Curr Opin Clin Nutr Metab Care. Lee DH, Keum N, Hu FB, et al. Development and validation of anthropometric prediction equations for lean body mass, fat mass and percent fat in adults using the National Health and Nutrition Examination Survey NHANES Br J Nutr.

Duren DL, Sherwood RJ, Czerwinski SA, et al. Body composition methods: Comparisons and interpretation. J Diabetes Sci Technol. Rothney MP, Brychta RJ, Schaefer EV, Chen KY, Skarulis MC.

Body composition measured by dual-energy X-ray absorptiometry half-body scans in obese adults. Obesity Silver Spring. By Elizabeth Quinn, MS Elizabeth Quinn is an exercise physiologist, sports medicine writer, and fitness consultant for corporate wellness and rehabilitation clinics.

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At its core, it is not intended to be an estimate of body composition, i. When used as a means of tracking weight changes over time it can be a valuable tool in predicting health and for recommending lifestyle modifications.

Multiple methods exist to estimate body composition. Remember, body composition is the ration of FM and FFM used to help determine health risks. Of the other methods already mentioned waist, waist- to-hip ratio, and BMI , none provide estimates of body composition but do provide measurements of other weight- related health markers, such as abdominal fat.

Experts have designed several methods to estimate body composition. While they are not flawless, they do provide a fairly accurate representation of body composition.

The most common are:. At one time, hydrostatic weighing also and maybe more accurately called hydrodensitometry was considered the criterion for measuring body composition.

Many other methods are founded on this model, in one form or another. The mass and volume components are measured by using dry weight and then weight while being submerged in a water tank. Since fat is less dense than muscle tissue, a person with more body fat will weigh less in the water than a similar person with more lean mass.

Using the measurements, the density can be determined and converted into body fat percentage. Unfortunately, the expense and practicality of building and maintaining a water tank limits access for most. Also, for those with a fear of water, this would obviously not be the preferred method.

While underwater weighing accurately compartmentalizes FM and FFM, DEXA adds a third compartment by using low-radiation X-rays to distinguish bone mineral. This addition slightly increases the accuracy of DEXA by eliminating some of the guess work associated with individual differences, such as total body water and bone mineral density.

Originally, DEXA scanners were designed to determine and help diagnose bone density diseases. However, a full body scan, which takes only a few minutes, is all that is needed to also determine body fat percentage.

Major disadvantages to this method are its high cost and the need for a well-trained professional to operate the equipment and analyze the results. A good alternative to more expensive methods, air displacement determines body density using the same principle as underwater weighing, by measuring mass and volume.

Clearly, the main difference is that mass and volume are being determined by air displacement rather than water displacement.

Using a commercial device the Bod Pod is most commonly referenced , a person sits in a chamber that varies the air pressure allowing for body volume to be assessed.

Air displacement provides a viable alternative for those with a fear of water. Like many other methods, the expense, availability, and training of personnel Air Displacement requires limit accessibility. Additionally, its accuracy is slightly less than underwater weighing.

BIA takes a slightly different approach to measuring FFM. The premise behind BIA is that FFM will be proportional to the electrical conductivity of the body. Fat-tissue contains little water, making it a poor conductor of electricity; whereas, lean tissue contains mostly water and electrolytes, making it an excellent conductor.

BIA devices emit a low-level electrical current through the body and measure the amount of resistance the current encounters. Based on the level of impedance, a pre-programed equation is used to estimate body fat percentage.

The most accurate BIA devices use electrodes on the feet and hands to administer the point-to-point electrical current. Because BIA devices primarily measure hydration, circumstances that may influence hydration status at the time of measurement must be taken into account.

Recent exercise, bladder content, hydration habits, and meal timing can cause wide measurement variations and influence accuracy.

However, this method is generally inexpensive, often portable, and requires limited training to use, making it a very practical option. Skinfold analysis is a widely used method of assessing body composition because of its simplicity, portability, and affordability.

It is also fairly accurate when administered properly. The assumption of skinfold measurement is that the amount of subcutaneous fat is proportionate to overall body fat. As such, a technician pinches the skin at various sites and uses calipers to measure and record the diameter of the skin folds.

