue, body composition, as well as weight, determines leanness. Two people of the same gender and body weight may look completely different because they have a different body composition.<ref>{{Cite web|title = Body Composition Tests|url = http://www.heart.org/HEARTORG/GettingHealthy/NutritionCenter/Body-Composition-Tests_UCM_305883_Article.jsp|website = www.heart.org|access-date = 2015-11-25}}</ref>
In [[physical fitness]], '''body composition''' refers to quantifying the different components (or "compartments") of a [[human body]].<ref name="MCM"/> The selection of compartments varies by model but may include [[fat]], [[bone]], [[water]], and [[muscle]].<ref>{{Cite web|title = composition of the body – FREE composition of the body information {{!}} Encyclopedia.com: Find composition of the body research|url = http://www.encyclopedia.com/doc/1O128-compositionofthebody.html|website = www.encyclopedia.com|access-date = 2016-01-10}}</ref> Two people of the same gender, height, and body weight may have completely different body types as a consequence of having different body compositions. This may be explained by a person having low or high [[body fat]], dense muscles, or big bones.<ref>{{Cite web|title = Body Composition Tests|url = http://www.heart.org/HEARTORG/GettingHealthy/NutritionCenter/Body-Composition-Tests_UCM_305883_Article.jsp|website = www.heart.org|access-date = 2015-11-25}}</ref>


== Compartment models ==
== Body density==
The most accurate estimation of body composition is derived from body density by means of the equation of fractional densities which states that the overall [[Density of states|density]] of a mixture containing more than one substance (each with a different density) can be calculated if the proportion and density of each component substance is known. For determination of body composition the body is often assumed to be composed of four basic substances ("four compartment model") with the general form of the equation as follows:


Body composition models typically use between 2 and 6 compartments to describe the body. Common models include:<ref name="MCM">{{cite web |title=Multi-component models |url=https://www.measurement-toolkit.org/anthropometry/objective-methods/multi-component-models |website=DAPA Measurement Toolkit |publisher=Cambridge Biomedical Research Centre |access-date=26 September 2023}}</ref>
:<math>1/Db = w/Dw + f/Df + p/Dp + m/Dm</math><ref name=Siri>{{cite journal |author=Siri William E |title=The gross composition of the body |journal=Advances in Biological and Medical Physics |volume=4|pages=239–280|year=1956|pmid=13354513|doi=10.1016/B978-1-4832-3110-5.50011-X |isbn=9781483231105 }}</ref>{{rp|262}}
Where: <math>Db</math> = overall body density, <math>w</math> = proportion of water, <math>f</math> = proportion of fat, <math>p</math> = proportion of protein, <math>m</math> = proportion of mineral, <math>Dw</math> = density of water, <math>Df</math> = density of fat, <math>Dp</math> = density of protein, <math>Dm</math> = density of mineral


* 2 compartment: Fat mass (FM) and fat-free mass (FFM)
In a research laboratory setting, the overall density of the body (Db) is calculated from its mass and volume (Db = mass/volume). The mass of the body is found by simply weighing a person on a scale. The volume of the body is most easily and accurately determined by completely immersing a person in water and calculating the volume of water from the weight of water that is displaced (via "underwater weighing"). The proportions of water, protein and mineral in the body are found by various chemical and radiometric tests.<ref name=Siri/>{{rp|239–278}} The densities of water, fat, protein, and mineral are either measured or estimated. The equation is then rearranged to solve for the proportion of fat (f) from the other quantities.
* 3 compartment: Fat mass (FM), water, and fat-free dry mass
* 4 compartment: Fat mass (FM), water, protein, and mineral
* 5 compartment: Fat mass (FM), water, protein, bone mineral content, and non-osseous mineral content
* 6 compartment: Fat mass (FM), water, protein, bone mineral content, non-osseous mineral content, and glycogen


As a rule, the compartments must sum to the body weight. The proportion of each compartment as a percent is often reported, found by dividing the compartment weight by the body weight. Individual compartments may be estimated based on population averages or measured directly or indirectly. Many measurement methods exist with varying levels of accuracy. Typically, the higher compartment models are more accurate, as they require more data and thus account for more variation across individuals. The four compartment model is considered the reference model for assessment of body composition as it is robust to most variation and each of its components can be measured directly.<ref name="MCM"/>
A reasonably accurate [[Body fat percentage|estimation of body fat]] can be obtained by means of a "two compartment model" of the human body which is based upon two simplifying assumptions: 1. Human fat has a density of 0.9 grams/ml, and 2. The lean (non-fat) components of the human body have an overall density of 1.1 grams/ml.


== Measurement methods ==
The two compartment model allows for an estimation of the proportions of fat and lean components of the body to be made from the overall body density. And, as explained above, the overall body density (Db) is easily calculated from body mass and body volume. Rearranging the equation of fractional densities to solve for the proportion of fat (f) will yield the following equation:


A wide variety of body composition measurement methods exist. The [[Gold standard (test)|gold standard]] measurement technique for the 4-compartment model consists of a weight measurement, body density measurement using [[hydrostatic weighing]] or [[air displacement plethysmography]], total body water calculation using [[isotope dilution]] analysis, and mineral content measurement by [[dual-energy X-ray absorptiometry]] (DEXA).<ref name="MCM"/> However, it is also common to use a DEXA scan alone and refer to this as the "gold standard".<ref>{{cite journal |last1=Scafoglieri |first1=A |last2=Clarys |first2=JP |title=Dual energy X-ray absorptiometry: gold standard for muscle mass? |journal=Journal of Cachexia, Sarcopenia and Muscle |date=August 2018 |volume=9 |issue=4 |pages=786–787 |doi=10.1002/jcsm.12308 |pmid=29786955|s2cid=29152747 |doi-access=free |pmc=6104103 }}</ref> These claims are somewhat dubious since measurements methods vary significantly from study to study. In practice, the measurement methods used will be a tradeoff between cost, availability, and accuracy.
:<math>f = 495/Db - 450</math><ref>{{cite journal |author=Siri William E |title=Body composition from fluid spaces and density: analysis of methods |journal=Donner Laboratory of Biophysics and Medical Physics |volume=UCRL 3349 |page=14 |year=1956}}</ref>


