Influence of subject presentation on interpretation of body composition change after 6 months of self-selected training and diet in athletic males

Best practice recommendations for body composition considerations in sport to reduce health and performance risks: a critical review, original survey and expert opinion by a subgroup of the IOC consensus on Relative Energy Deficiency in Sport (REDs)

BACKGROUND

The assessment of body composition (BC) in sport raises concern for athlete health, especially where an overfocus on being lighter or leaner increases the risk of Relative Energy Deficiency in Sport (REDs) and disordered eating.

METHODS

We undertook a critical review of the effect of BC on performance (29 longitudinal, prospective or intervention studies) and explored current practice related to BC considerations via a follow-up to a 2013 internationally distributed survey.

RESULTS

The review found that a higher level of body fat was negatively associated with endurance performance, while a gain in muscle mass resulted in performance benefits across sports. BC did not contribute to early talent identification, and no unique cut-off to signify a performance advantage for BC was identified. BC appears to be one of an array of variables impacting performance, and its influence should not be overstated. The survey (125 practitioners, 61 sports and 26 countries) showed subtle changes in BC considerations over time, such as an increased role for sport dietitian/nutrition practitioners as BC measurers (2013: 54%, 2022: 78%); less emphasis on reporting of body fat percentage (2013: 68%, 2022: 46%) and reduced frequency of BC assessment if ≥every fourth week (2013: 18%, 2022: 5%). Respondents remained concerned about a problematic focus on BC (2013: 69%, 2022: 78%). To address these findings, we provide detailed recommendations for BC considerations, including an overview of preferable BC methodology.

CONCLUSIONS

The 'best practice' guidelines stress the importance of a multidisciplinary athlete health and performance team, and the treatment of BC data as confidential medical information. The guidelines provide a health focus around BC, aiming to reduce the associated burden of disordered eating, problematic low energy availability and REDs.

Influence of Upper-Extremity and Lower-Extremity Resistance Exercise on Segmental Body Composition and Body Fluid Estimates

ABSTRACT

Rodriguez, C, Florez, CM, Prather, J, Zaragoza, J, Tinnin, M, Brennan, KL, Taylor, L, and Tinsley, GM. Influence of upper-extremity and lower-extremity resistance exercise on segmental body composition and body fluid estimates. J Strength Cond Res XX(X): 000-000, 2022-The purpose of this analysis was to determine if acute, localized resistance exercise (RE) artificially influences total and regional estimates of body composition from dual-energy X-ray absorptiometry (DXA) and bioelectrical impedance analysis (BIA). Recreationally active male (n = 14) and female (n = 18) subjects completed 3 testing visits: rest (R), upper-extremity RE (U), and lower-extremity RE (L). Dual-energy X-ray absorptiometry scans were completed before exercise and 60 minutes after exercise. Bioelectrical impedance analysis was completed immediately before and after exercise and at 15, 30, and 60 minutes after exercise. Subjects were not allowed to intake fluid during the exercise session or during the postexercise assessment period. The effects of the acute RE session on DXA and BIA estimates were analyzed using linear mixed-effects models with a random intercept for subject. Condition by time interactions were observed for most BIA outcomes. Relative to the reference model (i.e., R condition at baseline), total body water and fat-free mass estimates were, on average, approximately 1 and approximately 1.2 kg higher, in the U condition. In contrast, lower-extremity RE exerted little or no impact on most BIA variables. Some DXA estimates exhibited time main effects, but the magnitude of changes was negligible. An acute bout of localized RE, particularly upper-extremity RE, can artificially influence BIA body fluid and composition estimates, whereas DXA may be robust to the acute biological error introduced by RE. Although body composition assessments should ideally be conducted under standardized conditions, DXA may be suitable in less standardized situations. In addition, BIA is differentially influenced by upper-extremity and lower-extremity resistance exercise.

