Carlene A Johnson Stoklossa1, Mary Forhan2, Raj S Padwal3, Maria Cristina Gonzalez4, Carla M Prado5. 1. Department of Agricultural, Food and Nutritional Science, University of Alberta, 4-002 Li Ka Shing Centre, Room 2-021E, 8602-112th Street, Edmonton, T6G 2E1, AB, Canada. cajohnso@ualberta.ca. 2. Department of Occupational Therapy, University of Alberta, Edmonton, Alberta, Canada. 3. Department of Medicine, University of Alberta; Alberta Diabetes Institute, Edmonton, Alberta, Canada. 4. Postgraduate Program on Health and Behavior, Catholic University of Pelotas, Pelotas, Brazil. 5. Department of Agricultural, Food and Nutritional Science, University of Alberta, 4-002 Li Ka Shing Centre, Room 2-021E, 8602-112th Street, Edmonton, T6G 2E1, AB, Canada. cprado@ualberta.ca.
Abstract
PURPOSE OF REVIEW: The purpose of this review is to explore the practical considerations for body composition assessment of adults with class II/III obesity. Studies assessing adults (18-64 years) with a body mass index (BMI) ≥35 kg/m2 with bioelectrical impedance analysis (BIA) and/or dual-energy X-ray absorptiometry (DXA) were included. RECENT FINDINGS: Twelve studies met inclusion criteria. Five considerations were identified: variances in equipment and technology, equipment weight capacity, subject positioning, tissue penetration, and total body hydration. In subjects with BMI ≥35 kg/m2, BIA overestimated fat-free mass with scaling errors as BMI increased. DXA provided accurate and reliable body composition measures, but equipment-related barriers prevented assessment of some taller, wider, and heavier subjects. BIA is an unreliable method to assess body composition in class II/III obesity. Advancements in DXA technology (e.g., iDXA), methodology (e.g., subject positioning, longer scan times), and more inclusive testing criteria (e.g., use equipment limits not just BMI) may improve access and understanding of body composition in this cohort.
PURPOSE OF REVIEW: The purpose of this review is to explore the practical considerations for body composition assessment of adults with class II/III obesity. Studies assessing adults (18-64 years) with a body mass index (BMI) ≥35 kg/m2 with bioelectrical impedance analysis (BIA) and/or dual-energy X-ray absorptiometry (DXA) were included. RECENT FINDINGS: Twelve studies met inclusion criteria. Five considerations were identified: variances in equipment and technology, equipment weight capacity, subject positioning, tissue penetration, and total body hydration. In subjects with BMI ≥35 kg/m2, BIA overestimated fat-free mass with scaling errors as BMI increased. DXA provided accurate and reliable body composition measures, but equipment-related barriers prevented assessment of some taller, wider, and heavier subjects. BIA is an unreliable method to assess body composition in class II/III obesity. Advancements in DXA technology (e.g., iDXA), methodology (e.g., subject positioning, longer scan times), and more inclusive testing criteria (e.g., use equipment limits not just BMI) may improve access and understanding of body composition in this cohort.
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