=== DEXA ===
The density of human fat is remarkably constant across all sub-groups studied but variations have been reported in the density of the fat free mass (i.e. lean or non-fat components). To address these differences, unique equations for the two compartment model have been proposed for specific populations.<ref>{{cite journal |vauthors=Wagner DR, Heyward VH |title=Measures of body composition in blacks and whites: a comparative review |journal=J Clin Nutr |volume=71 |issue=6 |pages=1392–1402 |year=2000|doi=10.1093/ajcn/71.6.1392 |pmid=10837277 |doi-access=free }}</ref>
{{Main|Dual energy X-ray absorptiometry}}
Body composition measurement with [[dual energy X-ray absorptiometry]] (DEXA) is used increasingly for a variety of clinical and research applications. A DEXA scan requires medical supervision by a radiologist. Total body scans using DEXA give accurate and precise measurements of body composition, including bone mineral content (BMC), bone mineral density (BMD), lean tissue mass, fat tissue mass, and fractional contribution of fat.<ref>{{cite journal |vauthors=Kiebzak GM, Leamy LJ, Pierson LM, Nord RH, Zhang ZY |title=Measurement precision of body composition variables using the lunar DPX-L densitometer |journal=J Clin Densitom |volume=3 |issue=1 |pages=35–41 |year=2000 |pmid=10745300 |doi=10.1385/jcd:3:1:035 |s2cid=24304339 }}</ref>


DEXA measurements are highly reproducible if the same type of machine is used,<ref>{{cite journal |last1=Fuleihan |first1=Ghada El-Hajj |last2=Testa |first2=Marcia A. |last3=Angell |first3=Jennifer E. |last4=Porrino |first4=Nancy |last5=Leboff |first5=Meryl S. |date=3 December 2009 |title=Reproducibility of DXA absorptiometry: A model for bone loss estimates |url=https://asbmr.onlinelibrary.wiley.com/doi/10.1002/jbmr.5650100704 |journal=Journal of Bone and Mineral Research |volume=10 |issue=7 |pages=1004–1014 |doi=10.1002/jbmr.5650100704 |pmid=7484275 |s2cid=41871793 |access-date=8 July 2022}}</ref> making them excellent for monitoring pharmaceutical therapy, nutritional or exercise intervention, sports training, and other body composition altering programs. They are also fast, simple, non-invasive, and expose the subject to a level of x-rays less than that of a cross-country flight. DEXA exams provide both total body and up to 14 regional (trunk, individual arms & legs, android, gynoid, etc.) results. However, the role of DEXA in clinical evaluations and research studies has been questioned by Wang et al.<ref>{{cite journal |vauthors=Wang ZM, Deurenberg P, Guo SS, Pietrobelli A, Wang J, ((Pierson RN Jr)), Heymsfield SB |title=Six-compartment body composition model: inter-method comparisons of total body fat measurement |journal=Int J Obes Relat Metab Disord |volume=22 |issue=4 |pages=329–337 |year=1998|doi=10.1038/SJ.ijo.0800590 |pmid=9578238 |s2cid=20815053 |doi-access= }}</ref> who stated that "the errors of the DXA [DEXA] method are still of concern if it were to be used as the criterion."
== DEXA==
Body composition measurement with [[dual energy X-ray absorptiometry]] (DEXA) is used increasingly for a variety of clinical and research applications. A DEXA scan requires medical supervision by a radiologist and some consider it to be the new "Gold Standard" in body composition testing. Total body scans using DEXA give accurate and precise measurements of body composition, including bone mineral content (BMC), bone mineral density (BMD), lean tissue mass, fat tissue mass, and fractional contribution of fat.<ref>{{cite journal |vauthors=Kiebzak GM, Leamy LJ, Pierson LM, Nord RH, Zhang ZY |title=Measurement precision of body composition variables using the lunar DPX-L densitometer |journal=J Clin Densitom |volume=3 |issue=1 |pages=35–41 |year=2000 |pmid=10745300 |doi=10.1385/jcd:3:1:035 |s2cid=24304339 }}</ref>


===Hydrostatic weighing===
The estimation of body fatness from body density (using underwater weighing) was accepted as the "gold standard" for many decades. However, some researchers now claim that whole-body scanning techniques (e.g., "DEXA") are the new "gold standard." But these claims are somewhat dubious since the scanning algorithms are validated against body composition assessments based on fractional density from underwater weighing.
{{Main|Hydrostatic weighing}}
Hydrostatic weighing, also referred to as underwater weighing, hydrostatic body composition analysis and hydrodensitometry, is a technique for measuring the density of a living person's body. It is a direct application of Archimedes' principle, that an object displaces its own volume of water.


===Air displacement plethysmography===
DEXA measurements are highly reproducible if the same type of machine is used,<ref>{{cite journal |last1=Fuleihan |first1=Ghada El-Hajj |last2=Testa |first2=Marcia A. |last3=Angell |first3=Jennifer E. |last4=Porrino |first4=Nancy |last5=Leboff |first5=Meryl S. |date=3 December 2009 |title=Reproducibility of DXA absorptiometry: A model for bone loss estimates |url=https://asbmr.onlinelibrary.wiley.com/doi/10.1002/jbmr.5650100704 |journal=Journal of Bone and Mineral Research |volume=10 |issue=7 |pages=1004–1014 |doi=10.1002/jbmr.5650100704 |s2cid=41871793 |access-date=8 July 2022}}</ref> making them excellent for monitoring pharmaceutical therapy, nutritional or exercise intervention, sports training, and other body composition altering programs. They are also fast, simple, non-invasive, and expose the subject to a level of x-rays less than that of a cross-country flight. DEXA exams provide both total body and up to 14 regional (trunk, individual arms & legs, android, gynoid, etc.) results. However, the role of DEXA in clinical evaluations and research studies has been questioned by Wang et al.<ref>{{cite journal |vauthors=Wang ZM, Deurenberg P, Guo SS, Pietrobelli A, Wang J, ((Pierson RN Jr)), Heymsfield SB |title=Six-compartment body composition model: inter-method comparisons of total body fat measurement |journal=Int J Obes Relat Metab Disord |volume=22 |issue=4 |pages=329–337 |year=1998|doi=10.1038/SJ.ijo.0800590 |pmid=9578238 |doi-access=free }}</ref> who stated that "the errors of the DXA [DEXA] method are still of concern if it were to be used as the criterion."