These numbers can then be plugged into an equation to generate an estimate of body fat percentage. The proportionality of subcutaneous fat and overall body fat depends on age, gender, ethnicity, and activity rates. As such, technicians should use the skinfold technique specific to the equation that accounts for those variables to improve accuracy.

Despite the well-known health concerns implicated in overweight and obesity and the availability of multiple methods for assessment and tools to improve body composition, current trends in the United States and around the world are moving in the wrong direction. The unprecedented number of obese Americans has led experts to label it an epidemic, much like they would a disease in a developing country.

Of those, In , the overweight and obesity rates for adults in the U. Of more concern are the increasing number of obese children ages and adolescents ages , amounting to With such a diverse population in the U. and with an understanding of how BMI is calculated, it is only natural to question the high number of overweight and obese citizens based on BMI alone.

However, it is generally believed this is an accurate portrayal of weight status. In a study attempting to compare BMI measurements to actual body fat percentage, it was determined that the total number of obese citizens may be underestimated, and its current prevalence may be worse than is currently being reported.

With the available tools to identify health risks associated with body fat, anyone concerned about their health should gather as much data about body composition and body fat distribution as possible.

For example, BMI alone can be beneficial. But when combined with waist circumference, a greater understanding of risk can be achieved. Likewise, when combining BMI and waist circumference with body fat percentage, an ideal conclusion of health status can be made.

In the lab accompanying this chapter, you will be guided through the process of assessing your BMI, waist circumference, waist-to-hip ratio, and body fat percentage. The next course of action is to set goals and formulate a plan to get to a healthy range of weight and body fat percentage.

This might also include tracking your current eating and activity habits. More specific information on weight management strategies will be discussed in a later chapter.

Because more people experience excess body fat, the focus up to this point has been on health concerns related to overweight and obesity. However, fat is an essential component to a healthy body, and in rare cases, individuals have insufficient fat reserves, which can also be a health concern.

Attempting to, or intentionally staying in those ranges, through excessive exercise or calorie restriction is not recommended.

Unfortunately, low body fat is often associated with individuals struggling with eating disorders, the majority of whom are females.

The main concern of low body fat relates to the number and quality of calories being consumed. Foods not only provide energy but also provide the necessary nutrients to facilitate vital body functions. For example, low amounts of iron from a poor diet can result in anemia.

Potassium deficiencies can cause hypokalemia leading to cardiovascular irregularities. If adequate calcium is not being obtained from foods, bone deficiencies will result.

Clearly, having low body fat, depending on the cause, can be equally as detrimental to health as having too much. The health concerns most often linked to low body fat are:. In some cases, despite attempts to gain weight, individuals are unable to gain the pounds needed to maintain a healthy weight.

In these cases, as in the case of excess fat, a holistic approach should be taken to determine if the low levels of body fat are adversely affecting health. These individuals should monitor their eating habits to assure they are getting adequate nutrition for their daily activity needs.

Additionally, other lifestyle habits should be monitored or avoided, such as smoking, which may suppress hunger. Additional reading on low body fat and its impact can be found on the Livestrong.

com website, on this page: At what body fat percent do you start losing your period? Concepts of Fitness and Wellness Copyright © by Mark Abel is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.

Skip to content By Scott Flynn Objectives: What is body composition? What are the health risks and costs associated with overweight and obesity? What is the significance of body fat distribution?

What is Body Mass Index BMI and why is it important?

and Vivian H. Heyward, Ph. Body Composition The body is composed of water, protein, minerals, and fat. A two-component model of body composition divides the body into a fat component and fat-free component.

Body fat is the most variable constituent of the body. The total amount of body fat consists of essential fat and storage fat. Fat in the marrow of bones, in the heart, lungs, liver, spleen, kidneys, intestines, muscles, and lipid-rich tissues throughout the central nervous system is called essential fat, whereas fat that accumulates in adipose tissue is called storage fat.

Essential fat is necessary for normal bodily functioning. The essential fat of women is higher than that of men because it includes sex-characteristic fat related to child-bearing. Storage fat is located around internal organs internal storage fat and directly beneath the skin subcutaneous storage fat.

