during this period, when actually the economy was being refurbished and ...... Android fat is on the trunk, abdomen, chest, shoulders, but less on lower portions.
HUMAN BODY MEASUREMENTS: Concepts and Applications
S.P. Singh, Ph.D. Professor, Department of Human Biology Punjabi University, Patiala &
P. Mehta, Ph.D. Professor, Department of Human Biology Punjabi University, Patiala
Table of Contents Preface 1. Introduction 2. Body Measurements 2.1 Planes axes of the body 2.2 The body cavities 2.3 Instrumentation 2.4 Protocols for Anthropometric Measurements 2.5 IBP/HA Body Measurements 2.6 Kinanthropometric Measurements 2.7 Lohman et al. (1988) protocol of measurements 2.8 Accuracy and Reliability of Measurements 2.9 Which side to measure? 2.10 Age assessment and Age Grouping 2.11 Log Transformations 2.12 Human biological variations 3. Body Proportions 3.1 Body Proportions 3.2 The phantom stratagem 3.3 The O-scale system 4. Body Composition 4.1 Historical perspective 4.2 Conceptual models of body composition 4.3 Five level model of body composition 4.4 The ‘Reference’ Man and a ‘Reference’ Woman 4.5 Hydration of body compartments and body fat 4.6 Densities of body components 4.7 Cadaver analysis for revalidation of body composition 4.8 Densitometric determination of body composition 4.9 Anthropometric determination of body composition 4.10 Adipo-muscular relationship 4.11 Matiegka’s method 4.12 Drinkwater tactic for estimating fractional body masses 4.13 Roentgenogrammetry 4.14 Hydrometry 4.15 Dual Energy X-ray Absorptiometry (DXA) 4.16 Neutron Activation 5. Human Physique
5.1 Viola’s classification 5.2 Kretschmer’s classification 5.3 Sheldon’s Method of Somatotyping
5.4 Somatotyping Criteria 5.5 Dominance of endomorphy 5.6 Dominance of mesomorphy 5.7 Dominance of ectomorphy 5.8 The trunk index and somatotype 5.9 The second order variables of human physique 5.10 Gynandromorphy 5.11 Dysplasia
5.12 Textural aspect 5.13 Hirsutism
5.14 Critical evaluation of Sheldon's method of Somatotyping 5.15 Parnell’s method of Somatotyping
6. HEATH-CARTER METHOD OF SOMATOTYPING 6.1 Heath-Carter method of Somatotyping 6.2 Anthropometric Measurement 6.3 Technique of Heath-Carter Anthropometric Somatotype 6.3.1 First component or endomorphy rating 6.3.2 Second component or mesomorphy rating 6.3.3 Third component or ectomorphy rating 6.3.4 Somatochart and Somatoplot 6.3. 5 Somatotype Distributions 6.3.6 Somatotyping Children 6.3.7 Critical Evaluation of Heath-Carter Anthropometric Somatotype Method 6.3.8 Calculating the Heath-Carter Anthropometric Somatotype 7. Anthropometry and Nutritional Status
7.1 The World Food Scenario 7.2 Anthropometry and Economic Development 7.3 Energy Homeostasis 7.4 Pregnant Mother and the Newborn 7.5 Anthropometric Indicators of Nutritional Status 8. Growth, Maturation and Physical performance 8.1 Physical growth 8.2 Physical fitness 8.2.1 AAHPERD Youth Fitness Test (1976) 8.2.2 The Presidential Youth Physical Fitness Award Program 8.3 Bodily Maturity, strength and physical fitness 9. Applications of Anthropometry 9.1 Growth and development 9.2 Prediction of adult height 9.3 Physique and disease 9.4 Nutritional Status 9.5 Estimating skeletal frame size 9.6 Obesity 9.7 Chronic illness and health 9.8 Sports 9.9 Human dimensions for design solutions 9.10 Appliances for left hander References Bibliography Appendix I. Values of 1/cube root of weight
PREFACE Human body measurements catch the fancy of every human being. Such curiosity often comes to our notice at the railway stations and bus terminals where people jostle around the weighing machines to measure their body weights. Though the physical appearance and bulk of the body is often visually appreciated in the society yet actually how much it is has to be carefully assessed with the help of body measurements. The purpose of this book is to acquaint the reader about various types of techniques for taking body measurements and also to reflect on their importance. The body measurements take us into the realm of human body composition, physique and nutrition. The under and over nutrition which has strong linkages with different types of diseases is usually judged with the help of body measurements. The reader is introduced to different aspects of human body measurements (anthropometry). It deals with the recommendations of International Biologiocal Pragramme (IBP) on Human Adaptability. A growth sub-committee under this programme designed the protocol for taking various body measurements. It is a well known protocol which is widely in use throughout the world. Kinanthropometric techniques and those of Lohman and colleagues which are somewhat different from those of IBP measurements are also included which are used in the fields of sports sciences and physical education. Traditionally, body proportions
of one body measurement to another have usually been attempted to know the variations in one body measurement by keeping the other constant. Such differences are of use in numerous situations of an individual to show the differential pace of development of body parts. Traditionally, the methods employing anthropometry, densitometry, roentgenogrammetry and hydrometry were used for the assessments of human body composition. The most convenient model of human body composition was to fractionate the body mass into fat mass and the fat free mass. But recently a five level model of body composition is being vigorously investigated by researchers to find association of body composition variables at each level. Human physique has always invited interest for its association with disease. Numerous methods of studying physique including those of Viola, Sheldon, Kretschmer, Parnell and Heath-Carter have been given in extensive detail. Basic information on physical growth of children is provided here. There are wide differences between the two sexes in physical performance and muscular strength. Various tests for judging physical performance like AAHPERD would prove useful not only to sportsmen but also to those dealing with human health and disease. Human body measurements have immense applications almost in every field since all the gadgets, machines and devices meant for human use always rely on these measurements. The present book is a compendium of numerous conceptual issues dealing with human physique, body composition, and nutritional status and how these can be approached through the use of body measurements. It would fulfill a much needed gap in this area of information for the post graduate students of different courses in Indian universities especially in the subject of Human Biology, Anthropology, Sports Science, Physical Education, Physiotherapy, Medical Sciences. It lays special emphasis on concept building supplemented with solutions to practical problems wherever necessary.
The authors are thankful to Professor J.E.L. Carter, Ph.D. formerly of the Department of Physical education, San Diego State University, San Diego, USA, who is a pioneer in somatotyping and kinanthropometry. He has been kind enough to suggest valuable modifications in somatotyping which are explicit in the text. We feel greatly obliged to him for his going through our draft and also for allowing us to use some of the material on somatotyping. Professor William D. Ross, Ph.D., formerly of the Department of Kinesiology, Simon Fraser University, Burnaby, Canada has also critically examined our text particularly related with body measurements, body proportions and phantom stratagem. We thank him and his colleagues for being so generous in providing us their material and allowing us to use some of it in our book. The teachers, students and research scholars of the Department of Human Biology have always been a source of inspiration to us and the present book is an outcome of interactions with all of them. First and foremost, we wish to acknowledge Professor L.S. Sidhu, our teacher for teaching us the very basics of the subject. The fruitful discussions, suggestions and help provided by our former doctoral students Dr. Jaswinder Singh, Dr. Abha Mandira, Dr. Sarita, Dr. Amrit Pal Kaur, Dr. Zora Singh, Nirlep Kaur, Dr. Prit
Pal Singh, Dr. Ranbir Singh Parmar, Dr. Rupinder Kaur Bansal, Dr. Kamaljit Kaur, Dr. Dolly Monisha, Dr. Ajit Pal Singh, Gulshan Veer Kaur, Dr. Ginjinder Kaur and Dr. Rupinder Kaur has really improved the draft of this book and their efforts would always be kept in mind. Our special appreciation is for many of our M.Sc. Human Biology students for proof checking and especially for Ms Parminder Kaur, Ms Meenakshi and Mr Sudhanshu Abhishek who have gladly posed for photographs depicting the techniques of some body measurements. We feel indebted to Mrs. Narinder Jit Kaur wife of the senior author for the editorial work of checking the manuscript. We are thankful to Mr. Darshan Singh for his help in making the necessary drawings and to Mr Devinder Singh Dhiman for typing the manuscript.
S.P. Singh P.Mehta
1. INTRODUCTION Human body measurements convey a lot of information about the individual’s physical status, shape, size, and physique and body composition. There has been a variety of procedures for taking any measurement. That asks for standardization for taking different measurements. One of the most important objectives of kinanthropometry is to observe variations in various body measurements among different individuals and among different populations for understanding the processes of growth and maturation and ultimately its bearing upon physical performance and work capacity of the individual. This objective can be achieved by reaching a consensus on the techniques of measurements and standardizing them. The new emerging scientific specialization of kinanthropometry devoted to body measurements and its use in body dynamics was first conceived and developed during the nineteen seventies. According to its foremost proponents Ross et al. (1978) “it is the application of measurement to the study of human size, shape, proportion, composition, maturation and gross function. Its purpose is to help understand human movement in the context of growth, exercise, performance and nutrition”. The word kinanthropometry is an acronym of three Greek words, viz., kineein means to move, anthropos means man and metreein means to measure. A description of kinanthropometry after Ross et al. (1980) has been given below: 1.
IDENTIFICATION Kinanthropometry
2.
Movement
Human
Measurement
SPECIFICATION For the study of
3.
Size
Shape
Proportion
Composition
Maturation
Gross function
APPLICATION To help understand
4.
Growth
Exercise
Performance
Nutrition
RELEVANCE With implications for
Medicine
Education
Government
Various terms of dynamic anthropometry, sport anthropometry, physiological anthropometry, anthropomotorika, etc., often used by different scientists fall easily in the realm of kinanthropometry. The roots of kinanthropometry can be traced to various scientific fields and it gets its strength from them. The interested readers in various fields such as human biology, anthropology, auxology, physical education, sport sciences, etc., will find some of the concepts of these fields imbibed in kinanthropometry. To illustrate this point, as Ross et al. (1980) put it that Galileo Galilee gave the theoretical concept of geometric forms which finds its applicability in kinanthropometry. He stated that if shape and composition of a body remain constant, volume or
mass increase as cube of the linear dimensions whereas strength would increase only as its square. This law is called cube-square law, which finds its use in kinanthropometry. Metaphorical models find their use in various fields and are of immense value. In kinanthropometry also, the metaphorical models get their due place. Torricelli conceived the air pressure as "sea of air" which puts pressure on all subjects which can be thought of as immersed in air. It was an example of a metaphorical model! Experts in the fields of mathematics and natural sciences who propounded various statistical theories, which are being widely used, naturally become the contributors to kinanthropometry. Ross (1978) has emphasized that metaphorical models may serve as reference models in kinanthropometry and lead to new inferences and understanding. The importance of unisex universal reference theoretical human or phantom can be appreciated in proportionality profiling of the subjects to evaluate differences between subjects and groups and to study temporal changes in the same subject. Kinanthropometry is thus a useful tool in the hands of sports scientists, physical educationists, coaches, pediatricians, human biologists, anthropologists, etc. The research workers in such fields can pursue their research ideals of understanding and exploring the mysteries of various dynamic processes and phenomena of life with the help of kinanthropometry. For example, a human biologist may like to know the dynamic pattern of height growth of an individual. How does the size change with age of a person? He would measure the child's height at various ages and would find out that the child races very fast on the track of his growth at some ages and slows down at others. What causes such changes can be answered by the knowledge generated at the tissue, cellular and molecular levels. Kinanthropometry equips us with the techniques of various body measurements, e.g., height, body weight, transverse diameters of various parts of the body, circumferences and lengths of various parts of the body and skin and subcutaneous tissue fold thicknesses, etc. The body measurements can be utilized to study the gross size of an individual. How tall and heavy is a person? An idea about his shape, size and proportion can be generated. How does an individual
look like from various directions and with respect to his various body parts? What are the relationships of length, breadth and height of any body part with respect to another? How would be the three dimensional outlook and perception of the head, neck, trunk and extremities? Shape is thus a composite picture of various segments of the body and their proportions. The relationships of lengths to breadths, height to thickness, length to length, etc., of various parts of body represent proportions. The importance of proportions becomes evident when we want to compare a particular body part of two persons who are otherwise different in overall size. The proportions or ratios keep one measurement constant in all subjects compared and evaluate the differences in the other measurement. Physical and physiological maturity can be evaluated by taking body measurements. It can be useful in monitoring the health and nutritional regimens of the human subjects. It must be noted that anybody with a beautiful body must have it well proportioned. The famous 15th century Italian artist, engineer and architect, Leonardo da Vinci (1452-1519) gave the concept and drawing of such a well proportioned physique. His ‘Vitruvian Man’ survives till date and is widely used as a logo. It says that if you set your legs apart in such a way that this distance is one-fourteenth part of your height and you open and raise your arms so that the middle fingers touch the horizontal line drawn from the crown of your head, then the circle thus formed of the extremities would be situated at the naval. The span of the stretched arms will be equal to the height and the legs would form an equilateral triangle. If the trunk length is the same, Blacks show longer arms and legs. There are vast differences in the bodily proportions of different races. It has been well established till now that people of African origin have relatively longer lower extremities than others. Tracking the growth of children determines how the extremities had a very small proportion to height at the time of birth as compared to that of the head circumference. The role of body proportions is now being appreciated in the selection of world class athletes. There are indications that the longevity of adult humans is closely associated with a desirable body weight for height. That’s why during the earlier part of the twentieth century these
standards became very popular to designate individuals within the normal range. Body mass index (BMI) which was earlier known as Quetelet’s index became very important to health authorities. Weight for height standards are being used by the insurance companies and the military authorities to assess the desirable weight of the persons during the first half of the twentieth century. Employers are now increasingly seeking the desirable people they wish to employ on the basis of weight for height standards so as they may prove to be assets to their companies. But it must be noted that in case of trained athletes having large body weight, the BMI would designate them as overweight. It goes to the credit of Professor Behnke (1942) who exposed the fallacy of such weight for height standards and found these athletes highly muscular and extremely fit individuals with very little amounts of fat. Terming them as physically non-fit simply for being overweight was a cruel joke on them as they were the best by virtue of their body composition analysis. This landmark study opened new vistas in body composition research which later found wider applications in the fields of physical fitness, sports science and medicine. The human body mass may be conceptually divided into numerous fractional masses. Various concepts make use of the qualities of body tissues, their water holding qualities and differential densities of various tissues. On the basis of these qualities, the models may be conceived of as a range from a single-compartment to multi-compartment models. There are different levels of the organization of the body. Making use of this concept Wang et al. (1992) proposed a five-level model of body composition. These levels started with the atomic or elemental level and proceeded on to molecular, cellular and tissue level and culminated with the whole body level model. The models detailing fractionation of body mass qualitatively can be very useful in correlating physical performance with the fractional masses. There can be many approaches to the assessment of body composition. The various techniques for estimating body composition include densitometry, hydrometry, roentgenogrammetry, ultrasound, photon absorptiometry, neutron activation, bioelectrical impedance, total body water by dilution, CAT scanning, total body potassium, anthropometry, creatinine excretion, etc. While some of these
methods are highly invasive others are very costly, time consuming and need lots of equipment. Anthropometry is the easiest of all; it is non-invasive, very economical and subject friendly. In the era of computers the need of the hour is to develop and use simple techniques with wide applications which can be processed through computers using all the statistical tools to extract the maximum information out of it. The body measurements especially the skinfolds are useful in evaluating body fat and lean body mass. The percentage of body fat is a good indicator of the obesity of an individual. Effect of physical activities on percentage of body fat can also be gauged from the skinfold measurement. The fatty tissue is a storehouse of energy but can be considered as an additional burden on athletes and physically active persons. The body mass which is simply put as the body weight less the amount of body fat can find its value in monitoring the health of the individuals and their physical fitness. The maximum the quantity the better it would seem to be. The percentage of lean body mass would be more authoritatively interpreted if its distribution per unit height is attempted otherwise an athletic and a lean individual cannot be distinguished from each other. The lean body mass seems to have a direct proportion to the strength of the body. One always wonders about his body and its form. Human physique which explains how a human body looks like seems to be a formidable concept. Popular wisdom has given its three forms. Almost all cultures of the world have been identifying human physique as thin, muscular and fat. But this classification is qualitative and very discrete which does not allow numerous other types of physique to be explained. Cherished human bodies seem to promise youthfulness, health and vigour and have always attracted the opposite sex.
Hippocrates a great Greek
philosopher and physician of the fifth century BC described two different types of people as habitus phthisicus who were thin and lean persons with long extremities and habitus apoplecticus who were short persons with thick and massive bodies. In the context of classification of human physique, the efforts of Kretschmer, a German psychiatrist, in the beginning of the twentieth century are appreciable. He gave a detailed account of the characteristics of three categories of
humans which were named as pyknic or fatty, athletic or muscular and leptosome or lean. His method was based on making anthroposcopic observations on the human subjects. Kretschmer wanted to explore further by explaining temperaments along with the human physique. This was done by the studies of physique classification and that of temperament then correlating the two. The earliest attempt at classification of human physique with the help of body measurements was done by an Italian physician Viola during the early part of the twentieth century. His four-way classification of human physique as longitype having relatively long limbs, brachitype or broad type, normotype which fall in between the above two categories and mixed type who show characteristics of different types in different parts of the body. William H. Sheldon, S.S. Stevens and W.B Tucker appreciated that the human physique is a continuously distributed characteristic. They successfully devised a method in 1940 to analyse and quantify human body form called Somatotyping. According to Sheldon, somatotype shows the variations in human morphology which is represented on a continua of variation and it may be considered as a step towards human taxonomy. The somatotype is aimed at providing some sort of identification tag to the subject and may also be referred to as something similar to the Mendeleyev’s periodic table of the elements in chemistry. Sheldon recognised three basic components of physique, viz., endomorphy, mesomorphy, ectomorphy. Each individual has varying degrees of development of these three components. The somatotype is always written in three numerals: the first indicating the development of endomorphy, the second the mesomorphy and the third the ectomorphy. Sheldon was perhaps the first scientist to appreciate the continuity of human physique (not a few discrete types) and invented a workable method to achieve this. After Sheldon's method of somatotyping, there have been many attempts to make it simpler, easily executable and more objective. Later on, Heath and Carter in 1967 gave their own modified method of somatotyping. This method, however, differs from that of Sheldon's in the sense that it evaluates the body form or physique at the given time compared to the unchanging somatotype of Sheldon. The ratings of three primary components of physique are assigned from
the tables on the basis of the anthropometric measurements. Before going into the details of the method, it is necessary to acquaint with their concepts of somatotype and the three components, viz., endomorphy, mesomorphy, ectomorphy. Growth process of children is highly organised. Generally the children follow a predestined curve of growth. It can be said that the route of growth of children is established early in life and they follow it normally except for the situations of stress. Children
and
adolescents
provide
excellent opportunities of such episodes of undernutrition, physiological distress or disease for research on their growth and physical performance. It is quite interesting to note that during adolescent period the boys and girls can be seen in all stages of their development. For example, at 14 years, in boys and 12 years in the case of girls, there will be a certain number of them who are still to enter their adolescent or pubertal periods, and look like preadolescent children, having no growth of sexual hair, and no abrupt increase in height. There can be another group of children midway through their adolescent cycles. They may show certain level of development of sexual maturation characteristics and may exhibit increased velocities. Still some others may have completed their full sexual growth. The growth of genitalia and pubic hair may be complete in them and physically they may look like full grown adults. This is all part of the normal pubertal variations in human which are so dramatic. The children who enter adolescence later are called late maturers and those entering early are referred to as early maturers. There is no indication that the late maturers will end up smaller than their early maturing counterparts. Rather they will get more years to grow and have tendencies of linearity. Not only do the variations in ages at entry of various pubertal characteristics exist but the duration of various developmental stages and complete maturation processes also vary greatly. It is largely their genetic make-up which sets up the tempo of growth and development. However, this developmental status has a lot of bearing on the child with respect to his physical performance as also to his social status and peer relationships. The maximum gain in height around the period of adolescence is called ‘Peak Height Velocity’ (PHV). There are large variations in the ages of adolescence in boys and girls in
different populations. Generally the populations of the west and those more affluent are advanced in reaching adolescent periods. The ages at PHV and its intensity are very informative and refer to an important developmental milestone. World Health Organization and the health authorities of different nations put a lot of emphasis on the growth, health and nutrition of the children of the world. Weight for age, height for age and weight-height standards are available on numerous world populations through which the children can be screened for malnutrition. Children with deficit in height and weight carry health risks. It is now well understood that they have a greater chance of morbidity and mortality. Cut-off lines have also been standardized for height-age and weight-age of children not only to distinguish between normal and undernourished ones but also to discriminate between acute and chronic under-nourished children using 2-Z and 3-Z scores (Waterlow et al., 1977; WHO 1986, 1995a, 1995b). In order to use height-age and weight-age standards accurately the exact date of birth/ age of the child must be known.
But weight-height standards can be used even if the
accurate age of the child is not known. Mother’s health is the all important determinant of the health and well being of the newborn. Maternal anthropometric status has emerged as a good indicator of the birth outcome of the baby. It is a generally accepted fact that overweight women with excessive weight gain during pregnancy give birth to large-for-dates babies. Among the various parameters of the pregnant mothers influencing birth outcome include the pre-pregnancy weight, weight gain during pregnancy, pregnancy weight gain at each trimester, skinfold thicknesses and limb circumferences. Anthropometry, the science of measurements of human body, is of immense use to the society. The knowledge of these characteristics is undoubtedly very useful in almost every sphere of human affairs. All the utilities are so deigned which fit in the needs of every particular group. The articles of use by human beings are being designed on the basis of anthropometric measurements even though the designers of these articles may be unaware about the science of
anthropometry. Ergonomics is a special field which deals with this interface of human need and instrumentation.
The populations living under these conditions have undergone special changes in their bodies which provide them selective advantage for survival and procreating. For example, to be successful in a desert climate, the body must evolve a strategy to dissipate body heat which can be done by increasing the surface area. This seems to be the reason for thin and elongated bodies of the inhabitants of the deserts. On the other hand, people of the arctic have thick bodies which prevent heat loss. Similarly, the residents of the high altitude have greater chest diameters in order to increase the pulmonary ventilation which provides them with an opportunity to increase the availability of the oxygen which otherwise is less in the rarefied atmosphere of the altitude. The populations of the world have lots of variations in body size and structure. There are very tall populations measuring as much as 180 cm in comparison to the pygmies of central Africa who are barely 130 cm in height. This range of averages of body height of the two extremes amply point towards the need of having specific reference data for different populations. Because of these adaptations, the humans have inhabited the globe successfully from equator to the poles and from deserts to the high altitude zones which have drastically different climatic conditions and physical properties of the environment.
2. BODY MEASUREMENTS
Chapter details Planes and axes of the body The body cavities Instrumentation Protocols for Anthropometric Measurements IBP/HA Body Measurements Kinanthropometric Measurements Lohman et al. (1988) protocol of measurements Accuracy and Reliability of Measurements Which side to measure? Age assessment and Age Grouping Log Transformations Human biological variations
The overall size and mass of the human body are used as proxy measures for many purposes for the assessment of health status, obesity, malnutrition, disease and work capacity. The measurements of different body parts which include the segmental lengths, bodily breadths, circumferences of the trunk and limbs and skin and subcutaneous tissue fold thicknesses are used for research and for designing the instruments and equipments for human use. Measurement techniques need to be standardized so that different studies may become comparable. One of the most important objectives of kinanthropometry is to observe variations in various body measurements among different individuals and among different populations for understanding the processes of growth and maturation and ultimately its bearing upon physical performance and work capacity of the individual. This objective can be achieved by reaching a consensus on the techniques of measurements and standardizing them. The exact location of the landmarks and position of various reference points for the purpose of taking body measurements can best be understood by first acquainting with different planes and axes of the body. These have been explained below.
2.1
Planes and axes of the body
Sagittal plane or antero-posterior plane This plane is parallel to the vertical plane and divides the whole body into two parts, right and left. The plane which divides the body exactly into left and right halves is called mid-sagittal plane. Coronal plane or frontal plane This plane is at right angles to the abovementioned sagittal plane and divides the body into front and rear parts. Transverse plane This plane is at right angles to the above two planes and divides the body into upper and lower parts. Fig 2.1 displays various axes and planes of the human body.
Insert Fig 2.1 somewhere here
The lateral axis Any line resulting from the intersection of frontal and transverse planes is called the lateral axis. Longitudinal axis Any line resulting from the intersection of frontal and sagittal planes represents the longitudinal axis. Antero-posterior or sagittal axis Any line resulting from the intersection of sagittal and transverse planes represents the antero-posterior or sagittal axis.
2.2 The Body Cavities The human body is constituted by two major portions called the axial portion and the appendicular portion. The head, neck and truck are included in the axial portion whereas the arms and legs are included in the appendicular portion. The axial portion has two cavities, viz., the dorsal cavity and the ventral cavity. Fig. 2.2 shows various bodily cavities. The dorsal cavity contains the brain and the spinal cord. The diaphragm which is a muscular sheet divides the ventral cavity into an upper thoracic cavity which houses the visceral organs such as lungs and heart and a lower abdomino-pelvic cavity. The abdominal cavity contains stomach, spleen, liver gall bladder and most portions of small and large intestines. The pelvic cavity contains the internal reproductive organs, urinary bladder and some portions of the large intestines.
Insert Fig 2.2 somewhere here
2.3 Instrumentation A brief introduction of various instruments used for taking body measurements appears below:
Weighing scales
There are two different types of weighing scales or weighing machines generally used. One is a round disc on which the subject stands and the reading is taken directly from the scale which is inset at the top of the weighing machine. Usually, weight up to the nearest 0.5 kg can be taken. The other is a beam balance which is level actuated and the person stands on the platform and reading is taken after balancing the beam with appropriate weights. The calibration of this type of machine is much more precise and up to 50 gm can be measured.
Stadiometer
Stadiometer is used for measuring height and sitting height of the subjects. It comprises of a platform to which a rectangular vertical column is attached (Fig. 2.3). The subject has to stand against this column with his back touching it. A movable horizontal plate is attached to this vertical column which is brought down on the head of the subject. Alongside this movable plate, there is a counter from which the reading is taken directly.
Insert Fig 2.3 somewhere here
Anthropometer rod
An anthropometer rod is generally 2 meter long. A single rod of such length can be very inconvenient to carry. Therefore it has been designed in the form of 4 inter-fitting rods of 50 cm each (Fig. 2.4). The rods carry a Batch number specific for the instrument and another number which is similar for the inter-fitting edges of two segments of the rod. The rod is calibrated in centimeters and can measure up to a minimum value of 1 millimeter. A movable socket is also included which can be moved up or down for taking the measurements and it has a place for fitting a cross-bar. When the rod is held vertically the cross bar is in a horizontal position with which the top of the head is touched for the measurement of height.
Insert Fig 2.4 somewhere here
The anthropometer has a fixed socket at the top in which another horizontal bar can be attached. The top segment has two calibrations; one which increases upwards from the first segment and is used for reading the measurements and the other starts from the top. Two cross-bars can be fit each into each socket in the top segment of the anthropometer rod; one which is fixed at the top and the other which is movable. This forms a big caliper called “anthropometer compass” and is used for measuring major breadths and diameters of the body.
Infantometer
It consists of a rectangular plate which is to be kept horizontally and on which the infant has to lie down. One end of this plate is fixed to a vertical plate. The top of the head of the infant has to touch this vertical plate. On the other side, there is another horizontal plate which slides over the first horizontal plate in order to adjust to the size of the infant. This movable horizontal plate is also attached to a fixed vertical plate. The infant is placed in the infantometer, his head touching the vertical plate and the movable plate is brought towards the feet of the infant till it touches them. A measuring scale is attached to it for recording the measurement.
Sliding calipers
The sliding calipers are ordinary calipers used in physical sciences for measuring straight distances. The sliding caliper has a thick metallic bar in which the metric scale is engraved. One end of this bar has a fixed cross bar whereas and the second cross bar slides over it which is moved in either direction to fit in the points over which the measurement is to be taken (Fig. 2.5). The calipers used for taking body measurements should have the two cross bars with blunt edges
and not with sharp edges so that the subject is not injured. The reading is generally taken up to the nearest millimeter.
Spreading calipers
The points for measuring on the curved surfaces cannot be taken with the sliding calipers therefore spreading calipers are used for taking such measurements. The edges of one side of the two curved arms of the spreading caliper are joined with a screw whereas those of the other side have blunt points which are moved and brought in contact with the points over which the measurements is to be taken (Fig. 2.5). A proportionate scale is attached closer towards the screw which joins the ends of the caliper and it gives the actual distance between the two points over which the measurement has been taken.
Insert Fig 2.5 somewhere here
Skinfold caliper
The skinfold calipers measure the thickness of skin and subcutaneous tissue folds. Since the subcutaneous tissue is compressible hence there is a need to apply some sort of pressure for measuring it. The skinfold calipers are generally designed with a standard pressure of 10 g/mm 2 on the measuring surfaces exerted with the help of springs. The surfaces of the skinfold calipers which measure the skinfold should be sufficiently large so as to hold the fold of the skinfold tissue comfortably. The popular brands of skinfold calipers include Harpenden, Lange, Skyndex and Slim Guide.
Insert Fig 2.6 somewhere here
Steel tape
A flexible but non-stretchable tape made of steel is used for measuring circumferences of the body. A one meter tape should have a width of less than one centimeter so that it should fit snuggly over the soft tissues. A measurement up to the nearest millimeter is taken.
2.4 Protocols for Anthropometric Measurements The anthropometric measurements must be taken according to some standard procedures so that the variations in taking measurements should be minimized and also the values of variables become comparable with other studies. One of the oldest classical standard procedure appeared in a book entitled ‘Lehrbuch der Anthropologie’ by Martin and Saller (1959) which served the purpose of a hallmark in anthropological research. Later on during the last quarter of the 20 th century many recommendations were given about the techniques to be used for taking measurements. Some of these have been provided below:
One of the most important protocols has been suggested by an expert committee of three scientists, viz., Tanner, Jarman and Heirnaux, under the aegis of International Biological Programme/Human Adaptability Section (IBP/HA) (Weiner and Lourie 1969, 1981).
The second protocol is
that of Kinanthropometric approach suggested by Leon and
Thea Koerner Foundation Study Group held at the University of British Columbia IN 1973. This group included authorities on kinanthropometry, viz., Drs. J.E.L. Carter, William D. Ross, A. R. Behnke Jr., S. Brown, M. Hebbelinck and M.V. Savage. The recommendations of this group as well as those modified later on were published in the electronic version of Anthropometry Illustrated by Ross, Karr and Carter (2000).
The third set of recommendations on the measurement techniques and applications along with their special issues was presented by Lohman, Roche and Martorell (1988).
The measurements recommended by all these three protocols have been given.
2.5
IBP/HA Body Measurements One of the most important protocol of taking these measurements had been standardized
by the International Biological Programme/Human Adaptability (IBP/HA) growth subcommittee in 1969 (Tanner et al. 1969, 1981). This protocol has immensely been used since then and innumerable studies are available which have utilized these recommendations. This is perhaps one of the best reasons why these recommendations find their place in this manual. The following is the list of measurements which have been standardized by the IBP/HA growth sub-committee: 2.5.1
Gross Body Measurements
Body weight 2.5.2
Stature/Supine length
Lengths or Heights of Body Parts
Sitting height/Crown-rump length
Lower leg length
Suprasternal height
Foot length
Total arm length
Buttocks-knee length
Upper arm length
Head length
Forearm length
Nose height
Height of anterior superior iliac
Morphological face height
spine
Upper face height
Height of tibiale
Ear length
Head height 2.5.3
Diameters or Breadths of Body Parts
Biacromial diameter
Lip thickness
Biiliocristal diameter
Minimum frontal diameter
Transverse chest
Ear breadth
Antero-posterior chest
Bicondylar femur
Head breadth
Bicondylar humerus
Bizygomatic diameter
Wrist breadth
Nose breadth
Hand breadth
Bigonial diameter
Ankle breadth
Mouth width 2.5.4
2.5.5
Circumferences or Girths of Body Parts
Chest circumference
Head circumference
Upper arm circumference (relaxed)
Neck circumference
Upper
Abdominal circumference
arm
circumference
(contracted)
Forearm circumference
Calf circumference
Wrist circumference
Thigh circumference
Ankle
Skinfold Thickness
Biceps
Forearm
Triceps
Thigh
Subscapular
Medial calf
Suprailiac
Chest (juxta nipple)
circumference
Midaxillary
Abdomen
There is no substitute to hard work and practice. The readers are advised to master the techniques before starting the work. Most of the experts on kinanthropometry feel that techniques for taking each measurement be repeated a large number of times. In order to have a check on accuracy, the same sample of a few subjects should be measured on two different occasions and the differences be noted. Most of the measurements should not differ more than one or two percent on two different occasions. It must be noted that all the bilaterally represented measurements must be taken on the left side of the body as recommended by the expert committee. The following is the detailed outline for taking these measurements. The names of the instruments appear in brackets along with the measurement.