==Air displacement plethysmography==
[[File: Adult body composition through air displacement plethysmography.jpg|thumb|Body composition measurement with [[air displacement plethysmography]] or whole-body air displacement plethysmography (ADP) technology]]
[[File: Adult body composition through air displacement plethysmography.jpg|thumb|Body composition measurement with [[air displacement plethysmography]] or whole-body air displacement plethysmography (ADP) technology]]
{{Main|Air displacement plethysmography}}
Air displacement plethysmography is an alternative to underwater weighing for measuring body volume. The technique uses air as opposed to water and is known as [[air displacement plethysmography]] (ADP). Subjects enter a sealed chamber that measures their body volume through the displacement of air in the chamber. Next, body volume is combined with [[body weight]] (mass) to determine body density. The technique then estimates the percentage of body fat and [[lean body mass]] (LBM) through empirically derived equations similar to those used with underwater weighing (for the density of fat and fat-free mass).


=== Isotope dilution analysis ===
Another technique for measuring body composition has been developed for measuring body volume using a different method than underwater weighing. The technique uses air as opposed to water and is known as [[air displacement plethysmography]] (ADP). Subjects enter a sealed chamber that measures their body volume through the displacement of air in the chamber. Next, body volume is combined with [[body weight]] (mass) to determine body density. The technique then estimates the percentage of body fat and [[lean body mass]] (LBM) through empirically derived equations similar to those used with underwater weighing (for the density of fat and fat-free mass).


Total body water may be effectively measured using [[isotope dilution]] analysis of deuterium oxide.<ref>{{cite journal |last1=Cataldi |first1=D |last2=Bennett |first2=JP |last3=Quon |first3=BK |last4=Liu |first4=YE |last5=Heymsfield |first5=SB |last6=Kelly |first6=T |last7=Shepherd |first7=JA |title=Agreement and Precision of Deuterium Dilution for Total Body Water and Multicompartment Body Composition Assessment in Collegiate Athletes. |journal=The Journal of Nutrition |date=6 September 2022 |volume=152 |issue=9 |pages=2048–2059 |doi=10.1093/jn/nxac116 |pmid=35665820|doi-access=free }}</ref>
== From conductivity==
Another method is [[bioelectrical impedance analysis]] (BIA), which uses the resistance of electrical flow through the body to estimate body fat. Unfortunately, BIA is highly sensitive to hydration status and water intake. Drinking water dilutes the electrolytes in the body making it less conductive as does increasing body fat. Recent advancements such as 8-point electrodes, multi-frequency measurements, and Direct Segmental Analysis,<ref>{{cite journal |vauthors=Ling CH, Craen AJ, Slagboom PE, Gunn DA, Stokkel MP, Westendorp RG, Maier AB |title=Accuracy of direct segmental multi-frequency bioimpedance analysis in the assessment of total body and segmental body composition in middle-aged adult population|journal=Clinical Nutrition |volume=30 |issue=5 |pages=610–615 |year=2011 |url=https://www.clinicalnutritionjournal.com/article/S0261-5614(11)00066-5/fulltext | doi=10.1016/j.clnu.2011.04.001|pmid=21555168|doi-access=free }}</ref> have improved the accuracy of BIA machines.<ref>{{cite journal |vauthors=Miller R, Chambers TL, Burns SP |title=Validating InBody ® 570 Multi-frequency Bioelectrical Impedance Analyzer versus DXA for Body Fat Percentage Analysis |journal=Journal of Exercise Physiology Online |volume=19 |issue=5 |pages=71–78 |year=2016 |url=https://www.researchgate.net/publication/318348260}}</ref> BIA machines have found acceptance in medical, fitness, and wellness space owing to their ease-of-use, portability, quick measurements, and cost efficiency.


== Body Volume Indicator ==
=== Total body potassium ===


Potassium 40 is a naturally occurring radioactive isotope found in intracellular water, but is not present in stored triglycerides (fat). [[Whole body counting]] can measure the amount of potassium 40 (40K) in the body, a quantity called total body potassium (TBK). This can be used to estimate fat-free mass directly. It has mostly been replaced by newer, more accurate techniques such as DEXA.<ref>{{cite web |title=Whole body counting of total body potassium |url=https://www.measurement-toolkit.org/anthropometry/objective-methods/whole-body-counting-of-total-body-potassium |website=DAPA Measurement Toolkit |publisher=Cambridge Biomedical Research Centre}}</ref>
The Body Volume Indicator (BVI) is a technique used for measuring body shape. Initially, BVI technology employed white light scanning machines to measure an individuals body shape.<ref>Jose Medina-Inojosa et al. (2016) "Reliability of a 3D Body Scanner for Anthropometric Measurements of Central Obesity". Obes Open Access. 2(3): 10.16966/2380-5528.122.</ref> However, recent technological advances in 3D measurement have enabled BVI to be calculated using images taken on a smartphone. Two images are required to create an individual 3D silhouette. By comparing this 3D silhouette with MRI data, body volume and fat distribution can be calculated.


=== Bioelectrical impedance analysis ===
==Skin folds==
{{Main|Bioelectrical impedance analysis}}
Another method to estimate body water is [[bioelectrical impedance analysis]] (BIA), which uses the resistance of electrical flow through the body. BIA is highly sensitive to hydration status and water intake. Drinking water dilutes the electrolytes in the body, making it less conductive, as does increasing body fat. By controlling hydration status or performing multiple impedance measurements, it is possible to estimate body fat and other variables.

[[InBody]] developed the world's first 8-point tactile electrode system in 1996, a direct segmental analysis method that measures the impedance of five torsos using multiple frequencies. Many BIA products provide partial muscle and fat mass measurements, but not impedance, especially in the torso.<ref>{{cite tech report |last1=E.L. |first1=Thomas |title=Validation of 'InBody'bioelectrical impedance by whole body MRI |date=2001 |pages=1–2|url=https://web.archive.org/web/20120128155324/http://www.bodyanalyse.no/studier/03.pdf}}</ref>

Recent advancements such as 8-point electrodes, multi-frequency measurements, and Direct Segmental Analysis,<ref>{{cite journal |vauthors=Ling CH, Craen AJ, Slagboom PE, Gunn DA, Stokkel MP, Westendorp RG, Maier AB |title=Accuracy of direct segmental multi-frequency bioimpedance analysis in the assessment of total body and segmental body composition in middle-aged adult population|journal=Clinical Nutrition |volume=30 |issue=5 |pages=610–615 |year=2011 |url=https://www.clinicalnutritionjournal.com/article/S0261-5614(11)00066-5/fulltext | doi=10.1016/j.clnu.2011.04.001|pmid=21555168|doi-access=free }}</ref> have improved the accuracy of BIA machines.<ref>{{cite journal |vauthors=Miller R, Chambers TL, Burns SP |title=Validating InBody ® 570 Multi-frequency Bioelectrical Impedance Analyzer versus DXA for Body Fat Percentage Analysis |journal=Journal of Exercise Physiology Online |volume=19 |issue=5 |pages=71–78 |year=2016 |url=https://www.researchgate.net/publication/318348260}}</ref> BIA machines have found acceptance in medical, fitness, and wellness space owing to their ease-of-use, portability, quick measurements, and cost efficiency.