Tracking changes in body composition: comparison of methods and influence of pre-assessment standardisation

The present study reports the validity of multiple assessment methods for tracking changes in body composition over time and quantifies the influence of unstandardised pre-assessment procedures. Resistance-trained males underwent 6 weeks of structured resistance training alongside a hyperenergetic diet, with four total body composition evaluations. Pre-intervention, body composition was estimated in standardised (i.e. overnight fasted and rested) and unstandardised (i.e. no control over pre-assessment activities) conditions within a single day. The same assessments were repeated post-intervention, and body composition changes were estimated from all possible combinations of pre-intervention and post-intervention data. Assessment methods included dual-energy X-ray absorptiometry (DXA), air displacement plethysmography, three-dimensional optical imaging, single- and multi-frequency bioelectrical impedance analysis, bioimpedance spectroscopy and multi-component models. Data were analysed using equivalence testing, Bland-Altman analysis, Friedman tests and validity metrics. Most methods demonstrated meaningful errors when unstandardised conditions were present pre- and/or post-intervention, resulting in blunted or exaggerated changes relative to true body composition changes. However, some methods - particularly DXA and select digital anthropometry techniques - were more robust to a lack of standardisation. In standardised conditions, methods exhibiting the highest overall agreement with the four-component model were other multi-component models, select bioimpedance technologies, DXA and select digital anthropometry techniques. Although specific methods varied, the present study broadly demonstrates the importance of controlling and documenting standardisation procedures prior to body composition assessments across distinct assessment technologies, particularly for longitudinal investigations. Additionally, there are meaningful differences in the ability of common methods to track longitudinal body composition changes.

Influence of Acute Water Ingestion and Prolonged Standing on Raw Bioimpedance and Subsequent Body Fluid and Composition Estimates

This study evaluated the influence of acute water ingestion and maintaining an upright posture on raw bioimpedance and subsequent estimates of body fluids and composition. Twenty healthy adults participated in a randomized crossover study. In both conditions, an overnight food and fluid fast was followed by an initial multi-frequency bioimpedance assessment (InBody 770). Participants then ingested 11 mL/kg of water (water condition) or did not (control condition) during a 5-minute period. Thereafter, bioimpedance assessments were performed every 10 minutes for one hour with participants remaining upright throughout. Linear mixed effects models were used to examine the influence of condition and time on raw bioimpedance, body fluids, and body composition. Water consumption increased impedance of the arms but not trunk or legs. However, drift in leg impedance was observed, with decreasing values over time in both conditions. No effects of condition on body fluids were detected, but total body water and intracellular water decreased by ~0.5 kg over time in both conditions. Correspondingly, lean body mass did not differ between conditions but decreased over the measurement duration. The increase in body mass in the water condition was detected exclusively as fat mass, with final fat mass values ~1.3 kg higher than baseline and also higher than the control condition. Acute water ingestion and prolonged standing exert practically meaningful effects on relevant bioimpedance variables quantified by a modern, vertical multi-frequency analyzer. These findings have implications for pre-assessment standardization, methodological reporting, and interpretation of assessments.

Short-Term Precision Error of Body Composition Assessment Methods in Resistance-Trained Male Athletes

Athletic populations require high-precision body composition assessments to identify true change. Least significant change determines technical error via same-day consecutive tests but does not integrate biological variation, which is more relevant for longitudinal monitoring. The aim of this study was to assess biological variation using least significant change measures from body composition methods used on athletes, including surface anthropometry (SA), air displacement plethysmography (BOD POD), dual-energy X-ray absorptiometry (DXA), and bioelectrical impedance spectroscopy (BIS). Thirty-two athletic males (age = 31 ± 7 years; stature = 183 ± 7 cm; mass = 92 ± 10 kg) underwent three testing sessions over 2 days using four methods. Least significant change values were calculated from differences in Day 1 Test 1 versus Day 1 Test 2 (same-day precision), as well as Day 1 Test 1 versus Day 2 (consecutive-day precision). There was high agreement between same-day and consecutive-day fat mass and fat-free mass measurements for all methods. Consecutive-day precision error in comparison with the same-day precision error was 50% higher for fat mass estimates from BIS (3,607 vs. 2,331 g), 25% higher from BOD POD (1,943 vs. 1,448 g) and DXA (1,615 vs. 1,204 g), but negligible from SA (442 vs. 586 g). Consecutive-day precision error for fat-free mass was 50% higher from BIS (3,966 vs. 2,276 g) and SA (1,159 vs. 568 g) and 25% higher from BOD POD (1,894 vs. 1,450 g) and DXA (1,967 vs. 1,461 g) than the same-day precision error. Precision error in consecutive-day analysis considers both technical error and biological variation, enhancing the identification of small, yet significant changes in body composition of resistance-trained male athletes. Given that change in physique is likely to be small in this population, the use of DXA, BOD POD, or SA is recommended.