2.5.1
Gross Size and Mass Body weight (Weighing machine) Body weight is the weight of the nude body when the bowels are empty. Normally it is
not possible to take the nude weight of the body. In such circumstances it is advised to take care of the weight of the clothes worn by the subject when he is being weighed. This weight of the clothes must be subtracted from his recorded weight in order to obtain the nude weight. Or the investigator can provide a standard garment to be worn by the subject while he is being weighed. The weight of this garment should later be deducted from the body weight. In most studies a minimum of up to 0.5 kg measurements can be alright but in certain studies on infants and longitudinal records, the measurements should be more precise, in order to gain more valuable information.
Stature or standing height (Stadiometer or Anthropometer)
The subject should stand erect on a horizontal surface. Ask him to stretch as much as possible taking care that his heels are touching each other and the horizontal surface. Slight upward pressure is applied below the mastoid processes in order to help in stretching to the fullest. The head should be held so that his Frankfort plane becomes horizontal. Frankfort plane is that plane which touches the inferior most point on the infraorbital crest (lower border of the eye orbit) and the point situated in the ear notch above the tragus of the ear. The counter-weighted board of the stadiometer is brought down till it touches gently the head (See Fig.2.7). In case of anthropometer, the rod is held vertically & the horizontal arm is brought down so that it touches the highest point on the head in the midsagittal plane. The stature is highly sensitive to fatigue and even up to 3 cm of diurnal differences have been recorded in it in the same subjects (Tanner 1964). So, it is necessary to take all precautions in positioning the subject and preferably the measurement be taken in the morning to minimize the effect of fatigue. Insert Fig. 2.7 somewhere here
Supine length (Infantometer) Supine length is the length of the infant when he is lying supine. The infants cannot
stand, so they cannot be measured that way. It is advised that infants and children up to about two years be measured for the supine length. The infant's head is held in such a position so as the Frankfort plane be parallel to the headboard and the top of his head is brought in contact with the fixed headboard by putting slight upward pressure so that he is slightly stretched. The infant's feet be held in such a way so as his toes point upwards and he is gently stretched. The footboard of the infantometer is brought to touch firmly with the heels of the infant.
2.5.2
Lengths or Heights of Various Body Parts
The importance of extremities of the human body and the trunk cannot be undervalued because of the habitual physical activity functions these have been performing and also because of their role
during the course of human evolution. Stature is in fact a composite measure of different segments of the body which include lower extremity length, trunk, neck length and head height. Similarly the extremities have also different segments. The upper extremity length is composed of upper arm length, forearm length and hand length whereas lower extremity length includes thigh length and the lower leg length. The variations exist in different segments of the body in different populations groups living under various ecological conditions. The importance of these measures is perceived in the fields of medicine, designing of the occupational utilities and in the ergonomic context. Lohman et al. (1988) have highlighted that the actual and proportional lengths of various segments of the body or with respect to the trunk are of major diagnostic value in order to find out the abnormal situations or dys-morphology. The designing of utilities for humans
like
clothing, shoes, chairs and sitting furniture, aircrafts and vehicles, machines and tools have to be undertaken on the basis of segmental lengths and gross size of the human beings. Segmental lengths are generally taken from a bony landmark to the flat surface as a vertical distance or between two bony landmarks. These should not be taken from the creases of the joints because that will always lead to small errors due to the soft tissues lying underneath. The segmental measures can be taken directly or indirectly. The measurements taken indirectly are called projected measurements. For example the direct measurements of upper arm length can be taken across the acromiale and radiale points whereas the indirect or projected estimate of this measurement will be to subtract height radiale from height acromiale. The projected measurements run the risk of being inaccurate if necessary precautions in the positioning of the subject are not taken. If many measurements are to be taken on a subject, especially on a young one, his posture must be checked every time so that a correct measurement could be taken.
Positioning of the subject
In most of the segmental lengths of the body, an erect posture is recommended. The heels should touch each other with toes a little apart and the body weight equally supported on both the feet. The arms should be by the sides of the individual and palms facing the thighs.
Sitting height (Stadiometer or Anthropometer) The subject sits on a stool or table top. His legs hang down freely. The back of the subject
be stretched as far as possible. The head is held so that Frankfort plane becomes horizontal and gentle upward pressure is applied to the mastoid processes. The muscles of the thigh and buttocks be contracted so that they may help in stretching the subject to the fullest. The counter-weighted board of the stadiometer is brought gently in contact with the head. Or the horizontal bar of the anthropometer rod is brought down so as it touches the highest point on the head.
Crown-rump length (Infantometer) It is the length of the infant or child from his head to the buttocks when legs are bent at
right angles. The child or infant is so positioned that his back is towards the infantometer. The head is held in the Frankfort plane being parallel to the headboard of infantometer. Gentle upward pressure is applied to the mastoid processes of the subject. The knee is bent at right angles and the footboard of infantometer is brought inwards to touch the buttocks.
Suprasternal height (Anthropometer) Mark the suprasternal point which is the deepest point in the suprasternal notch. The
position of the subject is upright as has been in the case of taking stature. The horizontal bar of anthropometer is brought in contact with the marked suprasternal point. Care must be taken to keep the rod vertical.
Total arm length (Anthropometer)
This is the distance between the inferior border of acromion process to the tip of the middle finger or the longest finger. Arm should be hanging down by the side and fully stretched.
Upper arm length (Anthropometer) This is the distance between the inferior border of the acromion process and the external
superior border of the head of radius. The arm should be hanging down normally, the palm of the hand directed towards the thigh. Mark the two abovementioned points and measure the distance between them with the help of the anthropometer.
Forearm length (Anthropometer) It is the distance between the head of radius and the tip of the lateral styloid process.
Mark the superior border of head of radius and the tip of the lateral styloid process. Arm should be hanging down and the distance between these two points is measured.
Height of anterior superior iliac spine (Anthropometer) This is the height of the anterior superior iliac spine from the ground. The point is
situated on the anterior superior iliac crest medially and is the most prominent. The subject should stand erect and the body weight equally supported on both the feet. Mark the point and measure the distance from the ground keeping anthropometer rod vertical.
Height of tibiale (Anthropometer) It is the height of tibiale point from the ground. Tibiale is the upper point of the inner
border of the medial condyle of the tibia. The subject should stand erect, feet a little apart and body weight equally distributed. Measure the distance of point tibiale from the ground keeping the rod vertical.
Lower leg length (Anthropometer) It is the vertical distance from tibiale to malleolus. Malleolus is the lowermost or most
inferior point. Mark the tibiale and malleolus points and measure the distance between them.
Foot length (Anthropometer or sliding caliper)
The subject is asked to sit. Place the anthropometer or sliding caliper along the axis of the foot. Bring one arm of the instrument in contact with the centre of the heel and the other with the longest toe. Care should be taken to touch the toe and not the nail which may be sometimes overgrown.
Buttocks knee length (Anthropometer) The subject should sit erect in such a way so as his knees are bent at right angle. The
horizontal distance between the fronts of the kneecap to the rearmost point on the left buttock is measured.
Head length (Spreading caliper) It is the maximum distance between the most prominent point between the eyebrows and
the most prominent point on the occiput at the back of the head. Pressure must be applied to press the soft tissues beneath while measuring.
Nose height (Sliding caliper) It is the distance between the nasion and the point of union of nasal septum with the
upper lip. Nasion lies at the root of the nose where frontal and nasal bones unite. It can also be located by joining the left and right epicanthic eye folds by a horizontal line. The distance between the two points is measured with a sliding caliper.
Morphological face height (Sliding caliper) It is the distance between the nasion and gnathion points. Gnathion is the most inferior
point on the chin in the mid-sagittal plane. The mouth should be closed and the teeth in full occlusion. The distance between the nasion and gnathion points is measured with a sliding caliper.
Upper face height (Anthropometer) It is the vertical distance between the highest point on head when it is held in Frankfort-
horizontal plane and the point of contact of two lips in the mid-sagittal plane. The head of the
subject is held in the Frankfort-horizontal plane and the counter-weighted headboard is allowed to rest on the head. With the anthropometer the vertical distance between the headboard and the union of lips in mid-sagittal plane is measured.
Ear length (Sliding caliper) It is the maximum length of the ear between the uppermost and lowermost points of the
ear and is measured with a sliding caliper.
Head height (Anthropometer and Stadiometer) It is the vertical distance from the highest point on head when it is in Frankfort-horizontal
plane and the external auditory meatus. The counter-weighted headboard of stadiometer is brought in contact with the top of head of the subject. The vertical distance between the headboard and the external auditory meatus is measured with the anthropometer.
2.5.3
Diameters or Breadths of Various Body Parts
The breadths of the body reflect the frame size and the robustness of the skeletal frame. These find their utility in techniques of assessing body physique like that of Heath and Carter Somatotype and in projecting the gains in lean body mass in the special groups including athletes and patients of anorexia nervosa. The breadth measurements are taken with the help of anthropometer compass, sliding calipers and spreading calipers. In case of larger measurements including shoulder width and hip width, the anthropometer compass can be conveniently used. For measuring smaller width as those of wrist and ankle, elbow and knee, the small sliding caliper serve the purpose better. There are certain measurements which would include curved surface of the body. It is convenient to use the spreading caliper in those cases. The instruments are generally calibrated to the nearest millimeter. The calibration of the scale is of actual size in all the instruments used for breadth measurements except for spreading calipers. In this case the calibration is displayed on a scale near the joint of the two spreading arms of the calipers and is made in such a way as to conform
to the actual reading between the tips of the two arms of the caliper which are farther away from the scale.
Biacromial diameter or shoulder width (Anthropometer) It is the maximum width of shoulders when the shoulders are relaxed and slumping
forward. The subject should stand erect and the shoulders drooping a little forward. The measurement is taken between the outside edges of both the acromion processes, from the backside of the subject.
Bi-iliocristal diameter or hip width (Anthropometer) It is the maximum width between the iliac crests of both sides. The subject should stand
erect, and the investigator behind him. The bars of the anthropometer are applied to the iliac crests so as it gives the maximum width. The overlying soft tissue should be pressed hard in order to obtain the real measurement which represents the development of the bone.
Transverse chest (Anthropometer) This is the transverse diameter of chest at the level of the union of 3rd and 4th sternebrae
at the end of a normal expiration. The subject should stand erect. Apply the arms of anthropometer at the lateral sides of the chest at the marked level and measure it by exerting slight pressure when the subject has ended the normal expiration.
Antero-posterior chest (Spreading caliper) This is the antero-posterior diameter of the chest between the point of union of 3rd and
4th sternebrae on the anterior side and the tip of a spine on the posterior side, perpendicular to the axis of the body. The arms of the caliper rest on the two above mentioned points and the measurement is taken at the end of a normal expiration Slight pressure is also exerted while taking the measurement.
Head breadth (Spreading caliper)
This is the maximum breadth of the head in transverse plane. The two arms of the caliper are placed on the most lateral points and are moved in order to obtain the maximum breadth. Slight pressure is exerted before noting the measurement.
Bizygomatic diameter (Spreading caliper) This is the maximum breadth between the two zygomatic arches. Spreading caliper is
applied to the two zygomatic arches and the maximum diameter is recorded by moving the spreading caliper in all directions.
Nose breadth (Sliding caliper) The maximum breadth of the nose is measured from the outsides of the two nares. The
arms of the caliper are brought in contact with the outside of the nares of the nose while keeping the instrument horizontal.
Bigonial diameter (Spreading caliper) It is the maximum diameter between the angles of the mandible. Arms of the caliper are
brought in contact with the outside of the angles of mandible and pressure is applied to compress the soft tissue beneath.
Mouth width (Sliding caliper) It is the distance between the corners of the mouth when it is normally closed. The arms
of the caliper are placed at the corners of the mouth taking care that the mouth is normally closed.
Lip thickness (Sliding caliper) It is the maximum thickness of the lips. The caliper is held vertically, the upper arm of
the caliper is placed on the medial point on the tangent of the highest points of the upper lip and the other is brought to the medial point on the tangent of the lowest points on the lower lip.
Minimum frontal diameter (Spreading caliper) It is the minimum horizontal diameter between the temporal crests at the points of
maximum inward depression. The caliper is allowed to touch the bony crests and not the temporal
muscles.
Ear breadth (Sliding caliper)
It measures the maximum breadth of the ear. The breadth of the ear is measured by keeping the two arms of the sliding caliper parallel to the long axis of the ear.
Bicondylar femur or knee width (Sliding caliper) It is the maximum diameter across the outermost points or condyles on the lower end of
the femur bone. The subject should be sitting with his knee bent at right angle. Arms of the caliper are applied to the outermost poil1t on the lower end of femur and pressure is applied to compress the soft tissue in order to obtain the bony diameter.
Bicondylar humerus or elbow width (Sliding caliper) It is the maximum diameter across the outermost points on the condyles of lower end of
humerus. The arm of the subject should be bent at right angles. The arms of the caliper are applied to the outermost points on the lower end of humerus. There is a need to exert pressure in order to obtain the bony measurements. Since the inner condyle is lower than the outer one, so while taking the measurement, the position of the instrument is oblique and not perpendicular to the long axis of upper arm (Fig. 2.8). Insert Fig. 2.8 somewhere here
Wrist breadth (Sliding Caliper)
It is the maximum width between the two lateral styloid processes of radius and ulna. Strong pressure is applied to compress the soft tissue before noting the measurement. Usually the caliper is oblique and not perpendicular to the long axis of the bone.
Hand breadth {Sliding Caliper) It is the breadth of band across the distal tips of second and, fifth metacarpals. The hand of
the subject should rest on a flat surface, palm facing it, fingers together and in line with the axis of the forearm. The caliper arms are applied to the outside of distal tips of second and fifth metacarpals.
Ankle breadth (Sliding Caliper) It is the breadth of the ankle across the two malleoli. The subject should sit on a table with
legs hanging freely. The caliper arms are placed on two malleoli and pressure is exerted before taking the measurement.
2.5.4 CIRCUMFERENCES The circumferences of the body and those of the limbs provide vital information about the growth and development of a child. The assessment of nutritional status during early years of life can be conveniently done with the help of mid arm circumference, chest and head circumference, etc. The amounts of musculo-skeletal structures and the lean tissue assessments can also be made from the circumferences along with the use of skin and subcutaneous tissue fold thicknesses at various body sites. Assuming the limbs as cylindrical entities, the cross-sectional areas of muscles plus bone and fatty tissue can be easily calculated. The assessment of general obesity, the deep adipose tissue and masculine-feminine type of distribution of body fat can also be assessed with the help of certain circumferential measures. The circumferences can be measured with flexible but non-stretchable tapes especially made of steel. The tape must wrap around the body part snuggly without compressing the soft tissues underneath and must be touching all along. In cases where the gaps between the body and the tape persist, tape should not be compressed to reduce the gap. For example in case of a thin subject, the measurement of chest circumference would involve a gap between the body and the tape especially in the area of the back between the shoulder blades. In case of the measurements of circumferences, the position of the tape is to be kept perpendicular to the axis of the body or the body part being measured. The position of the tape is
generally horizontal to the ground. Only in the case of neck circumference does it show a variation as the axis of the neck is variable and show a marked variation in its tilt.
Chest circumference (Steel tape) It is the circumference of the chest measured at the level of the union of 3rd and 4th
sternebrae. The measurement should be taken at right angles to the body axis at the end of a normal expiation. Make sure the tape is in contact with the body throughout and it should be gently touching it.
Upper arm circumference-relaxed (Steel tape) It is the circumference of the upper arm taken mid-way while the arm is hanging down
freely by the side. Mark the midpoint of the upper arm between the inferior border of acromion process and the superior border of the head of radius. The measurement is taken at the marked level keeping the tape horizontal (Fig.2.9).
Insert Fig. 2.9 somewhere here
Upper arm circumference-flexed (Steel tape) It is the maximum circumference of the upper arm when it biceps muscle is fully flexed or contracted. Ask the subject to flex his biceps muscle fully by bending the arm at the elbow. The measurement is taken at right angles to the long axis of the upper arm where the maximum girth is affected. Calf circumference (Steel tape) It is the maximum circumference of the lower leg when the calf muscle is relaxed. Ask the subject to sit so that his knee is bent at right angles and his lower leg hanging freely. The measurement is taken at right angles to the axis of the lower leg where it is registers a maximum development.
Thigh circumference (Steel tape) It is the circumference of the thigh just beneath the gluteal fold with the body weight equally supported by the two legs. It is measured horizontally. Head circumference (Steel tape) It is the maximum circumference of the head, taken just above the brow ridges. The subject is asked to sit. The tape is placed around the head, above the brow ridges and adjusted on the back of the head in such a way as it gives the maximum circumference. Neck circumference (Steel tape) It is the circumference of the neck slightly above the thyroid cartilage. The tape is placed around the neck and is kept horizontal while taking the measurement. Abdominal circumference (Steel tape) It is the circumference of the abdomen at the level of the umbilicus when the abdominal muscles are relaxed. Wrap the tape around the abdomen at the middle of the umbilicus horizontally asking the subject to keep his abdominal muscles relaxed. Forearm circumference (Steel tape) It is the maximum circumference of the forearm usually recorded proximal to the elbow joint. The arm of the subject should be hanging normally and relaxed and the measurement is taken at the level of maximum development. Wrist circumference (Steel tape) It is the minimum circumference of the wrist taken slightly proximal to the styloid process of ulna. The tape is so placed around wrist just proximal to the styloid process of ulna as it gives the minimum circumference of the wrist. Ankle circumference (Steel tape) It is the minimum circumference of the leg taken above the two malleoli. The tape s wrapped around the legs above the malleoli where the minimum circumference is obtained.
2.5.5 Skinfolds Skin and subcutaneous tissue fold thicknesses reflect the development of adipose tissue (fatty tissue) overlying the body as well as the general obesity. The tissue is compressible and hence there is a need to apply some standardized pressure for measuring it. There is general agreement on taking the measurement at a standard pressure of 10 g/mm square. The standard skinfold caliper is available which exert a pressure of 10g/mm square while taking the measurements. These measurements involve a fold of the adipose tissue and the skin. Usually the fold of the adipose tissue can be picked up very easily between the forefinger and the thumb, though in obese cases, there is some difficulty in taking the skinfold measurement. The jaws of the caliper should be applied to the already marked point and the reading be noted after two seconds of the applying the full pressure. Biceps skinfold (Skinfold caliper) The biceps skinfold is measured over the biceps muscle in the middle of the upper arm. Pick the skin and subcutaneous tissue fold over the biceps muscle about one cm above the marked level (mid point of the distance between the inferior border of the acromion process and the external superior border of the head of radius), in line with the cubital fossa. Apply jaws of the caliper at the marked level. Precaution must be taken to pick up all the subcutaneous adipose tissue. The measurement is noted two seconds after applying the full pressure. Triceps skinfold (Skinfold caliper) The triceps skinfold is measured over the triceps muscle in the middle of the arm at the level of the upper arm circumference or the biceps skinfold, in line with the olecranon process. Mark the mid – point of the landmarks acromiale and radiale over the triceps muscle at the back of the upper arm and pick up skinfold about one cm above the marked level. Apply the jaws of the caliper to the fold at the marked level and note the value after two seconds (Fig.2.10).
Insert Fig. 2.10 somewhere here
Subscapular skinfold (Skinfold caliper) The subscapular skinfold is measured below the angle of the scapula. Pick up the skinfold a little below the angle of the scapula, pointing downwards and outwards. Apply the jaws of the skinfold caliper to the fold and take the value after two seconds. Suprailiac skinfold (Skinfold caliper) The suprailiac skinfold is taken about one cm above and two cm medical to the anterior superior iliac spine. Pick up the skinfold at the abovementioned site and measure with a skinfold caliper. Forearm skinfold (Skinfold caliper) Forearm skinfold is measured midway between the superior border of the head of radius and its styloid process at the wrist. The skinfold is picked up the lateral side and in line with the long axis of the forearm at the marked and point of the radius bone. Thigh skinfold (Skinfold caliper) The thigh skinfold is measured in the middle of the mid-inguinal point and the proximal line of the patella when the knee is bent at right angle. The skinfold is picked over the quadriceps muscle, i.e. on the anterior aspect of the thigh and the fold should be pointing downwards. Medial skinfold (Skinfold caliper) The medial calf skinfold is measured at the level of maximum development of the calf muscle on the medial side. The fold is picked up medially and in line with the long axis of the leg and measured with a skinfold caliper. Chest skinfold or Juxta Nipple skinfold (Skinfold caliper) The chest skinfold is measured just lateral to the nipple. Pick a fold of the subcutaneous tissue lateral to the nipple at the same level and apply the jaws of the caliper for measurement.
Mid- axillary skinfold (Skinfold caliper) The mid-axillary skinfold is measured on the mid-axillary line at the level of the xiphoid process. Mark the level of the xiphoid bone on the mid-axillary line and pick up the skinfold at this level fore measurement. Abdominal Skinfold (Skinfold caliper) Abdominal skinfold is taken at the level of the umbilicus about five cm lateral to it. Pick up the fold of the subcutaneous tissue at the given site and measure it with a skinfold caliper.
2.6 KINANTHROPOMETRIC MEASUREMENTS The IBP techniques have been and are being employed by research workers in the fields of auxology, human biology, anthropology, etc. So, the data which have been cumulating over the last two decades in these fields are generally comparable and provide for opportunities to explore geographical and temporal variations between groups of individuals. In physically active groups, like sports and performing arts, the impetus of anthropometry should be on the level of development of the musculo-skeletal structures. The human body which is subjected to exercise may elicit bilateral differences; the side used more may show greater development. Generally it is the right side which is of special significance. So, the experts in sports sciences feel that the landmarks depending upon the laterality of the body should be different in sportsmen from the other protocols because of the different types of objectives to be achieved especially to know the maximum development of muscularity, as well as maintaining uniformity with the techniques employed by sports scientists in the past, throughout the world. One such agreement has been reached by a Leon and Thea Koerner Foundation Study Group held at the University of British Columbia (1973). The group included authorities on kinanthropometry such as Drs. J.E.L. Carter, William D. Ross, AR. Behnke Jr., S. Brown, M. Hebbelinck and M.V. Savage. These experts have played the pivotal role in nurturing and
developing the field of kinanthropometry. Later research workers in this field have been using these techniques and whatever future developments have taken place, these are mainly based on these techniques. One major difference in the IBP and the above study group recommendations is that the former suggested taking measurements on the left side whereas the later have emphasized to take them on the right side of the body. Various points on the body (landmarks) which are required for different body measurements used in kinanthropometry have been described after Ross, Brown, Hebbelinck, Faulkner (1978) and Ross, Karr and Carter (2000) which are given below. International Working Group on Kinanthropometry (IWGK) which later on became the International Society for the Advancement of Kinanthropometry (ISAK) has also endorsed these techniques and has been imparting instructions to various study groups on these lines. . Human body can take many postures; therefore before describing the points, it is necessary to use some standard pose. Most commonly used standard anatomical posture is the one where the subject stands erect, head in the Frankfort horizontal plane, feet together and arms hanging down normally. 2.6.1 Landmarks on the body Various points or landmarks which have been recommended by the kin anthropometric study group and reported by Ross et al. (1978) for taking various measurements on the subjects have been described below. Generally the techniques of taking body measurements are similar as reported in the IBP protocol. The major difference is in the definition and position of these points which may be different for certain measurements. Vertex (v) It is the superior most point on the skull in the midsagittal plane when head is held in Frankfort horizontal plane (Figs 2.11, 2.16). Gnathion (gn)
This is the point which lies in the midsagittal plane on the inferior most border of the mandible (Fig. 2.14, 2.15). Insert Fig. 2.11 somewhere here
Suprasternale (sst) It is the point which lies in the midsagittal plane on the superior border of sternal notch. Mesosternale (mst) The point is located at the intersection of midsagittal plane by the horizontal plane through the middle of the IVth chondrosternal articulation. Epigastrale (eg) It is the point the horizontal plane where midsagittal plan is intersected by the horizontal plane through the most inferior points on the tenth ribs. Thelion (thl) The point lies in the middle of the breast nipple of the right side. Omphalion (om)
.
The point is situated in the middle of the naval cavity. Symphysion (sy) The point is situated in the midsagittal plane on the superior border of the pubis symphysis. Acromiale (a) The point lies at the superior and external border of the acromion process of the right side of the subject standing erect and shoulders relaxed. This definition of the acromiale point is different from the IBP definition where it is the inferior most point on the external border of the acromion process. While the biacromial width or the shoulder width by these two descriptions may be similar, other measurements, e.g. those of the upper extremity and its parts which involve this
point, will be different. The definition in this section will result in larger measurements over the IBP measurements. Insert Fig. 2.12 somewhere here
Radial e (r) The point lies on the superior and lateral border of the head of radius of the right side. Stylion (sty) It is the most distal point of the styloid process of the radius of the right side (2.12).
Dactylion (da) The point lies most distally on the tip of the middle finger or any digit of the right hand when the arm hangs down normally, fingers stretched and pointing downwards. In case any digit other than the middle finger is longer, the point may be qualified by writing along with the digit number as dactylion I, II, IV, V. Metacarpale radiale (mr) The point is the outermost or lateral on the distal head of IInd metacarpal of the right hand when the hand is stretched (Fig. 2.17). Metacarpale ulnare (mu) The point is the outermost or medial on the distal head of ulna of the right side of the stretched hand. Iliocristale (ic) The point lies most laterally on the iliac crest of the right side (Fig. 2.13). Iliospinale (is) The point lies on the tip of the right anterior superior iliac spine.
Insert Fig. 2.13 somewhere here
Trochanterion (tro) The point lies most superiorly on the greater trochanter of the femur of right side. Tibiale (ti) The point lies most proximally on the medial border of the head of tibia of right side. Tibiale externum (te) It is the most proximal point on the head of the tibia of the right side on the lateral side. Sphyrion (sph) It is the most distal point on the tip of the medial malleolus of right side. Sphyrion fibulare (sphf) It is the most distal point on the tip of the lateral malleolus of right side. Pternion (pte) The point is the most posterior on the heel of the right foot when the subject stands erect.
Insert Figs. 2.14, 2.15, 2.16 somewhere here
Akropodion or acropodion (ap) The most anterior point on the toe of the right foot when the subject stands erect is called akropodion (Fig. 2.18). Insert Figs. 2.17, 2.18 somewhere here
Metatarsale tibiale (mtt) It is the outermost point which is situated on the head of the 1st metatarsal of the right foot when the subject stands erect.
Akropodion (ap) It is the most anterior point on the toe of the right foot when the subject stands erect. Metatarsale tibiale (mt t) It is the outermost point which is situated on the head of the 1st metatarsal of the right foot when the subject stands erect. Metatarsale fibulare (mt f) It is the outmost point which is situated on the head of the 5th metatarsal of the right foot when the subject stands erect. Cervicale (c) The point is situated on the tip of the 7th cervical vertebra most posteriorly (on the midsagittal plane). Gluteale (g) It is point in the mid-sagittal plane at the sacro-coccygeal fusion.
The following are the measurements recommended by Ross, Karr and Carter (2000) in Anthropometry Illustrated. 2.6.2 Basic four measurements
Stature (free standing stature; stature against a wall; stretch stature against a wall; recumbent length) (Anthropometer).
Stretch stature reflects the maximum distance from the surface on which the subject stands to the point vertex of the head, when the head is held in the Frankfort horizontal plane. It is desirable to apply some gentle pressure upwards on the mastoid processes in order to help the subject stretching him to the fullest.
Sitting Height (Anthropometer)
Sitting height reflects the maximum distance from the surface on which the subject sits to the point vertex of the head, when the head is held in the Frankfort horizontal plane and the subject stretches his back to the maximum. It is desirable to apply some gentle pressure upwards on the mastoid processes in order to help the subject stretching him to the fullest.
Weight/Mass (Weighing scale)
It is the force of gravity acting on the mass of the body. Ideally it should be measured with a beam balance up to the nearest 0.1 kg; however, in most cases a value nearer to 0.5 kg is also acceptable.
Span (Steel Tape)
It is the maximum distance between the two dactylion points of the left and right hands when the arms are outstretched and are horizontal at the level of the shoulder with palms facing the wall. The subject is positioned in front of the wall facing it.
2.6.3 The Lengths
Acromiale – radiale length (Arm length) (Anthropometer compass)
The arm length or the upper arm length is the distance between points acromiale to radiale.
Radiale – Stylion length (Forearm length)(Anthropometer compass)
The forearm length is the distance between points radiale and stylion.
Mid-stylion – dactylion length (Hand length)(Sliding caliper)
The distance from the middle of two Stylion points on the wrist to the Dactylion point is called hand length.
Iliospinale height (Anthropometer)
This is the vertical distance of Iliospinale point from the ground.
Trochanterion height (Anthropometer)
Trochanterion height represents the vertical distance from the point trochanterion to the ground.
Trochanterion – tibiale length (thigh length) (Anthropometer)
This is the straight distance between the points Trochanterion and tibiale.
Tibiale laterale height (Leg length) (Anthropometer)
The leg length or tibiale laterale height is the vertical distance from the point tibiale laterale to the ground
Tibiale mediale – Sphyrion tibiale length (Tibial length) (Anthropometer)
The length of the tibia is represented as the straight distance between the points tibiale mediale to sphyrion of the tibia.
Foot length (Sliding caliper)
This is the distance between the points acropodion to pternion.
2.6.4 Breadths
Biacromial Breadth (Anthropometer compass)
This is the distance between the acromiale points on each scapula which are the most lateral points on the acromion processes with the subject in an erect posture and his arms hanging down at the sides.
Biiliocristal Breadth (Anthropometer compass)
The biiliocristal breadth is taken between the two most lateral points on the superior border of each iliac crest.
Transverse Chest Breadth (Anthropometer compass)
The transverse breadth of the chest is the breadth taken at the mesosternale level between the two lateral aspects.
Anterior-Posterior Chest Depth (Spreading caliper)
The chest depth is taken at the mesosternale level between the front and the back aspects of the chest. The spreading calipers are used for taking this measurement.
Biepicondylar Humerus Breadth (Sliding caliper)
Distance between the two epicondyles of the humerus when the arm is bent at a right angle at the elbow.
Wrist Breadth (Sliding caliper)
It is the width of the wrist taken between the two styloid processes when the hand is flexed at the wrist to an angle of about 90 o.
Hand Breadth (Sliding caliper)
It is the distance between the metacarpale mediale and metacarpale laterale. The measurement is taken when the subject firmly holds a pencil in his hand.
Biepicondylar Femur Breadth (Sliding caliper)
Biepicondylar femur breadth is the distance between medial and lateral condyles of the femur. The subject is instructed to sit with the knee bent at a right angle.
Ankle Breadth (Sliding caliper)
It is the distance between the two outermost projections of each ankle (malleoli).
Foot Breadth (Sliding caliper)
Foot breadth is the distance between metatarsale tibiale and metatarsale fibulare.
2.6.5 The Girths
Head Girth (Steel tape)
It is the maximum circumference of the head taken a little above the point glabella (the point in the middle of the supra orbital ridges in the mid-sagittal plane). The tape should be kept horizontal.
Neck Girth (Steel tape)
It is the neck circumference taken slightly above the larynx.
Arm Girth (Relaxed) (Steel tape)
It is the circumference of the upper arm taken at right angles to the long axis of the arm midway between the points acromiale and radiale when the arm hangs down freely.
Arm Girth (Flexed and Tensed) (Steel tape)
It is the circumference of the upper arm taken at the level of its maximum development when the biceps muscles are fully contracted.
Forearm Girth (Steel tape)
It is the circumference of the forearm at its maximal development.
Wrist Girth (Steel tape)
It is the circumference of the wrist taken slightly away from the styloid processes.
Chest Girth (Steel tape)
It is the circumference of the chest at the mesosternale level taken after the end of a normal expiration.
Waist Girth (Steel tape)
It is the circumference of the abdomen at the level of marked narrowing and is generally located approximately mid way between the costal border and iliac crest.
Omphalion Girth (Abdominal) (Steel tape)
It is the circumference of the abdomen taken at the mid-point of the naval or umbilicus.
Gluteal Girth (Hip) (Steel tape)
It is the circumference of the hips at the level of the point symphysion where the buttocks register the maximum development.
Thigh Girth (Upper) (Steel tape)
It is the circumference of the thigh at the level where it joins the gluteus muscle. The subject must support his weight equally on both the feet.
Mid-Thigh Girth (Steel tape)
It is the circumference of the thigh taken mid-way between the points trochanterion and tibiale.
Calf Girth (Steel tape)
It represents the maximum circumference of the calf when the subject stands erect and weight is equally distributed on both the feet.