[[AURA Devices]] developed and launched a number of wearable bioimpedance trackers, including the first smart strap for Apple Watch that tracks body fat, muscles, lean mass, water levels, etc.<ref>{{Cite web |author1=Oliver Haslam |date=2020-01-07 |title=AURA Strap replaces your boring Apple Watch band with more health sensors |url=https://www.imore.com/aura-strap-replaces-your-boring-apple-watch-band-more-health-sensors |access-date=2024-06-27 |website=iMore |language=en}}</ref>

=== Body Volume Index ===

The Body Volume Index (BVI) is a technique used for measuring body shape. Initially, BVI technology employed white light scanning machines to measure an individual's body shape.<ref>Jose Medina-Inojosa et al. (2016) "Reliability of a 3D Body Scanner for Anthropometric Measurements of Central Obesity". Obes Open Access. 2(3): 10.16966/2380-5528.122.</ref> However, recent technological advances in 3D measurement have enabled BVI to be calculated using images taken on a smartphone. Two images are required to create an individual 3D silhouette. By comparing this 3D silhouette with MRI data, body volume and fat distribution can be calculated.

===Skin folds===
Body composition can also be measured using the skin fold test, which is performed using a measuring [[caliper]]. It can be done in nine steps:
Body composition can also be measured using the skin fold test, which is performed using a measuring [[caliper]]. It can be done in nine steps:
# Take measurements on the right side of the body.
# Take measurements on the right side of the body.
Line 54: Line 71:
A common skin fold method is by using gun style [[caliper]]s to measure the thickness of [[subcutaneous fat]] in multiple places on the body. This includes the abdominal area, the [[subscapularis muscle|subscapular]] region, arms, buttocks and thighs. These measurements are then used to estimate total body fat.
A common skin fold method is by using gun style [[caliper]]s to measure the thickness of [[subcutaneous fat]] in multiple places on the body. This includes the abdominal area, the [[subscapularis muscle|subscapular]] region, arms, buttocks and thighs. These measurements are then used to estimate total body fat.


==Ultrasound==
===Ultrasound===
Ultrasound has also been used to measure subcutaneous fat thickness, and by using multiple points an estimation of body composition can be made. Ultrasound has the advantage of being able to also directly measure muscle thickness and quantify intramuscular fat.<ref>{{cite journal |last1=Mayans |first1=David |last2=Cartwright |first2=Michael S. |last3=Walker |first3=Francis O. |date=February 2012 |title=Neuromuscular Ultrasonography: Quantifying Muscle and Nerve Measurements |journal=Physical Medicine and Rehabilitation Clinics of North America |volume=23 |issue=1 |pages=133–148 |doi=10.1016/j.pmr.2011.11.009 |pmc=3321511 }}</ref>
Ultrasound has also been used to measure subcutaneous fat thickness, and by using multiple points an estimation of body composition can be made. Ultrasound has the advantage of being able to also directly measure muscle thickness and quantify intramuscular fat.<ref>{{cite journal |last1=Mayans |first1=David |last2=Cartwright |first2=Michael S. |last3=Walker |first3=Francis O. |date=February 2012 |title=Neuromuscular Ultrasonography: Quantifying Muscle and Nerve Measurements |journal=Physical Medicine and Rehabilitation Clinics of North America |volume=23 |issue=1 |pages=133–148 |doi=10.1016/j.pmr.2011.11.009 |pmid=22239880 |pmc=3321511 }}</ref> In the abdomen, ultrasonography is a useful tool for quantifying both subcutaneous and visceral fat. <ref>{{Cite journal |last=Kim |first=Jihyun |last2=Kim |first2=Keunyoung |date=2023-12-18 |title=Author Correction: CT-based measurement of visceral adipose tissue volume as a reliable tool for assessing metabolic risk factors in prediabetes across subtypes |url=http://dx.doi.org/10.1038/s41598-023-49371-z |journal=Scientific Reports |volume=13 |issue=1 |doi=10.1038/s41598-023-49371-z |issn=2045-2322|pmc=10730510 }}</ref> <ref>{{Cite journal |last=Störchle |first=Paul |last2=Müller |first2=Wolfram |last3=Sengeis |first3=Marietta |last4=Lackner |first4=Sonja |last5=Holasek |first5=Sandra |last6=Fürhapter-Rieger |first6=Alfred |date=2018-11-02 |title=Measurement of mean subcutaneous fat thickness: eight standardised ultrasound sites compared to 216 randomly selected sites |url=https://www.nature.com/articles/s41598-018-34213-0 |journal=Scientific Reports |language=en |volume=8 |issue=1 |pages=16268 |doi=10.1038/s41598-018-34213-0 |issn=2045-2322|pmc=6214952 }}</ref> Ultrasonography has many advantages over CT scan and MRI as it is non-invasive and doesn't utilize ionizing radiation, making it more accessible to special populations. <ref>{{Cite journal |last=Kim |first=Jihyun |last2=Kim |first2=Keunyoung |date=2023-10-20 |title=CT-based measurement of visceral adipose tissue volume as a reliable tool for assessing metabolic risk factors in prediabetes across subtypes |url=https://www.nature.com/articles/s41598-023-45100-8 |journal=Scientific Reports |language=en |volume=13 |issue=1 |pages=17902 |doi=10.1038/s41598-023-45100-8 |issn=2045-2322|pmc=10589349 }}</ref>


