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Presentation Package for Concepts of Fitness and Wellness 6e

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Sample calculation: 26. Concepts of Fitness and Wellness 6e ... Abdominal obesity predicts CHD risk independent of BMI, smoking, cholesterol and hypertension ... – PowerPoint PPT presentation

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Title: Presentation Package for Concepts of Fitness and Wellness 6e


1
Presentation Package for Concepts of Fitness and
Wellness 6e
  • Section V Concept 15
  • Body Composition

2
Trends in the Prevalence of Obesity in the U.S.
1991-98,
Click to see progression oftrends over time
Obese
Mokdad et al. JAMA 1999 2821519
Web15-1
3
Health Risks Associated with Being Overweight
  • Coronary heart disease
  • Hypertension
  • Hypercholesterolemia
  • Diabetes

There are also health risks associated with
being too thin!
4
Definitions of Overweight(Based on ht /wt
tables)
  • Moderately Overweight
  • 20 over desirable body weight
  • Severely overweight
  • 40 over desirable body weight

Burton, Foster, Hirsch, and Van Itallie, Health
implications of obesity An NIH consensus
development conference. Int J. Obesity, 9,
155-169, 1985.
Problem Ht/Wt tables do not take muscles mass
into account
5
Definitions of Overweight (Based on BMI values)
Click for info on BMI
  • BMI accounts for differences in frame size better
    than height weight tables. BMI Wt (kg) / Ht2
    (m)
  • Standards
  • Overweight 25
  • Obesity 30
  • Severe obesity 40

Problem BMI does not take muscles mass into
account
Web15-1 for moreinformation on standards
6
Levels of Body Fatness
Click for calculations of ideal wt based on fat
  • Men Women
  • Essential fat 5 10
  • Borderline 6-9 11-16
  • Good fitness - health 10-20 17-28
  • Marginal fitness 21-25 29-35
  • Overfatness 25 35

7
Regional Fat Deposition
Click for more info on fatdeposition
  • Abdominal body fat poses greater health risks
    than fat stored in other areas
  • Males store more fat centrally and have
    increased health risks associated with body
    fatness

8
Body Composition Assessment Techniques
  • Underwater weighing
  • Technological assessments
  • Skinfold technique
  • Anthropometric measurements

9
Underwater Weighing Technique
Click for more info


Body fat provides more bouyancy so a fatter
person weighs less (on a relative basis) than a
lean person


Web15-2 for info on underwater weighing
10
Technological Assessments of Body Composition
Click to seemore info on all techniques
  • Dual X-Ray Absorptiometry (DXA)
  • Bioelectric impedance
  • Infra-red spectroscopy
  • Ultrasound
  • Imaging techniques (DEXA, MRI)

Click individualtechnique to see more detail
11
Skinfold Technique
Layers of subcutaneous fat are measured at
different sites of body to estimate total body
fat levels
Cross sectional view
12
Benefits of Skinfold Technique
  • Fairly accurate
  • Easy to perform
  • Inexpensive

13
Common Skinfold Sites
Lab 15a info
  • 7 site procedure
  • Chest
  • Axilla
  • Tricep
  • Subscapular
  • Abdomen
  • Supraillium
  • Thigh

Jackson and Pollack Males Female Chest Triceps A
bdomen Supraillium Thigh Thigh
Alternative Sites (Males Females) Tricep Abdom
en Calf
Validation statistics on 3 site test - r .97
with 7 site procedure - R2 .80 with underwater
weighing
Web15-3
14
Research Quality Skinfold Calipers
Lange Calipers
Harpenden Calipers
15
Anthropometric Measurements
Lab 15binfo
  • Body Mass Index (BMI)
  • Waist to Hip Ratio (WHR)
  • Circumference measures

More info
More info
More info
16
Body Composition AssessmentImplications of
Results
  • Values are estimates (/- 2-3 at best)
  • Values are personal and confidential
  • Proper uses of results
  • - Serve as baseline data for repeated testing
  • - Provide motivation for goal setting
  • - Provide awareness about health risks

