Arthur D. Stewart

Current status of body composition assessment in sport: review and position statement on behalf of the ad hoc research working group on body composition health and performance, under the auspices of the I.O.C. Medical Commission.

Quantifying human body composition has played an important role in monitoring all athlete performance and training regimens, but especially so in gravitational, weight class and aesthetic sports wherein the tissue composition of the body profoundly affects performance or adjudication. Over the past century, a myriad of techniques and equations have been proposed, but all have some inherent problems, whether in measurement methodology or in the assumptions they make. To date, there is no universally applicable criterion or ‘gold standard’ methodology for body composition assessment. Having considered issues of accuracy, repeatability and utility, the multi-component model might be employed as a performance or selection criterion, provided the selected model accounts for variability in the density of fat-free mass in its computation. However, when profiling change in interventions, single methods whose raw data are surrogates for body composition (with the notable exception of the body mass index) remain useful.

Prediction of fat and fat-free mass in male athletes using dual X-ray absorptiometry as the reference method

The ability of bioelectrical impedance analysis and anthropometry to predict fat mass and fat-free mass was compared in a sample of 82 male athletes from a wide variety of sports, using dual-energy X-ray absorptiometry (DXA) as the reference method. The percent fat measured by DXA was 10.9 - 4.9% (mean - s ), and fat mass was predicted with a standard error of the estimate of 1.7 kg for skinfolds and 2.8 kg for bioelectrical impedance analysis (P≪0.001). Fat-free mass was predicted with a standard error of the estimate of 1.7 kg for anthropometry and 2.6 kg for bioelectrical impedance analysis (P≪0.001). Regression of various individual skinfolds and summed skinfolds, to examine the eff ect of skinfold selection combinations by stepwise regression, produced an optimal fat mass prediction using the thigh and abdominal skinfold sites, and an optimal fat-free mass prediction using the thigh, abdominal and supra-ilium sites. These results suggest that anthropometry off ers a better way of assessing body composition in athletes than bioelectrical impedance analysis. Applying the derived equations to a separate sample of 24 athletes predicted fat and fat-free mass with a total error of 2.3 kg (2.9%) and 2.2 kg (2.7%), respectively. Combining the samples introduced more heterogeneity into the sample (n=106), and the optimal prediction of fat mass used six skinfolds in producing a similar standard error of the estimate (1.7 kg), although this explained a further 4% of the variation in DXA-derived fat. Fat-free mass was predicted best from four skinfolds, although the standard error of the estimate and coefficient of determination were unchanged.

How to minimise the health risks to athletes who compete in weight-sensitive sports review and position statement on behalf of the Ad Hoc Research Working Group on Body Composition, Health and Performance, under the auspices of the IOC Medical Commission

A focus on low body weight and body fat content, combined with regulations in some weight-sensitive sports, are considered risk factors for extreme dieting, eating disorders (EDs) and related health consequences among athletes. At present there are, from a health perspective, no generally accepted optimum values for body weight or percentage of fat mass in different sports and there is no ‘gold standard’ method for body composition assessment in athletes. On the basis of health considerations as well as performance, medical support teams should know how to approach elite athletes who seek to achieve an unrealistic body composition and how to prevent restrictive eating practices from developing into an ED. In addition, these teams must know when to raise the alarm and how to advice athletes who are affected by extreme dieting or clinical EDs. However, there is no consensus on when athletes struggling with extreme dieting or EDs should be referred for specialist medical treatment or removed from competition. Based on the present review, we conclude that there is a need for (1) sport-specific and gender-specific preventive programmes, (2) criteria for raising alarm and ‘does not start’ (DNS) for athletes with EDs and (3) modifications to the regulations in some sports. Further, the key areas for research identified include the development of standard methods for body composition assessment in elite athletes; screening measures for EDs among athletes; development and testing of prevention programmes; investigating the short and long-term effects of extreme dieting; and EDs on health and performance.

Estimation of thigh muscle and adipose tissue volume using magnetic resonance imaging and anthropometry

Thigh muscle volume is a useful determinant of functional fitness. However, anthropometric prediction of muscle content is influenced by the variability of adipose tissue accumulation. The aims of this study were to predict thigh muscle and adipose tissue volumes from anthropometry and to assess the validity of the method by examining the various components of the measurements and the assumptions involved. The 19 participants (9 men, 10 women; age 23-49 years) varied in adiposity. They all underwent magnetic resonance imaging (MRI) of the upper leg and the eight men and two women with the lowest adiposity underwent detailed anthropometry involving girths and skinfolds. Using MRI as the reference method, muscle volume was predicted from anthropometry using a circular concentric model, and the assumptions inherent in the method were tested further using the MRI data alone. Muscle volume was best predicted by anthropometry in the 10 leanest participants using a five-slice truncated cone model that overestimated the mean MRI value by 30% ( R 2 = 0.95; standard error of estimate = 288 cm 3 ; P ≪ 0.001). A single skinfold plus girth measurement at the mid-thigh almost matched its predictive ability, but with an increased bias. Measurements of leg circumference by means of the two techniques agreed well. The assumption of a circular cross-section was valid. In contrast, the agreement between skinfold thickness measured by caliper and superficial adipose tissue thickness by MRI was poor, contributing to the scatter of fat and lean area comparisons. An anterior skinfold thickness measurement underestimated the area of superficial adipose tissue at that level, particularly at the most proximal and distal sites. Although these limitations increase the uncertainties of muscle volume determination by anthropometry, they do not prevent its valid prediction in leaner individuals. The prediction of superficial adipose tissue was poorer.