== Quantitative magnetic resonance==
=== Quantitative magnetic resonance===
Quantitative magnetic resonance (QMR) applies a magnetic field to the body and measures the difference in relaxation rates of hydrogen atoms within fat versus lean mass.<ref>{{cite journal |vauthors=Taicher GZ, Tinsley FC, Reiderman A, Heiman ML|title=Quantitative magnetic resonance (QMR) method for bone and whole-body-composition analysis |journal=Analytical and Bioanalytical Chemistry |volume=377 |issue=6 |pages=990–1002 |year=2003 |doi=10.1007/s00216-003-2224-3 |pmid=13680051 |s2cid=34947455 |url=https://link.springer.com/article/10.1007%2Fs00216-003-2224-3}}</ref> It functions similarly to [[magnetic resonance imaging]] (MRI) but instead of providing an image like MRI, QMR gives quantities of fat mass, lean mass, and total body water. QMR is also widely used for body composition analysis of animals, including laboratory animals like mice,<ref>{{cite journal |vauthors=Jones AS, Johnson MS, Nagy TR|title=Validation of quantitative magnetic resonance for the determination of body composition of mice |journal=International Journal of Body Composition Research |volume=7 | issue=2 |pages=67–72 |year=2009 |pmid=20467582 |url=https://pubmed.ncbi.nlm.nih.gov/20467582/}}</ref> and wildlife including birds.<ref>{{cite journal |vauthors=Guglielmo CG, McGuire LP, Gerson AR, Seewagen CL|title=Simple, rapid, and non-invasive measurement of fat, lean, and total water masses of live birds using quantitative magnetic resonance |journal=Journal of Ornithology |volume=152 |year=2011 |doi=10.1007/s10336-011-0724-z |s2cid=7371842 |url=https://link.springer.com/article/10.1007%2Fs10336-011-0724-z}}</ref>
Quantitative magnetic resonance (QMR) applies a magnetic field to the body and measures the difference in relaxation rates of hydrogen atoms within fat versus lean mass.<ref>{{cite journal |vauthors=Taicher GZ, Tinsley FC, Reiderman A, Heiman ML|title=Quantitative magnetic resonance (QMR) method for bone and whole-body-composition analysis |journal=Analytical and Bioanalytical Chemistry |volume=377 |issue=6 |pages=990–1002 |year=2003 |doi=10.1007/s00216-003-2224-3 |pmid=13680051 |s2cid=34947455 |url=https://link.springer.com/article/10.1007%2Fs00216-003-2224-3}}</ref> It functions similarly to [[magnetic resonance imaging]] (MRI) but instead of providing an image like MRI, QMR gives quantities of fat mass, lean mass, and total body water. QMR is also widely used for body composition analysis of animals, including laboratory animals like mice,<ref>{{cite journal |vauthors=Jones AS, Johnson MS, Nagy TR|title=Validation of quantitative magnetic resonance for the determination of body composition of mice |journal=International Journal of Body Composition Research |volume=7 | issue=2 |pages=67–72 |year=2009 |pmid=20467582 |pmc=2868277 }}</ref> and wildlife including birds.<ref>{{cite journal |vauthors=Guglielmo CG, McGuire LP, Gerson AR, Seewagen CL|title=Simple, rapid, and non-invasive measurement of fat, lean, and total water masses of live birds using quantitative magnetic resonance |journal=Journal of Ornithology |volume=152 |year=2011 |pages=75–85 |doi=10.1007/s10336-011-0724-z |s2cid=7371842 |url=https://link.springer.com/article/10.1007%2Fs10336-011-0724-z}}</ref>


==Circumferences and other measurements==
===Circumferences and other simple measurements===
Assessment of somatic (skeletal) protein is typically determined by simple measurements and calculations, including mid-arm circumference (MAC), mid-arm muscle circumference (MAMC), and creatinine height ratio (CHI). [[Creatinine]] height ratio is calculated as 24-hour urine creatinine multiplied by 100 over the expected 24-hour urine creatinine for height. This calculation results in a percentage that can indicate protein depletion.<ref>{{cite journal |last1=Wang |first1=Wei |last2=Du |first2=Cong |last3=Lin |first3=Laixiang |last4=Chen |first4=Wen |last5=Tan |first5=Long |last6=Shen |first6=Jun |last7=Pearce |first7=Elizabeth N. |last8=Zhang |first8=Yixin |last9=Gao |first9=Min |last10=Bian |first10=Jianchao |last11=Wang |first11=Xiaoming |last12=Zhang |first12=Wanqi |date=23 May 2018 |title=Anthropometry-based 24-h urinary creatinine excretion reference for Chinese children |journal=PLOS ONE |volume=13 |issue=5 |pages=e0197672 |doi=10.1371/journal.pone.0197672 |pmid=29791502 |pmc=5965866 |doi-access=free }}</ref>
Assessment of somatic (skeletal) protein is typically determined by simple measurements and calculations, including mid-arm circumference (MAC), mid-arm muscle circumference (MAMC), and creatinine height ratio (CHI). [[Creatinine]] height ratio is calculated as 24-hour urine creatinine multiplied by 100 over the expected 24-hour urine creatinine for height. This calculation results in a percentage that can indicate protein depletion.<ref>{{cite journal |last1=Wang |first1=Wei |last2=Du |first2=Cong |last3=Lin |first3=Laixiang |last4=Chen |first4=Wen |last5=Tan |first5=Long |last6=Shen |first6=Jun |last7=Pearce |first7=Elizabeth N. |last8=Zhang |first8=Yixin |last9=Gao |first9=Min |last10=Bian |first10=Jianchao |last11=Wang |first11=Xiaoming |last12=Zhang |first12=Wanqi |date=23 May 2018 |title=Anthropometry-based 24-h urinary creatinine excretion reference for Chinese children |journal=PLOS ONE |volume=13 |issue=5 |pages=e0197672 |doi=10.1371/journal.pone.0197672 |pmid=29791502 |pmc=5965866 |bibcode=2018PLoSO..1397672W |doi-access=free }}</ref>

Many methods of determining body composition use the [[body weight]] as a measurement, determined via a [[weighing scale]]. Other details such as height and age can be correlated with other measures and are often used in estimation formulas.


