D b can be used Quinoa stir fry recipes two- or three-compartment plethysmotraphy composition models for plethysmohraphy total body fat displacemfnt patients with Air displacement plethysmography validation pleethysmography. Pediatric Research Valudation of Air Displacement Air displacement plethysmography validation in the Enhance metabolism naturally of Percentage of Fat Mass in African American Children. Article Google Scholar Modlesky CM, Lewis RD, Yetman KA, Rose B, Rosskopf LB, Sparling PB: Comparison of body composition and bone mineral measurements from two DXA instruments in young men. Mast, C. All participants agreed to refrain from participating in any other weight loss program and gave written informed consent prior to participation in the study. Accepted : 16 March

Air displacement plethysmography validation -

The BOD POD air displacement plethysmography ADP system can accommodate a large body volume and may provide an opportunity for measuring body density D b in obese subjects.

D b can be used in two- or three-compartment body composition models for estimating total body fat in patients with severe obesity. The purpose of this study was to compare D b measured by ADP to D b measured by underwater weighing UWW in subjects ranging from normal weight to severely obese.

Research methods and procedures: D b was measured with UWW and BOD POD in subjects 89 men and 34 women; age, Bland-Altman analysis showed no significant bias between D b measured by UWW and ADP. systems are also not practical to install in clinical and The costs of publication of this article were defrayed, in part, by the payment of page research settings.

Section solely to indicate this fact. Address correspondence to Steven B. Heymsfield, Weight Control Unit, Amsterdam 1 Avenue, 14th Floor, New York, NY Nonstandard abbreviations: UWW, underwater weighing; Db, body density; ADP, air E-mail: sbh2 columbia.

edu displacement plethysmography; VTG, thoracic gas volume; SEE, standard error of the Copyright © NAASO estimate. by which to measure Db in research and clinical settings 5. acrylic bathing cap.

Subjects were weighed to the nearest The ADP procedure, provided commercially as the BOD 0. The scale was calibrated daily using the subject rests inside a sealed chamber, to estimate Db 6. a kg weight. Before subject evaluation, a two-point The ADP method has been validated in normal weight chamber calibration was performed using the empty cham- adults 7 , but studies of overweight and obese subjects are ber and a Two trials were presently limited.

In one study, Vescovi et al. If the measurements did not meet the reference. The maximum BMI evaluated in the study of the reproducibility criteria, a third trial was performed, and Vescovi et al. was Petroni et al.

If none of the three showed the feasibility of using ADP to evaluate nine se- volume measurements were within mL or 0. The two or more components The availability of accurate subject was connected to the breathing circuit housed in the Db estimates that are practical to acquire in subjects with rear chamber through a disposable filtered tube, and the moderate and severe obesity would facilitate phenotyping subject was instructed to breathe normally until the moment efforts.

Accordingly, in this study, we compared Db mea- the system induced an airway occlusion. VTG was calculated surements provided by ADP to those obtained by UWW in during occlusion, where subjects were instructed to puff subjects varying widely in BMI, notably in a sample en- gently. Final body volume was computed based on the riched in overweight, obese, and severely obese subjects.

initial body volume corrected for VTG and a surface area artifact. All subjects had acceptable BOD POD lung volume measurements.

The within-subject day-to-day coefficient of Research Methods and Procedures variation for Db measurement of four adults, age and weight Protocol and Subjects range from 22 to 33 years and 52 to 95 kg, respectively, was The subjects were adults over the age of 18 years who 0. had Db measured by ADP and UWW on the same day.

Subjects with a diagnosed illness were excluded from the UWW cohort, and all subjects were participants in other unrelated Db was measured using a four-point force transducer- research programs. The subjects were instructed to fast platform scale system 13 Precision Biomedical System, overnight before body composition studies the following University Park, PA.

the subject was clothed in a bathing suit. Subjects were The ADP measurement was carried out first, followed by asked to maximally expel as much air as possible from their UWW, because the BOD POD estimates are sensitive to lungs during complete submersion.

An underwater weight subject moisture The Body Composition Core Labo- was recorded after 5 to 10 trials as the average of the highest ratory of the New York Obesity Research Center uses a 1 to three values reflecting the greatest exhalations Resid- 10 point grading system for compliance with the UWW ual lung volume was determined before UWW using the procedure including maximal exhalation underwater oxygen dilution method The within-subject day-to-day Subjects with high scores are those able to optimally com- coefficient of variation for Db measurement in our labora- ply with the UWW procedure.

All subjects were graded by tory is 0. Patients were weighed to the nearest 0. Standing Electronics Development, New York, NY.

height was measured without shoes to the nearest 10 mm with a wall-mounted Holtain stadiometer Cross-well, Statistical Methods Wales, United Kingdom. All participants signed an in- All statistical analyses were computed using SPSS Analyses included the entire cohort as pital Center Institutional Review Board.

Details regarding the physical concepts and operational Simple linear regression analysis was used to compare Db principles of ADP are reported by Dempster and Aitkens estimates by UWW and ADP and corresponding percent fat 6.

Subjects were clothed in a tight-fitting bathing suit and estimates by UWW and ADP. Multiple linear regression OBESITY RESEARCH Vol. analyses were performed to evaluate whether the relation- Bland-Altman plots 15 were used to study Severely obese potential bias in ADP Db measurements.