Ankle Girth (Steel tape)
It is the smallest circumference of the leg just above the point sphyrion tibiale.
2.6.6 Skinfolds
Triceps skinfold (Skinfold caliper)
The skinfold is taken mid-way between the points radiale and acromiale over the triceps muscle.
Subscapular skinfold (Skinfold caliper)
The skinfold is picked up just below the inferior angle of scapula. The direction of the fold is downwards and outwards.
Biceps skinfold (Skinfold caliper)
The skinfold is taken mid-way between the points radiale and acromiale over the biceps muscle.
Iliac Crest skinfold (Skinfold caliper)
The skinfold is taken just above the iliac crest at the mid-axillary line. The fold should run anteriorly downwards.
Supra-Spinale (Heath-Carter referred to it as Supra-Iliac) skinfold (Skinfold caliper)
The skinfold is picked about seven centimeters above the point Iliospinale at the level of anterior axillary line. The fold runs inwards and downwards.
Abdominal skinfold (Skinfold caliper)
The skinfold is picked up about 3 to 5 cm laterally towards the right side at the level of point omphalion.
Front Thigh skinfold (Skinfold caliper)
The skinfold site is mid-way between the inguinal line and the superior distal margin of patella. The skinfold is taken when the subject sits with the leg is bent at right angle.
Medial Calf skinfold (Skinfold caliper)
The skinfold is to be taken on the medial side of the calf where the maximum circumference is noticed.
Chest skinfold (Skinfold caliper)
The skinfold site is mid-way between the point thelion and the axilla.
2.7 Lohman et al. (1988) protocol of measurements
The above authors while recommending the techniques of these measurements have used common names for the measurements wherever possible so that even those people who are not familiar with anthropometry be able to use them. In most of the techniques the head is to be held in Frankfurt Horizontal Plane. The inferior most point on the left eye orbital margin is to be held at the same horizontal level as that of left tragion. Tragion can be defined as the deepest point in the notch above the tragus of the ear.
2.7.1 Gross measurements
Stature / Recumbent Length
Weight
2.7.2 Segmental Lengths
Sitting height / Crown Rump Length
Calf Length
Lower Extremity Length
Arm Span
Thigh Length
Shoulder Elbow Length
Elbow Wrist Length
Hand Length
Forearm Hand Length
2.7.3 Body Breadths
Chest Breadth
Knee Breadth
Chest Depth
Ankle Breadth
Biiliac Breadth
Elbow Breadth
Bitrochanteric Breadth
Wrist Breadth
2.7.4 Circumferences
Head Circumference
Thigh Circumference
Minimum Neck Circumference
Calf Circumference
Shoulder Circumference
Ankle Circumference
Chest Circumference
Arm Circumference
Waist Circumference
Forearm Circumference
Abdominal Circumference
Wrist Circumference
Buttocks Circumference
2.7.5 Skinfolds
Subscapular Skinfold
Suprapatellar Skinfold
Midaxillary Skinfold
Medial Calf Skinfold
Pectoral (Chest) Skinfold
Triceps Skinfold
Abdominal Skinfold
Biceps Skinfold
Suprailiac Skinfold
Forearm Skinfold
Thigh Skinfold
Techniques of all these measurements have been provided in great detail in the Anthropometric Standardization Reference Manual by Lohman, Roche and Martorell (1988). The reader can make comparisons between the measurements recommended by IBP versus this protocol in order to find out which measurements are new in this protocol. The IBP measurements are taken on the left side while those recommended by Lohman et al. (1988) protocol are taken on the right side of the body wherever applicable. The following is the description of only those measurements in this protocol which were not given in the IBP protocol.
Lower Extremity Length
The lower extremity length is the distance between the hip joint and the plane on which the subject stands. In living subjects the exact location of hip joint cannot be determined. Therefore the best alternative is to subtract sitting height from height for obtaining lower extremity length.
Arm Span (Steel tape)
It the distance across the tips of the middle fingers of the laterally and maximally outstretched hands at the level of the shoulders.
Forearm Hand Length (Anthropometer compass)
It is the distance between the most posterior surface at the elbow overlying the olecranon process and the tip of the middle finger when the arm is bent at right angle so that the upper arm is vertical and the forearm is horizontal.
Biiliac Breadth (Anthropometer compass)
It is the distance across the two iliac crests. The measurement is best taken from behind across the two lateral aspects with a lot of pressure in order to press any overlying soft tissues including fat and other tissues.
Bitrochanteric Breadth (Anthropometer compass)
It is the distance across the most projecting points of the greater trochanters of the hip joints.
Shoulder Circumference (Steel tape)
The shoulder circumference is taken at the level of the maximum development of deltoid muscles slightly inferior to the acromion processes of the shoulder blades. The measurement should be taken at the end of a normal expiration. The tape must touch the soft tissues on all sides but should not be compressed. It shows the development of muscles of the shoulder and upper thorax
Waist Circumference (Steel tape)
The waist circumference is measured at the smallest circumference of the torso which is the level of the natural waist. The waist circumference is of immense value in assessing deep adipose tissue. The ratio of waist to hip circumference is important in designating masculine type of fat deposition which shows a greater susceptibility to adult onset o diabetes mellitus.
Abdominal Circumference (Steel tape)
The abdominal circumference is taken at the level of the maximum bulging of the abdomen which may be at the level of the naval but not always.
Buttocks Circumference (Steel tape)
The circumference is taken at the level of maximum extensions of the buttocks without compressing the soft tissues. It reflects the adipose tissue in this region and also shows the size of the pelvic region.
Pectoral (Chest) Skinfold (Skinfold caliper)
The skinfold is picked over the anterior axillary fold as high as possible.
Suprapatellar skinfold (Skinfold caliper)
The skinfold is taken in the sagittal plane over the anterior aspect of the thigh about two cm above the superior border of patella. It I take while the subject stands relaxed.
2.8 Accuracy and Reliability of Measurements Anthropometric measurements are usually taken by a vast majority of scientists and professionals from epidemiologists to sports scientists. The two most widely used measurements include height and body mass and utilizing these two, an important index is calculated which is popularly known as Body Mass Index (BMI). A wide variety of people engaged in taking measurements from different disciplines calls for maintaining a high level of accuracy and reliability in taking these measurements. Only then would it be possible to compare the values among different populations enhancing the credibility of such measurements. Lots of variation and differences occur as a result of measuring the same individual by many investigators or the same investigator over a passage of time. This results in errors in the data. The ideal situation for measurements demands for accuracy and reliability of different measurements. 2.8.1 Reliability (Reproducibility) The difference in measurements conducted on the same subject on two occasions either by the same investigator or by different investigators is an indicator of reliability. In other words, reliability is the within-subject variability. According to Habicht et al. (1979), this within-subject
variability has two components:
Imprecision or error originating due to the investigator taking measurements which are different on two occasions. This is usually recorded from repeated measurements taken consecutively over a very short span of time. Either the random errors in the measuring instrument are responsible for imprecision or the investigator himself is to be held responsible for being imperfect in measuring technique or recording it.
Undependability which means that there are physiological measurements which cannot be repeated by anybody howsoever an expert he may be and show inherent tendency to fluctuate for example blood pressure body weight.
Thus any within-subject variation would be called unreliability and it has the above two components and can be briefly expressed as:
Unreliability = imprecision + undependability
2.8.2 Accuracy There is a real or true value of a measurement on a subject. The investigator strives to the best of his ability to obtain that. How far is he successful in taking that determines his accuracy? The only indicator of accuracy is the repeated measurements taken on a subject by an expert investigator. Since an expert is a well trained professional, therefore his measurements taken on a subject repeatedly will be very near to each other and it can be stated that these values approximate each other. Such an expert is now referred to as a “criterion measurer or criterion anthropometrist”. In any anthropometric study, it is really important to be accurate. A training programme under an expert is mandatory to achieve this. Measurement techniques have to be mastered and only when the learner consistently achieves values very close to those of the criterion measurer can he become a qualified measurer to start the job.
The differences between measurements taken on different subjects on two occasions by a trainee would reflect his imprecision whereas the differences in measurements taken on different subjects by a trainee and a criterion measurer would depict the inaccuracy of the former. Zerfas (1985) has provided a protocol of repeat measurements where the differences can be judged as good, fair and poor for a trainee and has been given in table 2.1. Comments on intra- and inter-observer error in anthropometric measurements have been put forth by Ulijaszek and Lourie (1994). One must strive hard to achieve the values of repeat measurements in the ‘good’ range; only then one would have an acceptable level of reliability. Insert table 2.1 somewhere here The difference or variation in taking the repeat measurements by an investigator or those between a trainee and a trainer is called the Technical Error of Measurement (TEM) and can be expressed as follows: TEM = (∑D2 / 2N)0.5 Where D represents the difference between measurements taken on two occasions N is the number of subjects
Exercise 2.1. Calculate the TEM on the basis of the data given in Table 2.2 about the repeat measurements taken by an investigator on ten subjects on two occasions. The technical error of measurement (TEM) = (∑D2 / 2N) 0.5 = (0.49/2 x 10) 0.5 = 0.157 cm
Insert table 2.2 somewhere here
In case of height, the criterion for judging TEM as good is if its value is < 0.5 cm. Since in the
above cited example, the investigator’s TEM is 0.157 cm, this being within the stipulated value, therefore it can be judged as ‘good’. The coefficient of reliability ® can be calculated as follows and it ranges between 0 and 1, the nearer the value is to 1 the better is its reliability: R= 1 – [(TEM)2 / SD2]
Where TEM is the technical error of measurement
SD is the inter-individual variability
Ex. 2.2. Calculate the coefficient of reliability taking the values from Ex. 2.1 of TEM and SD.:
R= 1 – [(TEM)2 / SD2] = 1 – [0.1572 / 4.2962] = 1 – 0.001 = 0.999 The nearer the value of coefficient of reliability to unity the better it is and shows a consistency in taking the measurements by the investigator. In the above example, the coefficient of reliability is 0.999 which is an excellent level of consistency by the investigator.
Ulijaszek has provided the upper limits of technical error of measurements (TEM) for males and females modified from Zerfas (1985) which are presented in table 2.3. Insert table 2.3 somewhere here
2.9 Which side to measure?
Majority of us are right handed and we show a great preference for hand use. People who use their right or left arms for very strenuous jobs like the blacksmiths have a great tendency to greatly develop their specific arms which would show wide bilateral differences in the muscle mass between the left and the right arms. The most important point, however, is the quantum of the differences between the measurements on the left and the right side and which measurements are affected more by the laterality of the subjects. A study on people with traditional occupations of Punjab conducted by Singh and Singh (2007) indicates that the maximum percentage distribution of bilateral variations has been found in biceps skinfold among carpenters, in femur bicondylar diameter, thigh circumference and hand length among blacksmiths. Laubach and MacConville (1967) studied the bilateral differences in a group of individuals for 21 anthropometric measurements. The results indicated that the right side had significantly larger values for circumferences of upper arm at axilla and at mid-point (relaxed as well as flexed), forearm and wrist circumferences. A similar type of findings have been reported from the data of Health and Nutrition Examination Survey I (HANES I) where right side measurements have been consistently larger than those on the left side. The arm circumference and triceps skinfold are larger on the right side by 0.23 cm and 0.48 mm, respectively as compared to those of the other side. The elbow width is larger on right side by 0.06 cm whereas the subscapular skinfold is larger on the left side by 0.11mm than those of the respective sides. According to Cohen (1977), if the differences between the right and left sides are converted into the proportion of their Standard Deviation then all these four differences are just below one tenth value of their SD. These differences are very small and can be ignored very easily. Asymmetry between the two sides can be quantified with the help of the following formula of Relative Index of Asymmetry given by Wolanski (1972): Relative Index of Asymmetry (RIA) = (2 D /[ X1 + X2]) x 100 Where D is the difference between the measurement on the right and the left side of the body,
X1 is the larger measurement of the two sides of the body, X2 is the measurement on the opposite side of the body. Ex. 2.3: Calculate the relative index of asymmetry if a person’s left arm length is 37.0 cm and that of right arm is 38.5 cm. RIA = (2 D / X1 + X2) x 100 = (2 X 1.5/ [37 + 38.5]) X 100 = (3/75.5) X 100 =3.97
The findings point out that there are differences between the right side and the left side for the measurements of the arm where the values are larger on the right side. It has been pointed out by Martorell et al. (1988) that these differences are smaller than those for measurement error. It is also important to mention that the International Biological Programme has recommended that all the bilaterally represented anthropometric measurements be taken on the left side of the body (Weiner and Lourie 1981). The traditional anthropometry has also focused on the left side for taking these measurements. Most of the developing world and the countries of Europe have accumulated huge anthropometric data where the left side has been measured. On the other hand, in the American continent the measurements were taken on the right side of the body. Keeping in mind the small differences in anthropometric measurements between the left and the right side, it is immaterial which side is measured and the decision about the choice of side may be left to the investigators and the type of study they are undertaking.
2.10 Age assessment and Age Grouping Chronological age is an important variable in growth studies which is often required while dealing with children. Accurate ages can enhance the credibility of such studies. The ages can be
calculated from the date of birth and the date of examination. In case of literate subjects and their parents, recall of the date of birth is not a problem. However, in case of illiterate people the exact date of birth may not be known. Usually, they remember these dates in comparison with some important festival or some historic event, etc. These reference points can come in quite handy to assess the date of birth of the child.
In order to calculate the age of the child, the days and months are converted into the fraction of a year and then the age can be obtained in decimal years by subtracting the date of birth from the date of examination as follows. Ex. 2.4. Calculate the age of the given child whose date of birth (DOB) and date of examination (DOE) are December 25, 1994 and January 12, 2003, respectively. DOE is January 12 = 12 days of the year =12/365 years DOE = 0.033 years DOB is December 25=360 days of the year = 360/365 years DOB = 0.984 years Age= DOE – DOB = 2003.033 –1994.984 years = 8.049 years Table 2.4 shows the conversion of days of specific months in decimal proportion of a year.
Insert Table 2.4 somewhere here
In sample surveys, a large number of subjects are measured and there is a need to make some sort of groups. Groups according to ages can be made for the purpose of assessing growth and development of children as given below. It is important to know how large a group should be in terms of time, for example, a year, six months, three months, etc. While studying very young
children, the age groups should be small, say of three months or six months, however, in older subjects, yearly age groups are usually attempted.
If all the subjects have been studied on their birthdays, then the ages would be in precise years, e. g. these can be exact 8.000 or 9.000 years, etc. Age groups based on the exact whole year figures of all the subjects can be designated as 8.0, 9.0 years, etc.
When the subjects are not studied on their birthdays, then their ages will be distributed along time axis. Yearly age groups can be made in such a way so that the average age of the group is depicted as a whole year figure, e.g. all subjects from 7.500 to 8.499 years would be grouped on one year which can be designated as 8 ± years, from 8.500 to 9.499 years designated as 9± years.
Another age grouping can also be attempted where the average age of the group tend to be at a half year figure, e.g. all subjects from 8.0 0 to 8.999 years can be combined in one year age group which is designated as 8+ years, from 9.000 to 9.999 years designated as 9+ years and so on.
2.11 Log Transformations In general, body weight, skinfolds and circumferences have frequency distributions skewed to the right side whereas the rest of the measurements exhibit normal distributions or Gaussian distributions. Fig. 2.19 shows a diagrammatic representation of Gaussian distribution whereas Fig. 2.20 displays the skewed distribution. The first step before analysis of those measurements which show skewed distributions is to apply necessary transformation so that the distributions become normal. Insert Figs. 2.19, 2.20 somewhere here
Generally, log transformations to weight, skinfolds and circumferences are sufficient to achieve
this target. Edwards et al. (1955) gave a formula to transform the skinfold measurement as follows. Log skinfold =100 Log10 (skinfold in 0.1 mm–18) So, it is recommended to transform weight, skinfold thicknesses and circumferences using suitable formulae before statistical analysis is made. Table 2.5 presents the log transformed values of skinfolds as given by Edwards et al. (1955). Ex. 2.4. Using table 2.5 provide log transformed value to 12.5 mm triceps skinfold. Also assign log transformed value to the sum of three skinfolds, viz., triceps as 12.5 mm, subscapular as 14 mm and suprailiac as 12 mm.
A triceps skinfold value of 12.5 mm would be assigned a log transformed value of 203 (table 2.5). Triceps + subscapular + suprailiac skinfolds = 12.5 + 14 +12 = 38.5 mm A skinfold value of 38.5 mm would correspond to a log transformed value of 256.
Insert Table 2.5 somewhere here
2.12 Human biological variations
The human beings successfully inhabit the globe from equator to the poles and from deserts to the high altitude zones. These regions have drastically different climatic conditions and physical properties of the environment. The populations living under these conditions have undergone special changes in their bodies which provide them selective advantage for survival and procreating. For example, to be successful in a desert climate, the body must evolve a strategy to dissipate body heat which can be done by increasing the surface area. This seems to be the reason
for thin and elongated bodies of the inhabitants of the deserts. On the other hand, people of the arctic have thick bodies which prevent heat loss. Similarly, the residents of the high altitude have greater chest diameters in order to increase the pulmonary ventilation which provides them with an opportunity to increase the availability of the oxygen which otherwise is less in the rarified atmosphere of the altitude. The populations of the world have lots of variations in body size and structure. There are very tall populations measuring as much as 180 cm in comparison to the pygmies of central Africa who are barely 130 cm in height. This range of averages of body height of the two extremes amply point towards the need of having specific reference data for different populations. Height and weight are the two most important measurements on the basis of which assessment about the growth status of either the individual or that of the population can be assessed. In the case of the individual child, his present status with respect to his percentile position in the given reference standards can be assessed. If his position is significantly below 3 rd centile, his growth performance is doubtful and needs monitoring. On the other hand, the status of groups in the standards can provided and thus the performance of the group as a whole becomes clear. Characteristic changes in height and weight take place during the growth period of children. The pattern does not show a linear growth but witnesses many ups and downs. The period of adolescence is of a special significance as the child witnesses dramatic changes in his physical appearance. Abrupt increase in height and weight popularly known as adolescent growth spurt transforms a boy into a man and girl into a woman. Besides during this period sexual maturity takes place and the bones become fully mature by closing their epiphysis. The body measurements are useful in studying different groups. The absolute and proportional differences between groups can reveal a lot of information and throw light on the factors responsible for effecting such a change. The same group migrated to an affluent setting can be compared to the native group in order to gauge the effect of
migration which might be
responsible for a drastic change in the life style as a result of acculturation. A comparison of the
body measurements between normal and abnormal group could reveal the differences and the effect of such abnormality on human body. The children usually follow a pre-destined growth curve and would try to follow them religiously. Only during the period of adolescence can they wander slightly from these curves. This highly organized characteristic of children’s growth opens new vistas in the field of prediction of adult height. Usually the height achieved at any age is a good indicator of how tall a child would become as an adult. Height of the child at any given age clubbed with a few more indicators as the skeletal age, parental height and growth velocity during the preceding few years can be a wonderful combination in the prediction of adult height. The accuracy of such predictions is very high. Tanner et al. (1975, 1983) have provided equations for the prediction of adult height of children on the basis of the above characteristics.
The body measurements of the child serve as a very good proxy measure of his nutritional status. The child spends energy on growth, maintenance and play. If his energy intake is more than these needs combined together he is stated to be in a positive energy balance and would grow favorably and also runs the risk of becoming fat. If on the other hand, he maintains equilibrium between the energy intake and the energy expenditure including all his needs of growth as well, he is healthy and grows normally. But a situation where the energy balance is negative which means the energy intake is lower than the energy expenditure, the child would be undernourished. In this case, the growth of the child runs the risk of being affected. Nutritional anthropometry which is based on various measurements like height, weight, fat folds and upper arm circumference is considered to be a safe, easy and quite effective way of screening the children whether they grow normally or not with a comment on their nutritional status.
Chapter 2 Exercises Ex. 2. 1. The plane which divides the body into two parts, right and left is called ___ and the line
resulting from the intersection of frontal and sagittal planes is called____ , respectively. Ex. 2.2. The skinfold calipers are generally designed with a standard pressure of ___ on the measuring surfaces. Ex.2. 3. Enumerate different protocols for taking body measurements given in this chapter? Ex.2. 4. What is a Frankfort plane? . Ex.2. 5 Calculate the relative index of asymmetry (RIA) of the following measurements taken on the two sides of a subject are as follows: a. Humerus bicondylar diameter 6.7 cm and 6.9 cm. b. Upper arm circumference 24.0 am and 27.2 cm. c. Hand length 27.2 cm and 26.1 cm. d. Forearm length 36.0 cm and 37.3 cm. Ex.2.6. Calculate the TEM and the coefficient of reliability from the repeat measurements of height (cm) given in the following table and if the SD is 10.125 cm.
Sr. No of the subject
1st occasion
2nd occasion
1
148.2
148.8
2
166.7
166.1
3
173.8
173.4
4
178.3
178.1
5
162.3.
162.0
6
163.6
163.9
7
178.5
178.8
8
168.5
168.1
9
176.3
176.5
10
184.2
184.0
Chapter 2 Answers Ans 2.1: Sagittal plane or antero-posterior plane and longitudinal axis, respectively. Ans 2.2. 10 g/mm2 Ans 2.3. IBP/HA, Kinanthropometric and Lohman et al. (1988). Ans2.4 Frankfort plane is that plane which touches the inferior most point on the infraorbital crest (lower border of the eye orbit) and the point situated in the ear notch above the tragus of the ear Ans: 2.5 a. 2.94 b. 12.5 c. 4.13 d. 3.55 Ans. 2.6 TEM = 0.267 coefficient of reliability = 0.999
Table 2.1 The criteria for assessment of measurement error between a trainee and a trainer Measurement
Good
Fair
Poor
Height/length(cm)
Up to 0.5
From 0.6 to 0.9
≥1.0
Skinfolds (mm)
Up to 0.9
From 1.0 to 1.9
≥2.0
Arm circumference (cm)
Up to 0.5
From 0.6 to 0.9
≥1.0
Table 2.2 Repeat measurements of height (cm) of ten subjects by an investigator along with their differences (D) and squared differences (D2) Sr. No of the subject
1st occasion
2nd occasion
D
D2
1
160.2
160.0
0.2
0.04
2
165.5
165.7
0.2
0.04
3
173.3
173.4
0.1
0.01
4
168.3
168.1
0.2
0.04
5
172.3
172.0
0.3
0.09
6
169.6
169.9
0.3
0.09
7
173.5
173.8
0.3
0.09
8
168.5
168.4
0.1
0.01
9
166.3
166.5
0.2
0.04
10
174.2
174.0
0.2
0.04
Total
1691.7
1691.8
2.1
0.49
Note: The standard deviation (SD) of above measurements of height on 1st occasion is 4.52 cm and that on 2nd occasion is 4.42 cm.
Table 2.3 The acceptable differences in taking measurements on two occasions at different levels of reliability (adapted from Zerfas 1985) Age group
Height (cm)
Sitting height (cm)
Arm circ. (cm)
T
Sub
ri
sca
c
pul
e
ar
p
ski
s
nfol
s
d
k
(m
i
m)
n f o l d ( m m
)
Reliability 0.95 M
F
M
F
M
F
MF MF
1-4.9
1.0
0.4
0.3
0.3
0.3
0 0 0 0
1.0
. . . . 6 7 4 5 5-10.9
1.3
1.4
0.4
0.4
0.5
0.5
1 1 0 1 . . . . 0 1 9 1
11.17.9
1.7
1.5
0.3
0.3
0.8
0.8
1 1 1 1 . . . . 5 6 6 7
18-64.9
1.5
1.4
0.3
0.3
0.7
1.0
1 1 1 2 . . . . 4 9 8 4
65+
1.5
1.4
0.3
0.3
0.7
1.0
1 1 1 2 . . . . 3 9 7 3
Reliability 0.99
1-4.9
0.5
0.5
0.2
0.2
0.1
0.1
0 0 0 0 . . . . 3 3 2 2
5-10.9
0.6
0.6
0.2
0.2
0.2
0.2
0 0 0 0 . . . .
4 5 4 5 11-17.9
0.8
0.7
0.1
0.1
0.3
0.4
0 0 0 0 . . . . 7 7 7 8
18-64.9
0.7
0.6
0.1
0.1
0.3
0.4
0 0 0 1 . . . . 6 9 8 1
65+
0.7
0.6
0.1
0.1
0.3
0.4
0 0 0 1 . . . . 6 8 9 0
M –male F – female
Table 2.4. The decimal age calendar for the calculation of exact ages.
1 2 3 4 5 6 7 8 9 10 11 12
JAN. FEB. 1 2 000 085 003 088 005 090 008 093 011 096 099
14 15 16 17 18 19 20 21 22 23 24 25
014 016 019 022 025 027 030 033 036 038 041 044 047 049 052 055 058 060 063 066
26 27 28 29 30
068 071 074 077 079
153 156 159
31
082
13
l01 104 107 110 112 115 118 121 123 126 129 132 134 137 140 142 145 148 151
MAR. 3 162 164 167 170 173
APR. 4 247 249 252 255 258
MAY 5 329 332 334 337 340
JUNE 6 414 416 419 422 425
JULY 7 496 499 501 504 507
175 178 181 184 186 189 192 195 197 200 203 205 208 211 214 216 219 222 225 227
260 263 266 268 271 274 277 279 282
342 345 348 351 353 356 359 362 364
427 430 433 436
510 512 515 518 521 523 526 529 532 534 537 540 542 545 548 551 553 556 559 562
595 597 600 603 605 608 611 614 616 619 622 625 627 630 633 636 638 641 644 647
679 682 685 688 690 693 696 699 701 704 707 710 712 715 718 721 723 726 729 731
564 567 570 573 575
649 652 655 658 660
734 737 740 742 745
578
663
230 233 236 238 241 244
438
288 290 293 296 299 301 304 307 310 312
370 373 375 378 381 384 386 389 392 395
441 444 447 449 452 455 458 460 463 466 468 471 474 477 479
315 318 321 323 326
397 400 403 405 408
482 485 488 490 493
285 367
411
AUG. SEPT. OCT. 8 9 10 581 666 748 584 668 751 586 671 753 589 674 756 592 677 759 762 764 767 770 773 775 778 781 784 786 789 792 795 797 800 803 805 808
NOV. DEC. 11 12 833 915 836 918 838 921 841 923 844 926
814
847 849 852 855 858 860 863 866 868 871 874 877 879 882 885 888 890 893 896 899
929 932 934 937 940 942 945 948 951 953 956 959 962 964 967 970 973 975 978 981
816 819 822 825 827
901 904 907 910 912
984 986 989 992 995
811
830
997
Table 2.5 Log transformed values of skinfolds using the formula (Log skinfold =100 Log10 (skinfold in 0.1 mm–18)) mm 0.0 0.1 0.2 0.3 0.4 0.5 0.6 2 30 48 60 70 789 85 90 3 108 111 115 118 120 123 126 4 134 136 138 140 141 143 145 5 151 152 153 154 156 157 158 6 162 163 164 165 166 167 168 7 172 173 174 175 176 176 176 8 189 180 181 181 182 183 183 9 186 186 187 188 188 189 189 10 191 192 192 193 193 194 194 11 196 197 197 198 198 199 199 12 201 201 202 202 203 203 203 13 205 205 206 206 206 207 207 14 209 209 209 210 210 210 211 15 212 212 213 213 213 214 214 16 215 216 216 216 216 217 217 17 218 218 219 219 219 220 220 18 221 221 221 222 222 222 223 19 224 224 224 224 225 225 225 20 226 226 226 227 227 227 227 21 228 229 229 229 229 229 230 22 231 231 231 231 231 232 232 23 233 233 233 233 233 234 234 24 235 235 235 235 235 236 236 25 237 237 237 237 237 238 238 26 238 239 239 239 239 239 239 27 240 240 240 241 241 241 241 28 242 242 242 242 243 243 243 29 243 244 244 244 244 244 244 30 245 245 245 245 246 246 246 31 247 247 247 247 247 247 248 32 248 248 248 249 249 249 249 33 249 250 250 250 250 250 250 34 251 251 251 251 251 251 252 35 252 252 252 253 253 253 253 36 253 254 254 254 254 254 254 37 255 255 255 255 255 255 255 38 256 256 256 256 256 256 257 39 257 257 257 257 258 258 258
0.7 95 128 146 159 169 177 184 190 195 200 204 208 211 214 217 220 223 225 228 230 232 234 236 238 240 241 243 245 246 248 249 250 252 253 254 256 257 258
0.8 100 130 148 160 170 178 185 190 195 200 204 208 211 215 218 220 223 226 228 230 232 234 236 238 240 241 243 245 246 248 249 251 252 253 254 256 257 258
0.9 104 132 149 161 171 179 185 191 196 200 205 208 212 215 218 221 223 226 228 230 232 234 236 238 240 242 243 245 246 248 249 251 252 253 255 256 257 258
3.
BODY PROPORTIONS
Chapter details Body Proportions The phantom stratagem The O-scale system
Large and small individuals may look different from each other but it may happen that some of them have similar bodily shapes. In other words if both the subjects are scaled to equal height then the similarities in their body shapes would become more explicit. Shape of the body can be judged with the help of body proportions. It has been noticed that some persons have very long legs compared to their trunks whereas there are also those persons in whom trunk is relatively much bigger than the legs. Studying one measurement with respect to another provides clues about the shape of the body. Such ratios of different body parts are called body proportions. Body proportions are useful in various fields such as human biology, anthropology, sports sciences, auxology, etc., however, some inherent difficulties are encountered in interpreting the body proportions. There are other approaches like that of the phantom which are now used to define and interpret body proportions. The phantom is an imaginary human model which is based on the male and female data taken from different groups and is said to represent all people of the globe. It is only a comparative device with the help of which the bodily proportions are judged and comparisons are made between individuals and populations. The phantom is used to derive zscores of differences in body proportions which are easy to interpret and these also dxprovide good information.
3.1 Body Proportions Traditionally, body proportions of one body measurement to another have usually been attempted to know the variations in one body measurement by keeping the other constant in the subjects to be compared. Virtually any two measurements can be taken for such proportions
depending upon the objectives of the study. A few of such body indices which are often used are provided below:
(Sitting height/height) x 100
(Lower extremity length/height ) x 100
(Sitting height/lower extremity length)x 100
(Thoracic trunk/ abdominal trunk) x 100
(Head breadth/ head length) x 100
(Bicristal diameter/biacromial diameter)x 100
(Chest depth/chest breadth)x 100
(Upper arm length/ forearm length)x 100
(Thigh length/leg length)x 100
(Hand breadth/ hand length)x 100
(Foot breath/ foot length )x 100
If two people differ in their sitting height but are also different in their heights then a simple comparison of their sitting height would not yield much information. However, if sitting height in relation to height is compared, it would be giving a better picture. Ex.3.1 Calculate the simple proportional sitting height vis-à-vis that of height of the following two subjects: Subject 1,
Sitting height = 76.0 cm,
height = 170.0 cm
Subject 2,
Sitting height = 75.0 cm,
height = 165.0 cm
The proportional sitting height of Subject 1 = (76 x 100) /170 = 44.71 % of height The proportional sitting height of Subject 2 = (75 x 100) /165 = 45.45 % of height A comparison of sitting height/ height ratio between the two subjects reveals that the subject no.2 has relatively longer trunk or sitting height compared to the subject no.1 whereas a comparison of absolute values of their sitting height would have yielded the opposite results.
Body Mass Index (BMI) Body mass index (BMI) which is also known as Quetelet's index can be expressed as
follows: BMI= Weight/Height2
Ex. 3.2 Calculate the BMI of a person if his height and weight are 170 cm and 66 kg, respectively. BMI = 66/(1.7)2 = 22.84 Here weight is taken in kg whereas height is taken in meters. Body weight is a three dimensional entity whereas height is one-dimensional. According to the dimensional rules, the best representation of weight vis-à-vis height would be to take the cube root of weight or calculate the cube of height as follows. Height/Weight0 33 Or Height3/ Weight Much work has been done on body mass index and it has also been used in assessing adiposity of children. According to Rolland-Cachera et al. (1982), a good weight/height index meant for adiposity monitoring should be one which should be independent of height, highly correlated with fat mass and body weight. Body mass index according to them fulfils these conditions in growing children and they have suggested using it in determining the adiposity among children (Rolland-Cachera et al. 1991). However, many scientists feel that body mass index as an indicator of adiposity is neither as simple nor informative as it seems to be (Ross and Ward 1982). The variations in body weight are not simply due to the variations in adiposity but due to other factors as well. Therefore its utility in adiposity profiling of various groups may not be as useful as it is made out to be. But in case of groups which have extensively been studied for BMI with good results; the use of BMI in them can not be ignored.
