Body-composition changes with diet and exercise in obese women: a comparison of estimates from clinical methods and a 4-component model

Am J Clin Nutr. 1999 Jul;70(1):5-12. doi: 10.1093/ajcn/70.1.5.


Background: Most methods available to clinicians for estimating body-composition changes have been validated against estimates from densitometry, based on a 2-component (fat mass and fat-free mass) model.

Objective: Estimates of changes in percentage body fat (%BF) from dual-energy X-ray absorptiometry (DXA), skinfold thicknesses (SFTs), bioelectrical impedance analysis (BIA), and body mass index (BMI; in kg/m2) were compared with estimates from a 4-component (fat, water, mineral, and protein) model (%BFd,w,m), a more accurate method.

Design: Determinations of body density from hydrostatic weighing, body water from deuterium dilution, bone mineral and %BF from whole-body DXA, resistance from BIA, and anthropometric measures were made in 27 obese women (BMI: 31.1 +/- 4.9) assigned to 1 of 3 groups: control (C; n = 9), diet only (DO; n = 9), or diet plus aerobic exercise (DE; n = 9).

Results: After the 16-wk intervention, changes in body mass (BM) averaged 0.5 +/- 2.0, -7.2 +/- 7.4, and -4.0 +/- 3.3 kg and changes in %BFd,w,m averaged 2.1 +/- 1.0%, -1.2 +/- 1.4%, and -2.4 +/- 1.6% in the C, DO, and DE groups, respectively. Compared with changes in %BFd,w,m, the errors (SD of bias) for estimates of changes in %BF by DXA, BIA, SFTs, and BMI were similar (range: +/-2.0-2.4% of BM). BIA, SFTs, and BMI provided unbiased estimates of decreases in %BFd,w,m, but DXA overestimated decreases in %BF in the DO and DE groups.

Conclusions: DXA, BIA, SFTs, and BMI are comparably accurate for evaluating body-composition changes induced by diet and exercise interventions; however, small changes in %BF may not be accurately detected by these clinical methods.

MeSH terms

  • Absorptiometry, Photon
  • Adipose Tissue
  • Adult
  • Anthropometry
  • Body Composition*
  • Body Mass Index
  • Body Water
  • Deuterium
  • Diet, Reducing*
  • Electric Impedance
  • Energy Intake
  • Exercise*
  • Female
  • Humans
  • Obesity / physiopathology*
  • Obesity / therapy*
  • Skinfold Thickness
  • Weight Loss


  • Deuterium