==Validity==
==Validity==
The methods above are each valid and notable in providing a reasonably accurate range of the "true body composition" of the tested individual. However, each method does possess its own individual limitations, indeed precluding to the existence of so many variable methods available for an individual to use. Therefore, the actual method of testing body composition is not as important as the '''consistency of measurement''' in between each test. (See [[internal consistency]] for merits on testing in this manner.) If an individual is to be tested from one period to the next, all factors should ideally remain as similar as possible to reflect the best indicator of true change in composition.<ref>{{cite journal |pmc=2082845|year=2006|last1=Wells|first1=J. C.|title=Measuring body composition|journal=Archives of Disease in Childhood|volume=91|issue=7|pages=612–617|last2=Fewtrell|first2=M. S.|doi=10.1136/adc.2005.085522|pmid=16790722}}</ref>
The methods above are each valid and notable in providing a measurement that can be used to determine the "true body composition" of the tested individual. However, each method does possess its own individual limitations, such as accuracy, precision, or expense, and the combination of methods also has limitations. Often, the relative change from one period to the next is most important; if an individual can maintain all factors as similar as possible, even a simple method such as weighing may give enough information to determine the true change in composition.<ref>{{cite journal |pmc=2082845|year=2006|last1=Wells|first1=J. C.|title=Measuring body composition|journal=Archives of Disease in Childhood|volume=91|issue=7|pages=612–617|last2=Fewtrell|first2=M. S.|doi=10.1136/adc.2005.085522|pmid=16790722}}</ref>


== Types of exercises ==
== Types of exercises ==
The exercises needed to maintain optimal body composition differ from man to woman to child, but the ideal types of fitness remain the same.<ref>{{Cite web|title = Normal ranges of body weight and body fat|url = http://www.humankinetics.com/excerpts/excerpts/normal-ranges-of-body-weight-and-body-fat|website = human-kinetics|access-date = 2015-11-25}}</ref>
The ideal percent of body mass which should be fat depends on an individual's sex, age, and physical activity. For example, a female thirty year old will have a different ideal fat percentage than a male thirty year old. An athlete will have a different ideal than a non athlete, and it can depend on the sport.<ref>{{Cite web|title = Normal ranges of body weight and body fat|url = http://www.humankinetics.com/excerpts/excerpts/normal-ranges-of-body-weight-and-body-fat|website = human-kinetics|access-date = 2015-11-25}}</ref>


The primary exercises needed to improve body composition involve fat burning and cardiovascular exercises.<ref>{{Cite web|title = Examples of Body Composition Exercises|url = http://healthyliving.azcentral.com/examples-body-composition-exercises-12586.html|website = Healthy Living - azcentral.com|access-date = 2015-11-25}}</ref>
The physical activities which can help decrease fat mass, increase lean mass, or both are the same for everybody. Aerobic exercise, also known as cardio (heart) exercise, decreases fat. High intensity interval training (HIIT) in particular helps decrease visceral fat. Visceral fat is near the internal organs, while subcutaneous fat is just under the skin. The former is more tightly associated with poor metabolic health. Bone and muscle strengthening exercise, also known as resistant training, decreases fat mass and increases lean mass at the same time, though it does better at the latter. In order to prevent injury from repetitive motion, people should do resistant training with different parts of their bodies on different days.<ref>{{Cite web|title = Examples of Body Composition Exercises|url = http://healthyliving.azcentral.com/examples-body-composition-exercises-12586.html|website = Healthy Living - azcentral.com|access-date = 2015-11-25}}</ref>


==See also==
==See also==
Line 81: Line 100:
==External links==
==External links==
* {{Commons category-inline|Human body composition}}
* {{Commons category-inline|Human body composition}}

{{Authority control}}


{{DEFAULTSORT:Body Composition}}
{{DEFAULTSORT:Body Composition}}

Latest revision as of 04:34, 2 September 2024

In physical fitness, body composition refers to quantifying the different components (or "compartments") of a human body.[1] The selection of compartments varies by model but may include fat, bone, water, and muscle.[2] Two people of the same gender, height, and body weight may have completely different body types as a consequence of having different body compositions. This may be explained by a person having low or high body fat, dense muscles, or big bones.[3]

Compartment models

[edit]

Body composition models typically use between 2 and 6 compartments to describe the body. Common models include:[1]

  • 2 compartment: Fat mass (FM) and fat-free mass (FFM)
  • 3 compartment: Fat mass (FM), water, and fat-free dry mass
  • 4 compartment: Fat mass (FM), water, protein, and mineral
  • 5 compartment: Fat mass (FM), water, protein, bone mineral content, and non-osseous mineral content
  • 6 compartment: Fat mass (FM), water, protein, bone mineral content, non-osseous mineral content, and glycogen

As a rule, the compartments must sum to the body weight. The proportion of each compartment as a percent is often reported, found by dividing the compartment weight by the body weight. Individual compartments may be estimated based on population averages or measured directly or indirectly. Many measurement methods exist with varying levels of accuracy. Typically, the higher compartment models are more accurate, as they require more data and thus account for more variation across individuals. The four compartment model is considered the reference model for assessment of body composition as it is robust to most variation and each of its components can be measured directly.[1]

Measurement methods

[edit]

A wide variety of body composition measurement methods exist. The gold standard measurement technique for the 4-compartment model consists of a weight measurement, body density measurement using hydrostatic weighing or air displacement plethysmography, total body water calculation using isotope dilution analysis, and mineral content measurement by dual-energy X-ray absorptiometry (DEXA).[1] However, it is also common to use a DEXA scan alone and refer to this as the "gold standard".[4] These claims are somewhat dubious since measurements methods vary significantly from study to study. In practice, the measurement methods used will be a tradeoff between cost, availability, and accuracy.

DEXA

[edit]

Body composition measurement with dual energy X-ray absorptiometry (DEXA) is used increasingly for a variety of clinical and research applications. A DEXA scan requires medical supervision by a radiologist. Total body scans using DEXA give accurate and precise measurements of body composition, including bone mineral content (BMC), bone mineral density (BMD), lean tissue mass, fat tissue mass, and fractional contribution of fat.[5]

DEXA measurements are highly reproducible if the same type of machine is used,[6] making them excellent for monitoring pharmaceutical therapy, nutritional or exercise intervention, sports training, and other body composition altering programs. They are also fast, simple, non-invasive, and expose the subject to a level of x-rays less than that of a cross-country flight. DEXA exams provide both total body and up to 14 regional (trunk, individual arms & legs, android, gynoid, etc.) results. However, the role of DEXA in clinical evaluations and research studies has been questioned by Wang et al.[7] who stated that "the errors of the DXA [DEXA] method are still of concern if it were to be used as the criterion."

Hydrostatic weighing

[edit]

Hydrostatic weighing, also referred to as underwater weighing, hydrostatic body composition analysis and hydrodensitometry, is a technique for measuring the density of a living person's body. It is a direct application of Archimedes' principle, that an object displaces its own volume of water.

Air displacement plethysmography

[edit]
Body composition measurement with air displacement plethysmography or whole-body air displacement plethysmography (ADP) technology

Air displacement plethysmography is an alternative to underwater weighing for measuring body volume. The technique uses air as opposed to water and is known as air displacement plethysmography (ADP). Subjects enter a sealed chamber that measures their body volume through the displacement of air in the chamber. Next, body volume is combined with body weight (mass) to determine body density. The technique then estimates the percentage of body fat and lean body mass (LBM) through empirically derived equations similar to those used with underwater weighing (for the density of fat and fat-free mass).