Androgyny score
The human males have typical broad shoulders whereas the females have relatively large hips. A relationship of these two measures to a large extent can reveal the sexual dimorphism between the sexes. There are certain males who possess some characteristics of females and the vice versa. To what extent these features are present in either the males or the females can be known with the help of “androgyny score”. This score is calculated as follows:” Androgyny score = 3 X Biacromial diameter – 1 X Bi-iliac diameter
Ex. 3.3. Calculate the androgyny score of a person who has biacromial diameter as 36 cm and bi-iliac diameter as 27 cm. Androgyny score = 3 X 36 – 27 = 81 The higher values of this score denote masculinity whereas the lower scores indicate femininity thus making a good discrimination among individuals of either sex about the masculine and feminine features in their physiques.. This androgyny score has been extensively used by Tanner (1964) to discriminate between different players of the various sports for their physiques during 1960 Rome Olympics.
Conicity Index
Waist circumference for a given height and weight can be used as a predictor of central obesity. Valdez et al. (1993) described an index on the basis of waist circumference and named it as conicity index which can be calculated as follows: Conicity Index = waist circumference/ (0.109 x (weight)/height)0.5 Here waist circumference and height are expressed in metres whereas weight is taken in kg. Ex.3.4 Calculate the conicity index of the subject with following measurements: Height 150 cm = 1.5 m Waist circumference 50 cm = 0.50 m
Weight = 50 kg Conicity index = 0.50 / (0.109 X (50/ 1.5) 0.5) = 0.79 The principle implied is that if the abdomen is assumed to be a cylindrical entity, any deviation on the higher side in the size of the cylinder for a given height and weight from that of the standard is an indicator of central obesity.
3.2. The phantom stratagem Relationships of one measurement to another are informative in comparing individuals who otherwise differ in size or various other body measurements. Ross and Wilson (1974) have proposed the concept of a theoretical reference human which they prefer to call as phantom to be used as a reference standard for such comparison. According to them "the phantom is a conceptual unisex, bilaterally symmetrical model derived from reference male and female data". The phantom height is 170.18 cm and body weight is 64. 58 kg. The phantom specifications for various body measurements with their standard deviations are presented in tables 3.1 to 3.7. It is important to mention here that means values and SD’s of various body measurements of phantom can be used to study proportional differences in various populations, age and sex for comparative purposes. The values of the phantom specifications have been systematically given in the form of different tables as gross measurements (Table 3.1), projected heights (Table 3.2), derived and direct lengths (Table 3.3), body girths (Table 3.4), breadths (Table 3.5), skinfolds (Table 3.6), measurements of the heads and face (Table 3.7). The phantom stratagem has been used by many authors to study body composition, human physique and proportionality in general population of different age groups and also in case of elite athletes (Ross and Ward 1984a, Ross et al. 1986, 1987). Fig. 3.1 shows a sketch of the phantom along with a typical male and a female physique.
Insert figure 3.1 somewhere here
The phantom values have been obtained on the basis of the measurements and landmarks defined in the second chapter on body measurements (recommendations of kinanthropometry group). There is no need, however, to absolutely adhere to the techniques of the phantom measurements for calculating the differences. If the subjects or groups compared have been studied following a uniform procedure and if that differs from the phantom techniques, even then the differences in z-scores can be calculated and safely interpreted. But if different techniques are employed in the subjects to be compared, then it has been advised not to attempt this procedure for z-scores. 3.2.1 The z-scores The body measurement of any subject is first adjusted to the phantom height or size and its difference from the phantom reference value of the given variable is calculated. This difference is then represented in terms of phantom SD of the given variable and is known as z-scores. The zscores are calculated as follows: Z =(1/s)[v(170.18/h)d-p] Where z is a proportionality value of z-score v is any variable s is the phantom standard deviation for the given variable 170.18 cm is the phantom height constant h is the subject's height d is a dimensional constant whose values are 1
for all heights, lengths, breadths, girths and
skinfold thicknesses, 2
for all area values,
3
for all volumes and weights
p is the phantom value for the variable. If the z-score is zero, it means that the particular subject has the same proportion of the given variable as that of the phantom. The z-scores higher than zero (all positive values), indicate a greater proportional development of the given variable in the subject and the z-score less then zero (all negative values) indicate a lesser proportional development of the variable as compared to those of the phantom values.
Insert tables 3.1 to 3.7 somewhere here
It should be borne in mind that the phantom values of various measurements do not suggest as to what should be the most desirable values in the human beings but only serve the purpose of a calculating device for comparing groups and individuals. "The phantom is not a normative model but primarily used as a calculation device for comparing individuals and groups"(Ross and Ward 1982). Ex. 3.5. Calculate of z-scores of bodyweight in proportion to height of two subject whose heights and weights are provided below. Subject 1, height = 150.0 cm, weight = 50.0 kg Subject 2, height = 160.0 cm, weight = 60.0 kg Z =(1/s)[v(170.18/h)d-p] Since the proportional body weight is to be calculated therefore the value of d (dimensional constant) in this case would be 3. The s is the SD of body weight of phantom (See table 3.1), v is
the weight of the subject, h is the height f the subject whereas P is the body weight of the phantom (table 3.1). z-score (1)= (1/8.60) [50 (170.18/150.0)3 – 64.58] =0.981 z-score (2)= (1/8.60) [60 (170.18/160.0)3 – 64.58] =0.886 The z-scores of body weights of the two subjects are 0.981 and 0.886, respectively, both the values are greater than zero. It means both the subjects have proportionately greater body weight in relation to height than that of the phantom. Also, the subject no.1 is proportionately heavier in body weight for a given height than the subject no. 2. Ex. 3.6 Calculate the proportional z-scores of sitting height in relation to span if the values of sitting height and span are 80.2 cm and 161.0 cm, respectively. Z - score =(1/SD of sitting height of phantom)[sitting height of subject (span of phantom/span of the subject)d – sitting height of phantom] Take the phantom values from table 3.2. The proportional value of sitting height is to be obtained which is a uni-dimensional value therefore the value of d should be taken as 1. z-score = (1/4.5) [80.2 (172.35/161.0) – 89.92] = - 0.90 The above value of - 0.90 of Z-score indicates that this subject has proportionately smaller sitting height in relation to span than that of the phantom. Ex.3.7 Calculate the proportional z-scores of Abdominal Girth 1 (Waist) in relation to Chest Girth (mesosternale, end tidal) if the values of Abdominal Girth 1 (Waist) and Chest Girth (mesosternale, end tidal) are 82.2 cm and 71.50 cm, respectively. Values of phantom are taken from table 3.4. z-score = (1/4.45) [71.5 (87.86/82.2) – 71.91] = 1.01 Though the abdominal girth of the above subject is smaller than that of the phantom yet with a z-
score of 1.01 it has shown proportionately bigger abdominal girth in relation to chest girth when compared with the phantom. Ex.3.8 Calculate the proportional z-scores of biiliocristal diameter in relation tobiacromial diameter if the values of biiliocristal and biacromial diameters
are 29.2 cm and 37.5 cm,
respectively.Values of the phantom to be seen from table 3.5. z-score = (1/1.75) [29.2 (38.04/37.5) – 28.84] = 0.45 Ex.3.9 Calculate the proportional z-scores of triceps skinfold in relation to arm girth (fully flexed) if the values of triceps skinfold and upper arm girth flexed) are 14 mm and 27.5 cm, respectively. Values of the phantom for skinfolds are taken from table 3.6 and those for arm girth (fully flexed) are taken from table 3.4. z-score = (1/4.47) [14 (29.41/27.5) – 15.4] = - 0.0.96 Ex.3.10. Calculate the proportional z-scores of head breadth in relation to head length if the values of head breadth and head length are 14 cm and 18 cm, respectively. Values of the phantom for these measurements are taken from table 3.7. z-score = (1/0.58) [14 (19.15/18) – 15.4] = - 0.32. Phantom stratagem is a useful device
in evaluating the structural differences between the subjects for various measurements,
for quantifying the sexual differences,
in knowing the patterns of proportional growth in different phases of life,
and in exploring the proportional fractional body masses.
The phantom stratagem can be used to scale any variable to any other variable and not necessarily the phantom height. 3.3 The O-scale system The O-scale system for assessing the adiposity and proportional weight has been invented by Ross and Ward (1984b). The concept of O-scale is similar to that of the growth norms/standards
but different in the sense that the proportionally projected values to the universal means are used instead of the absolute values. According to this system, for assessing adiposity (A), the sum of six skinfolds is first scaled to the standard height of 170.18 cm. Then the adjusted sum of skinfolds is compared with the STANdard nINE scores (STANINE scores). The stanine scores are standard nine scores having divisions at 4%, 11%, 23%, 40%, 60%, 77%, 89% and 96% of the population for a given variable. The eight divisions have nine groups of frequencies, i.e., from 0 to 4%, 5 to 11%, 12 to 23%, 24 to 40%, 41 to 60%, 61 to 77%, 78 to 89%, 90 to 96% and 97 to 100%, which have been designated with the stanine scores from 1 to 9, respectively. The O-scale stanine scores for proportional weight (w) and adiposity (A) have been given in Tables 3.8 and 3.9, respectively. These standards were constructed by Ross and Ward (1984b) on the basis of a large data bank of 1236 children and young adults and 19000 adults of Canada. Since the O-scale stanine scores are based on population specific standards, therefore it is advisable to construct the O-scales for different populations. The adiposity and proportional weight of a person can be judged with respect to the O-scales for his population. A point of contrast between the z-scores and the stanine scores is that the former is sample independent whereas the latter is sample dependent.
Insert tables 3.8 and 3.9 somewhere here
For the adiposity (A) assessment, six skinfolds at triceps, subscapular, suprailiac, abdominal, front thigh and medial calf are taken. The techniques for these measurements have also been described by Ross and Ward (1984b). The measurements are so chosen as they may account for any regional variations in fat patterning and dysplasia in various parts of the body. Generally the measurement techniques resemble the kin anthropometric group measurements given in the previous chapter.
The O-scale proportional weight (w) can be calculated as follows: Proportional weight (w)
= Weight x (170.18/height)3
Now this value of proportional weight is checked to obtain the O-scale score or STANINE scores for weight from table 3.8 for the given age and the sex of the subject. The O-scale adiposity (A) rating can be calculated as follows: O-scale for adiposity (A) = Sum of skinfolds x (170.18/height) Now this value of adiposity is checked to obtain the O-scale score or STANINE scores for adiposity from table 3.9 for the given age and the sex of the subject. Ex.3.11. Calculate the O-scale score or STANINE score for adiposity of the given subject Sex =
Female
Age
=
19 Years
Height
=
160.0 cm
Weight
=
60.0 kg
Sum of 6 skinfolds = 100 mm The O-scale proportional weight (w) = 60.0 x (170.18/160.0)3 = 72.20 kg Table 3.8 provides the values of proportional weight for conversion into their STANINE score. The top row indicates the STANINE scores which are placed in between the columns representing the values of proportional weights at different ages. A value of a proportional body weight of 72.2 kg of a 19 year old female would be checked from the row of 18-19 year age group and falls in between the values of 71.0 and 77.8 kg. The two columns in which these two values are located represent a STANINE score of 8. The design of table 3.9 for obtaining O-scale scores or STANINE scores is also similar to that of the weight.
A value of 72.2 kg of proportional weight at 19 years in females corresponds to an O-scale score or STANINE scores of 8 for proportional weight (Table 3.8). O-scale adiposity (A)
=100 x (170.18/160.0) = 106.36 mm
A value of 106.36 mm at 19 years in females corresponds to an O-scale score or STANINE scores of 6 for adiposity (Table 3.9). The O-scale has a good practical utility in the follow up studies on the same individual to monitor the effects of exercise and dietary changes. In case of vigorous exercise and dietary constraints, the adiposity (A) is likely to decrease in greater proportion as compared to body weight. This can be illustrated with the help of following example: Ex. 3.12. The same female undergoes rigorous physical training for short durations and sheds a lot of her body weight and the skinfolds. Let her measurements after the training programme be as follows : Weight = 55.0 Sum of skinfolds = 60 mm O-scale adiposity (A) for 60 mm = 60 x (170.18/160.0) = 63.82 mm This corresponds to a STANINE score of 2 for O-scale adiposity (A). O-scale proportional weight (w) = 55.0 x (170.18/160.0)3 = 62.22 kg This corresponds to a STANINE score of 5 for O-scale weight (w). There is a difference of 4 stanine scores before and after exercise in the above subject in adiposity (from 6 stanine score to 2) as compared to 3 for proportional weight (from 8 stanine scores to 5). Thus the adiposity loss is proportionally greater than that of the body weight (Fig. 3.2). Insert figure 3.2 somewhere here
Chapter 3 Exercises Ex. 3.1. Calculate the proportion of head breadth to head length in the following cases: a. head breadth = 15cm head length= 18.3 cm b. head breadth = 13.4cm head length= 19.5cm c. head breadth = 14.4cm head length= 18.2 cm d. head breadth = 12.8cm head length= 17.3 cm Ex.3. 2. Calculate the BMI of the following cases whose respective height and eight values are given below: a. 155 cm, 52 kg b. 1.66 m, 61 kg c. 159 cm, 65.2 kg d. 1.78 m, 71 kg e. 165.1 cm, 62 kg Ex 3.3. Calculate the z-scores of bodyweight in proportion to height of following cases: a. Weight 63 kg Height 166 cm b. Weight 54 kg Height 170 cm c. Weight 22 kg Height 110 cm d. Weight 36 kg Height 120 cm e. Weight 46 kg Height 140 cm Ex.3. 4 Calculate the proportional z-scores of sitting height in relation to span of the following: a. sitting height 67 cm span 140 cm b. sitting height 78 cm span 148 cm c. sitting height 75 cm span 157 cm d. sitting height 70 cm span 156 cm e. sitting height 80 cm span 164 cm Ex. 3.5. Calculate the proportional z-scores of Abdominal Girth 1 (Waist) in relation to height in the following: a. Abdominal Girth 1 (Waist) 67 cm Height 158 cm b. Abdominal Girth 1 (Waist) 60 cm Height 157 cm c. Abdominal Girth 1 (Waist) 77 cm Height 160 cm d. Abdominal Girth 1 (Waist) 88 cm Height 175 cm e. Abdominal Girth 1 (Waist) 72 cm Height 183 cm Ex.3.6. Calculate following: a. triceps skinfold b. triceps skinfold c. triceps skinfold d. triceps skinfold e. triceps skinfold
the proportional z-scores of triceps skinfold in relation to height in the 18 mm 15 mm 22 mm 26 mm 13 mm
height height height height height
167 cm 173 cm 177 cm 186 cm 167 cm
Ex. 3.7 Calculate the proportional z-scores of head breadth in relation to head length of the following: a. head breadth 14 cm head length 19 cm
b. head breadth c. head breadth d. head breadth e. head breadth
10 cm 13 cm 15 cm 17 cm
head length head length head length head length
17 cm 18 cm 21 cm 21 cm
Ex.3. 8. Calculate the conicity index of the following a. waist circ. 65 cm Height 151 cm weight 50 kg b. waist circ. 67 cm Height 165 cm weight 54 kg c. waist circ. 72 cm Height 170 cm weight 61 kg d. waist circ. 70 cm Height 168 cm weight 58 kg e. waist circ. 75 cm Height 176 cm weight 67 kg Ex. 3.9. Find out the O-scale score for proportional weight and adiposity of the following subject: Male, age 26 years Weight 75 kg The sum of six skinfolds (triceps, subscapular, suprailiac, abdominal, front thigh and medial calf) is 72 mm.
Chapter 3. Answers Ans. 3.1. a. 81.97 b. 68.72 c. 79.12. d. 73.99 Ans.3.2 BMI of the subjects. Hint – the height of the subjects must be converted into meters before putting it in the equations. a. 21.64 b. 22.14 c. 25.79 d. 22.41 e. 22.75 Ans: 3.3 a. 0.3837 b. -1.2102 c. 1.9633 d. 4.4301 e. 2.0979 Ans: 3.4 a. – 1.65 b. 0.20 c. – 1.69 d. – 2. 80 e. – 1.30 Ans. 3.5 a. 0.06 b. – 1.54 c. 2.24 d. 3.07 e. – 1.11 Ans: 3.6 a. 0.66 b – 0.14 c. 1.29 d. 1.88 e. – 0.48 Ans. 3.7 a. – 1.67 b. – 6.58 c. – 2.15 d. – 2.42 e. 0.73
Ans. 3.8. a. 1.036 b. 1.074 c. 1.103 d. 1.093 e. 1.115 Ans: 3.9. O-scale score for weight 7 O-scale score for adiposity 5
Table 3.1 Gross phantom specification (After Ross and Ward 1982)
Variable
Mean
SD
______________________________________________________________________________ Stature (cm)
170.18
6.29
Body mass (kg)
64.58
8.60
Lean body mass (kg)
52.45
6.4
Fat mass (kg)
12.13
3.25
Percent fat
18.78
5.20
Density (gm/cc)
1.056
0.011
Bone mass (kg)
10.49
1.57
Muscle mass (kg)
25.55
2.99
Residual body mass (kg)
16.41
1.90
Ht (in)/cube root of wt lb
12.83
Ht (cm)/cube root of wt kg
42.41
[Cube root of wt (kg)/ht (cm)] x 10
23.58
Somatotype
5-4-2.5
Table 3.2 Phantom height projected (cm) (After Ross and Ward (1982)
Variable
Mean
SD
______________________________________________________________________________ Height vertex or stature
170.18
6.29
Height Gnathion
148.81
5.65
Height Suprasternale
138.31
5.46
Height Infrasternale
119.50
4.96
Height Symphysion
87.05
4.35
Height Acromiale
139.37
5.43
Height Radial
107.25
5.36
Height Stylion
82.68
4.13
Height Dactylion
63.83
3.38
Height Iliospinale
94.11
4.71
Height Trochanteric
86.40
4.32
Height Tibial (lateral or medial)
44.82
2.56
Height Sphyrion (fibular)
7.10
0.85
Height Sphyrion (tibial)
8.01
0.96
144.15
5.58
Height Cervical
Height Gluteal arch
88.33
4.41
Sitting height
89.92
4.50
172.35
7.41
Span (dactylion to dactylion)
Table 3.3 Phantom lengths derived and direct (cm) (After Ross and Ward 1982)
Length
Mean
SD
______________________________________________________________________________ Head height (vertex-gnathion)
27.27
1.02
Neck (gnathion-suprasternale)
9.48
1.71
Trunk (suprasternale-symphysion)
51.26
2.56
Back (cervicale-gluteal arch)
56.83
2.84
Upper extremity (acromiale-dactylion) 75.95
3.64
Upper extremity (acromiale-stylion)
57.10
2.74
Arm (acromiale-radiale)
32.53
1.77
Forearm (radiale-stylion)
24.57
1.37
Hand (stylion-dactylion)
18.85
0.85
Lower extremity (Stature-sitting ht)
81.06
4.05
Thigh 1(stature-sitting ht tibiale)
35.44
2.12
Thigh 2 (iliospinale-tibiale)
49.29
2.96
Thigh 3 (trochanterion-tibiale)
41.37
2.48
Tibia (tibiale mediale-t. sphyrion)
36.81
2.10
Lower Leg (tibiale lateral-f. sphyrion)
37.72
2.15
25.50
1.16
24.81
1.15
Foot length (standing akropodion-pternion) Foot length (Flat unweighted akropodion-pternion)
Table 3.4 Phantom girths (cm) (After Ross and Ward 1982)
Girth
Mean
SD
______________________________________________________________________________ Head
Girth
56.00
1.44
34.91
1.73
104.86
6.23
Chest Girth (mesosternale, end tidal)
87.86
5.18
Abdominal Girth 1 (Waist)
71.91
4.45
Abdominal Girth 2 (umbilical)
79.06
6.95
Abdominal Girth Av (mean 1and 2)
75.48
5.74
Hips Girth
94.67
5.58
Thigh Girth (1 cm distal, gluteal line)
55.82
4.23
Knee Girth
36.04
2.17
Calf Girth (standing)
35.25
2.30
Ankle Girth
21.71
1.33
Arm Girth (fully flexed, tensed)
29.41
2.37
Forearm Girth (relaxed)
25.13
1.41
Wrist Girth 1 (distal styloid)
16.35
0.72
Wrist Girth 2 (Proximal styloid)
16.38
0.72
Arm girth relaxed (-22/7 x triceps skf)
22.05
1.91
Chest girth (-22/7 x subscapular skf)
82.46
4.86
Thigh girth (-22/7 x front thigh skf)
47.34
3.59
Calf girth (-22/7 x medial calf skf)
30.22
1.97
Neck Girth Shoulders Girth
Table 3.5 Phantom breadths (cm) (After Ross and Ward 1982)
Breadth
Mean
SD
______________________________________________________________________________ Biacromial
38.04
1.92
Bideltoid
43.50
2.40
Transverse chest (mesosternale)
27.92
1.74
Biiliocristal
28.84
1.75
Bitrochanteric
32.66
1.80
Chest depth (AP, mesosternale)
17.50
1.38
Biepicondylar humerus
6.48
0.35
Wrist (max., stylion-ulnare)
5.21
0.28
Hand (distal II-V metacarpals)
8.28
0.50
Biepicondylar femur
9.52
0.48
Transverse tibia
9.12
0.47
Bimalleolare
6.68
0.36
Transverse foot (standing)
9.61
0.60
Transverse foot (flat, unweighted)
8.96
0.56
Foot (standing, distal I-V metatarsals)
10.34
0.65
Table 3.6 Phantom skinfolds (mm) (After Ross and Ward 1982)
Skinfold
Mean
SD
______________________________________________________________________________ Triceps
15.4
4.47
Subscapular (diagonal)
17.2
5.07
Subscapular (vertical)
17.5
5.17
Chest
11.8
3.27
Biceps
8.0
2.00
Suprailiac
15.4
4.47
Abdominal
25.4
7.78
Iliac crest
22.4
6.80
Front thigh
27.0
8.33
Rear thigh
31.1
9.69
Medial calf
16.0
4.67
Table 3.7 Phantom head and face measurements (cm) (After Ross and Ward 1982)
Measurement
Mean
SD
______________________________________________________________________________ Classic head ht (Vertex-gnathion)
27.27
1.01
Head length (glabella-occiput)
19.15
0.68
Head breadth (transverse parietal)
15.08
0.58
Head height (vertex-tragion)
13.31
0.75
Bizygomatic breadth
13.66
0.57
Bigonial breadth
10.59
0.58
Morphological face ht (nasion-gnathion) 11.94
0.69
Nose length (nasion-subnasale)
0.48
5.21
Table 3.8 O-scale proportional weight (kg) ratings for females and males (After Ross and Ward 1984b) O-scale STANINE scores for body weight Age (yr)
____________________________________________________________ 1
2
3
4
5
6
7
8
9
______________________________________________________________________________ Females 6
53.1
54.4
55.4
60.2
63.8
66.7
71.3
72.9
9
49.9
52.0
54.4
56.5
69.7
63.2
67.7
72.2
12
46.2
49.2
51.8
54.8
59.6
63.9
72.8
80.2
15
47.2
50.3
54.2
57.2
60.5
64.3
71.0
76.3
18-19
51.8
54.8
57.5
60.4
63.5
66.8
71.0
77.8
20-24
52.2
55.2
57.6
60.9
64.2
68.3
72.9
80.0
25-29
52.5
55.2
57.7
61.0
64.8
68.9
74.8
83.0
6
55.2
56.8
59.9
62.6
64.8
67.7
69.6
73.9
9
49.4
53.3
55.1
57.4
59.7
62.5
66.1
69.1
12
46.3
50.6
52.8
54.9
58.3
62.2
67.3
74.4
15
46.8
49.2
51.4
54.3
57.5
61.2
66.8
71.7
18-19
49.5
52.8
56.4
59.0
62.5
64.5
67.8
70.8
20-24
51.3
54.8
57.8
61.8
65.6
67.4
74.6
80.1
25-29
53.1
56.2
59.8
63.2
67.5
71.4
76.4
84.3
Males
Table 3.9 O-scale proportional adiposity (mm) ratings for males and females (After Ross and Ward 1984b) O-scale STANINE scores for adiposity Age
_________________________________________________________
(yr)
1
2
3
4
5
6
7
8
9
______________________________________________________________________________ Females 6
46.8
56.1
61.7
69.5
77.9
96.7
128.6
144.0
9
45.5
53.4
66.1
73.2
87.7
98.6
111.7
143.3
12
53.0
59.3
66.5
77.8
98.7
111.4
153.0
175.6
15
49.4
62.6
72.4
85.4
99.6
113.2
145.3
162.1
18-19
63.4
70.5
78.5
90.2
103.4
118.2
135.9
155.7
20-24
64.0
72.5
81.2
92.0
104.2
118.9
138.0
164.0
25-29
65.2
74.1
82.2
93.0
107.9
122.9
141.0
169.2
6
43.0
47.4
57.4
63.0
70.0
80.9
92.7
121.0
9
43.6
47.1
50.9
55.9
64.2
77.7
105.2
172.4
12
37.6
43.1
47.0
53.4
65.7
89.3
129.6
188.9
15
33.4
35.7
42.1
47.0
55.9
69.0
100.8
146.1
18-19
31.5
34.3
41.7
47.6
57.0
70.3
87.3
109.3
20-24
35.0
40.9
48.1
57.8
71.5
89.0
109.0
130.0
25-29
38.3
45.5
54.5
66.8
81.8
99.5
119.3
144.0
Males
Fig. 3.2 Effect of exercise on adiposity and proportional weight in a female
%
4
11
[ 23
40
60
77
89
96
______________________________________________________________________________ O-scale
1
2
3
4
5
6
7
8
9
______________________________________________________________________________
Adiposity
Weight
*
After exercise
#
Before exercise
*......................................................#
*.....................................#
4. BODY COMPOSITION
Chapter details
Historical perspective
Conceptual models of body composition Five level model of body composition The ‘Reference’ Man and a ‘Reference’ Woman Hydration of body compartments and body fat Densities of body components Cadaver analysis for revalidation of body composition Densitometric determination of body composition Anthropometric determination of body composition Adipo-muscular relationship Matiegka’s method Drinkwater tactic for estimating fractional body masses Roentgenogrammetry Hydrometry
Dual Energy X-ray Absorptiometry (DXA) Neutron Activation
Human body is composed of various tissues and numerous body cavities filled with body fluids. The composition of the human body creates a natural interest in every body. Earliest studies on body composition were conducted on animals with a view to analyzing the quality of meat and describing its composition. Changes in body fat and lean body mass as a result of feeding the animals have been studied and it was also noticed that the amount of fat varied inversely with the amount of body water. The greater the fat in the body the lesser would be the body water. Human cadavers were dissected and studied for water content and other components only during the beginning of the 20th century. It was increasingly being appreciated at that time that fat holds little water and whatever water is present in the human body is equally distributed in all other tissues. Thus the concept of fat and fat free mass was developed and this forms a formidable concept in body composition analysis even today.
4.1 Historical Perspective
Albert Behnke (1942) made pioneering efforts at distinguishing overweight from obesity. It was earlier understood that anybody whose weight is beyond certain defined limits is overweight and hence has unwanted amounts of fat. Since the densities of fat and the lean body mass differ, therefore it was possible to differentiate their relative amounts if the density of the body could be measured. Behnke applied Archimedes’s principle to evaluate body density and then to convert it into the amounts of fat and lean body mass. This was followed by a fervent activity at standardizing the techniques for assessing the body density by underwater weighing and by water displacement methods. Detailed experimentations were conducted by Keys and Brozek (1953) to measure the body density, correct it for residual lung volumes and to devise formulae for the calculation of percentage of fat and lean body mass. The works of these authors is still held in great esteem and used in the studies of body composition analysis. Weight for height standards were being used by the insurance companies and the military authorities to assess the desirable weight of the persons during the first half of the twentieth century. However Professor Behnke (1942) exposed the fallacy of such weight for height standards in designating overweight and fatty subjects. From the body composition studies of elite football players who were designated as too fat and overweight on the basis of height-weight standards, Behnke (1942) found them highly muscular and extremely fit individuals with very little amounts of fat. Terming them as physically non-fit simply for being overweight was a cruel joke on them as they were the best by virtue of their body composition analysis. This landmark study opened new vistas in body composition research which later found wide applications in the fields of physical fitness, sports science and medicine. The various techniques for estimating body composition include densitometry, hydrometry, roentgenogrammetry, ultrasound, photon absorptiometry, neutron activation, bioelectrical impedance, total body water by dilution, CAT scanning, total body potassium, anthropometry, creatinine excretion, etc. (Mettau et al. 1977, Baumrind 1986, Hodgdon & Fitzgerald 1987, Harrison 1987, Forsyth et al. 1988). While some of these methods are highly
invasive others are very costly, time consuming and need lots of equipment. Anthropometry is the easiest of all, it is non-invasive, very economical and even the subject can be persuaded for the measurements easily.
4.2 Conceptual models of body composition The human body mass may be conceptually divided into numerous fractional masses by assuming the different qualities of body tissues, water holding qualities and differential densities of various tissues. On the basis of these qualities, the models may be conceived as a range from a singlecompartment to multi-compartment models. The division of the body mass can be made by considering the major components of the body, e.g., fatty tissue, muscular tissue, skeletal tissue and connective tissue. The studies on body composition would therefore assess quantitatively the amounts of these tissues. For the study of body composition there are numerous methods which are available these days. Human cadavers and animals can become the subjects for the direct analysis of body composition; however, indirect methods are required to obtain information about the body composition in living persons. The following is the nomenclature of different conceptual body masses as suggested by Jebb and Elia (1995) a summary of which has been given in the tabular form (Table 4.1).
Insert Table 4.1 somewhere here
Single Compartment model – Body Mass
Two Compartment model - Fat and Fat Free Mass
Three Compartment model – Fat, Water and protein and mineral
Four compartment model – Fat, Water, Mineral, Fat free soft tissue
4.3 Five-level model of body composition The classical organizational levels of the body were used by Wang et al. (1995) who proposed a five-level model of body composition. These levels started with the atomic or elemental level and proceeded on to molecular, cellular and tissue level and culminated with the whole body. These levels have been explained as follows:
Level 1. Elemental level or atomic level It states the elements or different types of atoms present in the human body and their quantitative study. The body is composed of oxygen, hydrogen, carbon, nitrogen, calcium, phosphorus, sulfur, potassium, sodium and chlorine. Besides these, very small quantities of numerous other elements are also present in the human body which include magnesium, silicon, iron, fluorine, zinc, copper, manganese, iodine, rubidium, strontium, bromine, lead, aluminum, cadmium, boron, barium, tin, nickel, gold, molybdenum and many others. The following table (Table 4.2) shows the amounts of various elements in the human body in a reference man of 70 kg of body weight (Forbes 1987), however, these values would be different in different individuals and the study of such elements and their quantities would be of great importance. Insert Table 4.2 somewhere here
Level 2. Molecular level This level explains the composition of the body in terms of different molecules assembling together to give it a complete form. These include water, proteins, fat, carbohydrates, and other molecules (Table 4.3).
Insert Table 4.3 somewhere here
Level 3. Cellular level In the cellular level, the contents of the cell become the focus of study of body composition. The cell solids and cytoplasm which forms all the cell mass along with the extra-cellular fluid and extra-cellular solids are to be measured in this level. The human bodies contain about sixty percent of water, however, factors like age, degree of fatness, sex, populations or races influence this proportion. An average person of 170 cm. of height and 70 kg of body mass would have 42 kg of water and 28 kg of the rest of the mass. The adipose cells contain very little amount of water (about 10 to 30 %) as compared to the other tissues (about 70%). Therefore it is the amount of body fat which determines to a major extent the hydration of the body and its water content with respect to body weight. During childhood the water content of the body is very high about 70 %. An average man has about 60 % of his body mass as water as compared to 50 % of that of an average woman. An obese man may have 50 % of his body mass as water which is just equal to that of an average woman. This is because of the fact that the normal females have in addition some amounts of sex specific fat besides the normal amount of fat and hence have a reduced water content of the body. Obese females may have as little as 40 % of body weight due to body water. The proportion of body water and cell solids stays relatively constant in normal as well as obese subjects in their fat free mass compartment, though these would be quite variable if expressed in terms of total body mass. Table 4.4 shows the percentage of total body water in children, average adult male and female and in obese individuals of both the sexes.