17
Web Resources
18
Supplemental Graphics
  • Lab InformationDetail on BMI calculations
  • Graphics on Obesity Trends

19
Lab 15a InformationEvaluating Body Composition -
Skinfolds
  • The purpose of this lab is to evaluate body
    composition with the skinfold assessment.
  • Comparisons will be made between different
    procedures and testers to learn about the
    accuracy of the tests

20
Lab 15a InformationSkinfold Technique
Return to presentation
  • Measurement Technique
  • Mark site with marker
  • Pinch fold above and below mark with left and
    right hand
  • Measure fold with caliper using the right hand
  • Scoring Procedure
  • Sum skinfolds from the 3 sites
  • Look up percent body fat valuefrom chart in the
    book













21
Lab 15b InformationEvaluating Body Composition -
Anthropometry
  • The purpose of this lab is to evaluate body
    composition with some anthropometric assessments
  • Body Mass Index
  • Waist to Hip Ratio

22
Lab 15b Information BMI Measurement Technique
Return to presentation
  • Convert weight to kilograms (2.2 kg/lb.)
  • Convert height to meters (.0254 m/in)
  • Square the height in meters
  • Divide the squared height value into the weight
    value

BMI Wt (kg) / Ht2 (m)
See Web15-05 for BMI calculators
23
Lab 15b Information WHR Measurement Technique
Return to presentation
  • Waist Measure at the "natural waist" (smallest
    circumference) or at the level of the umbilicus
  • Hip Measure at the maximum circumference of the
    buttocks

Divide the hip measurement into the waist
measurement to obtain the WHR
24
Sample BMI Values
Return to presentation
This chart reveals how BMI values change for a
hypothetical 6 foot tall person of different
body weights
See Web15-05 for BMI calculators
25
Body Composition (2 compartment model)
  • Fat
  • Lean Body Mass (LBM) (bones, muscles, tissues,
    organs)

Sample calculation
  • 70kg person with 20 body fat
  • Lean tissue 70 kg x .80 56 kg
  • Fat tissue 70 kg x .20 14 kg

26
Calculating Desired Body Weight
See sample calculation


Current Lean weight
Wt. - (fat weight)
Desired Weight

Desired Lean
(1 - desired Fat)
27
Calculating Desired Body Weight (Example)
Return to presentation
28
Regional Fat DepositionVisceral Fat
  • Visceral body fat poses greater health risks
    because this fat is more labile and has greater
    access to the circulation.
  • The accumulation of visceral body fat is typical
    of the android (male) fat pattern
  • males visceral accounts for 10-35 of total fat
  • females visceral accounts for 8-13of total fat

29
Abdominal Body FatRelationships with CHD Risks
  • Abdominal obesity predicts CHD risk independent
    of BMI, smoking, cholesterol and
    hypertension(Kannel et al., J. Clin Epid., 44,
    183-190, 1991).
  • Abdominal obesity predicts CHD risk independent
    of total body fatness. (Larsson et al.
    ,Appetite, 13, 37-44, 1989).
  • Abdominal obesity statisticallly accounts for
    difference in CHD rates between men and women
    (Larsson et al., Am. J. Epi., 135 266-273, 1992).

30
Abdominal Body FatRelationships with other risk
factors
  • Abdominal obesity is strongly influenced by
    genetics - similar gain among twins (r.72).
    (Bouchard, NEJM, 322, 1477-1482, 1990).
  • Abdominal obesity is greater in smokers than
    non-smokers due to the presence of androgens
    (Barrett-Conner, Ann. Int. Med. 111, 783-787,
    1989).
  • Abdominal body fat is preferentially lost during
    a physical activity program(Kohrt, J.
    Gerontology, 47 M99-M105, 1992)

31
Waist to Hip Ratio (WHR)
Return to presentation
  • Waist to Hip Ratio is an effective way to examine
    regional fat distribution.






































































































































































