Unit IV.

BODY COMPOSITION AND ASSESSMENT

Introduction.
Most people manage their weight by using two sources of feedback—the numbers on the
scale and the way their clothing fits. As you will read in this chapter, these evaluations do not
tell the full story and can sometimes be misleading. A person may feel discouraged when he
or she is, in fact, making progress in losing body fat or may feel optimistic when he or she is,
in fact, losing critical lean body mass. A person who is attempting to lose weight can become
further discouraged if he or she has unrealistic expectations or vague goals based on the
“ideal body” that is portrayed in media. Understanding personal recommended body
weight and body composition is vital to setting clear and realistic weight loss goals.

Outcomes.
At the end of the chapter, the students must have:
1. Define body composition and understand how it relates to recommended body weight.
2. Explain the difference between essential fat and storage fat.
3. Describe various techniques used to assess body composition.
4. Be able to assess body composition using skinfold thickness and girth measurements.
5. Understand the importance of body mass index (BMI) and waist circumference (WC)
in the assessment of risk for disease.
6. Be able to determine recommended weight according to recommended percent body
fat values and BMI.

Learning Input 1. WHAT IS BODY COMPOSITION?

Read the following article.

To understand the concept of body composition, we must recognize that the human body
consists of fat and nonfat components. The fat component is called fat mass or percent body
fat. The nonfat component is termed lean body mass. To determine recommended body
weight, we need to find out what percent of total body weight is fat and what amount is lean
tissue—in other words, assess body composition.
Body composition should be assessed by a well-trained technician who understands the
procedure being used. Once the fat percentage is known, recommended body weight can be
calculated from recommended body fat. Guidelines for recommended body weight, also
called “healthy weight,” have been set at values where there are no medical conditions that
would improve with weight loss. The guidelines take into consideration body shape (or fat
distribution pattern) that is not associated with higher risk for illness.

Essential and Storage Fat

Total fat in the human body is classified into two types: essential fat and storage fat.
Essential fat is needed for normal physiological function. Without it, human health and
physical performance deteriorate. This type of fat is found within tissues such as muscles,
nerve cells, bone marrow, intestines, heart, liver, and lungs.
Essential fat constitutes about 3 percent of the total weight in men and12 percent in
women. The percentage is higher in women because it includes sex-specific fat, such as that
found in the breast tissue, the uterus, and other sex related fat deposits.
Storage fat is the fat stored in adipose tissue, mostly just beneath the skin (subcutaneous
fat) and around major organs in the body (intra-abdominal or visceral fat). This fat serves
three basic functions: as an insulator to retain body heat, as energy substrate for metabolism,
and as padding against physical trauma to the body. The amount of storage fat does not differ
between men and women, except that men tend to store fat around the waist and women
around the hips and thighs.

Why Does Body Composition Matter?

When studying large populations, simple height/weight measurements provide important
feedback. By averaging data across large groups of individuals, scientists have been able to
establish that the risk for premature illness and death is greater for those who are overweight
and that the risk is also increased for individuals who are underweight. When it comes to
understanding personal risk, however, simply finding the point where height and weight
intersect on a graph does not provide sufficient information about how your body weight may
affect your health. Formerly, people relied on simple height/weight charts to determine their
recommended body weight, but these tables can be highly inaccurate and can fail to identify
critical fat values associated with higher risk for disease.
Standard height/weight tables, first published in 1912, were based on average weights
(while wearing shoes and clothing) for men and women who obtained life insurance policies
between 1888 and 1905—a notably unrepresentative population. The recommended body
weight on these tables was obtained according to gender, height, and frame size. Because no
scientific guidelines were given to determine frame size, most people chose their frame size
based on the column in which the weight came closest to their own!
The best way to determine whether people are truly overweight or falsely at
recommended body weight is through assessment of body composition. Obesity is an
excess of body fat. If body weight is the only criterion, an individual might easily appear to
be overweight according to height/weight charts yet have a healthy amount of body fat.
Typical examples are football players, body builders, weight lifters, and other athletes with
large muscle size. Some athletes who appear to be 20 or 30 pounds overweight really have
little body fat. The importance of body composition was clearly demonstrated when a young
man who weighed about 225 pounds applied to join a city police force but was turned down
without having been granted an interview. The reason? He was “too fat.” When this young
man’s body composition was assessed at a preventive medicine clinic, it was determined that
only 5 percent of his total body weight was in the form of fat— considerably less than the
recommended standard. In the words of the director of the clinic, “The only way this fellow
could come down to the chart’s target weight would have been through surgical removal of a
large amount of his muscle
tissue.”