Insert Table 4.4 somewhere here
The water content of the body is distributed either within the cells or outside the cells and hence two compartments of fluid distribution inside the body are made. The fluid present within the cells is called intra-cellular fluid whereas that present outside the cells is referred to as extracellular fluid. The extra-cellular fluid is further distributed either in interstitial fluid spaces or as part of the blood plasma. The intra-cellular fluid constitute about two-thirds of the total body water as compared to one-third in case of extra-cellular fluid. The relationship between interstitial fluid and blood plasma within the extra-cellular fluid is three to one, respectively. Since the total body water constitutes 60 % of the total body mass, and two-third of this is the intra-cellular fluid which amounts to 40 % of that of the body mass. Similarly, one third of total body water is the amount of extra-cellular fluid which would be equal to 20 % of the total body mass. This extracellular fluid can be further fractionated as interstitial fluid and blood plasma in the ratio of three to one and in terms of the ratios of total body weight, the interstitial compartment constitute 15 % and the blood plasma constitutes 5% of the total body mass. Quantities of intra-cellular fluid, interstitial fluid and plasma in an average individual of 70 kg body mass and 42 litres of total body water are 28 litre or 40%, 10.5 litre or 15% and 3.5 litre or 5%, respectively. The composition of intra and extra-cellular fluids is also different. The extra cellular fluid has a very high concentration of sodium, chloride and bicarbonate ions (mmol/litre) whereas the potassium ions and protein is the mainstay of intra-cellular fluid (Table 4.5). Insert Table 4.5 somewhere here
Level 4. Tissue level The study of major tissues of the body and their amounts is included in this level of body composition analysis. Classical studies on body composition which include anthropometry, densitometry, roentgenogrammetry, hydrometry, etc., have focused on these tissues which include, fat, muscle, bone, blood, connective tissue, etc. A reference adult man of 70 kg body mass has about 28 kg muscles, 15 kg of adipose tissue and 10 kg of skeletal mass. The amount of skin in the reference man is about 5 kg (Forbes 1987). Insert Table 4.6 somewhere here
Level 5. Whole body The whole body and analyzing its composition externally is the final or fifth level o the study of body composition. The body measurements and estimating body density are important in the study of body composition. It is important to note that inter-connections exist between components at various levels. As an example, a common factor of fatness can be explained at different levels in the form of total body carbon (level 1), lipid or fat content (level 2), the contents of adipocytes or fat cells (level 3), amount of adipose tissue (level 4), thicknesses of skinfolds (level 5). All these are explicit examples of different expressions of fatness at different levels but these are linked by common factors. Heymsfield and Wang (1995) term these factors as steady-state relations which have the potential to be mathematically illustrated. In estimating the body composition, numerous assumptions about these steady-state relations are made. It is assumed that some components are independent of age, sex and population and are related to each other in a rather stable and predictable manner. Many assumptions about these steady state relations were indeed developed
in the past which could only be validated with the help of cadaver studies then. But now sophisticated techniques have evolved which can in vivo estimate these components and hence test these assumptions. Some examples are quoted from Heymsfield and Wang (1995): Fat Free Mass (FFM) is considered to be a homogeneous entity in the classical body composition studies. The different constituents of FFM at the molecular level (level 2) are assumed to be similar in young and old people. A controlled study on weight and height matched young and old was conducted by Heymsfield and Wang (1995) to find out the constituents of FFM at the molecular level to find out similarities between the old and young. The in vivo studies revealed that the TBW per unit of FFM and density of the FFM is similar in old and the young whereas there is a marked reduction of TBK per unit of FFM in the old when compared to that of the young.
4.4 The ‘Reference’ man and a ‘Reference’ woman The ‘Reference’ man and a ‘Reference’ woman are conceptual man and woman whose physical measurements and body composition are derived from very large samples of men and women. Such standard values can be assigned to body components such as height, weight, fat mass and percentage of fat, bone mineral and non osseous material, etc. for a theoretical man and a woman. Brozek et al. (1963) and McArdale et al. (1989) have provided such values on the basis of their own studies as well on the basis of data already existing. These values serve the purpose of standards in a ‘reference man’ and a ‘reference woman’ (Tables 4.8 and 4.9). Reference standards of body composition of males and females have been devised from large sets of data. These theoretical values of body composition are given for a reference man and a reference woman by McArdale et al. (1989) and are given in Table 4.7. Insert Table 4.7 somewhere here
The amounts of water, fat, protein, bone minerals and non-osseous materials per kg of body mass along with their densities have been provide in Table 4.8. These are the values as obtainable in a reference male and a female. Insert Table 4.8 somewhere here
4.5 Hydration of body compartments and body fat
Body fluid volumes are generally set into two compartments. The intra cellular fluid (ICF) is present in side the cells and the extra cellular fluid (ECF) is present in blood plasma and interstitium. Besides this, there is trans cellular fluid which includes synovial fliud, intraocular and cerebro-spinal fluid and that in the lumen of the intestine. Intracellular fluid is connected to the blood plasma and interstitial fluid and there is adequate transfer of materials. Orally administered substance reaches equilibrium with all compartments of the body and the amount of body fluid compartments can be assessed by the dilution principle.
Fat or lipids generally do not hold water and therefore are referred to as being anhydrous. All the water of the body is located in the lean tissue. On the basis of body fluids, the two-compartment model of body composition can be made which would be fat mass and fat free mass (or lean body mass). Studies on the water content of lean body mass (LBM) of human subjects have indicated that it ranged between 69.4 to 73.2% (Widdowson & Dickerson 1964). Forbes (1962) found an average factor of 72.4% of the human lean tissues. Other mammals like cat, dog, rat, rabbit, monkey, etc., show a range of the water in their LBM between 72.0 to 78.0% (Widdowson & Dickerson 1964). Table 4.9 provides values of hydration of lean body mass among humans and mammals.
The lipids are heterogeneous substances which are soluble in organic solvents but insoluble in water. In blood they are generally bound to plasma proteins and hence are called lipoproteins. The plasma lipoproteins facilitate the transport of water insoluble lipids. After a fatty meal, a large number of microscopic globular molecules appear in the blood which are known as chilomicrons. Major human plasma lipoproteins include chilomicrons, very low density lipids (VLDL), low density lipids (LDL) and high density lipids (HDL). Composition of various lipoproteins varies greatly and is shown in table 4.10. Insert Table 4.10 somewhere here
The cellular lipids are of two main types: neutral fat, stored in the adipose tissue as fat depots and structural lipids which are an integral part of the membranes and other parts. It is generally believed that neutral fat is utilized during starvation and is an adaptation to nutritional stresses.
A special type of adipose tissue which is very small in percentage to the total body fat is brown fat and performs a great thermogenic function especially in infants. In them it is quite abundant and is located around clavicles, towards axillla, around kidneys and in the posterior peritoneum. Brown fat is different in being multilocular and in having abundant mitochondria. Sympathetic nerve endings are very elaborate in brown fat and get easily stimulated by cold exposure which results in heat production when its triglycerides are oxidized in situ (Forbes 1987). After the age of 10 years it reduces greatly and is quite minimal in adulthood, however, the mammals and their young ones have abundant stores of brown fat. Merklin (1974) studied the growth and distribution of human brown fat during different periods of the foetal life.. White fat is the storage fat which is pressed
into service to meet the metabolic needs of the body. It has nothing to do with respect to the heat generation in response to cold stimuli.
The total body fat is generally divided into 2 depots, viz.: ‘essential fat’ and the ‘fat in the adipose tissue’. The essential fat is absolutely necessary for the normal physiological functioning of the body. It is stored in the central nervous system, and is present in the bone marrow, heart, liver, spleen, lungs, muscles, kidneys & intestines. In females essential fat also includes the fat in the mammary glands and the pelvic region. This is called the sex-specific fat of the females. Therefore the essential fat contains the lipid content of CNS, bone marrow and (in the females) the mammary glands. In males, of the total body mass it constitutes 3% whereas it amounts to about 20% of the total body fat. In case of females, it is 30% of the body fat and about 9% of the body mass (Lohman 1981). The second depot of fat is the adipose tissue which seems to have a dual function, the protection of the internal organs from injury and also serves the purpose of nutritional reserve. Table 4.11 provides an insight into the amounts of different types of fat in a reference male and a reference female. Insert Table 4.11 somewhere here
The division of body weight into various components can well be conceived of by considering the major tissues of the body, e.g. fatty tissue, muscular tissue, skeletal tissue. The studies on body composition would therefore assess quantitatively the amounts or proportions of these tissues of the body. How much is the contribution of each tissue to the body mass? The scientific research in this field is based on direct and indirect methods of assessing the body composition. Human cadavers and animals can become the subjects for direct analysis of body composition, but in living beings the indirect methods have to be applied to find out body composition. The direct methods serve as the basis of standardizing various methods. The division of body weight can begin from a minimum of two compartments (fat and non fat) to a maximum of as many as possible entities (fat, muscle, bone, water minerals, etc. The
fractionation must depend upon how accurately various assessments can be made and what is to be achieved by the study. The indirect methods of body composition analysis include surface anthropometry, hygrometry, densitometry, roentgenogrammetry, CAT scanning (Computer Axial Tomography) bioelectrical impedance magnetic resonance imaging, ultrasound, etc. Body fat can be divided into two parts, storage fat and the essential fat. The essential fat is stored in lungs, bon marrow, heart, liver, muscles, kidney, spleen, intestine and the nervous system. This essential fat is important in normal functioning of the body and its parts. Apart from this, there is another chunk of fat in females which is sex specific fat and this is mainly stored in the breasts and the pelvic region. The storage fat is that which comprises the adipose tissue or adipocytes. The number of adipocytes generally stabilizes around 9 to 12 months after the birth of the child. Later on it is the size of the adipocytes which changes. The function of the storage fat is to provide energy reserves and to protect the internal organs from injury. The adipose tissue is of two types – white and brown. The brown adipose tissue is a specialized tissue which produces heat in response to cold stimulation. Heaton (1972) gave a detailed account of the distribution of brown adipose tissue
in the humans. It is stored in the
arteries of the neck below the clavicle towards the axilla, around the kidneys and in the posterior peritoneum. Brown adipose tissue only produces heat and does not take part in the formation storage and supply of fatty acids. On the other hand, heat produced by the white adipose tissue is a by-product of its metabolic activity. It does not produce any heat in response to cold stimuli. The heat producing activity of the brown adipose tissue declines with age, however, it plays an important thermogenic role in the newborn. The subcutaneous tissue is that which lies beneath the skin. It contains mainly the adipocytes or fat cells. Major part other fat cells or adipocytes is constituted by the inert storage fat called triglyceride and in normal man the cytoplasm in the adipocytes may be less than 5% of the
adipocytes volume. The essential fat in females is generally about four times the amount in males because in females it includes the sex specific fat also, which is presumably required in their child bearing process. The amount of essential fat in a reference man in 2.09 kg compared to 6.80 kg in a reference woman (McArdale et al. 1989). The lean body mass in males is equivalent to the body weight minus the storage fat. It should be kept in mind that the essential fat is a part of the lean body mass and any attempt to lower or reduce the lean body mass or the essential fat would be at the cost of the normal functioning of the body. Minimal body weight in females, is a term which is an equivalent to lean body mass in males, and includes the essential fat (about 12%) and the sex specific fat in the adipose tissue, i.e., over the breasts and the pelvic region (about 3%). It is generally considered that even the leanest women do not have body fat levels lower than 10-12% of the body weight. So, this 10-12% limit can be thought of as the lowest limit for fatness for all women in normal health.
4.6 Densities of body components
Fat
Earlier studies on the density of ether extractable fat at a temperature of 37º C have prescribed a general figure of 0.9000 g/cm³ to it (Fidanza et al. 1953). However, studies by Mendez et al. (1960) have reported variations in the densities of fat which range from 0.9000 g/cm³ to 1.03 g/cm³. They have also reported an increase in fat density from 0.9000 to 0.9007 g/cm³ for temperature decrease of only 1ºC. Taking into account the typical combination of all types of fat in a reference person, the density of fat has been calculated as 0.915 g/cm³ (Brozek et al. 1963) and 0.9168 g/cm³ (Leonard et al. 1983) (Table 4.12).
Insert Table 4.12 somewhere here
Muscle and Lean Body Mass
The muscles have a peculiar characteristic in the sense that they have a relatively constant density at various sites and also at different ages. Mostly reported mean value for the muscle density is 1.05 g/cm³. On the other hand, the lean compartment of the body exhibit changes in density due to the changes in the hydration of this compartment. According to a study by Lohman (1986), the density of lean compartment of the body was 1.08 g/cm³ at the age of 10 years which increases in density to 1.10 g/cm³ in the adults.
Bone
Bone is the hardest and the densest of the body parts. The mean values for the density of human bone is 1.236 g/cm³ as reported by Ross et al. (1986). A most pragmatic estimate puts the range of the densities of human bones between 1.15 to 1.6 g/cm³. Osteoporosis which is the result of bone resorption during old age cleaves the bone density approximately at the rate of 0.020 g/cm³ per decade.
An overview of different methods for assessing body composition is presented in the table 4.13 as adapted from Norgan (1995). Insert Table 4.13 somewhere here
4.7 Cadaver analysis for revalidation of body composition Studies on the human dead bodies are an integral part of the direct analysis of human body composition. It provides accurate insights into the body compartmentalization and also serves the
purpose of validation of equations derived through indirect methods. The cadavers can be studied through two methods – the anatomical dissection and the chemical analysis.
Chemical analysis
The chemical analysis of the cadavers is done to obtain water, fat and mineral residue contents. The water content is determined by desiccation or by drying. The amount of body fat is extracted with the help of ether and the mineral residue by burning it to ashes.
Anatomical analysis
The anatomical dissections for body composition analysis are conducted on persons who have died accidentally or suddenly without a previous history of disease or illness. It can be assumed that they have minimum ante-mortem change in body composition.
Quick dissection
immediately following death also insures minimum post-mortem change and thus leads to excellent results. However, enormous amount of labour is involved in the dissections of the whole body cadavers, besides obtaining necessary legal permissions. Therefore this is one of the most tedious and cumbersome processes, nevertheless, most precious and indispensable because it serves the purpose of validation of equations for indirect estimation of body composition.
4.8 Densitometric determination of body composition The study pertaining to the measurement of body density is called densitometry. With this method, it is possible to assess the body fat and lean body mass because of the fact that the two body compartments generally have different densities. It is assumed that the densities of fat and lean body mass stay relatively constant (density of fat is 0.91 g/ml and density of lean body mass is 1.10 g/ml). A proportion of the densities of these two body compartments is utilized in the calculation of body fat of a given body density.
Relationship between body density and Percentage of Fat
The most widely accepted mean values of densities of fat free mass and fat are 1.1 g/cm³ and 0.90 g/cm³, respectively. The greater the body density the lesser the amount of fat and vice versa. On the basis of this principle, many equations are available which transform the density of body into percentage of body fat. Siri (1961) assumed the above densities and gave the following equation:
Fat (%) = (4.95/Density – 4.50)100 Ex. 4.1 Calculate the % amount of body fat with the formula of Siri (1961) if the body density is 1.08 g/cm³. Fat (%) = (4.95/1.08 – 4.50)100 = 8.33% However, Brozek et al. (1963) assumed an average density of the human body as 1.064g/cm³ and the density of fat as 0.9007g/cm³ which resulted in the following equation:
Fat (%) = (4.57/Density – 4.142)100 Ex. 4.2 Calculate the % amount of body fat with the formula of Brozek et al. (1963) if the body density is the same as above 1.08 g/cm³. Fat (%) = (4.57/1.08 – 4.142)100 = 8.95 % Another equation by Behnke & Wilmore (1974) which takes due care of fatty subjects can be represented as follows:
Fat (%) = (5.053/D - 4.614)100 Ex. 4.3 Calculate the % amount of body fat with the formula of Behnke & Wilmore (1974) if the body density is the same as above 1.08 g/cm³.
Fat (%) = (5.053/1.08- 4.614)100 = 6.47 %
The sources of error and discrepancy in assessing fat from these equations emanate from the fact that the bones of children, women and old subjects are less dense than those of adults and tend to be overestimated. Conversely, in athletes the bones being the densest, these equations are likely to yield underestimated fat amounts.
Density = Mass/Volume Body mass or weight can be easily determined on a weighing machine, however, it is relatively difficult to assess the body volume accurately. The principle of Archimedes can be applied to find the body volume either by water displacement or underwater/hydrostatic weighing methods. 4.8.1.
Water displacement method
Specially designed water tank is used to measure the volume displaced by the body immersed in it. A thin accurately calibrated tube is attached to the side of this tank for noting the volume of water displaced. The subject goes totally under water and the amount of water displaced can be noted from the finely calibrated tube. It is worth mentioning here that the air in the lungs will interfere in the assessment of exact volume of the body. The subject is instructed to expel all air. The residual lung volume is noted before the experiment and should be subtracted while noting the exact volume of the body. 4.8.2.
Under water weighing
Body volume is equal to the reduction of body weight in water. For example, if the body weight is 60 kg and the underwater or hydrostatic body weight is 3 kg, then body volume would be equal to (60kg – 3kg) 57 kg of water. Since it is already known that 1 g of water is equal to 1 ml at 39.2 degrees F, therefore 57,000 g of water in weight is equivalent to 57,000 ml in volume
provided the temperature of water is 39.2 degrees F. It the temperature of water is different, then necessary correction is applied to obtain the volume of water which is equivalent to the volume of the subject under study. Under water or hydrostatic weighing is also performed in a water tank. An automatic chair is provided in the tank in which the subject has to sit. The subject is tied to the chair with a belt and it is suspended in water so that the subject goes completely under water. The chair is attached to the weighing machine from which the under water body weight is recorded. Certain precautions are taken which includes the wearing of very thin and light under garments by the subject. Subject performs maximum forcible exhalation while he is being lowered in water. The subject is asked to hold his breath for at least 5 seconds and the weight is recorded after that. It is advised to repeat the under water weighing about 10 time because this weighing depends on the cooperation and ability of the subjects to expel air maximally from his lungs and to ensure that he has put in his maximum effort, it is necessary to repeat it a number of times. Even after maximal exhalation some residual volume still remains which can interfere in the overall determination of body volume. So, it is desirable to record the residual lung volume of the subject before taking his under water weight and its buoyancy effect is subtracted from the body volume. The calculations of percentage body fat and lean body mass can be done as given below: Body density = Body weight in air/Body volume Body volume = [ (Body weight in air – Body weight under water)/water temperature correction] – Residual lung volume Ex.4.4 Calculate the % of body fat and LBM and also the absolute amount of body fat and LBM of the given subject with Body weight as 60 kg, Body weight under water as 3 kg, residual lung volume as 1 litre and water temperature as 39.20F. Body volume
= [(60–3)/1] –1 =56 kg of water =56,000 ml
Body density = Body weight in air/Body volume Body density
= 60,000/56,000 =1.0714 g/ml
Percent body fat (Siri 1961) =(495/1.0714–450) =12.0123 % Percent of lean body mass (LBM)
= 100 – 12.0123 = 87.9877 %
Absolute mass of body fat = (Percent body fat x body weight/100) = 12.0123 x 60/100 kg = 7.20738 kg Absolute lean body mass = 60 –7.20738 kg = 52.7926 kg The densitometric method is a good method for assessing the body fat content and consequently the lean body mass but it encounters many difficulties and sometimes gross errors due to unknown reasons may be recorded. Since the requirement in this method is that of a water tank and the under water weighing equipment, therefore its availability is quite scarce. It cannot be taken to the field. Some subjects may not like to go under water for the experiment. Thus its practical utility is greatly impaired and it cannot be applied to certain groups of human subjects.
4.9 Anthropometric determination of body composition In the absence of densitometric assessment, the skin and the subcutaneous tissue fold thicknesses as well as body girths can be used to indirectly estimate body density to be converted into body fat and lean body mass or can be directly used in equations to reach at the values of different body components. The research employing skinfolds in determining body composition has been getting the top priority because it is easier to take these on any group of subject and moreover its equipment is inexpensive and is also available easily.
Over the last quarter of twentieth century, innumerable prediction equations have been generated to assess body fat from the skinfolds. These prediction equations were constructed by actually measuring the body density by under water/hydrostatic weighing and correlating the density to the skinfolds. The major limitation of these prediction equations is that they are highly specific for sex, age and population group. Cross-validation of a few of these equations has been attempted which boast of generality. Large variations have been found when these equations are used for estimating densities in different groups. The specificity of various equations may be due to various factors which are assumed similar to all the groups. For example, the lean body mass is comprised of bone, muscles and the rest of the mass. It is possible that there exist significant differences in the proportions and densities of these constituents of lean body mass among different sites and any differences in the general pattern of distribution of the subcutaneous tissue among different groups can lead to biased results. Some authors have questioned the uniform compressibility of the fatty tissue which may be affected by sex, age, fitness and fatness of the individual.
Skin and subcutaneous tissue fold thicknesses The measurement of skinfold is often used in bringing out differences with respect to age, sex and population group. It includes a fold of skin as well as the underlying adipose tissue. That equals two layers of these tissues. The adipose tissue is almost lacking in the eyelids, at the back of the hands, scrotum and nose. The thickness of the skin alone is not uniform throughout the body but show striking variations. According to a study of the cadavers it is the least over the biceps in the upper arm and the maximum in the soles of the feet (Clarys et al. 1987). The skin is thicker in males as compared to the females. The values of thickness of the skin over the biceps are 0.8 mm in men and 0.5 mm in women. The corresponding values of skin thickness over the trunk are 2.1 mm and 1.7 mm, respectively in males and females.
Perhaps the stresses of the hard physical labour are responsible for the sexual differences in the thickness of the skin. Typically the skinfolds have 60-85% of the fat content of its volume, however the ranges have been reported between 5-94%. The differences in skinfold thickness not only reflect the differences in the amounts of subcutaneous tissue but also the water content of the adipose tissue. Edema, which is sometimes associated with malnutrition is a condition when the water content of the tissues increases and may result in increased values of skinfolds as well.
Compressibility of skinfolds The subcutaneous tissue has an inherent quality of compressibility. This is the reason why skin fold measurements should be taken at some standard pressure which is universally accepted as 10 g/mm². Variations in skinfold compressibility not only exist from site-to-site but also with age and sex (Clarys et al. 1987). Compression of skinfolds continues from the time of application of the pressure (applying the calipers) till the reading is taken. In neonates it is compressed a lot which may continue up to 60 seconds. The compressibility of thigh and calf skinfolds is about 30% whereas that of biceps and supraspinale it is about 60% nearly double of the former (Becque et al. 1986).
Skinfold sites The skin and subcutaneous tissue can be measured from different sites of the body so that regional variations are duly taken care of. The International Biological Programme/Human Adaptability (Weiner & Lourie 1969) has recommended the following sites for taking skinfold measurements – biceps, triceps, subscapular, suprailiac, thoracic front, midaxillary, abdominal, thigh and calf. Needless to say that many new skinfold sites can be invented depending on the need of the research proposal. Instruments and Standardization for Measuring Skinfolds There are numerous skinfold calipers which are in use for measuring skinfolds which are Harpenden, Best, Lange, etc. The most widely accepted pressure is 10 g/mm² at a face area of 35
mm² and the reading is to be noted after two seconds. Edwards et al. (1955) have not only recommended this pressure but also gave formulae for the log transformations of skinfolds before obtaining descriptive statistics. It is not surprising to find variations in literature on the exerted pressure for taking skinfolds. Parizkova and Goldstein (1970) made studies on the skinfolds with the help of Best calipers exerting a pressure of 30 g/ mm² whereas Leger et al. (1982) found that even the much acclaimed Harpenden calipers can exert a little lower pressure than the recommended 10 g/mm². However, this variation in the exerted pressure may not actually be a real cause for concern as many authors have found that between the pressures of 9 to 20 g/mm², there is not much difference in the measured skinfold values but an upper limit of 15 g/mm² pressure is recommended (Keys & Brozek 1953, Behnke & Wilmore 1974). Harrison (1988) has dealt with the skinfolds in details at various sites and suggested the techniques for taking these measurements
Anthropometric Equations for obtaining fat mass For the interest of the readers, few prediction equations derived from skinfolds and other body measurements on different populations of the world are provided here. These can be applied to monitor changes in the fatness in the same individual over a span of time and to compare groups of subjects who otherwise do not form a heterogeneous group. The absolute values of fatness and other body masses may not be very accurate when applied to any group but these can be quite useful for comparative purposes.
Equations using skinfold thicknesses
Most of the authors have devised various equations to calculate the body density from the skinfolds. There are hundreds of such equations on different populations generated by different authors to predict body density of the subjects. One of the most widely used equations on adults and which was developed for the International Biological Programme (IBP) by Durnin and Womersley (1974) is the following one:
Density = 1.1765 – 0.0744 (log10 ∑S4) (males 20-69 years) Density = 1.1567 – 0.0717 (log10 ∑S4) (females 20-69 years) where ∑S4 is the sum of four skinfolds at biceps, triceps, subscapular and suprailiac. Ex. 4.5 Calculate the body density in males and females using the above equation of Durnin and Womersley (1974) if the sum of four skinfolds at biceps, triceps, subscapular and suprailiac is 40 mm in both the sexes. Density (male) = 1.1765 – 0.0744 (log10 40) = 1.0573 Density (female) = 1.1567 – 0.0717 (log10 40) = 1.0418
The number of sites of skinfolds to be used for obtaining the density is a debatable point. Some authors have used a minimal of even one while others have used as many as even 10 skinfolds. Considering all this, what should be the ideal number of skinfolds and the best sites/locations? A study conducted by Lohman (1981) indicated that using three or more skinfolds for calculating density does not improve much the prediction if it is done only from 2 skinfolds. The three skinfolds used by him for developing the following quadratic equation included the sum of chest, abdominal and thigh skinfolds(∑S3): Density = 1.0982 – 0.000815 (∑S3) + 0.0000084 (∑S3)2 Ex.4.6 Calculate the body densityusing the above equation of Lohman (1981) if the sum of three skinfolds (chest, abdominal and thigh) is 40 mm. Density = 1.0982 – 0.000815 (40) + 0.0000084 (40)2 = 1.05216
Cadaver validation of many equations by Martin et al. (1985) revealed that skinfolds from lower limb should also be included in the equations to provide better results. Equations of Jackson et al. (1978) fulfill the above criteria which have included seven skinfolds at chest, abdomen, thigh, axilla, triceps, subscapular and suprailiac (∑S7) and obtained direct %age of fat as follows:
Fat (%) = 0.197 (∑S7) – 0.00024 (∑S7)² – 2.2 Ex. 4.7 Calculate the % of body fat using equation of Jackson et al. (1978) if the sum of seven skinfolds at chest, abdomen, thigh, axilla, triceps, subscapular and suprailiac is 70 mm. Fat (%) = 0.197 (70) – 0.00024 (70)² – 2.2 = 10.414 How much accurate is the prediction of body fat from skinfolds? The equations which consider the age, sex and population are relatively better and can be considered quite accurate. Beddoe et al. (1984) and Mazess et al. (1984) found that body fat and fat free mass are highly correlated with skinfolds therefore very useful. The main sources of error in skinfold prediction of body fat according to Lohman (1981) are biological variations in the proportion of subcutaneous fat and technical measurement errors among investigators.
Equations using various measurements
The inherent difficulty in taking accurate measurements of skinfold has prompted many scientists to look for alternative measurements for predicting body components.
Circumferences have
been used by some authors to calculate body fat (Best et al. 1953, Noppa et al. 1979, Pollock & Jackson 1984, Murray & Shephard 1988). Some of the equations are reproduced below: Equation given by Best et al. (1953) . Body fat (%) = - 47.4 + 0.579(A) + 0.252(B) + 0.214(I) + 0.356(M) Where (A) is abdominal circumference, (B) is buttocks circumference, (I) is iliac circumference, and (M) is body mass. Equation of Noppa et al. (1979) Fat (kg) = 0.37(M) + 0.13(B) + 0.10 (∑S2) – 21.1 where (M) is body mass, (B) is buttocks circumference, (∑S2) is the sum of triceps and subscapular skinfolds.
Ex.4.8 Calculate the amount of fat using equation of Noppa et al. (1979) when body mass is 60 kg, buttocks circumference is 80 cm and the sum of triceps and subscapular skinfolds is 20 mm. Fat (kg) = 0.37(60) + 0.13(80) + 0.10 (20) – 21.1 = 13.5 kg % body fat =( fat/body wt)100 = (13.5/60 )100 = 22.5%
Anthropometric assessment of Lean body Mass Martin (1984) pooled the data on bone densities of men and women to obtain equations separately which are as follows: Skeletal mass (men) = 28.0(A) + 0.482(B) + 1.38(C) + 4265 r² = 0.98 Skeletal mass (women) = 0.182(D) – 6.42(E) + 1.15(F) +787 r² = 0.79 where A = (wrist dia)² * ankle width B = head girth * humerus width * biacromial width C = head girth * humerus width * femur width D = head girth * stature * wrist width E = (femur width)² * wrist width F = (humerus width)² * ankle width The lean body mass assessed was made by Bugyi (1972) in children with the following equation: LBM = 2.514(sum of two styloid dia. at two wrists) * Height (metres) The LBM prediction in case of adults has been proposed by Crenier (1966) as follows: LBM (men) = 0.846(T) + 0.469(H) + 1.44(A) – 0.394(B) – 109.50 LBM (women) = 0.935(T) + 0.173 (H) – 27.73 where (T) is lean (corrected for skinfold) thigh girth (H) is the height (A) is the lean arm girth (B) is the biacromial dia
Multiple regression equations were proposed by Steinkamp et al. (1965) for the assessment of LBM in adults: LBM(men) = M – [ 0.894W + 2.53S + 1.003C – 0.353A – 35.69] LBM(women) = M – [0.675B – 5.687D + 1.85A – 39.36] where M is body mass (kg) W is waist girth(cm) S is the arm skinfold (cm) C is the girth at iliac crest (cm) A is the arm length (cm) B is the Biacromial diameter (cm) D is the wrist girth (cm) Fuchs et al. (1978) devised another equation for the assessment of LBM from flexed arm girth and height as follow: LBM = 0.514(height-cm) + 0.0178 (flexed arm girth)² - 49.7 For Adult Men Sloan (1967) Density (kg/m3) = 1104.3 – 1.327 (Thigh skf) – 1.310 (Subscapular skf) Jackson and Pollock (1978) Density (kg/m3) = 1109.38 - 0.8267 (chest + abdominal + thigh skf) + 0.0016 (chest +abdominal + thigh skf)2 – 0.2574 (Age) Durnin and Womersley (1974) Density (kg/m3) = 1176.5 – 74.4 log10 (Sum of biceps + triceps + Subscapular + suprailiac) Weltman and Katch (1978) Density (kg/m3) = [Body weight/ (0.8719 Weight + 0.2629 Thigh circumference) – 7.795] x 103
Lohman (1981) Density (kg/m3) = 1098.2 - 0.815 (triceps + subscapular + abdominal) + (0.0084 (triceps + subscapular + suprailiac)2 Norgan and Ferro-Luzzi (1985) Density (kg/m3) = 1145.5 – 59.69 (log sum of thorax + triceps skf) – 0.529 (Age) Vickery et al. (1988) Density (kg/m3) (Blacks) = 1109.63 – 0.302492 (X) + 0.000550467 (X)2 – 0.503617 (Age) Where X is the sum of triceps, subscapular, chest, midaxillary, suprailiac, abdomen and thigh skinfolds For adult women Satwanti et al. (1978) Density (g/ml)=1.1963 – 0.0019 (Thigh girth) – 0.0016 (chest skf) – 0.0012 (iliac crest girth) + 0.0023 (biiliac diameter) For children and youth Slaughter et al. (1988) Around 10 years (White) boys Percent fat = 1.21 (triceps + subscapular)-0.008 (triceps + subscapular)2-1.7 Around 10years (Black) boys Percent fat = 1.21 (triceps + subscapular)-0.008 (triceps + subscapular)2-3.2 Pubescent (White) boys Percent fat = 1.21 (triceps + subscapular)-0.008 (triceps + subscapular)2-3.4 Pubescent (Black) boys Percent fat = 1.21(triceps + subscapular)- 0.008 (triceps+ subscapular)2 -5.2 All girls Percent fat = 1.33 (triceps +subscapular)- 0.013 (triceps +subscapular)2-2.5 In the above equations of Slaughter et al. (1988), if the sum of triceps and subscapular
skinfolds exceeds 35mm the following equations should be used:
Percent fat (Males) = 0.783 (triceps + subscapular) + 1.6 Percent fat (Females) = 0.546 (triceps + subscapular) +9.7
4.10 Adipo-muscular relationship Vague et al. (1971) devised formulae to estimate adipose mass (mass of the total adipocytes) from body measurements by the following procedure: Fat-muscle ratio in the arm This is also referred to as brachial adipo-muscular ration (BAMR). The circumference at the proximal part of the upper arm is taken along with the skinfolds at that level. The adipose and muscular cross-sectional areas are calculated from the circumference and the skinfolds as follows: Circumference = 2 x (22/7) x r or r = Circumference/2 x (22/7) Utilizing this value of 'r', cross-sectional area of the total upper arm is calculated assuming the limb as a circular entity at that plane as follows: Cross-sectional area= (22/7) x r2 Now cross-sectional area of muscle-bone is calculated by correcting 'r' for the adipose tissue thickness. The adipose or skinfold thickness is taken at four sites, i.e. anterior, posterior, lateral and medial at the level of the circumference. The average of these skinfolds is calculated and used in the adipose correction of muscle-bone Radius of upper arm corrected for adipose tissue = r – (1/2) average skinfold Cross-sectional area of upper arm corrected for the adipose tissue = (22/7) x (corrected radius)2 Given the cross-sectional area of the total upper arm and that corrected for the adipose tissue,
the cross-sectional area of the adipose tissue can be obtained by subtracting the cross-sectional area of muscle-bone from the total cross-sectional area of upper arm and the ratio of adipose muscular tissue is calculated as follows: Fat muscle ratio in the thigh This is usually called femoral adipo-muscular ratio (FAMR) The circumference of the thigh is taken at the level of the gluteal fold. Four skinfolds are taken at the level of the circumference, viz. anterior, medial and the cross-sectional areas of the thigh are calculated as described for the upper arm. The femoral adipo-muscular ratio is then obtained as follows: Femoral adipo-muscular ratio (FAMR) = (Area of adipose tissue/area of muscular tissue) Mean of the brachial and the femoral adipo-muscular ratios (MAMR) is calculated and used in the assessment of adipose mass: The percent of adipose mass = MAMR x Mean percentage of fat in adipose tissue (0.80) x density of adipose mass (0.92) x 100 The absolute amount of adipose mass = MAMR x 0.80 x 0.92 x body weight Brachial-Femoral adipo-muscular ratio (BAMR/FAMR) In order to get a picture of distributional pattern of adipose tissue in various groups, it is desirable to calculate the adipo-muscular ratios for arm and thigh. Relative development of the two tissues at these two body parts can be evaluated from the following ratio: Ex. 4.9 Calculate the Brachial-Femoral adipo-muscular ratio in the following person Body weight =50.0 kg Circumference of the upper arm = 22.0 cm Skinfolds at the upper arm, Anterior =8 mm Posterior = 12mm Media l= 8mm Lateral = 12mm
Mean skinfold of the upper arm =
(8+12+8+12) mm = 40/4 mm = 10mm or 1.0 cm.
