Oversimplification of the Relationship between Ultrasound and Skinfold Measurements of Subcutaneous Fat Thickness

Wagner, Dale R.

doi:10.1249/mss.0000000000002779

Medicine &Amp; Science in Sports &Amp; Exercise

2021

DOI: 10.1249/mss.0000000000002779

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Oversimplification of the Relationship between Ultrasound and Skinfold Measurements of Subcutaneous Fat Thickness

Dale R. Wagner¹

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Cited by 2 publications

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“…We wish to express our appreciation for Dr. Wagner’s insight on the topic of subcutaneous fat thickness estimation through distinct methods, namely, skinfold calipers and ultrasonography (1). We agree with the major points raised in the letter to the editor but also wish to clarify some items related to the methodology.…”

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confidence: 99%

“…As expressed in the letter to the editor (1), we believe that ultrasound is an important and useful technology with numerous applications, including body composition estimation. We are appreciative of a productive dialogue concerning ultrasound methodology and hope it will contribute to continued refinement of optimal procedures for incorporating this method into research and applied settings.…”

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Tinsley¹,

Chandler²,

Arent³

2021

Medicine &Amp; Science in Sports &Amp; Exercise

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We wish to express our appreciation for Dr. Wagner's insight on the topic of subcutaneous fat thickness estimation through distinct methods, namely, skinfold calipers and ultrasonography (1). We agree with the major points raised in the letter to the editor but also wish to clarify some items related to the methodology. A major point is that both investigations used an existing ultrasound analysis software that incorporates, by default, the doubling of single-layer subcutaneous thicknesses prior to use in the Jackson-Pollock body density equation, as well as a tissue thickness estimate that includes skin thickness.Both the investigation of Tinsley et al. ( 2) and Chandler et al. ( 3) utilized a commercially available ultrasound technique, which includes analysis software (MuscleSound®, Glendale, CO). This manufacturer-rather than the individual investigatorsimplemented the methods of body composition estimation from ultrasonography data. This analysis software was used to increase the practicality of the current studies, as methods can easily be applied to both clinical and field settings.Personal communication with MuscleSound® (date: July 28, 2021), as well as verification in our own data, confirms that the analysis software simply doubles the single-layer subcutaneous tissue thickness, with the rationale that a skinfold caliper represents a double layer of tissue (4). We recognize that it is unlikely this process is without error and that there is evidence the ratio between an ultrasonography single-layer estimate and a skinfold double-layer estimate is not precisely 1:2 (5). Furthermore, we recognize the valid points raised in the letter to the editor regarding the varying, and often unknown, compressibility of skinfolds at distinct body sites. This contributes to the current inability to fully understand the practical significance of assuming a constant 1:2 relationship between thicknesses, as was implemented in our investigations. We recommend that commercial entities employing these procedures within their analysis software, as well as independent investigators, perform additional work to clarify whether it is appropriate to adapt skinfold-based methods to ultrasonography when estimating total body composition and what ratio most accurately represents the relationship at distinct body sites. If adapting caliper-based equations is ultimately deemed unsuitable, new equations should be developed and validated specifically with ultrasonography data. 190

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Tinsley¹,

Chandler²,

Arent³

2021

Medicine &Amp; Science in Sports &Amp; Exercise

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Anthropometric Formulas Repurposed to Predict Body Fat Content from Ultrasound Measurements of Subcutaneous Fat Thickness

Muntean,

Miclos-Balica,

Macavei

et al. 2024

Symmetry

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Body composition assessment helps conducting a healthy life or tracking the effectiveness of a weight management therapy. Ultrasound (US)-based body composition research has gained momentum because of the emergence of portable and inexpensive instruments bundled with user-friendly software. Previously, US-based assessment of body fat percentage (% BF) was found precise, but inaccurate in certain populations. Therefore, this study sought to compute % BF from subcutaneous fat thicknesses (SFs) given by US converting an anthropometric formula that involves skinfold thicknesses (SKFs) measured at the same sites. The symmetry of the body with respect to the central sagittal plane is an underlying assumption in both anthropometry and US-based body composition assessment, so measurements were taken on the right side of the body. Relying on experimental data on skinfold compressibility, we adapted 33 SKF formulas for US use and tested their validity against air displacement plethysmography on a study group of 97 women (BMI = 25.4 ± 6.4 kg/m2, mean ± SD) and 107 men (BMI = 26.7 ± 5.7 kg/m2). For both sexes, the best proprietary formula had Lin’s concordance correlation coefficient (CCC) between 0.7 and 0.73, standard error of estimate (SEE) < 3% BF and total error (TE) > 6% BF—mainly because of the underestimation of % BF in overweight and obese subjects. For women (men) the best adapted formula had CCC = 0.85 (0.80), SEE = 3.2% (2.4%) BF, and TE = 4.6% (5.4%) BF. Remarkably, certain adapted formulas were more accurate for overweight and obese people than the proprietary equations. In conclusion, anthropometric equations provide useful starting points in the quest for novel formulas to estimate body fat content from ultrasound measurements.

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Oversimplification of the Relationship between Ultrasound and Skinfold Measurements of Subcutaneous Fat Thickness

Cited by 2 publications

References 7 publications

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Anthropometric Formulas Repurposed to Predict Body Fat Content from Ultrasound Measurements of Subcutaneous Fat Thickness

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