Body Shape and Health Risk

As you have seen, body weight affects more than just physical appearance. Excessive
body weight and lower health have been linked by research for decades. There is, however,
another critical element at work. A person’s total amount of body fat by itself is not the best
predictor of increased risk for disease but, rather, the location of the fat. Scientific evidence
suggests that the way people store fat affects their risk for disease. Android obesity is seen in
individuals who tend to store fat in the trunk or abdominal area (which produces the “apple”
shape). Gynoid obesity is seen in people who store fat primarily around the hips and thighs
(which creates the “pear” shape). Compared with people whose body fat is stored primarily in
the hips and thighs, obese individuals with abdominal fat are at higher risk for heart disease,
hypertension, type 2 diabetes (“non–insulin-dependent” diabetes), stroke, some types of
cancer, kidney disease, dementia, migraines, and diminished lung function. One poignant
study followed more than 350,000 people for almost 10 years and concluded that even when
body weight is viewed as “normal,” individuals with a large waist circumference nearly
double the risk for premature death. Evidence also indicates that among individuals with a lot
of abdominal fat, two different internal locations of abdominal fat have different effects on
disease. Those with fat deposits located around internal organs (visceral fat or intra-
abdominal fat) have an even greater risk for disease. Researchers believe that visceral fat is
more metabolically active than subcutaneous fat and secretes harmful inflammatory
substances that contribute to chronic conditions. Those with fat deposits right beneath the
skin (subcutaneous and retroperitoneal fat) have a better metabolic profile than people with
adipose tissue that is primarily visceral fat.

Learning Input no. 2 TECHNIQUES TO ASSESS BODY COMPOSITION

Body composition can be estimated using several methods. There is no method that can
determine a person’s exact amount of body fat. Some techniques, however, are more accurate
than others. The following describe the most commonly used procedures for estimating body
composition,along with a standard error of estimate (SEE) for each procedure. The SEE is a
measure of the accuracy of the prediction for each specific technique, determining how many
percentage points a result may deviate from the true percentage. For example, if the SEE for a
given technique is 3.0 and the individual tests at a fat percentage of 18.0, the actual fat
percentage may range from 15 to 21 percent.
Dual Energy X-ray Absorptiometry
Dual energy x-ray absorptiometry (DXA) is a method to assess body composition that is
used most frequently in research and by medical facilities. A radiographic technique, DXA
uses very low-dose beams of x-ray energy (hundreds of times lower than a typical body x-
ray) to measure total body fat mass, fat distribution pattern, and bone density. Bone density is
measured to assess the risk for osteoporosis. The procedure itself is simple and takes less than
15 minutes to administer. Many exercise scientists consider DXA to be the standard
technique to assess body composition. Because of its accuracy, DXA is used as a standard of
comparison for all other body composition tests. Due to costs, however, DXA is not readily
available to most fitness participants. Thus, other methods to estimate body composition are
used. The most common of these are:

1. Hydrostatic or underwater weighing

2. Air displacement
3. Skinfold thickness
4. Girth measurements
5. Bioelectrical impedance

Because these procedures yield estimates of body fat, each technique may yield slightly
different values. Therefore, when assessing changes in body composition, be sure to use the
same technique for pre- and post-test comparisons. Other techniques to assess body
composition are available, but the equipment is costly and not easily accessible to the general
population. In addition to percentages of lean tissue and body fat, some of these methods also
provide information on total body water and bone mass. These techniques include air
displacement, magnetic resonance imaging (MRI), computed tomography (CT), and total
body electrical conductivity (TOBEC).

