Body fat percentage

The body fat percentage (BFP) of a human or other living being is the total mass of fat divided by total body mass, multiplied by 100; body fat
includes essential body fat and storage body fat. Essential body fat is necessary to maintain life and reproductive functions. The percentage of
essential body fat for women is greater than that for men, due to the demands of childbearing and other hormonal functions. Storage body fat
consists of fat accumulation in adipose tissue, part of which protects internal organs in the chest and abdomen. The minimum recommended
total body fat percentage exceeds the essential fat percentage value reported above. A number of methods are available for determining body fat
percentage, such as measurement with calipers or through the use of bioelectrical impedance analysis.

The body fat percentage is a measure of fitness level, since it is the only body measurement which directly calculates a person's relative body
composition without regard to height or weight. The widely used body mass index (BMI) provides a measure that allows the comparison of the
adiposity of individuals of different heights and weights. While BMI largely increases as adiposity increases, due to differences in body
composition, other indicators of body fat give more accurate results; for example, individuals with greater muscle mass or larger bones will have
higher BMIs. As such, BMI is a useful indicator of overall fitness for a large group of people, but a poor tool for determining the health of an
individual.

Contents
Typical body fat amounts
Measurement techniques
Underwater weighing
Whole-body air displacement plethysmography
Near-infrared interactance
Dual energy X-ray absorptiometry
Expansions
Body average density measurement
Bioelectrical impedance analysis
Anthropometric methods
Skinfold methods
Ultrasound
Height and circumference methods
From BMI

See also
References
External links

Typical body fat amounts

Epidemiologically, the percentage of body fat in an individual varies according to sex and age.[1] Various theoretical approaches exist on the
relationships between body fat percentage, health, athletic capacity, etc. Different authorities have consequently developed different
recommendations for ideal body fat percentages.

This graph from the National Health and Nutrition Examination Survey in the United States charts the average body fat percentages of
Americans from samples from 1999–2004:
 QuickStats: Mean Percentage Body Fat, by Age Group and Sex --- National
Health and Nutrition Examination Survey, United States, 1999--2004

In males, mean percentage body fat ranged from 22.9% at age 16–19 years to 30.9% at age 60–79 years. In females, mean percentage body fat
ranged from 32.0% at age 8–11 years to 42.4% at age 60–79 years.[2]

The table below from the American Council on Exercise shows how average percentages differ according to the specified groups and categories:[3]

Description Women Men

Essential fat 10–13% 3–5%
Athletes 14–20% 6–13%
Fitness 21–24% 14–17%
Average 25–31% 18–24%
Obese 32%+ 25%+

Essential fat is the level at which physical and physiological health would be negatively affected, and below which death is certain. Controversy
exists as to whether a particular body fat percentage is better for one's health; athletic performance may also be affected. The leanest athletes
typically compete at levels of about 6-13% for men or 14–20% for women. Bodybuilders may compete at essential body fat range, in fact certified
personal trainers will suggest them to keep that extremely low level of body fat only for the contest time. However it is unclear that such levels are
ever actually attained since (a) the means to measure such levels are, as noted below, lacking in principle and inaccurate, and (b) 4–6% is
generally considered a physiological minimum for human males.[4]

Measurement techniques

Underwater weighing
Irrespective of the location from which they are obtained, the fat cells in humans are composed almost entirely of pure triglycerides with an
average density of about 0.9 kilograms per litre. Most modern body composition laboratories today use the value of 1.1 kilograms per litre for the
density of the “fat free mass”, a theoretical tissue composed of 72% water (density = 0.993), 21% protein (density = 1.340) and 7% mineral
(density = 3.000) by weight.

With a well engineered weighing system, body density can be determined with great accuracy by completely submerging a person in water and
calculating the volume of the displaced water from the weight of the displaced water. A correction is made for the buoyancy of air in the lungs and
other gases in the body spaces. If there were no errors whatsoever in measuring body density, the uncertainty in fat estimation would be about ±
3.8% of the body weight, primarily because of normal variability in body constituents.