It provides bodily protection and serves as an insulator to conserve body heat. The relationship between subcutaneous fat and internal fat may not be the same for all individuals and may fluctuate during the life cycle.

Lean body mass represents the weight of your muscles, bones, ligaments, tendons, and internal organs. Lean body mass differs from fat-free mass.

Since there is some essential fat in the marrow of your bones and internal organs, the lean body mass includes a small percentage of essential fat. However, with the two-component model of body composition, these sources of essential fat are estimated and subtracted from total body weight to obtain the fat-free mass.

Practical methods of assessing body composition such as skinfolds, bioelectrical impedance analysis BIA , and hydrostatic weighing are based on the two-component fat and fat-free mass model of body composition. Standards of Body Fatnessary Our bodies require essential fat because it serves as an important metabolic fuel for energy production and other normal bodily functions.

Body fat percentages for optimal fitness and for athletes tend to be lower than optimal health values because excess fat may hinder physical performance and activity. When prescribing ideal body fat for a client, you should use a range of values rather than a single value to account for individual differences.

As a result of these changes, men and women who weigh the same at age 60 as they did at age 20 may actually have double the amount of body fat unless they have been physically active throughout their life Wilmore et al.

Table 1. Body Composition: A round table. The Physician and Sportsmedicine, 14 3 , Assessing Body Composition The search for valid methods of measuring body composition that are practical and inexpensive is an ongoing process for exercise scientists and nutritionists.

Standard age-height-weight tables derived from life insurance data often incorrectly indicate individuals to be overweight. Some practical methods of measuring body composition include skinfolds, circumference girth measures, hydrostatic weighing, bioelectrical impedance, and near-infrared interactance.

Other advanced methods discussed in research journals include isotope dilution, neutron activation analysis, magnetic resonance imaging, and dual-energy x-ray absorptiometry.

This error factor may be increased dramatically due to the skill or lack of it of the technician taking the measurements. The following sections will focus on three body fat measurement techniques that are often accessible to fitness professionals: hydrostatic weighing, bioelectrical impedance, and skinfolds.

Hydrostatic Weighing Hydrostatic weighing is a valid, reliable and widely used technique for assessing body composition. It has been labeled the "Gold Standard" or criterion measure of body composition analysis. It is based on Archimedes' principle.

This principle states that an object immersed in a fluid loses an amount of weight equivalent to the weight of the fluid which is displaced by the object's volume. This principle is applied to estimate the body volume and body density of individuals.

Since fat has a lower density than muscle or bone, fatter individuals will have a lower total body density than leaner individuals.

As the person is being submerged, the air in the lungs must be exhaled completely. The air remaining in the small pockets of the lungs following a maximal expiration is referred to as the residual lung volume. The residual lung volume may be determined using a number of laboratory techniques or it is often estimated using age, height, and gender-specific equations.

Once your body weight, the underwater weight, and the residual lung volume are known, total body density may be calculated. From the total body density, the percent body fat can be estimated using the appropriate age-gender equation. One limitation of hydrostatic weighing is that it is based on the two- component model fat and fat-free mass which assumes when calculating total body density that the relative amounts and densities of bone, muscle, and water comprising the fat-free mass are essentially the same for all individuals, regardless of age, gender, race or fitness level.

It is now known that this is not the case. For instance, the fat-free body density of young Black men is greater than that of white men. Because of this, the lean body mass is overestimated and the body fat is underestimated for many Blacks. Also, after age 45 to 50, substantial changes in bone density, especially in women, invalidate the use of an assumed constant value for fat-free body density when converting total body density to percentage of body fat.

This is why age and gender specific equations need to be used for estimating body fat. As researchers learn more about age-related changes in bone mineral, hydrostatic weighing will eventually provide a more accurate prediction of body fat for older men and women.

Bioelectrical impedance analysis BIA is based on the fact that the body contains intracellular and extracellular fluids capable of electrical conduction. A non-detectable, safe, low-level current flows through these intracellular and extracellular fluids. Since your fat-free body weight contains much of your body's water and electrolytes, it is a better conductor of the electrical current than the fat, which contains very little water.