Hydrostatic Weighing
Until the advent of DXA, hydrostatic weighing had been the most common technique
used in determining body composition in exercise physiology laboratories. With hydrostatic
weighing, a person’s “regular” weight is compared with a weight taken underwater. Because
fat is more buoyant than lean tissue, comparing the two weights can determine a person’s
percentage of fat. The procedure requires a considerable amount of time, skill, space, and
equipment and must be administered by a well-trained technician (see Figure 4.5). The SEE
for hydrostatic weighing is ±2.5 percent. This technique has several drawbacks. First, because
each individual assessment can take as long as 30 minutes, hydrostatic weighing is not
feasible when testing a lot of people. Furthermore, the person’s residual lung volume (amount
of air left in the lungs following complete forceful exhalation) should be measured before
testing. If residual volume cannot be measured, as is the case in some laboratories and
health/fitness centers, it is estimated using the predicting equations, which may decrease the
accuracy of hydrostatic weighing. Also, the requirement of being completely underwater
makes hydrostatic weighing difficult to administer to aquaphobic people. For accurate results,
the individual must be able to perform the test properly. Forcing all of the air out of the lungs
is not easy for everyone but is important to obtain an accurate reading. Leaving additional air
(beyond residual volume) in the lungs makes a person more buoyant. Because fat is less
dense than water, overweight individuals weigh less in water. Additional air in the lungs
makes a person lighter in water, yielding a false, higher body fat percentage. For each
underwater weighing trial, the person has to (a) force out all of the air in the lungs, (b) lean
forward and completely submerge underwater for about 5 to 10 seconds (long enough to get
the underwater weight), and (c) remain as calm as possible (chair movement makes reading
the scale difficult). This procedure is repeated eight to ten times.

Air Displacement
When using air displacement (also known as air displacement plethysmography), an
individual sits inside a small chamber, commercially known as the Bod Pod. Computerized
pressure sensors determine the amount of air displaced by the person inside the chamber.
Body volume is calculated by subtracting the air volume with the person inside the chamber
from the volume of the empty chamber. The amount of air in the person’s lungs also is taken
into consideration when determining actual body volume. Body density and percent body fat
then are calculated from the obtained body volume.
The procedure to assess body composition according to air displacement takes only about
15 minutes. Initial research showed that this technique compared favorably with hydrostatic
weighing while being less cumbersome to administer. The published SEE for air
displacement was originally 62.2 percent; however, the SEE may actually be higher.
Subsequent research determined that percent body fat is about 5 percentage points higher
with air displacement than with hydrostatic weighing. Researchers have concluded that
further technical work is required to make air displacement an acceptable technique to
determine body composition.6 Furthermore, research is required to determine its accuracy
among different age groups, ethnic backgrounds, and athletic populations.

Skinfold Thickness
Because of the cost, time, and complexity of hydrostatic weighing and the expense of
Bod Pod equipment, most health and fitness programs use anthropometric measurement
techniques. These techniques, primarily skinfold thickness and girth measurements, allow
quick, simple, and inexpensive estimates of body composition. Assessing body composition
using skinfold thickness is based on the principle that the amount of subcutaneous fat is
proportional to total body fat. Valid and reliable measurements of this tissue give a good
indication of percent body fat. The SEE for skinfold analysis is 63.5 percent.
The skinfold test is done with the aid of pressure calipers. Several techniques requiring
measurement of three to seven sites have been developed. The following three-site procedure
is the most commonly used technique. The sites measured are as follows (also see Figure
4.6): All measurements should be taken on the right side of the body.
 Women: triceps, suprailium, and thigh skinfolds
Men: chest, abdomen, and thigh

Girth Measurements
Another method that is frequently used to estimate body fat is to measure
circumferences, or girth measurements, at various body sites. This technique requires only a
standard measuring tape. The limitation is that it may not be valid for athletic individuals
(men or women) who participate actively
in strenuous physical activity or for people who can be classified visually as thin or obese.
Measurements for women are the upper arm, hip, and wrist; for men, the waist and wrist.

Bioelectrical Impedance
The bioelectrical impedance technique is much simpler to administer, but its accuracy is
questionable. In this technique, sensors are applied to the skin and a weak (totally painless)
electrical current is run through the body to measure its electrical resistance, which is then
used to estimate body fat, lean body mass, and body water. The technique is based on the
principle that fat tissue is a less efficient conductor of electrical current than is lean tissue.
The easier the conductance is, the leaner the individual.