Thigh circumference = 45.0 cm Skinfolds of the thigh, anterior =18mm Posterior=20mm Medial =22mm Lateral =20mm Mean skinfold of thigh = 20mm or 2.0 cm Brachial adipo-muscular ratio (BAMR) Radius of upper arm=22.0/(2x22/7) = 3.5cm Corrected radius = 3.5-(1/2) skinfold = 3.0cm Cross-sectional area of upper arm = (22/7) x (3.5)2 = 38.5 cm2 Cross-sectional area of muscle = (22/7) x (3.0)2 = 28.28 cm2 Cross-sectional area of adipose tissue = 38.5-28.28cm2 = 10.22cm2 Brachial adipo-muscular ratio (BAMR) = 10.22/28.28 = 0.361 Femoral adipo-muscular ratio (FAMR) Radius of thigh = 45.0 (2x22/7) = 7.159cm Corrected radius of thigh = 7.159 - ½ skinfold = 6.159 cm Cross-sectional area of thigh = 161.08cm2 Cross-sectional area of the muscles of thigh = 119.22 cm2 Cross-sectional area of adipose tissue of thigh =161.08-119.22 cm2 = 41.86 cm2 Femoral adipo-muscular ratio = 41.86/119.22 =0.351
Mean adipo-muscular ratio (MAMR) = (0.361+0.351)/2 = 0.365 Percentage of adipose mass = 0.365 x 0.80 x 0.92 x 100.0 = 26.20% The absolute adipose mass = 0.356 x 0.80 x 0.92 x 50 =13.10 kg
4.11 Matiegka's method (1921) Jindrich Matiegka (1921) has been quite fascinated by anthropometry that he felt the need of developing a method to determine the physical efficiency of a given subject simply by taking body measurements of the individuals in much the same way as psychologists test the mental faculties of a person on the basis of intelligence tests. The physical efficiency of a person depends on various factors such as the quantities or amounts of various tissues (bone, muscle and subcutaneous fat0, the physiological qualities of various organs like the reaction time, fatigue, and the state of health. Matiegka concentrated on body measurements of extremities and thought that these represent the whole of the body well, just as the brain is a representative of the mentality of a person. The method which he developed is called somatotechnique by which quantitative analysis of various compartments of the body is made. His method of finding the amounts of various body masses is given below: W= O+D+M+R where W= body weight O= weight of bones D= weight of derma or fat
M= weight of skeletal muscles R = remainder weight The above component masses can be calculated by using the following equations: 1. Weight of bones or Ossa Ossa = O2 x L x K1 Where L is the height of the subject K1 = 1.2 (constant) O= (O1+O2+O3+O4)/4 O1 is the maximum diameter of humerus bicondylar (cm) O2 is the maximum diameter of femur bicondylar (cm) O3 is the maximum diameter of wrist (cm) O4 is the maximum diameter of ankle (cm) 2. D or derma D=d x S x K2 d = ½ of the mean skinfold d = (½) (d1+d2+d3+d4+d5+d6/6) (mm) Where d1= skinfold at biceps muscle. d2= skinfold of forearm, at maximum development, over the planter side d3= skinfold of thigh over quadriceps muscle in the middle of inguinal and knee d4= skinfold over the calf muscle d 5= skinfold over thorax in the middle of mammary gland and umbilicus d6 = skinfold over abdomen, in the middle of naval and the anterior superior iliac spine The science of anthropometry was in infancy in the time of Matiegka and there was no instrument for measuring skinfold thickness. So, the skinfold measurement was taken with a sliding caliper by picking up the fat fold with mild pressure. The readers can make out how inaccurate the measurements can be if there is no way of checking the pressure with which to
measure the skinfold thickness. S = surface area in cm2 = Wt0.425 x Ht0.725 x 71.84 Weight in kg and height in cm should be taken. K2= 0.13 (constant)
3. M or skeletal muscle M= r2 x Lx K3 R= (r1+r2+ r3 +r4)/4 Where L= height (cm) r1= corrected radius of upper are (flexed) r2= corrected radius of fore arm (maximum) r3 = corrected radius of thigh between trochanter and lateral epicondyle r4= corrected radius of calf K3= 6.5 (constant) The corrected radii can be calculated as follows assuming the limb as a cylindrical entry: Circumference = 2 x (22/7) x r or r = c/2 x (22/7) Corrected r = [c/2 x ( 22/7)] - ½ skinfold The units of skinfolds should be the same as for circumference or radius while subtracting it.
4. R or remainder mass R= W – (O+D+M) In the purpose of development of this method, Matiegka studied the corpses of 12 boys of 16-17 year of age, all in good health. The constants were calculated, however, he felt that these constants
must be finely
tuned by conducting further studies on large groups of cadavers. Concerning the physical efficiency, he found a good correlation between the amount of muscles and the dynamometric strength of persons, however, the correlation was not complete. Further improvements in the method can help in forming the basis for comparisons of various subjects from which it can be easily determined whether a person having average skeleton has feeble, medium or bulky muscles and insufficient, normal or excessive quantity of fat. Matiegka suggested that the constants for the above equations be carefully calculated which can be age, sex and height specific, on the basis of controls and the cadavers. The qualities of different tissues and the results of physiological tests must be carefully studied. Mental influence on muscular work also needs to be studied. Muscular work also depends on the state of mental health. Other things like the tests of strength, influence of exercise, training, experience and mental tone, all should be determined for a better understanding of a person’s physical efficiency. A deeper understanding of person’s physical and mental faculties and efficiencies can be highly useful in the choice of a suitable profession. A person can be happy and will be more satisfied if he finds a profession to which he is mentally and physically most suitable. Ex. 4.10 Calculate the amounts of fat, bone, muscle and remainder using Matiegka’s method from the following measurements. Height = 150gm Weight = 50kg Humerus bicondylar breadth = 6.8 cm Femur bicondylar breadth = Wrist breadth = 6.0cm Ankle breadth = 6.5cm Biceps skinfold = 5mm Forearm skinfold = 6mm Thigh skinfold = 10mm
6.8cm
Calf skinfold = 8mm Thoracic = 12mm Abdominal = 11mm Upper arm girth (flexed)= 27.0 cm Forearm girth = 25.0 Thigh girth = 45.0cm Calf girth = 32cm Ossa or mass of bones = O2 x L x K1 = (6.95) 2 x 150.0 x 1.2 = 8694 grams = 8.694 kg. B. Weight of derma or adipose tissue D= d x S x K2 d = (½) [ 5+6+10+8+12+11)/6] = 4.33 mm S= 500.425 x 1500.725 x 71.84 cm2 = 14325 cm2 D= 4.33 x 14320 x 0.13 = 8063 grams = 8.063kg C. Weight of skeletal muscles r1 = corrected radius of upper arm = [Circumference of upper arm/ 2 x (22/7)]- ½ skinfold = [ 27/2 x (22/7)] – 0.25 = 4.045 cm Likewise corrected radius of upper arm r2 = 3.677 cm
r3 = 6.659 cm r4 = 4.691 cm Mean corrected radius or r= (r1+r2+r3+r4)/4 cm = (4.045 +3.667+6.659+4.691)/4 cm = 4.768 cm Mass of skeletal muscle (M) = r2 x L x K3 = (4.768)2 x 150.0 x 6.5 = 22165 grams = 22.165 kg. D Remainder mass R= Body weight – (O+M+D) = 50 – (8.6940 +8.061+22.1650) kg = 50.0 – 38.920 kg = 11.080 kg.
Extensions of Matiegka’s Method Katch et al. (1979) suggested that for the calculation of fat mass, Matiegka’s formula can be modified by introducing a dynamic constant which would vary with the sum of 11 body girths and can be expressed as follows: Fat Mass = Surface area* Sum of skinfolds * k Deep fat and visceral mass can also be estimated directly from the total body mass with the following equation (Shephard 1991): Deep fat and visceral mass = 0.206 X Body mass Drinkwater and Ross (1980) suggested an alternative in Matiegka’s remainder mass and gave a formula to calculate the residual mass as follows: Residual mass = 0.35 [{(a+b+c)/3 + d}/2]² X Height
where a is biacromial diameter b is transverse chest diameter c is bicristal diameter d is antero-posterior chest diameter
Drinkwater & Ross (1980) modified and revised the constants given by Matiegka was applied his method to predict the masses of tissue components which surprisingly were accurate with an error of only 0.8%. In Brussels (Belgium), a team of anatomists conducted cadaver dissections in order to check the validity of Matiegka’s equations. The findings of these dissections revealed some differences in estimations of tissue masses from the one’s obtained through Matiegka’s method, which underestimated the fat mass, muscle mass and visceral mass but overestimated the bone mass (Drinkwater et al. 1986). It was, however, emphasized that sex-specific equations validated from cadavers are required for greater accuracy of predictions of body masses.
4.12 Drinkwater tactic for estimating fractional masses Various fractional body masses have been worked out from body measurement utilizing phantom stratagem by Drinkwater and Ross (1980) and the procedure is referred to as Drinkwater tactic for the calculation of fractional body masses. The z-scores obtained from the phantom specifications represent the difference in phantom standard deviation units. For example a z-score obtained of 0.981 of body weight of a subject means that his body weight is proportionally 0.981 standard deviations more than that of the phantom body weight when the height has been projected to the phantom height. Since we know the phantom standard deviation of body weight is 8.60 (Table 3.1), therefore a z-score of 0.981 corresponds to a standard deviation of 8.44 (0.981 x 8.60 = 8.44). The given subject is proportionally 8.44 kg heavier in body weight as compared to the phantom. Table 4.14 provides
the phantom specifications of various fractional masses and their subsets of measurements. Insert Table 4.14 somewhere here
The Drinkwater tactic for calculation of fractional masses is based on the principle that the deviation of the subject’s fat mass (or any other body mass) from that of the phantom is the same as the deviation of the indicators of fat which are skinfold measurements. Same principle will hold good for the other body masses. Skinfold correction for muscle mass= [(22/7) x skinfold (cm) The first step is to calculate z-scores for each of the various indicators of a given fractional mass say fat mass whose indicators are six skinfolds. Then calculate the mean z-score of these six indicators of fat. Now utilize this mean z-score to calculate the subject’s fat mass. The fat mass so obtained is a result of the projection of subject’s height to the phantom height. The value of the fat mass then has to be rescaled or adjusted to the actual height of the subject as follows: Fat mass = [Obtained fat mass/ (170.18/ht) 3] Similarly the other fractional masses can also be calculated. The various subsets of measurements used for obtaining fat mass with the help[ of Drinkwater tactic include triceps,
subscapular, suprailiac, abdominal, front thigh and
medial calf skinfolds. The measurements required for fractional skeletal mass include humerus bi-epicondylar width femur bi-epicondylar width, wrist girth and ankle girth. The fractional muscle mass is obtained using relaxed arm girth and triceps skinfold, chest girth and subscapular skinfold, thigh girth and front thigh skinfold, calf girth and medial calf skinfold and forearm girth and forearm skinfold. The residual fractional mass is calculated with the help of biacromial width, transverse chest width, bi-iliocristal breadth and antero-posterior chest depth Ex. 4.11 Assume the following values of various subsets of measurements and obtain fractional
body masses in the subject: Height =150.0 cm Triceps skinfold =10 mm Subscapular skinfold = 12 mm Suprailiac skinfold = 12 mm Abdominal skinfold = 12 mm Front thigh skinfold = 20 mm Medial calf skinfold = 5 mm Humerus biepicondylar width = 6.0 cm `
Femur biepicondylar width = 8.9 cm Wrist girth = 15.0 cm Ankle girth = 20.2 cm Relaxed arm girth =22.0 cm Chest girth =75.0 cm Thigh girth = 40.0 cm Calf girth = 28.0 cm Biacromial width =35.0 cm Transverse chest width = 25.0 cm Biiliocristal breadth =26.0 cm Anterior posterior chest depth = 16.0 cm
Fat mass calculation (use the phantom values of skinfolds from table 3.6) z (triceps) = (1/4.47) [10(170.18/150.0) –15.4] = – 0.907 z (subscapular) = (1/5.07) [12(170.18/150.0) – 17.2] = – 0.707 z (suprailiac) = (1/4.47) [12(170.18/150.0) – 15.4]= – 0.399 z (abdominal ) = (1/7.78) [20(170.18/150.0) –25.4]= – 0.348 z (thigh) = (1/8.33) [20(170.18/150.0) – 27.0]= – 0.507
z (calf)= (1/4.67) [15(170.18/150.0) – 16.0] = 0.218 Mean z – value of six skinfolds = – 0.4436 It means that the subject’s fat mass is 0.4436 SD less than that of the phantom’s fat mass. Table 4.14 shows the phantom’s measurements for fractional masses. The fat mass of phantom is 12.13 kg with SD of 3.25. A z –value of 0.4336 for fat mass corresponds to an amount of 1.4417 kg (0.4431 x phantom SD for fat mass which is 3.25 = 1.4417). Therefore the subject’s fat mass= 12.13 – 1.4417 kg = 10.6883 kg. The above fat mass of the subject has been calculated assuming his height as 170.18 cm. It is necessary to rescale this fat to his actual size which is 150.0 cm and can be done in the following manner: Actual fat mass
=
Obtained fat mass/ [170.18/height] 3
=
10.6883/ [170.18/150.0]3
=
7.319 kg
Utilizing the mean score, the fractional masses can be directly calculated with the following formula: M= [(z x s) + p]/ (170.18/h) d Where M is the fractional mass z is the mean phantom z-scores for the subset of variables p is the phantom value for the given fractional mass s is the standard deviation h is the subject’s height d is the dimensional constant and it’s value is 3 for all masses or volumes The fat mass of the above subject can be calculated with the above formula. Fat mass = [( - 0.4436 x 3.25) + 12.13]/(170.18/150.0)3 = 7. 319 kg Skeletal mass
z (humerus) =(1/0.35)[ 6.0 (170.18/150.0) –6.48] = 0.9349 z (femur) = (1/0.48)[8.9 (170.18/150.0)—9.52] = 1.2028 z (wrist) = (1/0.72) [15.0 (170.18/150.0)—16.35]=0.9278 z (ankle) = (1/1.33)[20.2(170.18/150.0)—21.71] = 0.9079 The mean z-score= 0.9933 M= [(0.9933 x 1.57) + 10.49] / (170.18/150.0) 3 M (Skeletal mass) = 8.251 kg
Muscle mass For the calculation of muscle mass, four body girths, viz, upper arm (relaxed), chest, thigh and calf are necessary. All these girths must be corrected for the subcutaneous tissue overlying the body, in the following manner: Corrected arm girth = Arm girth – [(22/7) x( triceps skinfold/ 10)] = 22.0 – [(22/7) x (10/ 10)] = 18.86 cm Corrected chest girth = Chest girth– [(22/7) x (subscapular skinfold /10)] = 75.0 – [(22/7) x (12 /10)] = 71.29 cm Corrected thigh girth = Thigh girth – [(22/7) x (front thigh skinfold/ 10)] = 40.0 – [(22/7) x (20/10)] = 33.71 cm Corrected calf girth = Calf girth – [(22/7) x (medial calf skinfold / 10)] = 28.0 – [(22/7) x (15/10)] = 23.29 cm These corrected body girths are utilized for the calculation of z – values. Since the body girths are taken in centimeters and the skinfolds in millimeters, so, while making the above corrections, all the skinfolds must be divided by a factor of 10 so as to convert them into centimeters, as has been done in the above calculations. z (arm) = (1/1.91) [ 18.86(170.18 /150.0) –22.05] = -0.3434 z (chest) = (1/4.86) [71.29 (170.18/ 150.0) – 82.46] = - 0.3393
z (thigh) = (1/3.59)( = [33.71 (170.18/150.0) – 47.34] = - 2.5320 z (calf) = 1/1.97) = [ 23.29 (170.18/ 150.0) – 30.22 ]= - 1.9297 Mean z – value = –1.28612 Muscle mass = [(–1.28612 x 2.99 )+ 25.55]/170.18/ 150.0)3 = 14.863 kg
The residual mass z (biacromial) = (1/1.92) [35.0 (170.18/ 150) – 38.04] = 0.8691 z (trans chest) = (1/ 1.74) [ 25.0(170.18/150) – 27.92) = 02548 z (bi- ilio) = (1/ 1.75) [26.0 (170. 18/150.0) – 28.84 ] = 0. 3759 z (ap- chest) = (1/ 1.38) [ 16.0 (170.18/ 150.0) –17.50]= 0.4728 The mean z-score is = 0.4932 The residual mass = [(0.4932 x 1.90) + 16.14]/ (170.18 / 150.0)3 = 11.694 kg. 4.13 Roentgenogrammetry The measurement of soft tissue on the X-ray photographs is generally called roentgenogrammetry. The X-rays or roentgen rays are the electromagnetic rays of very short wavelength which can penetrate matter opaque of light rays, produced when cathode rays impinge upon matter which were first discovered in 1895 by Konard von Roentgen, a German physicist. The roentgenograms meticulously taken on extremities of the human subjects can be very useful in differentiating the various tissues, viz., fat, muscle and bone which in turn can find their applications in body composition studies. The most important sites on the body for X- ray measurements are the upper arm, thigh and calf. Tanner (1964) described in details the standardized techniques for taking these X- ray
photographs, which have been described below: The upper arm should be placed in such a way that the two epicondyles of the humerus bone be overlapping each other in the X- ray film. The lateral aspect of the arm should be facing the source of the X-ray. The arm should be away from the film so that the central vertical plane of the arm is at a distance of 5.0 cm from the film. The anode of X- ray machine is placed precisely at 1.5 meters from the film. This distance helps in checking the unusual distortion of various areas on the X-ray film because the X- rays fall practically parallel on all areas. For the X- ray of calf, the posterior side of the leg should face the film while the anterior aspect should face the X- ray source. The distance of the film from the central vertical axis of the calf should be 10.0 cm. The anode of the X-ray machine should be at a distance of 1.5 meters from the film. The x- ray of the calf is taken at its maximum development. The x- ray of the thigh should be taken with the lateral aspect facing the source of X- rays. The lateral position can become more accurate if the two epicondyles of femur overlap each other in the film. The distance between the central vertical plane of the thigh and the film be 10.0 cm. The anode distance from the film is the same as for other regions, i.e. 1.5 metre. Garn and Shamir (1958) have suggested a voltage from 35 to 75 kilovolts at 10 to 20 milliampere seconds while taking the X- rays. However, depending upon the mass to the Xrayed, the appropriate alteration can be made in the voltage. Suitable precautions must be taken to provide protection to various areas, especially the sex glands. Specially designed leaded underwear or jockstrap or Armadillo (Tanner, et al. 1958) must be worn by the subject before taking the X- rays. It must be noted that the laterality of the body must be uniformly adhered to while taking the X-rays. As in the case of IBP anthropometric measurements, the X- rays should also be taken preferably on the left side of the body. The measurements on the radiograph of the upper arm are taken midway between the points acromiale and radiale. A line is first drawn along the axis of upper arm which should be passing
through the middle of the two skin borders. A perpendicular to this is drawn at the marked middle of the arm which is used for measurements. Usually the perpendicular line cuts the axes of the fat and muscle areas at right angles. But in the case of humerus bone, the perpendicular may not cut the long axis of the humerus at right angles. But in the case of humerus bone, the perpendicular may not cut the long axis of the humerus at right angles. Therefore, while the fat and muscle measurements can be taken along the perpendicular, the bone measurement should be taken at right angles to its own axis. The following widths are measured with finely calibrated calipers: 1.Bone width 2. Muscle width (Total with across the two muscle borders – bone width) 3. Fat width (Sum of two fat widths on either side). 5. Total width of the upper arm. Fig. 4.1 is a diagrammatic representation of radiogram of the upper arm where AA is the long axis of the limb, BB is perpendicular to it from which two fat widths (BC and B’C’) and the total muscle and hone width (CC’) is taken. Since the axis of the bone EE’ in this case is different from the limb, therefore a perpendicular to the bone axis (DD’) is measured for bone widths. Insert Fig 4.1 somewhere here
Calf should be measured at the level of its maximum development. Long axis of the tibia bone is drawn and a perpendicular to it at the level of maximum development should be used for the measurements. The following widths are taken: 1.Total width of the calf 2. Fat width (Sum of two fat widths on either side) 3. Muscle width (total width across the two muscle/ fat borders—tibia width) 4. Bone Width Fig. 4.2 is a diagrammatic representation of radiogram of the calf. AA represents the long axis of the tibia upon which a perpendicular BB’ is drawn. All the measurements are taken on this
perpendicular. The fat width = BC+ B’C’ The muscle width = Cc’ –DD’ Bone width = DD’ Width of the total calf = BB’ Insert Fig 4.2 somewhere here
Tanner (1964) included fibula as part of the muscle. However, this is a debatable question whether to retain fibula as part of the bone width or in muscles. Logically, fibula should become a part of the bone width, however, the difficulty may arise because many measurements of muscles will have to be taken which may interfere with the accuracy of such measurements. The measurements on the thigh radiograms have been recommended at a level which is above the lower border of femoral condyles by an amount equal to one-third of the subischial length. The subischial length is determined indirectly by subtracting sitting height from the height measurements, If the height of a person is 150.0 cm and the sitting height is 80.0 cm, then his subischial length would be 70.0 cm (150.0-80.0). One- third of subischial length would be 23.3 cm(70.0/3 cm= 23.3 cm). While determining the level for measurement a distance of 23.3 cm upwards from the lower border of femoral condyles will be taken. The measurements are taken at right angles to long axis of the femur bone. All measurements of bone, fat the muscle are taken according to the procedure outlined for upper arm. Fig. 4.3 shows the outline of thigh radiogram. Various widths on it are as follow: The fat width = BC+B'C' Muscle width = CC'- DD' Bone width = DD' Total width of the thigh = BB' The fat widths can be utilized later for estimating the fat mass or percentage of body fat. The
body mass can be fractionated into fat mass and lean body mass. This fat mass of a group of subjects can be determined first by hydrostatic weighting. Then linear regression equations can be fit to derive regression coefficient from which fat mass or percentage of body fat can be estimated by putting the values of fat widths obtained from the radiograms. Insert Fig 4.3 somewhere here
Body mass = a + bX Where 'a' is a constant representing lean body mass, 'b' is the slope of the regression line and X is the total fat width on the radiograms. Then Fat mass = bX From the estimated hydrostatic fat mass the total fat width from the radiograms (X), the value of 'b' can obtained. By putting the value of fat mass derived from radiographic measurements and the body mass in the equation. Body mass = a+ bX The lean body mass or 'a' mass or 'a' can be calculated. The above equation where the values of constants are known for a group of individuals or population, the procedure is easy for fat mass estimation from the radiographic measurements. Katch and McArdale (1983) have described a technique through which the percentage of body fat can be evaluated quite accurately from the radio-grams of the upper arm. Measurements of fat are taken at three specific sites on the radio-grams on both the anterior and posterior sides which are later used in fat calculation. They have found reasonably good agreement (r =0.90) in the body fat obtaining from radiographic measurements and the hydrostatic weighting methods. 4.14 Hydrometry The technique for the estimation of total body water and the extracellular volume has been
described after Graystone (1968). Estimation of total body water is based on the simple principle of dilution. A chemical substance is given orally and after it reaches an equilibrium in the body's its dilution in plasma or urine is noted. From the proportion of actual concentration, the amount of total body water can be estimated. A specific amount of sodium bromide is dissolved in deuterium oxide (which should be about 25 times the amount of sodium bromide). Deuterium oxide should be of 99.8 percent purity and having a density of 1.105 g/ml at 250C. The recommended doses to the subjects are 80mg of sodium bromide in 2 grams of deuterium oxide per kg of body weight. The subjects should observe overnight fast. Three to four hours after administering the above substances, the blood samples of about 20ml are taken out and the plasma is separated for analysis. Then the deuterium oxide concentration in plasma is determined along with that of the plasma bromide. The amounts of total body water and other spaces can be determined as follows as described by Graystone (1968): Total body water (litres) = [Volume of deuterium oxide administered in ml /Deuterium oxide concentratio in plasma water (ml/1)] Corrected bromide space or Extracellular water (litres) =[mEq sodium bromide administered – 10%]/[plasma bromide (mEq/1)/0.88] Total body chloride (mEq) =[mEq Sodium bromide/plasma bromide (mEq/1)] x plasma chloride (mEq/1) Intracellular water = Total body water – Extracellular water It is generally assumed that the fat mass is anhydrous, that it contains no water or very little amount of water. So, whatever the total amount of body water is, that is mainly distributed in the lean body mass.
Thus total body water ∞ Lean body mass or Total body water = C x Lean body mass Where 'C' is a constant. It can be determined by calculating the lean body mass from the hydrostatic weighing method and comparing it with its estimation from total body water. After determining the lean body mass, the fat mass can also be determined: Fat mass = Body mass – Lean Body mass The total body mass, fat mass, total body water and the intracellular water can be utilized to estimate the dry cell residue and the bone minerals, but it encompasses a lot of assumptions including the equitable distribution of body water every where. Body mass (M) can be fractionated as follows: M = F+T+S+B Where F = fat mass T = total body water S = dry cell residue B = bone minerals Intracellular water can be utilized in determining the dry cell residue and the bone minerals.
4.15 Dual Energy X-ray Absorptiometry (DXA) The photon absorptiometric technique is used to assess the mineral content of the human body especially that of skeleton. It started with Single Photon Absorptiometry (SPA) during the nineteen sixties and later resulted in the adoption of the dual photon absorptiometry (DPA) technique for the analysis of bone mineral density among humans. The different names for absorptiometric techniques are as follows: X-ray absorptiometry (XRA) Quantitative digital radiography (QDR) X-ray Spectrophotometry (DXA or DEXA)
In the case of dual energy absorptiometry, two sets of photon beams with different energies are used for the quantification of bone mineral content where the soft tissues have different compositions and also where the thickness of the bone does not remain constant. The principle involves the measurement of ‘initial’ and ‘emerging’ intensities of both the beams passing through the same volumes. Attenuation at two energy levels in the soft tissue provides estimates of fat and lean body mass whereas in regions which contain bones the assessments yield the amounts of bone mineral and soft tissues.
4.16 Neutron Activation The technique is useful in estimating the amounts of various constituents of the body including sodium, potassium, calcium, phosphorous and chlorine. The principle involves the bombardment of the subject with a known dose of fast neutrons. These are captured by different elements in the body which get transformed into unstable isotopes emitting gamma radiation. The amount of gamma radiation can be measured with the help of whole-body counters. Whole body nitrogen estimates can be made with this technique. The International Commission on Radiological Protection has provided estimates of the amount of nitrogen in lean tissues as 31.9g/kg. The estimates of nitrogen content of the muscle and in the rest of the tissues given by Cohn et al. (1980) are 30 g/kg and 36 g/kg, respectively. Standardization of amounts of nitrogen in various tissues is to be done. This may be used for the estimation of amounts of different tissues in the body.
Chapter 4 Exercises Ex 4.1. Calculate the %body fat with three equations of Siri, Brozek and Behnke & Wilmore if the body density are as follows a. 1.064 b. 1.043 c. 1.033 d. 1.055 e. 1.049 Ex. 4.2. Calculate the body density in males and females using the following equations Density = 1.1765 – 0.0744 (log10 ∑S4) (males 20-69 years) Density = 1.1567 – 0.0717 (log10 ∑S4) (females 20-69 years) Considering the values of four skinfolds required in the equation similar in each sex which are as follows: a. 56 mm b. 77 mm c. 71 mm d. 45 mm e. 59 mm Ex.4.3. Ex. Calculate the body density using the equation of Lohman (1981) if the sum of three skinfolds (chest, abdominal and thigh) is : a. 66 mm b. 73 mm c. 79 mm d. 45 mm e. 49 mm Ex. 4.4. Calculate the % of body fat using equation of Jackson et al. (1978) if the sum of seven skinfolds at chest, abdomen, thigh, axilla, triceps, subscapular and suprailiac is as follows: a. 59 mm b. 79 mm c. 102 mm d. 98 mm e. 105 mm Ex. 4.5 Calculate the amount of fat using equation of Noppa et al. (1979) in the following:where buttock circ. is in cm, body weight in kg and skinfolds in mm. a. buttock circ. 75 Body weight 59 Triceps +subscapular 23 b. buttock circ 85 Body weight 65 Triceps +subscapular 25 c. buttock circ 82 Body weight 64 Triceps +subscapular 24 d. buttock circ 77 Body weight 66 Triceps +subscapular 25 e. buttock circ 81 Body weight 67 Triceps +subscapular 28 Ex. 4.6. Calculate the bone mass using Matiegka’s method in the following: a. Humerus dia. 6.6cm, femur dia 8.8cm, wrist dia 5.4 cm, ankle dia 6.8cm, height 167 cm b. Humerus dia. 5.6cm, femur dia 7.8cm, wrist dia 5.4 cm, ankle dia 6.8cm, height 157 cm c. Humerus dia. 7.6cm, femur dia 8.0cm, wrist dia 6.0 cm, ankle dia 6.0cm, height 185 cm
d. Humerus dia. 7.0cm, femur dia 8.0cm, wrist dia 5.0 cm, ankle dia 7.0cm, height 170 cm e. Humerus dia. 6.8cm, femur dia 8.0cm, wrist dia 6.4 cm, ankle dia 7.8cm, height 178 cm Ex. 4.7. Calculate the mass of skeletal muscles using Matiegka’s method in the following: a. corrected mean radius 5.228 cm height 172 cm b. corrected mean radius 4.238 cm height 184 cm c. corrected mean radius 4.881 cm height 167 cm d. corrected mean radius 5.190 cm height 174 cm e. corrected mean radius 4.893cm height 179 cm Ex. 4.8. Calculate the mass of derma (D) using Matiegka’s method and surface area (S) in the following subjects: Note: Obtain the surface area (S) using the equation: S (cm2) = Wt0.425 x Ht0.725 x 71.84 a. ½ mean skinfold b. ½ mean skinfold c. ½ mean skinfold d. ½ mean skinfold e. ½ mean skinfold
5.40 mm 6.23 mm 5.88 mm 6.21 mm 6.68 mm
height height height height height
167cm 163cm 175cm 184cm 181cm
weight weight weight weight weight
64 kg 66 kg 75 kg 73 kg 69 kg
Ex.4.9. (X) Calculate the z-score of following skinfolds for fractional body masses (Drinkwater tactic) if the height of the subject is 164.6 cm. Also calculate the mean z-score of all the skinfolds a. Triceps 14 mm b. Subscapular 16 mm c. Suprailiac 18 mm d. Abdominal 20 mm e. thigh 19 mm f. calf 12 mm (Y) Use the above mean z-score to calculate the fat mass of the above individual.