Whole-body air displacement plethysmography

Whole-body air displacement plethysmography (ADP) is a recognised and scientifically validated densitometric method to measure human body
fat percentage.[5] ADP uses the same principles as the gold-standard method of underwater weighing, but representing a densitometric method
that is based on air displacement rather than on water immersion. Air-displacement plethysmography offers several advantages over established
reference methods, including a quick, comfortable, automated, noninvasive, and safe measurement process, and accommodation of various
subject types (e.g., children, obese, elderly, and disabled persons).[6] However, its accuracy declines at the extremes of body fat percentages,
tending to slightly understate the percent body fat in overweight and obese persons (by 1.68–2.94%
depending on the method of calculation), and to overstate to a much larger degree the percent body
fat in very lean subjects (by an average of 6.8%, with up to a 13% overstatement of the reported body
percentage of one individual — i.e. 2% body fat by DXA but 15% by ADP).[7]

Near-infrared interactance
A beam of infra-red light is transmitted into a biceps. The light is reflected from the underlying
muscle and absorbed by the fatileur . The method is safe, noninvasive, rapid and easy to use.[8]

Body composition measurement

with whole-body air displacement
Dual energy X-ray absorptiometry
plethysmography (ADP) technology
Dual energy X-ray absorptiometry, or DXA (formerly DEXA), is a newer method for estimating body
fat percentage, and determining body composition and bone mineral density.

X-rays of two different energies are used to scan the body, one of which is absorbed more strongly by fat than the other. A computer can subtract
one image from the other, and the difference indicates the amount of fat relative to other tissues at each point. A sum over the entire image
enables calculation of the overall body composition.

Expansions
There are several more complicated procedures that more accurately determine body fat percentage. Some, referred to as multicompartment
models, can include DXA measurement of bone, plus independent measures of body water (using the dilution principle with isotopically labeled
water) and body volume (either by water displacement or air plethysmography). Various other components may be independently measured,
such as total body potassium.

In-vivo neutron activation can quantify all the elements of the body and use mathematical relations among the measured elements in the
different components of the body (fat, water, protein, etc.) to develop simultaneous equations to estimate total body composition, including body
fat.[9]

Body average density measurement

Prior to the adoption of DXA, the most accurate method of estimating body fat percentage was to measure that person's average density (total
mass divided by total volume) and apply a formula to convert that to body fat percentage.

Since fat tissue has a lower density than muscles and bones, it is possible to estimate the fat content. This estimate is distorted by the fact that
muscles and bones have different densities: for a person with a more-than-average amount of bone mass, the estimate will be too low. However,
this method gives highly reproducible results for individual persons (± 1%), unlike the methods discussed below, which can have an uncertainty
of 10%, or more. The body fat percentage is commonly calculated from one of two formulas (ρ represents density in g/cm3):

Brozek formula: BF = (4.57/ρ − 4.142) × 100[10]

Siri formula is: BF = (4.95/ρ − 4.50) × 100[11]

Bioelectrical impedance analysis

The bioelectrical impedance analysis (BIA) method is a lower-cost (from less than one to several hundred US dollars in 2006[12]) but less
accurate way to estimate body fat percentage. The general principle behind BIA: two or more conductors are attached to a person's body and a
small electric current is sent through the body. The resistance between the conductors will provide a measure of body fat between a pair of
electrodes, since the resistance to electricity varies between adipose, muscular and skeletal tissue. Fat-free mass (muscle) is a good conductor as
it contains a large amount of water (approximately 73%) and electrolytes, while fat is anhydrous and a poor conductor of electric current. Factors
that affect the accuracy and precision of this method include instrumentation, subject factors, technician skill, and the prediction equation
formulated to estimate the fat-free mass.

Each (bare) foot may be placed on an electrode, with the current sent up one leg, across the abdomen and down the other leg. (For convenience,
an instrument which must be stepped on will also measure weight.) Alternatively, an electrode may be held in each hand; calculation of fat
percentage uses the weight, so that must be measured with scales and entered by the user. The two methods may give different percentages,
without being inconsistent, as they measure fat in different parts of the body. More sophisticated instruments for domestic use are available with
electrodes for both feet and hands.

There is little scope for technician error as such, but factors such as eating, drinking and exercising must be controlled[12] since hydration level is
an important source of error in determining the flow of the electric current to estimate body fat. The instructions for use of instruments typically
recommended not making measurements soon after drinking or eating or exercising, or when dehydrated. Instruments require details such as
sex and age to be entered, and use formulae taking these into account; for example, men and women store fat differently around the abdomen
and thigh region.

