The effect of different body positions on anthropometric measurements and derived estimates of body composition

Abstract

Ms Gail Carin-Levy was funded by the Stroke Association, UK (TSA 03/02). We are grateful to the staff of the Clinical Research Facility, Royal Infirmary Edinburgh, where this work was performed.Purpose: Measurement of cross-sectional lean limb area using physical anthropometry is usually performed in the standing position, but sometimes this may be impractical. Our aim was to determine the effect of different positions on cross-sectional lean area of the upper arm, calf and thigh derived from girth and skin-fold measurements. Methods: Twenty healthy volunteers participated. Girth and skin-fold thickness of the upper arm, calf and thigh were measured in the standing, sitting and supine positions. We derived lean cross-sectional area (cm2), and calculated the mean difference, its 95% confidence intervals (CI), and the 95% limits of agreement (LOA) between standing and the other two positions. Results: For the upper arm, mean differences in lean cross-sectional area for the supine-standing and sitting-standing positions were 0.7cm2, (95% CI -0.6 to 2.0) and -0.6cm2, (95% CI -1.4 to 0.3) respectively. Mean differences for thigh were 3.9cm2 (95% CI -2.3 to 10.1) and -4.3cm2 (95% CI -8.6 to 0.0) for supine-standing and sitting-standing respectively. For the calf, mean difference for supine-standing was -3.1cm2 (95% CI -5.3 to -0.9), while for sitting-standing it was 0.3cm2 (95% CI -1.8 to 2.4). The range of values expected to cover agreement for 95% of subjects (LOA) was widest for the thigh and narrowest for the upper arm. Conclusion: In young healthy subjects, lean cross-sectional area differs according to measurement position, particularly for the lower limb. The same measurement method should be used in any one individual when monitoring change.sch_occ1. Matiega J, The testing of physical efficiency. Am J Phys Anthropol 1921; 4: 223-230. 2. Behnke AR, Feen GB, Welham WC. The specific gravity of healthy men. JAMA 1942; 118: 495-501. 3. Durnin JVGA, Womersley J. Body fat assessed from total body density and its estimation from skinfold thickness: measurements on 481 men and women aged from 16 to 72 years. Br J Nutr 1974; 32: 77-97. 4. Jackson AS, Pollock ML. Generalized equations for predicting body density of men. Br J Nutr 1978; 40: 497-504. 5. Lohman TG, Roche AF, Martorell R (Eds). Anthropometric standardization reference manual. Champaign IL: Human Kinetics, 1988: 1-90. 6. ISAK International Standards for Anthropometric Assessment. The International Society for the Advancement of Kinanthropometry, Potchefstroom, South Africa, 2001: 57-72, 73-88. 7. Brynningsen PK, Damsgaard EMS, Husted SE Improved nutritional status in elderly patients 6 months after stroke The Journal of Nutrition, Health and Aging 2007;11:75-79 8. Bland MJ, Altman DG. Statistical Methods for Assessing Agreement Between Two Methods of Clinical Measurement. Lancet I; 1986: 307-10. 9. Martin AD, Spenst LF, Drinkwater DT, Clarys JP. Anthropometric estimation of muscle mass in men. Med Sci Sports Exerc; 1990: 22, 729-733. 10. Tothill P, Stewart AD. Estimation of Thigh Muscle and Adipose Tissue Volume using Magnetic Resonance Imaging and Anthropometry. J Sports Sci 2002; 20: 563-576. 11. Altman DG. Practical Statistics for Medical Research. London: Chapman and Hall, London, 1995: 396-400. 12. Carin-Levy G, Greig C, Lewis S, Hannan J, Young A, Mead G. Longitudinal changes in muscle strength and mass after stroke. Cerebrovasc Dis 2006; 21:201-207.6pub605pub