Ex. 4.10. Calculate the z-scores of the following diameters and circumferences to be used for the fractional skeletal mass when the height of the subject is 164.6 cm. Also obtain the mean z-score of these measurements and the amount of skeletal mass. a. humerus bicondylar dia. 7.2 cm b femur bicondylar dia 9.6 cm c wrist circumference 17.2 cm d. ankle circumference 21.4 cm Ex. 4.11. Calculate the z-scores of the following diameters to be used for the fractional residual mass (Drinkwater tactic) when the height of the subject is 164.6 cm. Also obtain the mean z-score of these measurements and the amount of residual mass. a. biacromial width 35 cm b. transverse chest width 28 cm c. bi-iliocristal breadth 25 cm d. antero-posterior chest depth 19 cm
Chapter 4 Answers Ans.4.1 The %age of body fat is as follows: a. Siri 15.23 Brozek 15.31 Behnke & Wilmore 13.51 b. Siri 24.59 Brozek 23.96 Behnke & Wilmore 23.07 c. Siri 29.19 Brozek 28.20 Behnke & Wilmore 27.76 d. Siri 19.19 Brozek 18.97 Behnke & Wilmore 17.56 e. Siri 21.88 Brozek 21.45 Behnke & Wilmore 20.30 Ans. 4.2. Densities are for male and female, respectively. a. 1.0464 1.0313 b. 1.0361 1.0214 c. 1.0387 1.0239 d. 1.0535 1.0381 e. 1.0447 1.0297 Ans.4.3. a. 1.0078 b. 0.9939 c. 0.9813 d. 1.0445 e. 1.0380 Ans. 4.4 a. 8.5875 b. 11.8651 c. 15.3970 d. 14.8010 e. 15.839 Ans. 4.5. Amount of body fat in Kg a. 12.78 b. 16.5 c. 15.64 d. 15.83 e. 17.02 Ans. 4.6. a. 9541 g or 9.541 kg b. 7717 g, 7.717 kg c. 10569 g or 10.569 kg d. 9295 g or 9.295 kg e. 11227 g or 11.227 kg
Ans. 4.7. a. 30557 g b. 21481 g c. 25861 g d. 30465 g e. 27856 g
Ans. 4.8. mass of derma (D) and surface area (S) ,respectively are: a. 12072 g or 12.072 kg b. 13866 g or 13.666 kg c. 14548 g or 14.548 kg d. 15751 g or 15.751 kg e. 16346 g or 16.346 kg
17197 cm2 17120 cm2 19031 cm2 19510 cm2 18823 cm2
Ans. 4.9 (X) a. -0.207023467 b. -0.129702992 c. 0.718167016 d. -0.606939937 e. -0.883060393 f. -0.769420905 Mean z-score = - 0.313 (Y) Fat mass = 10.055 kg Ans. 4.10 a. 2.754521784 b. 0.844673957 c. 1.990397597 d. 0.312381805 The mean z-score = 1.475494 Skeletal mass = 11.587 kg
Ans. 4.11 a. -0.965357938 b. 0.591500119 c. -1.709994793 d. 1.553700671 The mean z-score = -0.132537985 The residual mass = 14.375 kg
Table 4.1 Conceptual models of body composition (Adapted from Jebb and Elia 1995)
1 - compartment
Body mass. More or less body mass than the reference values. Being the only compartment, it does not take into consideration factors of an individual's physique.
2 - compartment
Fat and Fat Free Mass (FFM). It is one of the earliest attempted divisions of body weight made on the assumptions of differential densities of the two compartments, viz., fat = 0.9 g/cc and FFM =1.1 g/cc.
3 - compartment
Fat, Total Body Water and mineral
protein +
Jebb and Elia (1995) suggest a constant ratio for protein and mineral and hence have provided a density of protein +mineral as 1.52 g/cc.
4 – compartment
Fat, Total Body Water, protein, mineral Protein bears a direct relationship with total body nitrogen. Deuterium oxide provides estimates of total body water.
More compartments
Fat, Extra Cellular Water, Intra Cellular Water, protein, mineral, Numerous further divisions of body mass can be made, e.g., amounts of different types of minerals, glycogen and other molecules in the body.
Table 4.2 Different elements constituting human body and their amounts in a reference man of 70-kg body weight (Adapted from Forbes (1987)
Element Oxygen Carbon Hydrogen
Amount (kg). 43 .000 16.000 7.000
Amount (%) 61.43 22.86 10
Nitrogen Calcium Phosphorus
1.800 1.100 0.500
2.57 1.57 0.71
Sulfur Potassium Sodium
0.140 0.140 0.100
0.2 0.2 0.14
Chlorine Magnesium Silicon
0.095 0.019 0.018
0.14 0.027 0.025
Iron Fluorine Zinc
0.0042 0.0026 0.0023
0.006 0.0037 0.0032
Table 4.3 Major organic molecules of the body Category
Elements
% of body wt
Proteins
C,H,O,N
17
Lipids
C,H
15
Nucleic acids
C,H,O,N
2
Carbohydrates
C,H,O
1
Table 4.4 Percentage of total body water in children, average adults and obese adults of both the sexes Individuals
% Total Body Water
Children
70 %
Average man
60 %
Average woman
50 %
Obese man
50 %
Obese woman
40 %
Table 4.5 Amounts of various ions and proteins in Intra Cellular Fluid and Extra Cellular Fluid Substance
Plasma
Intra-cellular fluid
Extra-cellular fluid
Sodium ions (mmol/l)
140
10
145
Chloride ions (mmol/l)
100
3
115
Potassium ions (mmol/l)
4
160
4
Protein
16
55
10
Bicarbonate (mmol/l)
28
10
30
Table 4.6 The amounts of various tissue/organs in a reference adult man of 70 kg body weight (International commission on radiological protection 1975) Tissue/organ
Amount (kg)
Weight
70.000
Skeletal muscles
28.000
Adipose tissue
15.000
Skeleton (total)
10.000
Table 4.7 Body composition values of a reference man and a reference woman (after McArdale et al. 1989 and Ross and Ward 1982). Variable
Reference man
Reference woman
Phantom
Age (yr)
20-24
20-24
-
Height(cm)
174.0
163.8
170.18
Weight(kg)
69.9
56.7
64.58
Total fat (kg)
10.5
15.3
12.13
Percent fat
15.0
27.0
18.78
Table 4.8 Values of a reference man and a reference woman for amounts of water, protein, fat and others (modified from Brozek et al. 1963)
Variable
Weight (g/kg)
Density
Water
624
0.9937
Fat
153
0.9007
Protein
164
1.34
Non osseous minerals
10.5
3.317
Bone minerals
47.4
2.982
Total
999
1.064
Table 4.9 Hydration of the Lean Body Mass (LBM) in humans and mammals % of water
Source
LBM in humans
69.4 – 73.2 %
Widdowson & Dickerson (1964)
LBM in humans
72.4 %
Forbes (1962)
LBM in mammals(cat, dog, rabbit, 72.0 – 78.0 % etc.)
Widdowson & Dickerson (1964)
Table 4.10 Structural components and densities of different lipoproteins (adapted from Simons & Gibson 1980)
Feature
Chilomicr VLDL
LDL
HDL
1.006-
1.063-
1.063
1.21
ons Density(g/ml)
1.006
1.006
Triglycerides
87.5
52.78
8
4.5
Cholesterol ester
3.5
15
40
15
Unesterified cholesterol
2.5
7
10
3
Phospholipids
7
18
22.5
27.5
Protein
1.5
9
20
49.5
Table 4.11 The amounts of essential, intramuscular, thoracic-abdominal and inter-muscular fat expressed as % age of total body fat (Adapted from Lohman 1981)
Variable
Males
Females
Essential fat
20%
30%
Intra-muscular fat
10%
4%
Thoracic-abdominal fat
12%
8%
Inter-muscular fat
30%
20%
Table 4.12 Densities of fat at different sites
Specific fat & location
Density (g/cm³)
Source
Adipose tissue
0.9000
Fidanza et al.(1953)
Cell & interstitial fat
0.93
Mendez et al.(1960)
Brain fat
1.03
Mendez et al. (1960)
‘Average’ fat
0.915
Brozek et al. (1963)
‘Average’ fat
0.9168
Leonard et al. (1983)
Table 4.13 A summary of different methods of body composition assessment (After Norgan 1995)
Anatomical dissection and biochemical analysis of the cadavers Densitometry and Body density Hydrometry and Total body water Roentgenogrammetry and tissue widths Bioelectrical impedance analysis Magnetic resonance imaging Photon Absorptiometry Ultrasonography Near Infrared interactance (NIRI) Dual energy X-ray absorptiometry (DXA) Computer Axial Tomography (CAT) Anthropometry and skinfold thicknesses
Table 4.14 Phantom specifications of various fractional masses and their indicators or subsets of measurements (After Drinkwater and Ross 1980).
Mass Subset indicators SD
Mean
FAT (kg) triceps skinfold (mm) subscapular skinfold (mm) suprailiac skinfold (mm) abdominal skinfold (mm) front thigh skinfold (mm) medial calf skinfold (mm)
12.13 15.4 17.2 15.4 25.4 27.0 16.0
3.25 4.47 5.07 4.47 7.78 8.33 4.67
MUSCLE (kg) relaxed arm girth-triceps skf (cm) chest girth-subscapular skf (cm) thigh girth-front thigh skf (cm) calf girth-medial calf skf (cm) forearm girth (optional) (cm)
25.55 22.05 82.46 47.34 30.22 25.13
2.99 1.91 4.86 3.59 1.97 1.41
SKELETAL (kg) humerus bi-epicondylar width (cm) femur bi-epicondylar width (cm) wrist girth (distal to styloids) (cm) ankle girth (smallest) (cm)
10.49 6.48 9.52 16.35 21.71
1.57 0.35 0.48 0.72 1.33
RESIDUAL (kg) biacromial width (cm) transverse chest width (cm) bi-iliocristal breadth (cm) antero-posterior chest depth (cm)
16. 14 38.04 27.92 28.84 17.50
1.90 1.92 1.74 1.75 1.38
5. HUMAN PHYSIQUE
Chapter details
Viola’s classification Kretschmer’s classification Sheldon’s Method of Somatotyping
Somatotyping Criteria Dominance of endomorphy Dominance of mesomorphy Dominance of ectomorphy The trunk index and somatotype The second order variables of human physique Gynandromorphy Dysplasia Textural aspect Hirsutism
Critical evaluation of Sheldon's method of Somatotyping Parnell’s method of Somatotyping
The history of classification and analysis of human physique can be traced back to the very ancient times when the people with strong bodies and who had the ability to fight, hunt and organize must have achieved distinction and got noticed by the society. This seemed to have impressed the rulers and administrators to look for cherished human bodies and thus the foundations of visual classification of human physique might have started. Hippocrates a great Greek philosopher and physician of the fifth century BC described two different types of people:
Habitus phthisicus were thin and lean persons with long extremities. These individuals had a greater susceptibility to tuberculosis.
Habitus apoplecticus were short persons with thick and massive bodies who were very much prone to the diseases of the cardiovascular system.
After Hippocrates not much advances took place in this field. The idea of Hippocrates was further extended by many scientists in the beginning of the nineteenth century who described three different types of physical constitution:
Digestif type were the physiques with fatty characteristics
Musculaire type were the physiques with strong muscular and athletic features
Cerebrale type or brainy type was the physiques with lean and linear features.
It was as early as the seventeenth century that a luminary Elsholz at the University of Padua, Italy, started studying the body morphology with the help of anthropometric measurements.
Lambert Adolphe Jacques Quételet (1796 –1874) was a Belgian scieintist. However, it was much later during the nineteenth century that Quetelet started measuring the humans anthropometrically and provided the desired statistical treatment. His famous ratio of body weight to height called Quetelet’s index (Weight/height2) is now recognized the world over for assessing obesity and under-nutrition and is now popularly known as Body Mass Index (BMI) has withstood the test of time. A German psychiatrist Kretschmer (1925), in the beginning of the twentieth century, gave a detailed account of the characteristics of three categories of humans which were named as pyknic or fatty, athletic or muscular and leptosome or lean. His method was based on making anthroposcopic observations on the human subjects. Kretschmer also correlated the physique with the characteristics including the temperament of the person. His method is still very much popular with psychologists who aim at studying the behaviour and body constitution. But other scientists who tried to use his method found it very difficult to apply because majority of the people did not conform to the characteristics of any of these groups but fell in between. An Italian physician
Viola (1921) during the early part of the twentieth century devised a method of human physique analysis by utilised body measurements. He grouped physique as a) longitype having relatively long limbs compared to the trunk, massive thorax compared
to the abdomen, and greater
transverse diameters relative to the antero-posterior ones; b) brachitype or broad type, having the characteristics opposite to those of the longitype; c) normotype which fall in between the above two categories and d) mixed type who show characteristics of different types in different parts of the body, i.e. they may be brachitype in one part, longitype in the other and normotype in still another, etc. Though the same objection of discrete types may be levelled against this system as well, yet it provided an opportunity to classify humans in any of these categories without much difficulty. The major objective of this system was to correlate differential susceptibilities to various diseases in different types of physiques. The interest in the study of human physique classification considerably increased during the twentieth century. Numerous methods for the classification of human physique were invented or modifications were suggested in the already existing methods. These include the methods of Tucker and Lessa (1940), Sheldon et al.(1940), Bullen and Hardy (1946), Cureton (1947), Hooton (1951), Parnell (1954), Damon et al. (1962), Clarke ( 1971), Heath and Carter (1967). The details of some of these methods which have stood the test of time and which were in much use and are still being used is provided here.
5.1 VIOLA’S classification During the beginning of the twentieth century, an Italian scientists Viola presented a method for the classification of human physique. Anthropometric measurements were taken for this purpose. These measurements were combined with each other to derive certain indices and values which were used for classifying humans. The list of measurements required is presented below:
Upper extremity length Lower extremity length Thoracic length Thoracic breadth Thoracic depth Upper abdominal breadth Upper abdominal length lower abdominal breadth Lower abdominal length Abdominal depth The following indices were later calculated from different body measurements:
Thoracic index
Upper abdominal index = Upper abdominal breadth + Upper abdominal length
= Thoracic length + Thoracic breadth + Thoracic depth
+ Abdominal depth
Lower abdominal index = lower abdominal breadth + Lower abdominal length + Abdominal depth
The upper abdominal and lower abdominal indexes were combined together to obtain the total abdominal index.
Total abdominal index = Upper abdominal index + Lower abdominal index
These indexes were further combined together to get the values of trunk and extremities as follows:
Trunk value = Thoracic index + Total abdominal index
Limb value = Upper extremity length + Lower extremity length
On the basis of these measurements, indices and values, four different types of human physiques were identified which were longitype, brachitype, normotype and mixed type.
Longitype Physique: The physique is characterized by long limbs and elongated body. Relatively long limbs compared to the trunk Relatively larger transverse diameters as compared to the antero-posterior ones Relatively larger thorax compared to the abdomen Brachitype Physique This physique is characterized by massiveness and robustness of the body. Relatively short limbs compared to the trunk Relatively short transverse diameters as compared to the antero-posterior ones Relatively short thorax compared to the abdomen Normotype Physique This is the physique which is normal and falls between the longitype and brachitype Normally proportioned limbs versus trunk, thorax versus abdomen and transverse versus anteroposterior widths Mixed type Physique This type of physique shows disproportions in the human body. It lacks uniformity in the physique. It is longitype by way of certain characteristic, brachitype by the other and mixed type by still another characteristic. All the indicators for judging the physique fail to reach a specific conclusion about a physique. In the present day terminology this may be referred to as dysplasia.
5.2 KRETSCHMER’S (1925) classification A German psychologist E. Kretschmer proposed a model of human physique analysis in which he recognised three different types of physiques. Actually his interest was to discover psychoses of
different types and to find out if these types are related to specific types of physiques. The three different types of human physique described by him are pyknic, asthenic (leptosome), and athletic. A description of all these types is given below:
Pyknic: These are thick and short people. Mainly the massiveness of the human body is the characteristic of this type. The massiveness may be because of fat or a combination of fat and muscles. The people have characteristics where head is large and heavy, thorax and abdomen are massive or more developed with respect to the extremities. Though the distinction between muscled men and pyknic is very clear yet the latter may have some muscles. It can be stated that the pyknic physique ranges from an all fat to a combination of fat and muscles. As can be found in the studies on human physique by Sheldon, Kretschmer’s pyknic resemble mainly the physiques ranging from endomorphs to endomorph-mesomorph where the muscles and fat are equally expressed in a person. Asthenic (leptosome) The main characteristics of this type include long and thin features of the body. The people are tall and very thin. The extremities are extremely long as compared to the trunk. It seems as is the body lacks not only fat but muscles also. The transverse dimensions of the body relatively more prominent than the antero-posterior ones. These people seem to lack body strength and thus can be considered fragile. The physique can best be described as long and spidery. The body posture cannot be maintained as strictly upright but some type of swaying and tilting may be represented. Athletic This type of human physique has the characteristics of typical athletes. Strong and heavily muscled bodies is the mainstay of this type. Actually Kretschmer describes this physique as a type between the pyknic and the asthenic. So these people have very less fat but have considerable amounts of muscles. Thus they may not be as massive as the pyknic ones. All parts of the body exhibit prominent muscles. Physical strength is natural outcome in these physiques.
Besides these three types of physiques, another type of body morphology was also noticed by Kretschmer in which different parts of the body did not match. This was referred to as the dysplastic type. This type of physique does not show uniformity and hence is disproportional. Kretschmer was of the opinion that short and thick type of people show extraversion in their personalities and that is why these were more susceptible to manic-depressive type of psychosis. On the other hand, the asthenic type had introverted personalities which made them more prone to schizophrenia.
5.3 Sheldon’s Method of Somatotyping The morphological and structural differences among human beings are unique and that is why no two humans are alike in body form. Even the identical twins (monozygotic) can be identified from each other although they develop from the single ovum and share exactly similar genetic information. These large differences in body form, morphology and physique in humans must form the basis for any attempt at classification and analysis of human physique. It must be a precondition that all these variations from one extreme to another cannot simply be divided into a few discrete types or groups. The classification which is based on only the discrete types involves the human physique at the extreme poles whereas the majority of the other physiques falling in between the extremes remain unattended. So, a good classification must take care of the subtle human morphological variations and must be able to classify human physique into a large number of categories. That the human physique is a continuously distributed characteristic was appreciated by William H. Sheldon, S.S. Stevens and W.B Tucker, who successfully devised a method in 1940 to analyse and quantify human body form called Somatotyping. According to Sheldon et al. (1954): "Somatotypes are morphophenotypic ranges along continua of variation which possess
constantly recognizable characteristics and are the functional end products of the whole genetic and developmental complex". The somatotype is aimed at providing some sort of identification tag to the subject and may be regarded as an attempt towards general human taxonomy or classification. It may also be referred to as something similar to the Mendeleyev’s periodic table of the elements in chemistry. Sheldon recognised three basic components of physique, viz., endomorphy, mesomorphy, ectomorphy. Each individual has varying degrees of development of these three components. The somatotype is always written in three numerals: the first indicating the development of endomorphy, the second the mesomorphy and the third the ectomorphy. Sheldon was perhaps the first scientist to appreciate the continuity of human physique (not a few discrete types) and invented a workable method to achieve this. The existing methods of classification of human physique at that time, chiefly that of Viola’s and Kretschmer’s, were tested by Sheldon and his associates and it was found that the majority of the persons could not properly fit into any of the described types. Thus the ideas of grouping human beings into numerous categories got a firm support. According to them any method based on human measurements at best can take only a representative group of measurements which can be segmental and fragmentary and hence have limited value. Contrary to this, photographs in three standard poses can provide complete information about the human physique. Pictures taken with great care can exhibit muscular relief, the folds of skin and subcutaneous fat and the bony projections. So the nude photographs of the subjects were considered as the most desirable records for judging the physique. Photographic technique must be standardized so as to avoid any unnecessary distortion of certain body parts by keeping a respectable distance between the subject and the camera. All three views (front, back and side) of the subject can be taken on a single film by specially designing the camera where only one-third of the film is exposed.
A brief description of the three components of physique is given as follows:
Endomorphy Endomorphy is a structural component which has some similarities to the pyknic type of Kretschmer’s classification. Both denote massiveness, big, heavy and large. In Kretschmer’s terminology, the pyknic represents a compact body which is a combination both of sturdy musculo-skeletal frame along with a good degree of fatness. On the other hand, the endomorphy does not represent or involve muscular development. It is the development or presence of soft roundedness which accrues from the huge fat accumulation over the body and massiveness of the internal organs. General softness and roundness of the body and its various parts, proximal parts of the limbs relatively massive than the distal parts, tapering of the extremities, abdomen predominating over thorax, soft body contours, hands and feet relatively short, etc. Endotonia is a term used to denote a good level of development of endomorphy whereas endopenia is used to denote the lack of endomorphy.
Mesomorphy Similarities can be drawn between the athletic type of Kretschmer and the mesomorphy of this system. Both rely on the predominance of muscle and the skeletal frame. In the former the athletic are functionally defined. They perform physically better whereas the present system projects mesomorphy mainly as a structural component. General massiveness and sturdiness of the musculo-skeletal system of the body, highly developed muscles of the limbs, distal segments of the extremities relatively more prominent, strong thorax and predominating over abdomen which is highly muscular, antero-posterior diameters of the trunk smaller than the transverse ones, etc. For mesomorphic component, extreme development is called mesotonia and a lack of it is called mesopenia.
Ectomorphy In Kretschmer’s terminology asthenic seems to be that type which resembles ectomorphy of Sheldon’s concept. The former, however, denotes asthenic as weak or lacking in physical strength whereas the latter refers to ectomorphy as linearity or a proportionally less development of thicknesses of various body parts. The weak or lacking in strength may be due to the two components, viz., endomorphy or ectomorphy. Thin and lean body, weak muscles, thin skeletal diameters, pointed and sharp bony projections, long and slender extremities, little muscles, etc. Ectotonia and ectompenia are used to denote a maximum
and minimum development of
ectomorphy in a person. A critical examination of Kretschmer’s types of human physique vis-à-vis that of the Sheldon’s has revealed that though the three types superficially may give some idea of resembling each other in the two systems yet in fact these are quite different. This is one of the reasons why the authors did not retain the nomenclature of pyknic, athletic and asthenic and instead coined endomorphy, mesomorphy and ectomorphy which are more meaningful and shows uniformity. But at the same time, the authors were aware of the drawbacks of this nomenclature. These names are polysyllabic and may be difficult to pronounce and comprehend. However, they left this puzzle to the future scientists to explore. With the passage of time either the use of these terms would get a firm footing or these would be revised. It is worth mentioning here that there has been no attempt at re-designating these structural components. What the authors have designated reluctantly as compromises on terminology has firmly been stabilized and accepted. There are documented proofs which indicate the predominance of digestive viscera in extreme endomorphs, those who have the maximum development of endomorphy in them. The findings on the intestinal weights and lengths in male cadavers of various types are given in table 5.1 to highlight the point of predominance of digestive viscera in endomorphy. Insert table 5.1 somewhere here
Many anatomists have also found similar types of results on visceral length and weight. Thus the term endomorphy quite accurately reflects the component of physique which quite obviously is derived from the innermost embryonic layer – the endoderm. The characteristic endomorphs who exhibit fatty deposition and soft rounded features seem to be the result of the predominance of digestive viscera. There are tendencies of overeating therefore the body assimilates more than what is actually needed. This results in the excessive fat storage resulting in fatty deposits. The middle embryonic layer or mesoderm produces bones, muscles and connective tissues. These constituents are present in the second component of physique or mesomorphy. Relatively large surface area of the body predominates in the ectomorph. The outer embryonic layer or ectoderm forms the skin, nails and sensory organs. These features derived from ectodermic layer are most prominent in ectomorphs.
5.4 Somatotyping CriteriA Somatotyping is done by visual observations on nude photographs of the subjects taken in three poses; front, side and back. Typical somatotypes of an endomorph, mesomorph and ectomorph are given in Fig. 5.1. Insert Fig. 5.1 somewhere here The body is divided into 5 segments for the sake of somatotyping as follows: Region I- Head and neck Region II- Thoracic trunk above diaphragm Region III- Arms and hands Region IV- Abdominal trunk below diaphragm Region V- Legs and feet Somatotyping of each region is done independently of others, on the basis of 7 characteristics. Endomorphy, mesomorphy and ectomorphy ratings are assigned to each characteristic and the mean somatotypes of each region are calculated. The total somatotype is an average of the
somatotypes of the five regions. Sheldon studied 4000 male college students in order to know the possible range of variations in human physiques. He was able to recognise as many as 79 types of physiques from the above sample. Among them there were three extremes, 711, 171 and 117 which were in a negligible proportion in the whole series indicating that these extreme types are very rare. The recommended scale for each component is from 1 to 7 where 1 represents the minimum possible development and 7 the maximum. From 1 to 7 the ratings at each step represent equal-appearing intervals, e.g. the magnitude of difference in characteristics for any component between the ratings of 1and 2 is the same as between the ratings of 2 and 3 and so on. The reason why 1 was retained as the minimum rating instead of a possible 0, was that no human exhibits a total lack of any component of physique. Any subject who is extreme in one component cannot be extreme in the other two components. Sheldon found that a person cannot have a rating of more than 5 in two components. Similarly, there cannot be anybody having somatotypes as 111 or 777. Since there is some dependence of one component on another, hence the sum of three components is also limited from 9 to 12 instead of a theoretical value of 3 to 21. The person who is fat may have muscles to support it but he will not be linear then. In table 5.2 a list of all the somatotypes known to Sheldon from his data available at that time are presented.
Insert table 5.2 somewhere here Later on in 1954 Sheldon Published a book "Atlas of Men” based on a mammoth sample of 46,000 human subjects in the age range of 18 to 64 years which included people of all walks of life including academicians, delinquents, patients, etc. Not only White but Negro and Jews also got a place in this atlas. On the basis of this extensive data, tables of the distribution of height over cube root of weight ratios at different ages were devised. Somatotyping procedure was made less cumbersome and less subjective by utilising this distribution. Only a few somatotypes are
possible at any given height weight ratio First of all, the height weight ratio is obtained and the possible somatotypes at that ratio are noted. Then the somatotype photograph of the subject is compared with standard photographs available in an atlas, to make out with which it tallies most and a final decision is made regarding his somatotype. In order to make the designations of somatotypes quite lively and absorbing, Sheldon attached animal totems to different somatotypes to which they resemble most. For example,
711 was designated as an ‘American manatee-siren or mermaid’,
171 as an ‘eagle’,
117 as ‘walking sticks’,
741 as an ‘Ancient hippopotamus’ and so on.
The somatotype, as conceived of a biological tag to the individual should remain unaltered throughout life but in the absence of grossly disturbing pathology and malnutrition. The subjectivity of this system is in a sense its strength in achieving the above aim. It is expected of the experienced raters to possess the capacity to explore and judge deep inside the body for the amount of different components. That mass of tissues which would remain static throughout life and even under slight environmental insults. The person should also be experienced in the knowledge of the normal age changes taking place in various tissues and the effect of various factors impinging upon them. Sheldon perceived the usefulness of his method in constitutional studies where the particular type of body build may have some associations with certain diseases, behavioural characteristics, physical fitness and prowess. The detailed criteria outlined here for the three components of physique are for the males and are based on inspectional assessment of the photographs. The features are so described as would be seen in those individuals having the extreme manifestations of a given component.
5.5 Dominance of Endomorphy The general characteristics give the body a soft and round outlook as is humanly possible. The thickness of the body tends towards equality to the breadths, throughout the body. The body mass has a tendency to be centrally located. In a competition of thorax and abdomen, the latter excels the former in dominance. Trunk or torso overshadows the limbs in volume. The proximal segments of the extremities are well developed relative to the distal segments. The limbs generally resemble more or less, the inverted pyramids; the proximal segments being similar to the shape near the base and the distal segments being like the apex. There is a conspicuous tapering of the extremities and considerable hamming of the thighs and upper arms. Shoulders are soft and square. It is difficult to observe a neck which is usually short. Head attains a figure nearly spherical. The face is equally proportional with upper and lower segments nearly matching each other in size. Wide features of the face are generally noticed. There is no muscular relief in any part of the body. Even the proximal muscles like the deltoid, gastrocnemius and trapezius do not show themselves from underneath the skin and subcutaneous tissue. The extremities are short and weak and with conspicuous taper. The hands and feet are generally very short. The skeletal frame supporting the body is small and weak. As can be seen in the X-ray, the cortex is thin but the bony projections are nearly absent. Instead of an S-shaped vertebral column or spinal column, it is usually straight. It may be so because of heavy padding of fat and also due to the excessive centrally located mass. The trunk is relatively massive and long. The chest is broad at the base and the waistline is high and indistinguishable. The width of the body just above the iliac crest is the largest instead of that at the trochanteric level. Since the lower chest is highly distended therefore the ribs exhibit a wide
angle with the vertebral column and the sternum. Breasts also show some development due to the deposition of fatty tissue. Buttocks are round and without any dimpling. The outer curve of the thigh is of a feminine character, a full sweeping curve which may extend to the calf also. The skin is generally soft and velvety. The pubic hair distribution has a feminine characteristic. Generally, the hairs are distributed over scapula, deltoid and breasts but lesser in quantity. Thick bushy chests are quite uncommon. A tendency towards baldness is often noticed even during youth and it usually begins in the centre of the head extending peripherally later on. The quality of the hair is generally fine. The genitalia are less developed. The penis is usually small in size and lost in the hair. Generally the testes are un-descended and corona is small with very long foreskin.
5.6 Dominance of mesomorphy The general characteristics of the body include a hard and sturdy physique. The muscles are thick, prominent and rippling with the maximum perceptible relief. The skeletal structures are thick and very well developed. The breadths of the body at shoulders and of the forearm and calf being exceptionally large and exceed the depths or antero-posterior diameters. The trunk is massive and rugged with strong muscles. The extremities are massive; the distal segments are relatively more developed. Hand and feet are usually strong and broad. In the trunk, the thorax dominates over abdomen. Shoulders are heavy and broad. Hips are strong whereas the waist is thin and small. The various segments of arms and legs seem to be equally developed or proportionate. The head is strong and fully developed. Heavy muscles and thick bones of the head are prominent features. All bones are well developed. Neck is prominent and long with transverse diameters eclipsing the antero-posterior ones. The muscles of the neck are so developed especially the trapezius that it gives the neck a shape resembling a pyramid. In the thoracic region, the contour of the back or vertebral column
is straight. But there is a
highly prominent lumbar lordosis or a sharp convexity forward. The buttocks are usually deeply dimpled and heavily muscled. The abdominal muscles are prominent and show typical knotting. The skin is usually thick with a better developed
connective tissue. Thus the skin is tightly gripped by the
connective tissue to the adipose tissue and the creases or folds are heavy and deep.
The hair like the skin is coarse. The distribution of the hair around the body is highly variable. Pubic hair are typically masculine along with upwards growth medially towards naval and on lateral sides. The skin is light but elastic and has a tremendous capability of returning to its original position when it is pinched lightly. Genitalia and the scrotum are usually very well developed. They are firm and thick in characteristic.
5.7 Dominance of ectomorphy The ectomorphy is characterized by the fragility, linearity and the delicacy of the human body. The whole of the body has very thin and thready muscles. The skeletal frame is usually fragile and slightly built. There is an impression of drooping shoulders. The upper and lower extremities are relatively very long whereas trunk is short. The abdomen is flat and shallow. Lumbar lordosis and thoracic kyphosis are prominent. In trunk, the thoracic region is relatively long in comparison to the abdomen. There is lack of any bulging of muscles anywhere in the body, no muscular relief. Usually the shoulders are carried forward with the result that the arms hang in a plane anterior to the plane of the body. In extremities, the distal segments are relatively mote prominent. The upper arms and thighs are extremely weak. The ankles and wrists are usually small and fragile. If there is a prominence of joints which is not due to the pathological conditions, then this is a prominence of mesomorphy. Neck is thin but long with minimum muscles and projects forwards. The transverse diameter of neck is equal to the antero-posterior diameter but these are small. The head is slightly built with
minimum fat and muscles. Cranial mass overshadows the facial mass. The features of face are sharp, fragile and small. Usually the face presents a triangular outlook with sharp pointed chin. The lower jaw is usually small and delicate.
5.8 The Trunk Index and Somatotype In his later works, Sheldon et al. (1954) constructed somatotype-HWR tables to help the rater in quickly doing the job of somatotyping. These tables would depict the possible somatotypes at a given HWR value. It is easier to find out the best suitable somatotype from a limited range. In this study (Atlas of Men) 1175 somatotype photographs were given which were based on men of all ages beyond 18 years. The major objections of immutability of the somatotype along with a lot of subjectivity in rating the subject persisted even in this study. Sheldon then devised a trunk index and took its help in somatotyping procedure.
Trunk index is the ratio of the areas of thoracic trunk to the area of abdominal trunk of the somatotype photograph of a given subject. The areas were calculated with the help of planimeter (a simple geometrical instrument used to calculate the areas of non-uniform figures). The new method of somatotyping was provided on the basis of trunk index (Sheldon et al. 1969).
