The following are excerpts from Resource (1) below, The evaluation of body composition: a useful tool for clinical practice:
Abstract:
The increased prevalence of obesity together with chronic
illnesses associated with fat-free mass (FFM) loss will result in
an increased prevalence of sarcopenic obesity. In patients
with sarcopenic obesity, weight loss and the body mass index
lack accuracy to detect FFM loss. FFM loss is related to
increasing mortality, worse clinical outcomes, and impaired
quality of life. In sarcopenic obesity and chronic diseases,
body composition measurement with dual-energy X-ray absorptiometry, bioelectrical impedance analysis, or computerized tomography quantifies the loss of FFM. It allows tailored nutritional support and disease-specific therapy and
reduces the risk of drug toxicity. Body composition evaluation
should be integrated into routine clinical practice for the initial assessment and sequential follow-up of nutritional status.Sarcopenic obesity [obesity and decreased fat free mass (FFM)] is associated with decreased survival and increased therapy toxicity in cancer patients [5–10] , whereas FFM loss is related to decreased survival, a negative clinical outcome, increased health care costs [2] , and impaired overall health, functional capacities, and quality of life [4–11] . Therefore, the detection and treatment of FFM loss is a major issue of public health and
health costs [12].Which Technique of Body Composition Evaluation
Should Be Used for the Assessment of Nutritional
Status?In summary, DEXA, BIA, and L3-targeted CT images
could all measure body composition accurately. The technique
selection will depend on the clinical context, hardware,
and knowledge availability. Body composition evaluation
by DEXA should be performed in patients having
a routine assessment of bone mineral density. Also, analysis
of L3-targeted CT is the method of choice for body
composition evaluation in cancer patients. Body composition
evaluation should also be done for every abdominal
CT performed in patients who are nutritionally at risk or
undernourished. Because of its simplicity of use, BIA
could be widely implemented as a method of body composition
evaluation and follow-up in a great number of
hospitalized and ambulatory patients. Future research
will aim to determine whether a routine evaluation of
body composition would allow early detection of the increased
FFM catabolism related to critical illness [75]Body Composition Evaluation for the Calculation of
Energy NeedsThe evaluation of FFM could be used for the calculation
of energy needs, thus allowing the optimization of
nutritional intakes according to nutritional needs. This
could be of great interest in specific situations, such as severe
neurologic disability, overweight, and obesity.Towards the Implementation of Body Composition
Evaluation in Clinical PracticeThe implementation of body composition evaluation
in routine care presents a challenge for the next decades.
Indeed the concomitant increases in elderly subjects and
patients with chronic diseases and cancer, and in the
prevalence of overweight and obesity in the population,
will increase the number of patients nutritionally at risk
or undernourished, particularly those with sarcopenic
obesity. Body composition evaluation should be used to
improve the screening of undernutrition in hospitalized
patients. The results of body composition should be based
on the same principle as BMI calculation, towards the
systematic normalization for body height of FFM (FFMI)
and FM [FM (kg)/height (m) 2
= FM index] [94] . The results
could be expressed according to previously described
percentiles of healthy subjects [95, 96] . Body composition
evaluation should be performed at the different
stages of the disease, during the course of treatments and
the rehabilitation phase.
Resources:
The evaluation of body composition: a useful tool for clinical practice [PubMed Abstract] [Full Text HTML] [Full Text PDF]. Ann Nutr Metab. 2012;60(1):6-16. doi: 10.1159/000334879. Epub 2011 Dec 16.
The above article has been cited in PubMed 20 times as of 8-20-2018