Isotope dilution analysis

[edit]

Total body water may be effectively measured using isotope dilution analysis of deuterium oxide.[8]

Total body potassium

[edit]

Potassium 40 is a naturally occurring radioactive isotope found in intracellular water, but is not present in stored triglycerides (fat). Whole body counting can measure the amount of potassium 40 (40K) in the body, a quantity called total body potassium (TBK). This can be used to estimate fat-free mass directly. It has mostly been replaced by newer, more accurate techniques such as DEXA.[9]

Bioelectrical impedance analysis

[edit]

Another method to estimate body water is bioelectrical impedance analysis (BIA), which uses the resistance of electrical flow through the body. BIA is highly sensitive to hydration status and water intake. Drinking water dilutes the electrolytes in the body, making it less conductive, as does increasing body fat. By controlling hydration status or performing multiple impedance measurements, it is possible to estimate body fat and other variables.

InBody developed the world's first 8-point tactile electrode system in 1996, a direct segmental analysis method that measures the impedance of five torsos using multiple frequencies. Many BIA products provide partial muscle and fat mass measurements, but not impedance, especially in the torso.[10]

Recent advancements such as 8-point electrodes, multi-frequency measurements, and Direct Segmental Analysis,[11] have improved the accuracy of BIA machines.[12] BIA machines have found acceptance in medical, fitness, and wellness space owing to their ease-of-use, portability, quick measurements, and cost efficiency.

AURA Devices developed and launched a number of wearable bioimpedance trackers, including the first smart strap for Apple Watch that tracks body fat, muscles, lean mass, water levels, etc.[13]

Body Volume Index

[edit]

The Body Volume Index (BVI) is a technique used for measuring body shape. Initially, BVI technology employed white light scanning machines to measure an individual's body shape.[14] However, recent technological advances in 3D measurement have enabled BVI to be calculated using images taken on a smartphone. Two images are required to create an individual 3D silhouette. By comparing this 3D silhouette with MRI data, body volume and fat distribution can be calculated.

Skin folds

[edit]

Body composition can also be measured using the skin fold test, which is performed using a measuring caliper. It can be done in nine steps:

  1. Take measurements on the right side of the body.
  2. Mark client up.
  3. Pinch skin (KM) above mark
  4. Pull fat away from muscles
  5. Place caliper halfway between top and bottom of mark
  6. Allow caliper to settle (1–2 seconds)
  7. Take reading – repeat 15 seconds
  8. Add up total (4) – average
  9. Calculate body fat %

A common skin fold method is by using gun style calipers to measure the thickness of subcutaneous fat in multiple places on the body. This includes the abdominal area, the subscapular region, arms, buttocks and thighs. These measurements are then used to estimate total body fat.

Ultrasound

[edit]

Ultrasound has also been used to measure subcutaneous fat thickness, and by using multiple points an estimation of body composition can be made. Ultrasound has the advantage of being able to also directly measure muscle thickness and quantify intramuscular fat.[15] In the abdomen, ultrasonography is a useful tool for quantifying both subcutaneous and visceral fat. [16] [17] Ultrasonography has many advantages over CT scan and MRI as it is non-invasive and doesn't utilize ionizing radiation, making it more accessible to special populations. [18]

Quantitative magnetic resonance

[edit]

Quantitative magnetic resonance (QMR) applies a magnetic field to the body and measures the difference in relaxation rates of hydrogen atoms within fat versus lean mass.[19] It functions similarly to magnetic resonance imaging (MRI) but instead of providing an image like MRI, QMR gives quantities of fat mass, lean mass, and total body water. QMR is also widely used for body composition analysis of animals, including laboratory animals like mice,[20] and wildlife including birds.[21]

Circumferences and other simple measurements

[edit]

Assessment of somatic (skeletal) protein is typically determined by simple measurements and calculations, including mid-arm circumference (MAC), mid-arm muscle circumference (MAMC), and creatinine height ratio (CHI). Creatinine height ratio is calculated as 24-hour urine creatinine multiplied by 100 over the expected 24-hour urine creatinine for height. This calculation results in a percentage that can indicate protein depletion.[22]

Many methods of determining body composition use the body weight as a measurement, determined via a weighing scale. Other details such as height and age can be correlated with other measures and are often used in estimation formulas.

Validity

[edit]

The methods above are each valid and notable in providing a measurement that can be used to determine the "true body composition" of the tested individual. However, each method does possess its own individual limitations, such as accuracy, precision, or expense, and the combination of methods also has limitations. Often, the relative change from one period to the next is most important; if an individual can maintain all factors as similar as possible, even a simple method such as weighing may give enough information to determine the true change in composition.[23]

Types of exercises

[edit]

The ideal percent of body mass which should be fat depends on an individual's sex, age, and physical activity. For example, a female thirty year old will have a different ideal fat percentage than a male thirty year old. An athlete will have a different ideal than a non athlete, and it can depend on the sport.[24]

The physical activities which can help decrease fat mass, increase lean mass, or both are the same for everybody. Aerobic exercise, also known as cardio (heart) exercise, decreases fat. High intensity interval training (HIIT) in particular helps decrease visceral fat. Visceral fat is near the internal organs, while subcutaneous fat is just under the skin. The former is more tightly associated with poor metabolic health. Bone and muscle strengthening exercise, also known as resistant training, decreases fat mass and increases lean mass at the same time, though it does better at the latter. In order to prevent injury from repetitive motion, people should do resistant training with different parts of their bodies on different days.[25]

See also

[edit]

