Abstract
Objectives: To determine the ability of handgrip strength combined with body mass index (BMI, kg/m2) to estimate body fat percentage (BF%) in middle-aged and older Asian adults. Methods: Middle-aged and older Asian adults (n=459, males=197) were randomly divided into a validation and model development group (n=303) and cross-validation group (n=156). A whole-body scan using dual energy x-ray absorptiometry measured BF%. Bland-Altman plots, standard error of the estimates, total errors and mean absolute errors were used to compare prediction equations. Stepwise regression analysis was used to determine a new prediction equation for middle-aged and older Asian adults. Right and left handgrip strength, age, sex and BMI were included in the analysis. Results: A previously developed prediction equation that included handgrip strength poorly predicted BF% in our current sample with the mean difference being -6.0 ± 4.2%. Predicted BF% values were significantly lower than measured BF% values (22.7% vs. 28.7%, p<0.05). A new prediction equation was developed that included sex, BMI, left handgrip strength and age. Validation of the new equation revealed a constant error of 0.2 ± 3.9% with there being no significant difference between measured and predicted BF% (28.2% vs. 28.5%, p=0.467). Previously developed BF% equations using BMI, but not handgrip strength, had similar constant errors and mean absolute errors compared to the new prediction equation. Conclusion: Handgrip strength does not appear to improve the estimation of body fat percentage from BMI prediction equations in middle and older-aged Asian adults.
Highlights
The obesity crisis continues to remain a challenge in our society with the prevalence increasing over the past two decades from 27.5% to 43.0% for men and from 33.4 to 41.9% for women[17]
A Bland-Altman plot was used to investigate how Validation of Nickerson Equation accurate the estimated BF% was compared to The differences in predicted
Based on the results of the Nickerson equation compared to Dual-energy x-ray absorptiometry (DXA) and the other prediction equations, we developed a new equation that included handgrip strength and BMI in Asian adults to see if it would improve on previously developed equations
Summary
The obesity crisis continues to remain a challenge in our society with the prevalence increasing over the past two decades from 27.5% to 43.0% for men and from 33.4 to 41.9% for women[17]. Common methods that are used to assess BF% include dual-energy x-ray absorptiometry, air displacement plethysmography, underwater weighing and bioelectrical impedance[10] and ultrasound [20]. Some of these methods are expensive, not readily available or require unique training. The measurements of body mass and height are done in a medical clinic and require little training. These measurements can be misleading as one systematic review and metaanalysis noted poor sensitivity of BMI to label individuals as obese when they had excessive body fat[18]. Athletic individuals with large amounts of muscle mass can be identified as obese when they have low levels of body fat
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