{"id":2130,"date":"2024-04-26T05:10:35","date_gmt":"2024-04-26T09:10:35","guid":{"rendered":"https:\/\/pressbooks.bccampus.ca\/humannutrition\/?post_type=chapter&p=2130"},"modified":"2025-01-26T08:47:40","modified_gmt":"2025-01-26T13:47:40","slug":"indicators-of-health-body-mass-index-body-fat-content-and-fat-distribution-2","status":"publish","type":"chapter","link":"https:\/\/pressbooks.bccampus.ca\/humannutrition\/chapter\/indicators-of-health-body-mass-index-body-fat-content-and-fat-distribution-2\/","title":{"raw":"Measuring Body Fat and Body Fat Distribution","rendered":"Measuring Body Fat and Body Fat Distribution"},"content":{"raw":"We have discussed that BMI may have limitations in predicting body fatness and disease risk, so let's learn more about other ways we can measure body fat and why body fat distribution may be important.\r\n

Measuring Body Fat Content<\/h2>\r\nWater, organs, bone tissue, fat, and muscle tissue make up a person\u2019s weight. Having more fat mass may be indicative of disease risk, but fat mass also varies with sex, age, and physical activity level. Females have more fat mass, which is needed for reproduction and, in part, is a consequence of different levels of hormones. The optimal fat content of females is between 20 and 30 percent of total body weight and for males, it is between 12 and 20 percent. Fat mass can be measured in a variety of ways. The simplest and lowest-cost way is the skinfold test. In a skinfold test, a health professional uses a caliper to measure the skin thickness on the back, arm, and other parts of the body and compares it to normative standards to assess body fatness. It is a fairly accurate method of measuring fat mass, but similar to BMI, it is compared to standards of mostly young to middle-aged adults. Another issue with skinfold tests is that they can be perceived as modestly invasive and uncomfortable procedures since they involve the pinching of subcutaneous fat with a caliper. Because of this, healthcare professionals may choose to avoid using skinfold measurements, especially among individuals who experience body insecurity or body image issues.\r\n\r\n[caption id=\"attachment_114\" align=\"aligncenter\" width=\"500\"]\"Skinfold Figure 14.3 Measuring skinfold thickness using calipers.[\/caption]\r\n\r\nOther methods of measuring fat mass are more expensive and more technically challenging. They include:\r\n
    \r\n \t
  1. Underwater weighing:<\/strong> This technique requires a chamber full of water big enough for the whole body to fit in. First, a person is weighed outside the chamber and then weighed again while immersed in water. Bone and muscle weigh more than water, but fat does not\u2014therefore a person with a higher muscle and bone mass will weigh more in water than a person with less bone and muscle mass.<\/li>\r\n \t
  2. Bioelectric Impedance Analysis (BIA):<\/strong> This device is based on the fact that fat slows down the passage of electricity through the body. When a small amount of electricity is passed through the body, the rate at which it travels can be used to determine body composition. These devices are also sold for home use and are commonly called body composition scales.<\/li>\r\n<\/ol>\r\n[caption id=\"attachment_115\" align=\"aligncenter\" width=\"640\"]\"A Figure 14.4 BIA hand device.[\/caption]\r\n\r\n3. Dual-energy X-ray absorptiometry (DEXA<\/strong>): This can be used to measure bone density. It can also determine fat content via the same method, which directs two low-dose X-ray beams through the body and looks at the amount of energy absorbed from the beams. The amount of energy absorbed is dependent on the body\u2019s content of bone, lean tissue mass, and fat mass. Using standard mathematical formulas, fat content can be accurately estimated.\r\n\r\n[caption id=\"attachment_116\" align=\"aligncenter\" width=\"1024\"]\"DEXA Figure 14.5 Dual-energy X-ray absorptiometry (DEXA).[\/caption]\r\n