Between-method Db differences for the One-way ANOVA was carried out Mean to determine whether between-group Db differences existed among the BMI subgroups.

There were evaluated adults, 89 men and 34 Of the subjects, 15 Mean The mean Db values for UWW and ADP did not differ After entering Db measured by ADP, no significant additional Mean The relationship between percent fat estimates from UWW and ADP is shown in Figure 3.

Total Bland-Altman analysis revealed no significant bias for the Mean Height cm Discussion The phenotyping of obese subjects for adiposity is im- Weight kg Age years Subjects portant to several current research areas.

Although BMI is a useful measure of adiposity at the population level, BMI is inaccurate for characterizing adiposity in individual subjects Traditional imaging methods such as DXA, magnetic OBESITY RESEARCH Vol.

Table 2. resonance imaging, and computed tomography are often evaluate ADP in these earlier reports. The first approach is incapable of accommodating subjects with a very large to compare Db by ADP to Db by UWW, as in this study, and body volume and weight 3 , as is characteristic of patients the second is to compare ADP-percent fat estimates from with moderate and severe obesity.

These concerns prompted the two-compartment model to those provided by other us to examine ADP as a means of measuring Db in subjects methods such as DXA and the total body water two-com- with a wide range of BMIs.

Our findings suggest that Db partment model. Studies in children 12,17,18 , adults estimates by ADP do not differ significantly from those 5,8,12,19 —22 , elderly 23 , adult athletes 24 —26 , Mexi- provided by the traditional UWW method, even in subjects cans 27 , Japanese 28 , and African Americans 17,20 with severe obesity who have BMIs of up to report good agreement using these two evaluation ap- Although a time-honored method, UWW is impractical to proaches, with an occasional small bias detected between implement in most clinical and research settings, and some ADP and other methods.

Most of this earlier research, patients are incapable of cooperating sufficiently with the however, was carried out in non-obese subjects. In one of water submersion and maximal exhalation.

the few studies that included a large population, Vescovi et Our findings support and extend the ADP studies of al. Two approaches have been used to percent fat levels. Our results in 95 overweight and obese sub- Figure 1: Db measured by ADP vs. The solid 0.

The dashed lines represent the mean is the regression line. OBESITY RESEARCH Vol. patients are apprehensive about the UWW procedure or are unable to perform the required maneuvers 1.

Measure- ments of body volume by ADP are highly reproducible for the calibration cylinder 6 , healthy adults varying widely in body weight 5,8,29 , and athletes The comfort of a subject in the BOD POD relates to their physical dimensions and not only their weight.

Height and distribution of fat are more likely to limit the ability to accurately measure body volume. Subjects in our study up to weights of kg lb were successfully measured, and the BOD POD manufacturer reports measurements of subjects to weight of lb. Nonetheless, it can be assumed that some patients who are very tall or have larger midre- gions may not fit into the BOD POD.

In some instances, Figure 3: Percent fat estimates by ADP vs. Dashed line is the line of identity, and solid line of BOD POD Db estimates in overweight and obese sub- is the regression line.

These convenient and practical ADP measurements should prove useful in phenotyping subjects for adiposity. Acknowledgment jects, as defined by BMI, similarly show that no between- This study was supported by NIH grant PO-DIT method bias is present in measured Db up to a maximum BMI of ADP is a rapid and relatively simple method to apply in References clinical and research settings.

The dependence on the sub- 1. Das SK, Roberts SB, Kehayias JJ, et al. Body composition ject to properly perform the UWW procedure for accurate assessment in extreme obesity and after massive weight loss induced by gastric bypass surgery.

Am J Physiol Endocrinol Db measurement serves as a disadvantage compared with Metab. the minimal subject participation required for ADP mea- 2. Pietrobelli A, Formica C, Wang Z, Heymsfield SB.

Dual- surements. Entering and exiting the UWW system is often energy X-ray absorptiometry body composition model: review difficult and unsafe for patients with severe obesity.

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Annu Rev Nutr. Going SB. In: Roche AF, Heymsfield SB, Lohman TG, eds. Human Body Composition: Champaign, IL: Human Kinetics Publishers; , pp.

McCrory MA, Gomez TD, Bernauer EM, Mole PA. Eval- uation of a new air displacement plethysmograph for measur- ing human body composition. Med Sci Sports Exerc. Dempster P, Aitkens S. A new air displacement method for the determination of human body composition.

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Vescovi JD, Zimmerman SL, Miller WC, Hildebrandt L, Figure 4: Agreement between percent fat from UWW and ADP. Hammer RL, Fernhall B. The dashed adult humans. Eur J Appl Physiol. Petroni ML, Bertoli S, Maggioni M, et al.

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Evaluation of the BOD POD for estimating percent fat in residual volume and total lung capacity. female college athletes.

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Body composition in Mexican Buchowski MS. Use of air displacement plethysmography in adults by air displacement plethysmography ADP with the the determination of percentage of fat mass in African Amer- BOD-POD and deuterium oxide dilution using infrared spec- ican children.

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Concurrent valid- position. Diabetes Obes Metab.

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Body Plethysmography: Procedure, Purpose, and Uses