Contemporary training practices in elite British powerlifters: survey results from an international competition.

Swinton, PA, Lloyd, R, Agouris, I, and Stewart, A. Contemporary training practices in elite British powerlifters: survey results from an international competition. J Strength Cond Res 23(2): 380-384, 2009-The primary objective of this study was to investigate current powerlifting training methods in light of anecdotal evidence purporting increased similarity with the explosive training practices of weightlifters. The study also assessed the prevalence of contemporary training practices frequently recommended for powerlifters in the popular literature. A 20-item survey was distributed to 32 elite British powerlifters at an International competition. The subject group included multiple national, international, and commonwealth champions and record holders. Based on 2007 competition results, the average Wilks score of the group was 450.26 ± 34.7. The response rate for the surveys was 88% (28 of 32). The survey was sectioned into 6 areas of inquiry: a) repetition speed, b) explosive training load, c) resistance materials used, d) adjunct power training methods, e) exercise selection, and f) training organization. The results demonstrate that the majority of powerlifters train with the intention to explosively lift maximal and submaximal loads (79 and 82%, respectively). Results revealed that 39% of the lifters regularly used elastic bands and that 57% incorporated chains in their training. Evidence for convergence of training practices between powerlifters and weightlifters was found when 69% of the subjects reported using the Olympic lifts or their derivatives as part of their powerlifting training. Collectively, the results demonstrate that previous notions of how powerlifters train are outdated. Contemporary powerlifters incorporate a variety of training practices that are focused on developing both explosive and maximal strength.

Body composition for health and performance: a survey of body composition assessment practice carried out by the Ad Hoc Research Working Group on Body Composition, Health and Performance under the auspices of the IOC Medical Commission

Background Successful performers in weight-sensitive sports are characterised by low body mass (BM) and fat content. This often requires chronic energy restriction and acute weight loss practices. Aim To evaluate current use of body composition (BC) assessment methods and identify problems and solutions with current BC approaches. Methods A 40-item survey was developed, including demographic and content questions related to BC assessment. The survey was electronically distributed among international sporting organisations. Frequencies and χ2 analyses were computed. Results 216 responses were received, from 33 countries, representing various institutions, sports and competitive levels. Of the sample, 86% of respondents currently assess BC, most frequently using skinfolds (International Society for the Advancement of Kinanthropometry (ISAK): 50%; non-ISAK, conventional: 40%; both: 28%), dual energy X-ray absorptiometry (38%), bioelectrical impedance (29%), air displacement plethysmography (17%) and hydrostatic weighing (10%). Of those using skinfolds, more at the international level used ISAK, whereas conventional approaches were more reported at regional/national level (p=0.006). The sport dietitian/nutritionist (57%) and physiologist/sports scientist (54%) were most frequently the professionals assessing BC, followed by MDs and athletic trainers, with some reporting coaches (5%). 36% of 116 respondents assessed hydration status and more (64%) did so at international than regional/national level (36%, p=0.028). Of 125 participants answering the question of whether they thought that BC assessment raised problems, 69% said ‘yes’, with most providing ideas for solutions. Conclusions Results show high use of BC assessment but also a lack of standardisation and widespread perception of problems related to BM and BC in sport. Future work should emphasise standardisation with appropriate training opportunities and more research on BC and performance.

A biomechanical comparison of the traditional squat, powerlifting squat, and box squat

Abstract Swinton, PA, Lloyd, R, Keogh, JWL, Agouris, I, and Stewart, AD. A biomechanical comparison of the traditional squat, powerlifting squat, and box squat. J Strength Cond Res 26(7): 1805–1816, 2012. The purpose of this study was to compare the biomechanics of the traditional squat with 2 popular exercise variations commonly referred to as the powerlifting squat and box squat. Twelve male powerlifters performed the exercises with 30, 50, and 70% of their measured 1 repetition maximum (1RM), with instruction to lift the loads as fast as possible. Inverse dynamics and spatial tracking of the external resistance were used to quantify biomechanical variables. A range of significant kinematic and kinetic differences (p < 0.05) emerged between the exercises. The traditional squat was performed with a narrow stance, whereas the powerlifting squat and box squat were performed with similar wide stances (48.3 ± 3.8, 89.6 ± 4.9, 92.1 ± 5.1 cm, respectively). During the eccentric phase of the traditional squat, the knee traveled past the toes resulting in anterior displacement of the system center of mass (COM). In contrast, during the powerlifting squat and box squat, a more vertical shin position was maintained, resulting in posterior displacements of the system COM. These differences in linear displacements had a significant effect (p < 0.05) on a number of peak joint moments, with the greatest effects measured at the spine and ankle. For both joints, the largest peak moment was produced during the traditional squat, followed by the powerlifting squat, then box squat. Significant differences (p < 0.05) were also noted at the hip joint where the largest moment in all 3 planes were produced during the powerlifting squat. Coaches and athletes should be aware of the biomechanical differences between the squatting variations and select according to the kinematic and kinetic profile that best match the training goals.