    Measuring Fat Distribution<\/h2>\r\nConsidering body fat distribution is also important for health. You may have heard that fat on the hips is better than fat on the belly\u2014this is true. Fat can be found in different areas of the body and it does not all act the same, meaning it differs physiologically based on location. Fat deposited in the abdominal cavity is called visceral fat and is a better predictor of disease risk than total fat mass. Visceral fat releases hormones and inflammatory factors that contribute to disease risk. The only tool required for measuring visceral fat is a measuring tape. The measurement (of waist circumference) is taken just above the belly button. In North America, Men with a waist circumference greater than 40 inches (102 cm) and women with a waist circumference greater than 35 inches (88 cm) are predicted to face greater health risks. Waist circumference cut offs for other ethnic groups and countries of origin can be found in Table 14.2. For individuals with a BMI between 18.5 and 34.9, combining both BMI and waist circumference may provide added resolution to a health risk classification. See Table 14.3 for details.\r\n\r\n[caption id=\"attachment_117\" align=\"aligncenter\" width=\"594\"]\"Apple Figure 14.6 Types of obesity.[\/caption]\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n
    Table 14.2: Ethnic or Country Specific Values for Waist Circumference and Disease Risk<\/caption>\r\n
    Country or Ethnic Group<\/td>\r\nWaist Circumference<\/td>\r\n<\/tr>\r\n
    <\/td>\r\nWomen<\/td>\r\nMen<\/td>\r\n<\/tr>\r\n
    North American<\/td>\r\n>= 88 cm\/35inches<\/td>\r\n>= 102 cm\/40 inches<\/td>\r\n<\/tr>\r\n
    Europoid<\/td>\r\n>= 80 cm\/31.5inches<\/td>\r\n>= 94 cm\/37inches<\/td>\r\n<\/tr>\r\n
    South Asian, Chinese, and Japanese<\/td>\r\n>= 80 cm\/31.5inches<\/td>\r\n>= 90 cm\/35.4 inches<\/td>\r\n<\/tr>\r\n
    Data Source: \"Waist Circumference and Waist to Hip Ratio Report of a WHO Expert Consultation, 2008\".[footnote]Waist Circumference and Waist to Hip Ratio Report of a WHO Expert Consultation. 2008. https:\/\/iris.who.int\/bitstream\/handle\/10665\/44583\/9789241501491_eng.pd<\/a>f[\/footnote]<\/td>\r\n<\/tr>\r\n<\/tbody>\r\n<\/table>\r\n \r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n
    Table 14.3: Health Risk Classification According to BMI and Waist Circumference<\/caption>\r\n
    Waist Circumference<\/td>\r\nBMI<\/td>\r\n<\/tr>\r\n
    <\/td>\r\n18.5-24.9 (\"Normal\")<\/td>\r\n25-29.9 (Overweight)<\/td>\r\n30-34.9 (Obese class 1)<\/td>\r\n<\/tr>\r\n
    <= 88 cm\/35inches (Women)<\/td>\r\nLeast risk<\/td>\r\nIncreased risk<\/td>\r\nHigh risk<\/td>\r\n<\/tr>\r\n
    <=102 cm\/40 inches (Men)<\/td>\r\n<\/tr>\r\n
    >= 88 cm\/35inches (Women)<\/td>\r\nIncreased risk<\/td>\r\nHigh risk<\/td>\r\nVery high risk<\/td>\r\n<\/tr>\r\n
    >= 102 cm\/40 inches (Men)<\/td>\r\n<\/tr>\r\n
    Data Source: \"Canadian Guidelines for Body Weight Classification in Adults - Quick Reference Tool for Professionals\".[footnote]Canadian Guidelines for Body Weight Classification in Adults - Quick Reference Tool for Professionals https:\/\/www.canada.ca\/en\/health-canada\/services\/food-nutrition\/healthy-eating\/healthy-weights\/canadian-guidelines-body-weight-classification-adults\/quick-reference-tool-professionals.html<\/a>[\/footnote]<\/td>\r\n<\/tr>\r\n<\/tbody>\r\n<\/table>\r\nThe waist-to-hip ratio is often considered a better measurement than waist circumference alone in predicting disease risk. To calculate your waist-to-hip ratio, use a measuring tape to measure your waist circumference and then measure your hip circumference at its widest part. Next, divide the waist circumference by the hip circumference to arrive at the waist-to-hip ratio. Observational studies have demonstrated that people with \u201capple-shaped\u201d bodies, (who carry more weight around the waist) have greater risks for chronic disease than those with \u201cpear-shaped\u201d bodies, (who carry more weight around the hips). A study published in the November 2005 issue of Lancet with more than twenty-seven thousand participants from fifty-two countries, concluded that the waist-to-hip ratio is highly correlated with heart attack risk worldwide and is a better predictor of heart attacks than BMI.[footnote]Yusuf S, Hawken S, et al. Obesity and the Risk of Myocardial Infarction in 27,000 Participants from 52 Countries: A Case-Control Study. Lancet. 2005; 366(9497), 1640\u20139. http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/16271645<\/a> ?dopt=AbstractPlus. Accessed September 22, 2017.[\/footnote] Abdominal obesity is defined by the World Health Organization (WHO) as having a waist-to-hip ratio above 0.90 for males and above 0.85 for females.","rendered":"

    We have discussed that BMI may have limitations in predicting body fatness and disease risk, so let’s learn more about other ways we can measure body fat and why body fat distribution may be important.<\/p>\n