It is inexpensive and convenient, but accuracy depends on the skill and training of the measurer. At least three measurements are needed from different body parts. The calipers have a limited range and therefore may not accurately measure persons with obesity or those whose skinfold thickness exceeds the width of the caliper.

BIA equipment sends a small, imperceptible, safe electric current through the body, measuring the resistance. The current faces more resistance passing through body fat than it does passing through lean body mass and water.

Equations are used to estimate body fat percentage and fat-free mass. Readings may also not be as accurate in individuals with a BMI of 35 or higher. Individuals are weighed on dry land and then again while submerged in a water tank.

This method is accurate but costly and typically only used in a research setting. It can cause discomfort as individuals must completely submerge under water including the head, and then exhale completely before obtaining the reading.

This method uses a similar principle to underwater weighing but can be done in the air instead of in water.

It is expensive but accurate, quick, and comfortable for those who prefer not to be submerged in water. Individuals drink isotope-labeled water and give body fluid samples. Researchers analyze these samples for isotope levels, which are then used to calculate total body water, fat-free body mass, and in turn, body fat mass.

X-ray beams pass through different body tissues at different rates. DEXA uses two low-level X-ray beams to develop estimates of fat-free mass, fat mass, and bone mineral density. It cannot distinguish between subcutaneous and visceral fat, cannot be used in persons sensitive to radiation e.

These two imaging techniques are now considered to be the most accurate methods for measuring tissue, organ, and whole-body fat mass as well as lean muscle mass and bone mass. However, CT and MRI scans are typically used only in research settings because the equipment is extremely expensive and cannot be moved.

CT scans cannot be used with pregnant women or children, due to exposure to ionizing radiation, and certain MRI and CT scanners may not be able to accommodate individuals with a BMI of 35 or higher.

Some studies suggest that the connection between body mass index and premature death follows a U-shaped curve. The problem is that most of these studies included smokers and individuals with early, but undetected, chronic and fatal diseases.

Cigarette smokers as a group weigh less than nonsmokers, in part because smoking deadens the appetite. Potentially deadly chronic diseases such as cancer, emphysema, kidney failure, and heart failure can cause weight loss even before they cause symptoms and have been diagnosed.

Instead, low weight is often the result of illnesses or habits that may be fatal. Many epidemiologic studies confirm that increasing weight is associated with increasing disease risk.

The American Cancer Society fielded two large long-term Cancer Prevention Studies that included more than one million adults who were followed for at least 12 years.

Both studies showed a clear pattern of increasing mortality with increasing weight. According to the current Dietary Guidelines for Americans a body mass index below But some people live long, healthy lives with a low body mass index. But if you start losing weight without trying, discuss with your doctor the reasons why this could be happening.

Learn more about maintaining a healthy weight. The contents of this website are for educational purposes and are not intended to offer personal medical advice. You should seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The Nutrition Source does not recommend or endorse any products.

Skip to content The Nutrition Source. The Nutrition Source Menu. Search for:. Home Nutrition News What Should I Eat? Role of Body Fat We may not appreciate body fat, especially when it accumulates in specific areas like our bellies or thighs.

Types of Body Fat Fat tissue comes in white, brown, beige, and even pink. Types Brown fat — Infants carry the most brown fat, which keeps them warm. It is stimulated by cold temperatures to generate heat. The amount of brown fat does not change with increased calorie intake, and those who have overweight or obesity tend to carry less brown fat than lean persons.

White fat — These large round cells are the most abundant type and are designed for fat storage, accumulating in the belly, thighs, and hips.

They secrete more than 50 types of hormones, enzymes, and growth factors including leptin and adiponectin, which helps the liver and muscles respond better to insulin a blood sugar regulator. But if there are excessive white cells, these hormones are disrupted and can cause the opposite effect of insulin resistance and chronic inflammation.

Beige fat — This type of white fat can be converted to perform similar traits as brown fat, such as being able to generate heat with exposure to cold temperatures or during exercise. Pink fat — This type of white fat is converted to pink during pregnancy and lactation, producing and secreting breast milk.