Methodology review: using dual-energy X-ray absorptiometry (DXA) for the assessment of body composition in athletes and active people.

Dual energy X-ray absorptiometry (DXA) is rapidly becoming more accessible and popular as a technique to monitor body composition, especially in athletic populations. Although studies in sedentary populations have investigated the validity of DXA assessment of body composition, few studies have examined the issues of reliability in athletic populations and most studies which involve DXA measurements of body composition provide little information on their scanning protocols. This review presents a summary of the sources of error and variability in the measurement of body composition by DXA, and develops a theoretical model of best practice to standardize the conduct and analysis of a DXA scan. Components of this protocol include standardization of subject presentation (subjects rested, overnight-fasted and in minimal clothing) and positioning on the scanning bed (centrally aligned in a standard position using custom-made positioning aids) as well as manipulation of the automatic segmentation of regional areas of the scan results. Body composition assessment implemented with such protocol ensures a high level of precision, while still being practical in an athletic setting. This ensures that any small changes in body composition are confidently detected and correctly interpreted. The reporting requirements for studies involving DXA scans of body composition include details of the DXA machine and software, subject presentation and positioning protocols, and analysis protocols.

Body image perception, satisfaction and somatotype in male and female athletes and non-athletes: results using a novel morphing technique

Abstract Thirty-six adults (24 males, 12 females) were assessed for anthropometric somatotype and body image (perception and satisfaction) by a novel technique using quantitative distortion of a digital still image. Software produced random distortions in nine body regions. The participants manipulated interactive slider controls to adjust each body feature in turn, recreate their perceived image and indicate their desired image. There were no differences in perception between the sexes. However, the ideal-actual differences (i.e. satisfaction) indicated that males desired larger and females smaller features, respectively, in the chest and thighs (P<0.001) and arms and calves (P<0.01). When the male-derived data were partitioned by sport (strength, endurance, team-sport and controls), differences were found in the perceived image size in the chest and rib regions (P<0.01 and P<0.05, respectively). Strength athletes perceived these areas to be smaller and the control group perceived these areas to be larger than the true values. Somatotype analysis indicated that the physique associated with minimal dissatisfaction was 2.0-5.0-3.0 for males and 3.0-2.5-3.0 for females. Cluster analysis, combining anthropometric and satisfaction data, revealed seven distinct subgroups distinguished by particular attributes of physical appearance. We conclude that the method is reliable and that body image includes sex-specific, anthropometric, perceptual and personality-related components.

A biomechanical analysis of straight and hexagonal barbell deadlifts using submaximal loads.

Swinton, PA, Stewart, A, Agouris, I, Keogh, JWL, and Lloyd, R. A biomechanical analysis of straight and hexagonal barbell deadlifts using submaximal loads. J Strength Cond Res 25(7): 2000-2009, 2011—The purpose of the investigation was to compare the kinematics and kinetics of the deadlift performed with 2 distinct barbells across a range of submaximal loads. Nineteen male powerlifters performed the deadlift with a conventional straight barbell and a hexagonal barbell that allowed the lifter to stand within its frame. Subjects performed trials at maximum speed with loads of 10, 20, 30, 40, 50, 60, 70, and 80% of their predetermined 1-repetition maximum (1RM). Inverse dynamics and spatial tracking of the external resistance were used to quantify kinematic and kinetic variables. Subjects were able to lift a heavier 1RM load in the hexagonal barbell deadlift (HBD) than the straight barbell deadlift (SBD) (265 ± 41 kg vs. 245 ± 39 kg, p < 0.05). The design of the hexagonal barbell significantly altered the resistance moment at the joints analyzed (p < 0.05), resulting in lower peak moments at the lumbar spine, hip, and ankle (p < 0.05) and an increased peak moment at the knee (p < 0.05). Maximum peak power values of 4,388 ± 713 and 4,872 ± 636 W were obtained for the SBD and HBD, respectively (p < 0.05). Across the submaximal loads, significantly greater peak force, peak velocity and peak power values were produced during the HBD compared to during the SBD (p < 0.05). The results demonstrate that the choice of barbell used to perform the deadlift has a significant effect on a range of kinematic and kinetic variables. The enhanced mechanical stimulus obtained with the hexagonal barbell suggests that in general the HBD is a more effective exercise than the SBD.