    Measuring Body Fat Content<\/h2>\n

    Water, organs, bone tissue, fat, and muscle tissue make up a person\u2019s weight. Having more fat mass may be indicative of disease risk, but fat mass also varies with sex, age, and physical activity level. Females have more fat mass, which is needed for reproduction and, in part, is a consequence of different levels of hormones. The optimal fat content of females is between 20 and 30 percent of total body weight and for males, it is between 12 and 20 percent. Fat mass can be measured in a variety of ways. The simplest and lowest-cost way is the skinfold test. In a skinfold test, a health professional uses a caliper to measure the skin thickness on the back, arm, and other parts of the body and compares it to normative standards to assess body fatness. It is a fairly accurate method of measuring fat mass, but similar to BMI, it is compared to standards of mostly young to middle-aged adults. Another issue with skinfold tests is that they can be perceived as modestly invasive and uncomfortable procedures since they involve the pinching of subcutaneous fat with a caliper. Because of this, healthcare professionals may choose to avoid using skinfold measurements, especially among individuals who experience body insecurity or body image issues.<\/p>\n

    \"Skinfold
    Figure 14.3 Measuring skinfold thickness using calipers.<\/figcaption><\/figure>\n

    Other methods of measuring fat mass are more expensive and more technically challenging. They include:<\/p>\n

      \n
    1. Underwater weighing:<\/strong> This technique requires a chamber full of water big enough for the whole body to fit in. First, a person is weighed outside the chamber and then weighed again while immersed in water. Bone and muscle weigh more than water, but fat does not\u2014therefore a person with a higher muscle and bone mass will weigh more in water than a person with less bone and muscle mass.<\/li>\n
    2. Bioelectric Impedance Analysis (BIA):<\/strong> This device is based on the fact that fat slows down the passage of electricity through the body. When a small amount of electricity is passed through the body, the rate at which it travels can be used to determine body composition. These devices are also sold for home use and are commonly called body composition scales.<\/li>\n<\/ol>\n
      \"A
      Figure 14.4 BIA hand device.<\/figcaption><\/figure>\n

      3. Dual-energy X-ray absorptiometry (DEXA<\/strong>): This can be used to measure bone density. It can also determine fat content via the same method, which directs two low-dose X-ray beams through the body and looks at the amount of energy absorbed from the beams. The amount of energy absorbed is dependent on the body\u2019s content of bone, lean tissue mass, and fat mass. Using standard mathematical formulas, fat content can be accurately estimated.<\/p>\n

      \"DEXA
      Figure 14.5 Dual-energy X-ray absorptiometry (DEXA).<\/figcaption><\/figure>\n

      Measuring Fat Distribution<\/h2>\n

      Considering body fat distribution is also important for health. You may have heard that fat on the hips is better than fat on the belly\u2014this is true. Fat can be found in different areas of the body and it does not all act the same, meaning it differs physiologically based on location. Fat deposited in the abdominal cavity is called visceral fat and is a better predictor of disease risk than total fat mass. Visceral fat releases hormones and inflammatory factors that contribute to disease risk. The only tool required for measuring visceral fat is a measuring tape. The measurement (of waist circumference) is taken just above the belly button. In North America, Men with a waist circumference greater than 40 inches (102 cm) and women with a waist circumference greater than 35 inches (88 cm) are predicted to face greater health risks. Waist circumference cut offs for other ethnic groups and countries of origin can be found in Table 14.2. For individuals with a BMI between 18.5 and 34.9, combining both BMI and waist circumference may provide added resolution to a health risk classification. See Table 14.3 for details.<\/p>\n

      \"Apple
      Figure 14.6 Types of obesity.<\/figcaption><\/figure>\n\n\n\n\n\n\n\n\n
      Table 14.2: Ethnic or Country Specific Values for Waist Circumference and Disease Risk<\/caption>\n
      Country or Ethnic Group<\/td>\nWaist Circumference<\/td>\n<\/tr>\n
      <\/td>\nWomen<\/td>\nMen<\/td>\n<\/tr>\n
      North American<\/td>\n>= 88 cm\/35inches<\/td>\n>= 102 cm\/40 inches<\/td>\n<\/tr>\n
      Europoid<\/td>\n>= 80 cm\/31.5inches<\/td>\n>= 94 cm\/37inches<\/td>\n<\/tr>\n
      South Asian, Chinese, and Japanese<\/td>\n>= 80 cm\/31.5inches<\/td>\n>= 90 cm\/35.4 inches<\/td>\n<\/tr>\n
      Data Source: “Waist Circumference and Waist to Hip Ratio Report of a WHO Expert Consultation, 2008”.[1]<\/sup><\/a><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