References

[edit]
  1. ^ a b c d "Multi-component models". DAPA Measurement Toolkit. Cambridge Biomedical Research Centre. Retrieved 26 September 2023.
  2. ^ "composition of the body – FREE composition of the body information | Encyclopedia.com: Find composition of the body research". www.encyclopedia.com. Retrieved 2016-01-10.
  3. ^ "Body Composition Tests". www.heart.org. Retrieved 2015-11-25.
  4. ^ Scafoglieri, A; Clarys, JP (August 2018). "Dual energy X-ray absorptiometry: gold standard for muscle mass?". Journal of Cachexia, Sarcopenia and Muscle. 9 (4): 786–787. doi:10.1002/jcsm.12308. PMC 6104103. PMID 29786955. S2CID 29152747.
  5. ^ Kiebzak GM, Leamy LJ, Pierson LM, Nord RH, Zhang ZY (2000). "Measurement precision of body composition variables using the lunar DPX-L densitometer". J Clin Densitom. 3 (1): 35–41. doi:10.1385/jcd:3:1:035. PMID 10745300. S2CID 24304339.
  6. ^ Fuleihan, Ghada El-Hajj; Testa, Marcia A.; Angell, Jennifer E.; Porrino, Nancy; Leboff, Meryl S. (3 December 2009). "Reproducibility of DXA absorptiometry: A model for bone loss estimates". Journal of Bone and Mineral Research. 10 (7): 1004–1014. doi:10.1002/jbmr.5650100704. PMID 7484275. S2CID 41871793. Retrieved 8 July 2022.
  7. ^ Wang ZM, Deurenberg P, Guo SS, Pietrobelli A, Wang J, Pierson RN Jr, Heymsfield SB (1998). "Six-compartment body composition model: inter-method comparisons of total body fat measurement". Int J Obes Relat Metab Disord. 22 (4): 329–337. doi:10.1038/SJ.ijo.0800590. PMID 9578238. S2CID 20815053.
  8. ^ Cataldi, D; Bennett, JP; Quon, BK; Liu, YE; Heymsfield, SB; Kelly, T; Shepherd, JA (6 September 2022). "Agreement and Precision of Deuterium Dilution for Total Body Water and Multicompartment Body Composition Assessment in Collegiate Athletes". The Journal of Nutrition. 152 (9): 2048–2059. doi:10.1093/jn/nxac116. PMID 35665820.
  9. ^ "Whole body counting of total body potassium". DAPA Measurement Toolkit. Cambridge Biomedical Research Centre.
  10. ^ E.L., Thomas (2001). Validation of 'InBody'bioelectrical impedance by whole body MRI (PDF) (Technical report). pp. 1–2.
  11. ^ Ling CH, Craen AJ, Slagboom PE, Gunn DA, Stokkel MP, Westendorp RG, Maier AB (2011). "Accuracy of direct segmental multi-frequency bioimpedance analysis in the assessment of total body and segmental body composition in middle-aged adult population". Clinical Nutrition. 30 (5): 610–615. doi:10.1016/j.clnu.2011.04.001. PMID 21555168.
  12. ^ Miller R, Chambers TL, Burns SP (2016). "Validating InBody ® 570 Multi-frequency Bioelectrical Impedance Analyzer versus DXA for Body Fat Percentage Analysis". Journal of Exercise Physiology Online. 19 (5): 71–78.
  13. ^ Oliver Haslam (2020-01-07). "AURA Strap replaces your boring Apple Watch band with more health sensors". iMore. Retrieved 2024-06-27.
  14. ^ Jose Medina-Inojosa et al. (2016) "Reliability of a 3D Body Scanner for Anthropometric Measurements of Central Obesity". Obes Open Access. 2(3): 10.16966/2380-5528.122.
  15. ^ Mayans, David; Cartwright, Michael S.; Walker, Francis O. (February 2012). "Neuromuscular Ultrasonography: Quantifying Muscle and Nerve Measurements". Physical Medicine and Rehabilitation Clinics of North America. 23 (1): 133–148. doi:10.1016/j.pmr.2011.11.009. PMC 3321511. PMID 22239880.
  16. ^ Kim, Jihyun; Kim, Keunyoung (2023-12-18). "Author Correction: CT-based measurement of visceral adipose tissue volume as a reliable tool for assessing metabolic risk factors in prediabetes across subtypes". Scientific Reports. 13 (1). doi:10.1038/s41598-023-49371-z. ISSN 2045-2322. PMC 10730510.
  17. ^ Störchle, Paul; Müller, Wolfram; Sengeis, Marietta; Lackner, Sonja; Holasek, Sandra; Fürhapter-Rieger, Alfred (2018-11-02). "Measurement of mean subcutaneous fat thickness: eight standardised ultrasound sites compared to 216 randomly selected sites". Scientific Reports. 8 (1): 16268. doi:10.1038/s41598-018-34213-0. ISSN 2045-2322. PMC 6214952.
  18. ^ Kim, Jihyun; Kim, Keunyoung (2023-10-20). "CT-based measurement of visceral adipose tissue volume as a reliable tool for assessing metabolic risk factors in prediabetes across subtypes". Scientific Reports. 13 (1): 17902. doi:10.1038/s41598-023-45100-8. ISSN 2045-2322. PMC 10589349.
  19. ^ Taicher GZ, Tinsley FC, Reiderman A, Heiman ML (2003). "Quantitative magnetic resonance (QMR) method for bone and whole-body-composition analysis". Analytical and Bioanalytical Chemistry. 377 (6): 990–1002. doi:10.1007/s00216-003-2224-3. PMID 13680051. S2CID 34947455.
  20. ^ Jones AS, Johnson MS, Nagy TR (2009). "Validation of quantitative magnetic resonance for the determination of body composition of mice". International Journal of Body Composition Research. 7 (2): 67–72. PMC 2868277. PMID 20467582.
  21. ^ Guglielmo CG, McGuire LP, Gerson AR, Seewagen CL (2011). "Simple, rapid, and non-invasive measurement of fat, lean, and total water masses of live birds using quantitative magnetic resonance". Journal of Ornithology. 152: 75–85. doi:10.1007/s10336-011-0724-z. S2CID 7371842.
  22. ^ Wang, Wei; Du, Cong; Lin, Laixiang; Chen, Wen; Tan, Long; Shen, Jun; Pearce, Elizabeth N.; Zhang, Yixin; Gao, Min; Bian, Jianchao; Wang, Xiaoming; Zhang, Wanqi (23 May 2018). "Anthropometry-based 24-h urinary creatinine excretion reference for Chinese children". PLOS ONE. 13 (5): e0197672. Bibcode:2018PLoSO..1397672W. doi:10.1371/journal.pone.0197672. PMC 5965866. PMID 29791502.
  23. ^ Wells, J. C.; Fewtrell, M. S. (2006). "Measuring body composition". Archives of Disease in Childhood. 91 (7): 612–617. doi:10.1136/adc.2005.085522. PMC 2082845. PMID 16790722.
  24. ^ "Normal ranges of body weight and body fat". human-kinetics. Retrieved 2015-11-25.
  25. ^ "Examples of Body Composition Exercises". Healthy Living - azcentral.com. Retrieved 2015-11-25.
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