Body Composition

What is Body Composition?

Body composition is the measure of fat, muscle, and bone in the human body.

Body Composition Analyzer Index

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Why is Body Composition Important?

Assessing body composition is one method to evaluate nutritional status, which is directly related to health. Weight does not fully describe the specific composition of the human body since it accounts for body  fat, muscle, bone, and water. It is important to take these measurements into consideration when measuring body weight. Two individuals may have the same body weight, but differ in regards to body composition, in particular muscle and fat.

Often body composition is measured to assess risk for  development of diseases related to lifestyle, especially dietary intake and levels of physical activity. Therefore, body composition is important to determine the current state of an individual’s body and susceptibility for future ailments and diseases.

Why is Body Composition Important in HIV/AIDS?

Body composition is important to assess in people living with HIV/AIDS (PLWHA).  Often PLWHA are more susceptible to issues related to over- or undernutrition.  In addition, the virus itself, including duration of HIV-infection, and antiretroviral therapy (ART) may increase the risk for body shape changes.  

HIV-Associated Wasting: HIV-associated wasting has been identified as meeting one of the following criteria (Wanke, 2000; Guaraldi, 2012):

  • loss of 10% of body weight in one year
  • loss of 5% of body weight in six months
  • decrease in BMI < 20 kg/m2

Although HIV-associated wasting tends to be more prevalent in resource poor countries that do not have access to ART, there are still cases in resource rich areas.

HIV-Associated Lipodystrophy Syndrome (HALS): In addition to HIV-associated wasting, PLWHA may experience HALS, which is a syndrome that includes subcutaneous fat atrophy, visceral fat hypertrophy, or a mixed combination of both. Anthropometric measurements over time help to monitor the trend in body shape changes associated with HALS.

How do you measure Body Composition?

Weight/BMI: The BMI (Body Mass Index) utilizes an individual’s weight and height to determine if that individual is overweight, underweight, etc.

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Anthropometrics: Anthropometry is used to estimate the amount and location of body fat.  Anthropometric measurements are relatively easy to conduct and cost effective for evaluating and monitoring the nutritional status of people with HIV/AIDS. Basic measurements of circumferences (waist, hip, mid-upper arm, thigh, calf, chest, and neck) and skinfolds (triceps, biceps, subscapular, suprailiac, abdominal, thigh, and calf) are useful in monitoring changes in PLWHA.

Skinfold Caliper

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Measurements: Analysis, Examples and Research using each Measurement

1. Weight/BMI

  • Analysis of Data: BMI Analysis
  • Cost: Scales range from 20-150$ for medical scales
  • Research Using this Nutritional Assessment:

Examples of Research that uses the BMI Scale: National

Scherzera R, Heymsfield SB, Lee D, Powderly WG, Tien PC, Bacchetti P, et al. Decreased limb muscle and increased central adiposity are associated with 5-year all-cause mortality in HIV infection. AIDS. 2011; 25: 1405–1414.

Examples of Research that uses the BMI Scale: International

Hong SY, Hendricks KM, Wanke C, Omosa G, Patta S, Mwero B, et al. Development of a nutrient-dense food supplement for HIV infected women in rural Kenya using qualitative and quantitative research methods. Public Health Nutr. 2012; 14:1-9.

Tang AM, Bhatnagar T, Ramachandran R, Dong K, Skinner S, Kumar MS, et al. Malnutrition in a population of HIV-positive and HIV-negative drug users living in Chennai, South India. Drug Alcohol Depend. 2011; 118: 73–77.

Tang AM, Sheehan HB, Jordan MR, Duong DV, Terrin N, Dong K, et al. Predictors of weight change in male HIV-positive injection drug users initiating antiretroviral therapy in Hanoi, Vietnam. AIDS Research and Treatment. 2011; vol. 2011, Article ID 890308, 8 pages.

2. Anthropometrics

  • Analysis of Data: This cannot be completed with an online program, but requires specific analysis information from each anthropometric instrument.
  • Example of Anthropometrics Measure: Anthropometric Scales
  • Cost: Skinfold calipers can cost $20-500. Options are available at Skinfold Caliper Website.
  • Research Using this Nutritional Assessment:

Examples of Research that uses Anthropometrics: National

Brown TT, Xu X, John M, Singh J, Kingsley LA, and Palella FJ, et al. Fat distribution and longitudinal anthropometric changes in HIV-infected men with and without clinical evidence of lipodystrophy and HIV-uninfected controls: a substudy of the Multicenter AIDS Cohort Study. AIDS Research and Therapy 2009; 6:8.

Hendricks KM, Dong KR, Tang AM, Ding B, Spiegelman D, and Woods MN, et al. High-fiber diet in HIV-positive men is associated with lower risk of developing fat deposition. The American Journal of Clinical Nutrition 2003; 78:790–5.

Jacobson, DL, Knox T, Spiegelman D, Skinner S, Gorbach S, and Wank C. Prevalence of, Evolution of, and Risk Factors for Fat Atrophy and Fat Deposition in a Cohort of HIV-Infected Men and Women. Clinical Infectious Diseases 2005; 40:1837-1845.

Examples of Research that uses Anthropometrics: International

Dannhauser A, van Staden AM, van der Ryst E, Nel M, Marais N, Erasmus E, et al. Nutritional status of HIV-1 seropositive patients in the Free State Province of South Africa: Anthropometric and dietary profile. European Journal of Clinical Nutrition 1999; 53:165-173.

Advanced Body Composition Techniques:

1. BIA:

  • Analysis of Data:
  • Example:
  • Cost:
  • Research using BIA:

2. Bod Pod:

 

  • Analysis of Data:
  • Example:
  • Cost:
  • Research using BIA:

3. Underwater Weighing:

 

  • Analysis of Data:
  • Example:
  • Cost:
  • Research using BIA:

4. DEXA:

 

  • Analysis of Data:
  • Example:
  • Cost:
  • Research using BIA:

 

 

 

References:

American Heart Association. Body Composition Tests. March 18, 2014. <http://www.heart.org/HEARTORG/GettingHealthy/NutritionCenter/Body-Composition-Tests_UCM_305883_Article.jsp>.

Center for Disease Control. Body Mass Index. July 16, 2014. <http://www.cdc.gov/healthyweight/assessing/bmi/Index.html>.

Guaraldi G, Chiara S, Zona S, Bagni B. Anthropometry in the Assessment of HIV related lipodystrophy. 2013. <http://download.springer.com/static/pdf/40/chp%253A10.1007%252F978-1-4419-1788-1_152.pdf?auth66=1406816964_d933f8d2fcc4b1b5ea7fa37ebcf800ea&ext=.pdf>.

Sievenpiper JL, Jenkins DJA, Josse RG, Leiter LA, and Vuksan V. Simple skinfold-thickness measurements complement conventional anthropometric assessments in predicting glucose tolerance. Am J Clin Nutr. 2001; 73: 567-73.

Wanke CA, Silva M, Knox TA, Forrester J, Spiegelman, and Gorbach SL. Weight Loss and Wasting Remain Common Complications in Individuals Infected with Human Immunodeficiency Virus in the Era of Highly Active Antiretroviral Therapy. Clin Inf Diseases. 2000; 31(3): 803-805.