The following procedure was suggested to calculate the somatotype of a given subject:
The trunk index is first obtained. This is done with the help of an instrument called planimeter used to calculate the areas of thoracic trunk and that of the abdominal trunk from the given photograph.
The maximum and minimum values of body mass and height of a given subject as recalled by the subject are to be taken into account
Somatotyping Ponderal Index (SPI) of the subject is calculated. Ponderal Index is the index of height/weight
0.33
. If a person is more massive or has more weight for a given
height then his ratio would be lower whereas in the case of a person with low weight for a given height, this ratio would be higher. Somatotyping Ponderal Index (SPI) of a given subject is the value of his Ponderal Index (PI) at the greatest massiveness of the subject in his life time.
THE TABLES OF HWR AND TRUNK INDICES PROVIDED BY SHELDON ARE USED FOR FURTHER EVALUATION. THE BASIC TABLES FOR SOMATOTYPING INCLUDE TRUNK
INDEX,
MAXIMUM
HEIGHT,
SOMATOTYPING
PONDERAL INDEX (SPI). THE TABLES ARE MEANT DIFFERENTLY FOR MEN AND WOMEN.
5.9 THE SECOND ORDER VARIABLES OF HUMAN PHYSIQUE Needless to say that even with a continuous classification of physique which may include around 80 different body types, every type still may reflect lots of variations among the individuals themselves. Sheldon thought of grading every somatotype on the basis of some other features so that within a given somatotype further classification can be made and the individuals can be distinguished from one another. The features he thought of included
Gynandromorphy (mixing of male-female features),
Dysplasia (disproportionate body),
Textural aspect (quality of the texture of the skin) and
Hirsutism (growth of body hair).
It is worth mentioning that all these characteristics could be used to differentiate individuals from within a given somatotype. With the help of these features all the individuals within a given somatotype can be judged and separate identities can be established. However, these characteristics cannot be used to further differentiate different somatotypes. For example, if there are numerous individuals of the same somatotype say 5-3-2, then all of them may be further differentiated on the basis of second order variables including gynandromorphy, dysplasia, textural, hirsutism. But if the individuals have different somatotypes say 5-3-2, 5-4-2, 5-3-4, etc., then it is not advisable to further classify them on the basis of gynandromorphy, dysplasia, textural, hirsutism. Sheldon has very succinctly argued that the further gradations within the same somatotype has to be attempted and not by mixing the different somatotypes. It would be like grading a specific type of fruits like apples or oranges separately. But the apples and oranges cannot be mixed together for the purpose of grading them and then comparing them on the basis of these characteristics.
5.10 Gynandromorphy During the development of the embryo the gonads are bipotential (have the potential of developing into either male or female) and an interaction between genetic make-up and hormones makes the sex organs of one type develop further. This is why the rudimentary structures of the opposite sex are present in everybody. The males retain to some extent the female features and the females the male features. This mixing of the male-female features which can be recognized externally or morphologically is called gynandromorphy. The assessment of gynandromorphy has been recommended by Sheldon who prefers to call it the g-index or g-aspect on the basis of following criteria. These criteria are for males to judge the female features because Sheldon studied only the males:
It describes the extent to which features suggest femininity. The smallness of features, soft round relief, small oval eyebrows, long eyelashes delicate alae of nostrils, small mouth with full lips are some of the hallmarks of facial features.
There is a rounded delicacy of shoulders with weak arm. Subjects have feminine type of arms which are shorter and more delicate relative to legs.
The hips are disproportionately large compared to the body.
The structure is typically an hour glass figure or figure 8 appearance of the body as a whole. A high waist, softly moulded shoulders, full sweep of the outer contour from waist to knee, full pneumatic appearing buttocks are additional features. Groins and the inner surfaces of the thighs are full of flesh and massive.
There is a sparse distribution of secondary hair on the body with feminine distribution of pubic hair.
Feminine softness of subcutaneous finish of the entire body exists, which gives the body a feeling of child-like soft cushioning of the external body fat.
Presence of breast formation with lot of adipose tissue underneath and the tissue may become functional in some cases which is called gynecomasty.
Prominence of the outer curve of the lower leg as compared to the inner curve is generally noticed.
5.11 Dysplasia It is generally considered that the human body is bilaterally symmetrical and well proportioned. However, in actual practice it can be seen that not only do the two sides of the body differ in a given individual but show regional disproportions as well. It may be a massive thorax in a person with well muscled shoulders but with weak arms and legs. Or in a person, the lower portion of the body is more massive as compared to the upper parts of the body. Such types of disproportions
are quite often noticed. Sheldon has referred it to as ‘dysplasia’. In Indian mythology, a learned legend with uncanny wisdom had as many as eight defects of body proportions and hence was popularly known as ‘Ashtawakar’. An uneven mixing of body components in different parts of the body is called dysplasia. Dysplasia can also be measured and rated on a 7 – point scale. The minimum value of dysplasia (a rating of 1) indicates a very well proportioned body whereas the maximum value (a rating of 7) indicate a highly deformed and disproportionate body physique. For expressing dysplasia in the form of above ratings, the following procedure has to be applied: a) All the differences among different regional somatotypes component-wise are calculated and then added up. This is done separately for endomorphy, mesomorphy and ectomorphy and then all the differences are summed up. The procedure for calculating differences in a given component is similar as to making all possible combinations in sports in case of league matches of different teams. For example, in case of endomorphy it would involve all differences in this component between 1st region versus 2nd, 3rd, 4th and 5th regions and 2nd versus 3rd, 4th and 5th regions and 3rd versus 4th and
5th regions and 4th versus 5th regions. Thereafter all these
differences will be added up. In a similar fashion, the differences for mesomorphy and ectomorphy can also be calculated. Ex. 5.1 Calculate dysplasia assuming the following regional somatotypes of a given subject: 1st region 2nd region 3rd region 4th region 5th region
5–3-2 4-3-2 5-2-3 4-2-3 5-2-2
Differences for endomorphy = 1st vs. 2nd, 3rd, 4th, 5th regions = 1,0,1,0 = 2nd vs. 3rd, 4th, 5th regions
= 1, 0, 1
= 3rd vs. 4th, 5th regions
= 1, 0
= 4th vs. 5th regions
=1
Total difference for endomorphy = 6
Differences for Mesomorphy = 1st vs. 2nd, 3rd, 4th, 5th regions
= 0,1,1,1
= 2nd vs. 3rd, 4th, 5th regions
= 1, 1, 1
= 3rd vs. 4th, 5th regions
= 0, 0
= 4th vs. 5th regions
=0
Total difference for Mesomorphy = 6 Differences for Ectomorphy = 1st vs. 2nd, 3rd, 4th, 5th regions
= 0,1,1,0
= 2nd vs. 3rd, 4th, 5th regions
= 1, 1, 0
= 3rd vs. 4th, 5th regions
= 0, 1
= 4th vs. 5th regions
=1
Total difference for Ectomorphy = 6
The sum of all differences for endomorphy, mesomorphy, ectomorphy = 6 + 6 + 6 = 18 b) The total of all differences for the three components is taken and with the help of table 5.3, a rating of dysplasia can be assigned.
Insert table 5.3 somewhere here
The rating for dysplasia in the above subject with a total difference as 18 would be 6. So dysplasia rating = 6 units.
5.12 TEXTURAL ASPECT (t-index) This second order variable of human physique can only be useful to further categorize the individuals within a given somatotype. The texture of the human skin varies from a smooth finish
to a rough one. The evaluation of the quality of the texture of the skin was suggested by Sheldon. Judging the quality of human skin somehow smells of a feeling of racism. According to Sheldon there is a fairly clear gradation from very coarse to very fine physical texture or quality. If it is possible to arrange a series of pictures in an ascending order of textural fineness, judging the quality of the skin of a person becomes very easy. The rating scale for this variable has been suggested from 1 to 7 where 1 indicates the coarsest texture and 7 indicates the finest texture of the human skin. It is understood that the judgments on this variable in humans can lead to discriminatory complications. It is strongly advised against using this characteristic for the classification of human beings. Reference of textural aspect has been provided here in order to acquaint the reader about all the aspects of somatotyping and human physique.
5.13 HIRSUTISM The human beings have body hair all around. Some have dark pigmented and long hair all over the body whereas others have barely visible body hair. During the course of human evolution and with the wearing of clothes man started losing pigmentation of the body hair. Hirsutism is defined as excessive and increased growth of coarse and pigmented hair on those body areas of women where men generally have hair - like face, chest and back. The amount of body hair varies from individual to individual which may provide a criterion of classifying humans on the basis of body hair. Sheldon provided a scale of hirsutism from 1 to 5 where 1 indicated almost lack of pigmented hair on the body with extremely sparse pubic hair and 5 indicated extreme pigmentation and luxuriant growth of hair all over the body.
5.14 CRITICAL EVALUATION OF SHELDON’S METHOD OF SOMATOTYPING
This is a subjective method; the rater should be highly specialized in the art and techniques of somatotyping for the best results. Even the experienced raters may differ to some extent in somatotype assignments and a rater may give different
somatotypes to the same photograph if asked to rate at two different time intervals.
The method has been developed from the white males of limited age range, hence the complete variations in human physique are not known. The somatotypes of females and other ethnic groups and their range of variations are also unknown. The extremes which Sheldon has described in his work may not remain the extremes if whole of the population of the world at different times is studied. One is bound to find more extreme cases; but then they will be rated only 7 in the component in which they are extremes.
The system is based on the concept that the physique of an individual does not change from birth to death and is unaltered by environmental factors, such as malnutrition, disease, etc. It advocates the immutability of the physique throughout life. However, many students of constitution and body build do not entirely accept this viewpoint and consider that the changes do take place in body build with age.
The gross size and weight of the subject does not get a place in the assignment of somatotype. A six feet tall man and a five feet tall person both having the same somatotype cannot be differentiated although both these physiques may have different meanings.
On the whole, Sheldon's method of somatotyping is a useful tool for the students of human constitution and body build.
5.15 PARNELL’S METHOD OF SOMATOTYPING
R.W. Parnell (1954) a British physician described a method to objectively somatotype human subjects by physical anthropometry instead of by the visual inspection of photographs of the subjects. Sheldon’s method of somatotyping is based primarily on making visual observations on the nude photographs. An alternative approach to the visual inspection of photographs is to take
measurements on the photographs and then derive ratios and indices which
form the basis of
somatotype. According to Parnell’s experience, Sheldon’s photometric method which objectively assesses the somatotype, takes a long time to somatotype a person, may be more than an hour. Secondly, if the choice of dominance of the components in the beginning is wrong, the whole process may result in wrong assessment of the somatotype. There are certain inherent difficulties in Sheldon’s method which comes in the way of its wider use. Parnell thinks that the major difficulties include:
Subjectivity
Nude photographs
Cost, labour and time
Parnell’s attempt was to overcome these difficulties in the somatotype procedure and devise a new technique which could be applied on every body with ease. Parnell’s effort was to describe a short physical anthropometric method for obtaining somatotype with the following purposes:
To provide objective guidance on the dominance of somatotype components in a healthy person.
To estimate the Sheldonian somatotype objectively and as accurately at least as the agreement achieved between experts in photoscopic somatotyping.
To make an estimate of women’s somatotype possible although in the absence of a published reference somatotype data the estimate cannot be compared.
To reduce on cost, labour and time while doing somatotypes.
Deviation chart profile of physique
The method of estimating dominance of somatotype components chiefly depends on Standard Deviation Chart. This chart has been designed on the basis of following body measurements: 1. Height
3. Humerus bicondylar diameter
2. Weight
4. Femur bicondylar diameter
5. Upper arm circ. (biceps flexed) 6. Calf circumference 7. Subscapular skinfold 8. Suprailiac skinfold 9. Triceps skinfold 10. Biacromial diameter 11. Bi-iliac diameter 12. Chest width 13. Chest depth
For judging the somatotype, a Standard Deviation Chart was designed which is based upon the anthropometric data obtained from 405 undergraduates at Oxford and Birmingham. The mean values of all the measurements listed above were placed under one column which made the standard column in designing the chart. Thereafter, columns on the left were generated by subtracting one-half of the standard deviation from the mean value for each measurement. The similar procedure was adopted for generating the column towards the right side by adding one – half standard deviation to the mean value. The typical standard deviation chart as designed by Parnell (1954) appears in Table 5.4 Insert table 5.4 somewhere here
The profile of the somatotype can be estimated on the basis of the position of various measurements of a given subject in the deviation chart. In the following diagrams, “B” means the average of two bony diameters, “M” means the average of two muscle girths, “H” means height and “F” means sum of three fat folds (Fig. 5.3). Insert Fig 5.3 somewhere here
In endomorphs and endomorphic mesomorphs, the direction of HF line is from top left to bottom right in the deviation chart. In ectomorphs and Ectomorphic mesomorphs, the direction of the HF line is from top right to bottom left on the deviation chart. In case of average somatotypes (444) and endomorph-ectomorphs, the direction of the HF line is vertical. Mesomorphic dominance is present when the BM average point lies to the right of the H and also to the right of the HF line.
Lack of mesomorphy (a value of less than 3) is denoted when the average of the BM point lies to the left of the HF line.
An important point to be kept in mind in case of mesomorphy assessment is regarding the status of height. In order to be rated higher on mesomorphy a subject’s bone and muscles must be so much developed as to be placed ahead of the column for the height in the deviation chart. Once the dominance status of the components is known from the deviation chart, a most suitable somatotype can be assessed by using the subject’s ponderal index from the Sheldon’s set of tables.
Chapter 5 Exercises
Ex. 5.1 Answer the following questions. a. How many regions of the body are made for the purpose of Sheldon’s method of somatotyping? b. Which component of somatotype represents relative fatness in the body? c. What would be the somatotype of a person with extreme endomorphy but with the minimum values of mesomorphy and ectomorphy? d. What is the term used for uneven mixing of somatotype components in different regions of the body? e. What is Sheldon’s method of analysis of human physique referred to as?
Ex. 5.2. Calculate dysplasia in the subjects with following regional somatotypes A. 1st region 2nd region 3rd region 4th region 5th region B. 1st region 2nd region 3rd region 4th region 5th region C. 1st region 2nd region 3rd region 4th region 5th region
6– 3 - 2 3-4-2 4-2-3 4 - 4- 3 6-2-2 5–3-2 5-2-2 5-2-2 4-2-2 5-2-1 2–4-5 2-5-5 3-4-5 3-5-3 2-5-4
D. 1st region 2nd region 3rd region 4th region 5th region E. 1st region 2nd region 3rd region 4th region 5th region
2–7-3 2- 7 - 3 2- 7- 3 2-7-3 1-7-3 4–3-2 4-3-2 4-2-2 4-2-2 4-2-2
Chapter 5 Answers
Ans. 5.1 a. 5 b. endomorphy c. 711 d. dysplasia e. somatotyping
Ans. 5.2 A. total difference = 34, rating of dysplasia = 7 B. total difference = 12, rating of dysplasia = 4 C. total difference = 22, rating of dysplasia = 7 D. total difference = 4, rating of dysplasia = 2 E. total difference = 6, rating of dysplasia = 3
Table 5.1 The intestinal weights and lengths of cadavers who were extreme in endomorphy, mesomorphy and ectomorphy (adapted from Sheldon et al. 1940).
Type
N
Intestinal
Intestinal
Wt (kg)
Length(m)
Ht(cm)
Wt(kg)
Extreme endomorph
10
1.5
11.2
168
81
Extreme mesomorph
13
1.1
9.6
174
74
Extreme ectomorph
11
0.8
8.7
177
64
Table 5.2 Different types of somatotypes observed by Sheldon from his available data.
Endomorphy
Somatotypes
rating
1
171, 172, 162, 163, 154, 145, 136, 127, 126, 117
2
271, 263, 262, 261, 254, 253, 252, 245, 244, 236, 235, 226, 225, 217, 216
3
371, 362, 361, 354, 353, 352, 344, 345, 343, 335, 334, 326, 325, 316
4
461, 453, 452, 451, 444, 443, 442, 435, 434, 433, 425, 424, 415
5
551, 543, 542, 541, 534, 533, 532, 524, 523, 522, 515, 514
6
641, 632, 631, 623, 622, 621, 613, 612
7
731, 721, 712, 711
Table 5.3 Scale for conversion of differences into the rating of dysplasia Difference
Rating
Percentage
0
1
5
2-4
2
16
6-8
3
23
10-12
4
26
14-16
5
18
18-20
6
8
>20
7
4
Table 5.4 Parnell’s M.4 Deviation Chart
Fig. 5.1 Typical somatotype of an endomorph, mesomorph and ectomorph
Endomorph
Mesomorph
Ectomorph
6. HEATH-CARTER METHOD OF SOMATOTYPING
Chapter details Heath-Carter method of Somatotyping Anthropometric Measurements Technique of Heath-Carter Anthropometric Somatotype First component or endomorphy rating Second component or mesomorphy rating Third component or ectomorphy rating Somatochart and Somatoplot Somatotype Distributions Somatotyping Children Critical Evaluation Of Heath-Carter Anthropometric Somatotype Method
Sheldon’s method of Somatotyping has provided new techniques for the analysis and classification of human physique. However, there were numerous difficulties in applying this technique to quantify the physique of a person. The main difficulty was to have the nude photographs of the subject. Therefore, there have been many attempts to make it simpler, easily executable and more objective. Several attempts were later made in this direction to somatotype on the basis of anthropometric measurements (Cureton 1951, Parnell 1954, Damon et al. 1962); however, these methods remained relatively unused because of certain discrepancies. The HeatCarter method of somatotyping is one such attempt which fulfils to a major extent these requirements and is widely in use throughout the world during the last two decades. Its application is immense in the fields of sports sciences, anthropology, human biology, child growth, etc. It is based on anthropometric measurements which are easy to take on the subjectsHeath (1963) critically examined the shortcomings in Sheldon's method and suggested alterations and modifications in it. Later on, Heath and Carter in 1967 gave their own method of somatotyping. Though this method differs from that of Sheldon's in the sense that it evaluates the body form or physique at the given time compared to the unchanging somatotype of Sheldon. The ratings of three primary components of physique are assigned from the tables on the basis of the
anthropometric measurements. Before going into the details of the method, it is necessary to acquaint with their concepts of somatotype and the three components, Viz., endomorphy, mesomorphy, ectomorphy. Heath and Carter (1967) and Carter (1975, 1980), Carter et al. (1983), Carter and Heath (1990) have defined these concepts as follows: "A Somatotype is a description of the present morphological conformation. It is expressed in a three numeral rating, consisting of three sequential numbers, always recorded in the same manner. Each numeral represents the evaluation of three primary components of physique which describe individual variations in human morphology and composition" "First component (or endomorphy) refers to relative fatness in individual physiques; it also refers to relative leanness. That is, first component ratings are evaluations or degrees of fatness which lie on a continuum from the lowest recorded values to the highest recorded values". "Second component (or mesomorphy) refers to relative musculo-skeletal development per unit of height. Second component ratings are evaluations of musculo-skeletal development which lie on a continuum from lowest to highest degrees recorded. The second component can be thought of as Lean Body Mass relative to Height". "Third component (or ectomorphy) refers to relative linearity or individual physiques. Third component ratings are based largely, but not entirely on height/cube root of weight ratios. Height/cube root of weight ratios and third component ratings are closely related, so that at the low ends of their distributions both connote relative shortness of the several body segments, and the high ends connote elongation or linearity of several body segments. Ectomorphy ratings evaluate the form and degree of longitudinal distribution of the first and the second component". 6.1 Heath-Carter method of Somatotyping The Heath-Carter method of somatotyping described below is "THE HEATH CARTER ANTHROPOMETRIC SOMATOTYPE METHOD". It may be for the interest of the readers to note that in the Heath-Carter method a photoscopic somatotype rating can be made which
evaluates the physique from the photographs by visual inspection as well as height/cube root of weight ratios. The best estimate of physique or somatotype of an individual is a combination of the photoscopic and anthropometric estimates of somatotypes and is the criterion method. However, in the absence of trained raters and photographs, the anthropometric somatotype is a very good estimate of the physique of an individual 6.2 Anthropometric Measurements The following anthropometric measurements are required for obtaining the somatotype: 1. Height 2. Weight 3. Triceps skinfold 4. Subscapular skinfold 5. Supraspinale skinfold 6. Calf skinfold 7. Humerus biepicondylar diameter 8. Femur biepicondylar diameter 9. Biceps girth 10. Calf girth
Height (Stadiometer or Anthropometer)
It is the erect body length from the soles of the feet to the vertex. Vertex is the most superior or the highest point on the head when the head is in Frankfort horizontal plane (See chapter 2 for details).
Body weight (Weighing machine)
It is the nude weight o the body when the bowels are empty and is taken on a weighing machine or beam balance (details in chapter 2).
Triceps skinfold (Harpenden skinfold calliper)
The subject stands erect, arms normally hanging down by the side. The skinfold is picked up over the triceps muscle of the right arm midway between the acromion process and the superior border of radius in line with the olecranon process. The fold should be parallel to the long axis of the arm.
Subscapular skinfold (Harpenden skinfold calliper)
The subject stands erect and his shoulders are relaxed. The skinfold is picked up slightly below the most inferior angle of the right scapula. The skinfold should be pointing downwards and outwards.
Supraspinale skinfold (Harpenden skinfold calliper)
The subject stands erect and asked to inspire normally and hold his breath. The skinfold is picked up about 2 to 5cm above the anterior superior iliac spine on the line to the anterior axillary border of right side pointing forwards and downwards.
Calf skinfold (Harpenden skinfold calliper)
The subject is asked to sit on a chair with his knee bent at right angle. The skinfold is picked up on the medial side of the right calf slightly above the level of the maximum girth. The fold should be parallel to the long axis of the leg.
Humerus biepicondylar diameter (Sliding calliper)
It is the maximum diameter across the outermost points on the epicondyles of the distal end of humerus. The arm of the subject should be bent at right angle and the width across the two points is taken with a sliding calliper. Measurements are taken on both the sides and the larger value is recorded.
Femur biepicondylar diameter (Sliding calliper)
It is the maximum width across the outermost points on the epicondyles of the distal end of the femur. The subject sits on a chair with the knee bent at right angle. The calliper is applied to the epicondyles of the femur. Measurements are taken on both the sides and the larger value is recorded.
Biceps muscle girth (Steel tape)
It is the maximum circumference of the upper arm when the biceps muscle is fully contracted with elbow flexed. The tape is wrapped around the contracted upper arm taking care that it remains at right angles to the long axis of the upper arm and the largest value is taken by moving the tape in either direction where it is maximum. Measurements are taken on both the arms and the larger value is recorded.
Calf muscle girth (Steel tape)
The subject is asked to stand erect, both feet about 15 to 23 cm apart and body weight equally supported on both the legs. The tape is passed around the leg at right angle to its long axis and the maximum value is taken. Measurements on both the legs are taken and the larger value is recorded. The Heath-Carter anthropometric method is an objective one, i.e., any two raters who are provided with the same body measurements ill assign the same somatotypes. However, the accuracy to somatotype depends mainly upon how accurately the measurements are taken. So, the investigator is advised to master the techniques of taking these measurements. Inter and intra investigator comparisons of these measurements are necessary to make a check on the accuracy. There are certain measurements like the skinfolds which show large variations when taken at two
different times and by different investigators. It has been advocated by Tanner (1964) and recommended by Carter (1975) that the differences between the same measurements taken independently by a measurer on two occasions should not exceed 5%, So, on this basis, the recommendations are that the absolute differences for bone diameters should not exceed 1mm and for girths not more than 2 mm. 6.3 Technique of Heath-Carter Anthropometric Somatotype Table 6.1 is a typical Heath-Carter rating form which is required for obtaining the somatotypes. The minimum ratings of first component reflect the minimum possible non-essential fat, of second component of least development of musculo-skeletal structures and the third component, the least linearity. Theoretically, the minimum rating can be zero but practically, ratings less those 0.5 units are never assigned. Observed ratings so far for endomorphy, mesomorphy and ectomorphy are from 1 to 15, from 1 to 12 and from 0.5 to 9 units, respectively. The somatotype of 5-3-2 means a rating of 5 for endomorphy and 2 for ectomorphy. The procedure for calculating the somatotype from anthropometric measurements is described below.
Insert table 6.1 somewhere here
6.3.1
First component or endomorphy rating
The measurements required for endomorphy ratings are skinfolds at triceps, subscapular and supraspinale. Take the sum of these three skinfolds. Search the rating form for endomorphy evaluation for the nearest value to the recorded sum of the skinfolds. Here a reference to the rows and columns will be made quite often and the readers must acquaint themselves with these. The rows are horizontal sets of values and the columns the vertical ones. There are three rows, viz., upper limit, mid-point and lower limit. Circle the nearest value (in some cases where the difference is within a few millimetres, the values in the upper and the lower limit are circled
whereas in most of the cases the mid point is circled). Now deal with the columns and look in which column this circled value falls. Directly below this column the value of endomorphy can be seen (See appendix at the end of this chapter for easy and quick calculation of endomorphy, mesomorphy and ectomorphy) The endomorphy scale has been developed regardless of the height of the subject. If a subject is 170.18 cm tall and the other is 150.0 cm and both have the same sum of the skinfolds, then both of them will be assigned the same endomorphy rating. But in the real sense, a short person will be fattier than the tall one. Health- Carter has suggested a way out of this problem. The skinfolds are first corrected before estimating the endomorphy. The subject's height is brought to the level of universal average along with a modification in the sum of the three skinfolds in the following manner: Corrected sum of skinfolds = (Sum of skinfolds/ height) x 170.18 This corrected sum of skinfold is utilised for endomorphy assignments. Example: Let us assume the values of height, triceps, subscapular and subscapular and supraspinale skinfolds as 142.0 cm, 12mm, 10 mm and 8mm, respectively. The sum of skinfolds is 30mm and a value of 29.0 be circled on the rating form for endomorphy determination. The rating of endomorphy is 3 (Table 6.2). The corrected sum of skinfolds is 39.95 mm (30 x 170.18/142.0) which corresponds to a rating of 4 for endomorphy.
Insert table 6.2 somewhere here
Exact decimal rating of endomorphy can be assigned from the measurements directly using the following equation of Carter (1980): Endomorphy= – 0.7182 + 0.1451(X) – 0.00068(X)2 + 0.0000014(X)3 Where X is the sum of triceps, subscapular and supraspinale skinfolds, For obtaining height corrected endomorphy, X is multiplied by (170.18/ height in cm). Ex. 6.1 Calculate the endomorphy with and without height correction with the help of equation given by Carter (1980) if the sum of skinfolds = 30.0 and height is 142 cm. Endomorphy (without height correction)= – 0.7182 + 0.1451(X) – 0.00068(X)2 + 0.0000014(X)3 = – 0.7182 + 0.1451(30) – 0.00068(30)2 + 0.0000014(30)3 = – 0.7182 + 4.353 – 0.612 + 0.0378 = 3.06
Corrected sum of skinfolds = 30 x (170.18 /142) = 35.95 mm Endomorphy (with height correction)=
– 0.7182 + 0.1451(35.95) – 0.00068(35.95)2
+
0.0000014(35.95)3 = – 0.7182 + 5.216 – 0.8788 + 0.065 = 3.68
6.3.2 Second component or mesomorphy rating Record the values of height and the bone diameters in their respective boxes on the rating
form. Before entering the values of biceps muscle girth in the rating form, subtract triceps skinfold form it and similarly subtract calf skinfold from the calf muscle girth (since the triceps and calf skinfold are taken in millimetres and the muscle girths in centimetres, before subtracting the skinfolds from their respective muscle girths, it is necessary to divide them by 10, i.e. to covert them to centimetres). Circle the nearest height value of the height scale. Also put a height mark say an arrow (↑) at a column or a space between columns which corresponds to the exact height of the subject. Circle the nearest values of bone diameters and the muscle girths in their proper rows. In the case of measurement falling exactly in the middle, the lower value be circled. Next step is dealing only with columns and not the numerical values. Find the column or space between the columns which is the average of the columns deviations for the bone diameters and the muscle girths only (not height). This can be done in the following way: a. The left most circled column be designated as zero column (remember only the bone diameters and the muscle girths are taken). b. From the zero column, add the total number of columns to each of the other three circled values. c. Divide this total by four. d. Court this number of columns to the right of zero column and put some specific mark for your reference this point way be put at a columns or a space as the case may be. This way the average columns of bone and muscles in estimated which can be indicated by an asterisk (*). Again dealing with the columns only, count the number of columns and its fraction between the column of height and the average column. A rating of 4 for mesomorphy is taken as the standard value. If the average columns of bone and muscles fall on the height column, i.e. when the difference is zero, the mesomorphy rating is assigned as. If the average columns falls on the right of the height column, then the same number
of columns and fractions is moved to the right of 4 in the row of second component and if the average column is towards the left of the height column then the same number of columns are moved to the left of the columns of 4. If it lies exactly in the middle of the two ratings, then circle the value closer to 4 on the scale. For example, if the point lies in the middle of the two ratings of 3 and 3.5, a rating of 3.5 is assigned (3.5 is closer to 4) and if the point lies in the middle of the ratings 5 and 5.5, then a rating of 5 is assigned (5 being closer to 4) An alternative procedure for mesomorphy calculation The easiest way to calculate the mesomorphy rating is as given below. The circled height column is taken as the standard or zero column and the deviations of bone diameters and muscle girths from this column are noted. The difference of the columns which lie on the left side of the height column be written with a negative sign and the difference of those on the right side of height column with a positive sign. Then the algebraic sum of the four values is taken and written as D alone with the negative or positive sign. The average deviation is calculated by dividing it by 4 and then 2 (i.e. divide by 8) to convert to component units. The mesomorphy rating can then be directly calculated using the following formula: Mesomorphy (second component) = (D/8) = 4.0 Where D is the algebraic sum of columns as described above. Ex. 6.2 Calculate mesomorphy from the table of height, humerus biepicondylar, femur biepicondylar, corrected arm and calf girths are 142.0 cm, 5.5cm, 8.3cm, 27.0cm and 32.1 cm, respectively. The deviations of bone diameters and muscle girths from the height column are noted. The deviations are +1 for humerus biepicondylar, +3 for femur biepicondylar, +4 for biceps muscle girth and +5 for calf muscles girth. The algebraic sum of the deviations or D = 1+3+4+5=13
Mesomorphy = (D/8) +4.0 = (13/8) +4.0 =5.63 Another way of calculating mesomorphy With the following equation of Carter (1980) exact decimal rating mesomorphy can be easily obtained from the measurements directly. Mesomorphy= (0.858 x humerus width) + (0.601 x femur width) + (0.188 x corrected arm girth) + (0.161 x corrected calf girth) – (height x 0.131) + 4.50 Here, corrected arm girth is taken as the upper arm girth when biceps muscles are fully flexed and then subtracting
triceps skinfold from it. Similarly corrected calf girth is calculated by
subtracting calf skinfold from calf girth. Ex.6.3 Calculate mesomorphy rating if values of height, humerus biepicondylar, femur biepicondylar, corrected arm girth and calf girths are 142.0 cm, 5.5cm, 8.3cm, 27.0cm and 32.1 cm, respectively Mesomorphy = (0.858 x 5.5 + 0.601 x 8.3 + 0.188 x 27.0 + 0.161 x 32.1) – (142.0 x 0.131) + 4.50 = 5.85 There is some difference in the mesomorphy estimate by the above two methods (5.63 vs 5.85). The equation is very precise in its calculation because every millimetre is accounted for. However, in case of use of the table for calculation, lot of approximation is to be made for knowing the deviation of a measurement. 6.3.3 Third Component or Ectomorphy Rating. Height Weight Ratio (HWR) is calculated as follows: HWR = height/ (weight)1/3. Circle the closest value in the height weight ratio scale meant for determining ectomorphy. Assign the ectomorphy rating which falls below the column in which height weight ratio is circled.
Ex. 6.4 Calculate the HWR if weight= 40.0 kg and height = 142.0 cm HWR = 142/(40.0) 1/3 =41.52 A rating of 2 of ectomorphy will be assigned from the table. The calculation of height-weight ratio (height/weight1/3) is quite difficult. It can be made easy by consulting Appendix I, in which, 1/cube root of weight values are provided. Check the value of this factor from the table for the given weight and multiply it with the height of the subject to obtain this ratio as follows: Ex. 6.5 Calculate HWR using Appendix I for values of 1/cuberoot of weight Weight = 40.0kg, height = 142.0 cm HWR = 142.0 x 0.2924 = 41.52 Ectomorphy rating can be directly calculated from height weight ratios employing the following equation of Carter (1980): Ectomorphy = HWR x 0.732 – 28.58 If HWR 38.25, then Ectomorphy = HWR x 0.463- 17.63 If HWR