WOMEN
MEN
HEALTH RISK















































High Risk
1.0
.85
Moderate Risk
.90 -1.0
.80-.85
Low Risk


32
Underwater WeighingMeasurement issues
Return to presentation
  • Based on body density calculations
  • Density of lean tissue 1.1 g/cc
  • Density of fat tissue .9 g/cc
  • Sources of error
  • Residual lung volume
  • Bone density varies by age, ethnicity and
    activity level
  • General conclusions
  • Gold standard measure (1-2 error)
  • Impractical for most applications

33
Dual X-Ray Absorptiometry (DXA)
Return to presentation
  • The new criterion measure
  • Visit the Hologic website for examples and
    details from one of the leading manufacturers of
    DXA devices.

Web15-2 for info on DXA
34
Bioelectric Impedence(Measurement Issues)
Return to presentation
  • Based on resistance to current flow
  • Lean tissue has more water - less resistance
  • Fat tissue has less water - more resistance
  • Sources of error
  • Temperature
  • Hydration status
  • General conclusions
  • Overestimates lean / underestimates obese
  • Practical, but expensive, measure for general
    population

35
Infrared Spectroscopy(Measurement Issues)
Return to presentation
  • Based on differential absorbance rates
  • Lean tissue has a different energy absorption and
    reflectance pattern than fat tissue
  • Sources of error
  • Validity of absorbance readings is questionable!
  • General findings
  • NOT a valid measure!

36
Ultrasound(Measurement Issues)
Return to presentation
  • Based on reflection of sound
  • Fat content increases the time is required for
    sound to reflect off of bone and muscle.
  • Sources of error
  • Representative sites for measurement
  • Measurement error
  • General conclusions
  • Highly accurate measure of body fat - especially
    for obese
  • Expensive and not practical for most applications

37
Imaging Techniques(Measurement Issues)
Return to presentation
  • Based on imaging of body tissues
  • Based on cross sectional area measures
    calculated at different levels of the body
  • Sources of error
  • Representative sites for measurement
  • Measurement error
  • General conclusions
  • Very precise measure of body composition
  • Expensive and not practical measure for most uses

38
Circumferences (Measurement Technique)
Return to presentation
  • Based on circumference measures
  • sample prediction equation fat - 47.372
    (.579 x abdomen) (.252 x hip) (.214 x iliac)
    (.356 x BW)
  • Sources of error
  • Location of sites
  • Inability to distinguish fat and muscle
  • General conclusions
  • Provides reasonable estimate of body fat
  • Not as accurate as skinfold and takes same time

39
Obesity Trends Among U.S. Adults Proportion of
Obese Adults by StateBRFSS
(BMI ? 30, or 30 lbs overweight for 54 woman)
Slides from the CDC
40
Obesity Trends Among U.S. AdultsBRFSS, 1990
(BMI ? 30, or 30 lbs overweight for 54 woman)
41
Obesity Trends Among U.S. AdultsBRFSS, 1991
42
Obesity Trends Among U.S. AdultsBRFSS, 1992
43
Obesity Trends Among U.S. AdultsBRFSS, 1993
44
Obesity Trends Among U.S. AdultsBRFSS, 1994
45
Obesity Trends Among U.S. AdultsBRFSS, 1995
46
Obesity Trends Among U.S. AdultsBRFSS, 1996
47
Obesity Trends Among U.S. AdultsBRFSS, 1997
48
Obesity Trends Among U.S. AdultsBRFSS, 1998
49
Obesity Trends Among U.S. AdultsBRFSS, 1999
50
Obesity Trends Among U.S. AdultsBRFSS, 2000
51
Obesity Trends Among U.S. Adults BRFSS, 1991,
1995 and 2000
Source Mokdad A H, et al. J Am Med Assoc
199928216, 200128610.
52
Latest data (2003 BRFSS)
53
Web Links
  • Behavioral Risk Factor Surveillance System
    (BRFSS) Interactive Web Page
  • http//www.cdc.gov/brfss/
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