Essential fat — This type may be made up of brown, white, or beige fat and is vital for the body to function normally. It is found in most organs, muscles, and the central nervous system including the brain.

It helps to regulate hormones like estrogen, insulin, cortisol, and leptin; control body temperature; and assist in the absorption of vitamins and minerals.

Very high amounts of subcutaneous fat can increase the risk of disease, though not as significantly as visceral fat. Having a lot of visceral fat is linked with a higher risk of cardiovascular disease, diabetes, and certain cancers.

It may secrete inflammatory chemicals called cytokines that promote insulin resistance. Visceral adiposity and incident coronary heart disease in Japanese-American men.

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The simplest and lowest-cost way is the skin-fold test. A health professional uses a caliper to measure the thickness of skin on the back, arm, and other parts of the body and compares it to standards to assess body fatness. It is a noninvasive and fairly accurate method of measuring fat mass, but similar to BMI, is compared to standards of mostly young to middle-aged adults.

Other methods of measuring fat mass are more expensive and more technically challenging. They include:. Total body-fat mass is one predictor of health; another is how the fat is distributed in the body.

You may have heard that fat on the hips is better than fat in the belly—this is true. Fat can be found in different areas in 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 it 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.

Men with a waist circumference greater than 40 inches and women with a waist circumference greater than 35 inches are predicted to face greater health risks.

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.

A study published in the November 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.

Abdominal obesity is defined by the World Health Organization WHO as having a waist-to-hip ratio above 0. As such, individuals with well-toned muscles and low body weight are marketed as superior within the context of attractiveness, financial success, and multiple other traits.

Unfortunately, this emphasis, as seen in mainstream media, can result in unrealistic ideals and potentially harmful behaviors, such as eating disorders. Unlike the mainstream outlets, which focus on the association between fat levels and physical attractiveness, this chapter focuses on the health-related consequences related to good and bad body composition.

FFM includes bones, muscles, ligaments, body fluids and other organs, while FM is limited to fat tissue. Weight alone, in this case, does not distinguish between FFM and FM and would suggest both individuals have similar health. As body fat percentage increases, the potential for various diseases also increases significantly.

According to the National Institute of Health NIH , a wide array of diseases can be linked to excessive body fat.

An explanation of how being overweight relates to each disease those highlighted can be viewed by clicking on the following link. NIH-Explanation of Disease Risk Associated with Overweight. Fat is a necessary component of daily nutrition. It is needed for healthy cellular function, energy, cushioning for vital organs, insulation, and for food flavor.

Fat storage in the body consists of two types of fat: essential and nonessential fat. Essential fat is the minimal amount of fat necessary for normal physiological function. Fat above the minimal amount is referred to as nonessential fat. It is generally accepted that an overall range of percent for men and percent for women is considered satisfactory for good health.

A body composition within the recommended range suggests a person has less risk of developing obesity-related diseases, such as diabetes, high blood pressure, and even some cancers. In both males and females, non- essential fat reserves can be healthy, especially in providing substantial amounts of energy.

Excessive body fat is categorized by the terms overweight and obesity. These terms do not implicate social status or physical attractiveness, but rather indicate health risks. Overweight is defined as the accumulation of non-essential body fat to the point that it adversely affects health.

Obesity is characterized by excessive accumulation of body fat and can be defined as a more serious degree of being overweight. Diseases are not the only concern with an unhealthy body fat percentage. Several others are listed below. An important component of a healthy lifestyle and weight management is regular physical activity and exercise.

To the contrary, those who live a sedentary lifestyle will find it more difficult to maintain a healthy body weight or develop adequate musculature, endurance, and flexibility. Unfortunately, additional body weight makes it more difficult to be active because it requires more energy and places a higher demand on weak muscles and the cardiovascular system.

The result is a self-perpetuating cycle of inactivity leading to more body weight, which leads to more inactivity. Other studies suggest increases in BMI significantly increase the incidence of personality disorders and anxiety and mood disorders.

Additional studies have been able to associate a higher incidence of psychological disorders and suicidal tendencies in obese females compared with obese males. The association between obesity and diseases, such as cancer, CVD, and diabetes, suggests that people with more body fat generally have shorter lifespans.