       <\/p>\n\n\n\n\n\n\n\n\n\n
      Table 14.3: Health Risk Classification According to BMI and Waist Circumference<\/caption>\n
      Waist Circumference<\/td>\nBMI<\/td>\n<\/tr>\n
      <\/td>\n18.5-24.9 (“Normal”)<\/td>\n25-29.9 (Overweight)<\/td>\n30-34.9 (Obese class 1)<\/td>\n<\/tr>\n
      <= 88 cm\/35inches (Women)<\/td>\nLeast risk<\/td>\nIncreased risk<\/td>\nHigh risk<\/td>\n<\/tr>\n
      <=102 cm\/40 inches (Men)<\/td>\n<\/tr>\n
      >= 88 cm\/35inches (Women)<\/td>\nIncreased risk<\/td>\nHigh risk<\/td>\nVery high risk<\/td>\n<\/tr>\n
      >= 102 cm\/40 inches (Men)<\/td>\n<\/tr>\n
      Data Source: “Canadian Guidelines for Body Weight Classification in Adults – Quick Reference Tool for Professionals”.[2]<\/sup><\/a><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

      The waist-to-hip ratio is often considered a better measurement than waist circumference alone in predicting disease risk. To calculate your waist-to-hip ratio, use a measuring tape to measure your waist circumference and then measure your hip circumference at its widest part. Next, divide the waist circumference by the hip circumference to arrive at the waist-to-hip ratio. Observational studies have demonstrated that people with \u201capple-shaped\u201d bodies, (who carry more weight around the waist) have greater risks for chronic disease than those with \u201cpear-shaped\u201d bodies, (who carry more weight around the hips). A study published in the November 2005 issue of Lancet with more than twenty-seven thousand participants from fifty-two countries, concluded that the waist-to-hip ratio is highly correlated with heart attack risk worldwide and is a better predictor of heart attacks than BMI.[3]<\/sup><\/a> Abdominal obesity is defined by the World Health Organization (WHO) as having a waist-to-hip ratio above 0.90 for males and above 0.85 for females.<\/p>\n

      1. Waist Circumference and Waist to Hip Ratio Report of a WHO Expert Consultation. 2008. https:\/\/iris.who.int\/bitstream\/handle\/10665\/44583\/9789241501491_eng.pd<\/a>f ↵<\/a><\/li>
      2. Canadian Guidelines for Body Weight Classification in Adults - Quick Reference Tool for Professionals https:\/\/www.canada.ca\/en\/health-canada\/services\/food-nutrition\/healthy-eating\/healthy-weights\/canadian-guidelines-body-weight-classification-adults\/quick-reference-tool-professionals.html<\/a> ↵<\/a><\/li>
      3. Yusuf S, Hawken S, et al. Obesity and the Risk of Myocardial Infarction in 27,000 Participants from 52 Countries: A Case-Control Study. Lancet. 2005; 366(9497), 1640\u20139. http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/16271645<\/a> ?dopt=AbstractPlus. Accessed September 22, 2017. ↵<\/a><\/li><\/ol><\/div>","protected":false},"author":1955,"menu_order":3,"template":"","meta":{"pb_show_title":"on","pb_short_title":"","pb_subtitle":"","pb_authors":[],"pb_section_license":""},"chapter-type":[],"contributor":[],"license":[],"class_list":["post-2130","chapter","type-chapter","status-publish","hentry"],"part":2124,"_links":{"self":[{"href":"https:\/\/pressbooks.bccampus.ca\/humannutrition\/wp-json\/pressbooks\/v2\/chapters\/2130","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pressbooks.bccampus.ca\/humannutrition\/wp-json\/pressbooks\/v2\/chapters"}],"about":[{"href":"https:\/\/pressbooks.bccampus.ca\/humannutrition\/wp-json\/wp\/v2\/types\/chapter"}],"author":[{"embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/humannutrition\/wp-json\/wp\/v2\/users\/1955"}],"version-history":[{"count":25,"href":"https:\/\/pressbooks.bccampus.ca\/humannutrition\/wp-json\/pressbooks\/v2\/chapters\/2130\/revisions"}],"predecessor-version":[{"id":2825,"href":"https:\/\/pressbooks.bccampus.ca\/humannutrition\/wp-json\/pressbooks\/v2\/chapters\/2130\/revisions\/2825"}],"part":[{"href":"https:\/\/pressbooks.bccampus.ca\/humannutrition\/wp-json\/pressbooks\/v2\/parts\/2124"}],"metadata":[{"href":"https:\/\/pressbooks.bccampus.ca\/humannutrition\/wp-json\/pressbooks\/v2\/chapters\/2130\/metadata\/"}],"wp:attachment":[{"href":"https:\/\/pressbooks.bccampus.ca\/humannutrition\/wp-json\/wp\/v2\/media?parent=2130"}],"wp:term":[{"taxonomy":"chapter-type","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/humannutrition\/wp-json\/pressbooks\/v2\/chapter-type?post=2130"},{"taxonomy":"contributor","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/humannutrition\/wp-json\/wp\/v2\/contributor?post=2130"},{"taxonomy":"license","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/humannutrition\/wp-json\/wp\/v2\/license?post=2130"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}