Evaluation of body composition: practical guidelines

The measurement of body composition in the truest sense allows for the estimation of body tissues, organs, and their distributions in living persons without inflicting harm. It is important to recognize that there is no single measurement method that is error-free. Furthermore, bias can be introduced if a measurement method makes assumptions related to body composition proportions and characteristics that are inaccurate across different populations. Some methodologic concerns include hydration of fat-free body mass changes with age and differences across ethnic groups [73]; the density of fat-free body mass changes with age and differences between men and women [74, 75]; total body potassium decreases with age [73] and fatness [76] and differences between African Americans and Caucasians [77]; the mass of skeletal muscle differences across race group [63]; and VAT differences across sex [78] and race [67, 79, 80] groups, independent of total adiposity. These between-group differences influence the absolute accuracy of methods for estimating fatness or FFM that involve the two-compartment model approach. The clinical significance of the body compartment to be measured should be determined before a measurement method is selected, because the more advanced techniques are less accessible and more costly.