Other studies have tied the Years of Life Lost to body mass index measurements, estimating anywhere from 2 to 20 years can be lost, depending on ethnicity, age at time of obese classification, and gender.

The physical harm caused by obesity and overweight is mirrored by its economic impact on the health care system. Overweight and obesity also contribute to loss of productivity at work through absenteeism and presenteeism , defined as being less productive while working.

Body composition measurements can help determine health risks and assist in creating an exercise and nutrition plan to maintain a healthy weight. However, the presence of unwanted body fat is not the only concern associated with an unhealthy weight. Where the fat is stored, or fat distribution, also affects overall health risks.

Surface fat, located just below the skin, is called subcutaneous fat. Unlike subcutaneous fat, visceral fat is more often associated with abdominal fat.

Researchers have found that excessive belly fat decreases insulin sensitivity, making it easier to develop type II diabetes. It may also negatively impact blood lipid metabolism, contributing to more cases of cardiovascular disease and stroke in patients with excessive belly fat.

Body fat distribution can easily be determined by simply looking in the mirror. The outline of the body, or body shape, would indicate the location of where body fat is stored. Abdominal fat storage patterns are generally compared to the shape of an apple, called the android shape.

This shape is more commonly found in males and post- menopausal females. In terms of disease risk, this implies males and post- menopausal females are at greater risk of developing health issues associated with excessive visceral fat.

Individuals who experience chronic stress tend to store fat in the abdominal region. A pear-shaped body fat distribution pattern, or gynoid shape , is more commonly found in pre-menopausal females. Gynoid shape is characterized by fat storage in the lower body such as the hips and buttocks.

Besides looking in the mirror to determine body shape, people can use an inexpensive tape measure to measure the diameter of their hips and waist. Many leading organizations and experts currently believe a waist circumference of 40 or greater for males and 35 or greater for females significantly increases risk of disease.

In addition to measuring waist circumference, measuring the waist and the hips and using a waist-to-hip ratio waist circumference divided by the hip circumference is equally effective at predicting body fat-related health outcomes. According to the National Heart, Lung, and Blood Institute, a ratio of greater than 0.

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Bramlage P, Wittchen HU, Pittrow D et al. Recognition and management of overweight and obesity in primary care in Germany. Oxford University Press is a department of the University of Oxford.

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Advanced Search. Search Menu. Article Navigation. Close mobile search navigation Article Navigation. Volume Article Contents Introduction. How to measure body fat? Epidemiology of body fat measures and associated disease risk.

Journal Article. What aspects of body fat are particularly hazardous and how do we measure them? MB Snijder , MB Snijder. Institute of Health Sciences, Faculty of Earth and Life Sciences, Vrije Universiteit Amsterdam, De Boelelaan , HV Amsterdam, The Netherlands.

E-mail: marieke. snijder falw. Oxford Academic. Google Scholar. RM van Dam. M Visser. JC Seidell. PDF Split View Views.

Cite Cite MB Snijder, RM van Dam, M Visser, JC Seidell, What aspects of body fat are particularly hazardous and how do we measure them? Select Format Select format. ris Mendeley, Papers, Zotero. enw EndNote. bibtex BibTex. txt Medlars, RefWorks Download citation.

Permissions Icon Permissions. Close Navbar Search Filter International Journal of Epidemiology This issue Public Health and Epidemiology Books Journals Oxford Academic Enter search term Search. Introduction There is a worldwide increase in the prevalence of obesity, 1 which contributes to a higher incidence of cardiovascular disease and type 2 diabetes mellitus.

Body fat measurements Numerous techniques are available to estimate body composition and fat distribution, and the method to use will depend on the aim of the study, economic resources, availability, time, and sample size. Open in new tab Download slide.

Table 1 Capability of different body fat measurements to estimate total body fat and fat distribution. Capability measuring total body fat. Capability measuring fat distribution. Applicability in large population studies. Open in new tab. Semin Vasc Med. Diabetes Care. Geneva, Switzerland: WHO, Am J Clin Nutr.

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