Precision of Dual-Energy X-Ray Absorptiometry Reflection Scans in Muscular Athletes

BACKGROUND

Offset scanning procedures, such as reflection scanning, allow for dual-energy x-ray absorptiometry (DXA) body composition assessment of individuals who are too broad for standard scanning dimensions. However, limited information is available concerning the precision of this procedure, particularly in athletes.

METHODOLOGY

Twenty-seven muscular athletes (n = 17 males, BMI: 28.8 ± 2.0 kg/m², DXA body fat: 12.5 ± 2.7%; n = 10 females, BMI: 22.8 ± 1.6 kg/m², DXA body fat: 19.2 ± 3.4%) underwent consecutive DXA scans on a GE Lunar Prodigy scanner using the reflection scanning technique. The fully automated output was obtained for each scan, and an additional version of each scan's output was saved after manual adjustment of regions of interest (ROI). Metrics of reliability and precision were calculated for total and regional body mass (BM), lean mass (LM), fat mass (FM) and bone mineral content (BMC). These metrics included the precision error (PE), least significant change, ΔMean, technical error of measurement, intraclass correlation coefficient, smallest worthwhile effect and minimum difference considered real.

RESULTS

Reflection scanning produced small errors for BM (PE: ∼0.5%), LM (PE < 1%) and BMC (PE: ∼1.2%), with larger errors observed for total FM (PE: ∼3%). Manual ROI adjustment produced lower errors for total BM, LM, FM, and BMC, as well as lower errors for most regional estimates. The utilization of automated ROI revealed concerns unique to reflection scanning, including unnecessary estimation of trunk composition, which appreciably increased error in this region. Regional estimates produced higher errors for all variables as compared to whole-body estimates, although which regions produced the highest errors differed between BM, LM, FM, and BMC.

CONCLUSIONS

Reflection scanning allows DXA body composition assessment in individuals exceeding traditional scanning dimensions, including broad athletes. Although this procedure introduces error, it may be minimized through manual adjustment of ROIs and consistency of analysis methods.

Whole-body dual-energy X-ray absorptiometry demonstrates better reliability than segmental body composition analysis in college-aged students

Dual-energy X-ray absorptiometry (DXA) is rapidly becoming more accessible and popular as a technique to monitor body composition. The reliability of DXA has been examined extensively using a number of different methodological approaches. This study sets up to investigate the accuracy of measuring the parameters of body composition (BC) by means of the whole-body and the segmental DXA method analysis with the typical error of measurement (TEM) that allows for expressing the error in the units of measure. The research was implemented in a group of 63 participants, all of whom were university students. Thirty-eight males (22.6±2.9 years, average body mass 77.5±8.4 kg) and 25 females (21.4±2.0 years, average body mass 58.6±7.2 kg) were recruited. The measured parameters included body mass (BM), fat-free mass (FFM), body fat (BF), bone mineral content (BMC), bone mineral density (BMD). For the whole-body analysis, the determined TEM was: BM at the level of 0.12 kg in females and 0.29 kg in males; BF 0.25kg and 0.44% females, 0.52 kg and 0.66% males; FFM 0.24 kg females and 0.42 kg males; BMC 0.02 kg females and males; BMD 0.01g/cm2 females and males. The TEM values in the segmental analysis were: BF within the range of 0.04-0.28 kg and 0.68-1.20% in females, 0.10-0.36 kg and 0.72-1.94% in males; FFM 0.08-0.41 kg females and 0.17-0.86 males, BMC 0.00-0.02 kg females and 0.01-0.02 kg males in relation to the body segment (upper limb, trunk, lower limb). The BMD value was at the level of 0.01-0.02g/cm2. The study results showed high reliability in measuring body composition parameters using the DXA method. The whole-body analysis showed a higher accuracy of measurement than the segmental. Only the changes that are greater than the TEM, or the upper bound (95%) of the confidence interval of the measurement can be considered demonstrable when interpreting repeated measurements.