Lesson Input 3. Body Weight

Calculating recommended body weight is not only a scientific process, it is also a
personal one. You will want to consider what resources you can use to reach a realistic goal,
especially a goal to get and stay out of a category that puts your health at risk. You will need
to consider your lifestyle and the benefits that are important to you as you decide whether to
target health or high fitness standards.

Begin with Your Current Body Composition

Once you know your percent body fat, you can determine your current body composition
classification, which presents percentages of fat according to both the health fitness standard
and the high physical fitness standard.
For example, the recommended health fitness fat percentage for a 20-year-old female is
28 percent or less. Although there are no clearly identified percent body fat levels at which
the risk for disease definitely increases, the health fitness standard in Table 4.11 is currently
the best estimate of the point at which there seems to be no harm to health.
According to Table 4.11, the high physical fitness range for this same 20-year-old
woman would be between 18 and 23 percent. The high physical fitness standard does not
mean that you cannot be somewhat less than this number. Many highly trained male athletes
are as low as 3 percent, and some
female distance runners have been measured at 6 percent body fat (which may not be
healthy).
Some evidence indicates that a higher mortality rate is a danger not only for obese
people, but also for underweight people. “Underweight” and “thin” do not necessarily mean
the same thing. The body fat of a healthy thin person is near the high physical fitness
standard, whereas an underweight person has extremely low body fat, even to the point of
compromising the essential fat.
The 3 percent essential fat for men and 12 percent for women seem to be the lower limits
for people to maintain good health. Below these percentages, normal physiological functions
can be seriously impaired. Some experts point out that a little storage fat (in addition to the
essential fat) is better than no storage fat at all. As a result, the health and high fitness
standards for percent fat in Table 4.11 are set higher than the minimum essential fat
requirements, at a point beneficial to optimal health and wellbeing.
Finally, because lean tissue decreases with age, one extra percentage point is allowed for
every additional decade of life.

How is BMI calculated?

BMI is calculated the same way for both adults and children. The calculation is based on the
following formulas:
BMI is calculated the same way for both adults and children. The calculation is based on the following
formulas:
Measurement Units Formula and Calculation
Kilograms and meters Formula: weight (kg) / [height (m)]2
(or centimeters) With the metric system, the formula for BMI is weight in kilograms divided by
height in meters squared. Because height is commonly measured in
centimeters, divide height in centimeters by 100 to obtain height in meters.
Example: Weight = 68 kg, Height = 165 cm (1.65 m)
Calculation: 68 ÷ (1.65)2 = 24.98

How is BMI interpreted for adults?

For adults 20 years old and older, BMI is interpreted using standard weight status categories.
These categories are the same for men and women of all body types and ages.
The standard weight status categories associated with BMI ranges for adults are shown in the
following table.
The standard weight status categories associated with BMI ranges for adults are shown in the following
table.
BMI Weight Status
Below 18.5 Underweight
18.5 – 24.9 Normal or Healthy Weight
25.0 – 29.9 Overweight
30.0 and Above Obese

What are the health consequences of obesity for adults?

People who have obesity are at increased risk for many diseases and health conditions,
including the following: 
 All-causes of death (mortality)
 High blood pressure (hypertension)
 High LDL cholesterol, low HDL cholesterol, or high levels of triglycerides
(dyslipidemia)
 Type 2 diabetes
 Coronary heart disease
 Stroke
 Gallbladder disease
 Osteoarthritis (a breakdown of cartilage and bone within a joint)
 Sleep apnea and breathing problems
 Chronic inflammation and increased oxidative stress
 Some cancers (endometrial, breast, colon, kidney, gallbladder, and liver)
 Low quality of life
 Mental illness such as clinical depression, anxiety, and other mental disorders
 Body pain and difficulty with physical functioning
Reference: About Adult BMI
Retrived from: https://www.cdc.gov/healthyweight/assessing/bmi/adult_bmi/index.html

Activity: Perform the following:

1. Get your BMI.
2. Identify the Disease Risk According to your BMI. (If there are any)
3. Make a reflection. Briefly state your feelings about your body composition results. Do you
plan to reduce your percent body fat and increase your lean body mass? Write the goal(s) you
want to achieve by the end of the term and indicate how you plan to achieve them.