Different BIA analysers may vary. Population-specific equations are available for some instruments, which are only reliable for specific ethnic
groups, populations, and conditions. Population-specific equations may not be appropriate for individuals outside of specific groups.[13]

Anthropometric methods
There exist various anthropometric methods for estimating body fat. The term anthropometric refers to measurements made of various
parameters of the human body, such as circumferences of various body parts or thicknesses of skinfolds. Most of these methods are based on a
statistical model. Some measurements are selected, and are applied to a population sample. For each individual in the sample, the method's
measurements are recorded, and that individual's body density is also recorded, being determined by, for instance, under-water weighing, in
combination with a multi-compartment body density model. From this data, a formula relating the body measurements to density is developed.

Because most anthropometric formulas such as the Durnin-Womersley skinfold method,[14] the Jackson-Pollock skinfold method, and the US
Navy circumference method, actually estimate body density, not body fat percentage, the body fat percentage is obtained by applying a second
formula, such as the Siri or Brozek described in the above section on density. Consequently, the body fat percentage calculated from skin folds or
other anthropometric methods carries the cumulative error from the application of two separate statistical models.

These methods are therefore inferior to a direct measurement of body density and the application of just one formula to estimate body fat
percentage. One way to regard these methods is that they trade accuracy for convenience, since it is much more convenient to take a few body
measurements than to submerge individuals in water.

The chief problem with all statistically derived formulas is that in order to be widely applicable, they must be based on a broad sample of
individuals. Yet, that breadth makes them inherently inaccurate. The ideal statistical estimation method for an individual is based on a sample of
similar individuals. For instance, a skinfold based body density formula developed from a sample of male collegiate rowers is likely to be much
more accurate for estimating the body density of a male collegiate rower than a method developed using a sample of the general population,
because the sample is narrowed down by age, sex, physical fitness level, type of sport, and lifestyle factors. On the other hand, such a formula is
unsuitable for general use.

Skinfold methods
The skinfold estimation methods are based on a skinfold test, also known as a pinch test, whereby a
pinch of skin is precisely measured by calipers, also known as a Plicometer,[15] at several
standardized points on the body to determine the subcutaneous fat layer thickness.[16][17] These
measurements are converted to an estimated body fat percentage by an equation. Some formulas
require as few as three measurements, others as many as seven. The accuracy of these estimates is
more dependent on a person's unique body fat distribution than on the number of sites measured. As
well, it is of utmost importance to test in a precise location with a fixed pressure. Although it may not
give an accurate reading of real body fat percentage, it is a reliable measure of body composition
change over a period of time, provided the test is carried out by the same person with the same
technique.

Skinfold-based body fat estimation is sensitive to the type of caliper used, and technique. This method
also only measures one type of fat: subcutaneous adipose tissue (fat under the skin). Two individuals
might have nearly identical measurements at all of the skin fold sites, yet differ greatly in their body
fat levels due to differences in other body fat deposits such as visceral adipose tissue: fat in the Body Fat Caliper
abdominal cavity. Some models partially address this problem by including age as a variable in the
statistics and the resulting formula. Older individuals are found to have a lower body density for the
same skinfold measurements, which is assumed to signify a higher body fat percentage. However, older, highly athletic individuals might not fit
this assumption, causing the formulas to underestimate their body density.

Ultrasound
Ultrasound is used extensively to measure tissue structure and has proven to be an accurate technique to measure subcutaneous fat thickness.[18]
A-mode and B-mode ultrasound systems are now used and both rely on using tabulated values of tissue sound speed and automated signal
analysis to determine fat thickness. By making thickness measurements at multiple sites on the body you can calculate the estimated body fat
percentage.[19][20] Ultrasound techniques can also be used to directly measure muscle thickness and quantify intramuscular fat. Ultrasound
equipment is expensive, and not cost-effective solely for body fat measurement, but where equipment is available, as in hospitals, the extra cost
for the capability to measure body fat is minimal.[12]

Height and circumference methods

There also exist formulas for estimating body fat percentage from an individual's weight and girth measurements. For example, the U.S. Navy
circumference method compares abdomen or waist and hips measurements to neck measurement and height and other sites claim to estimate
one's body fat percentage by a conversion from the body mass index. In the U.S. Navy the method is known as the "rope and choke." There is
limited information, however, on the validity of the "rope and choke" method because of its universal acceptance as inaccurate and easily
falsified.

The U.S. Army and U.S. Marine Corps also rely on the height and circumference method.[21] For males, they measure the neck and waist just
above the navel. Females are measured around the hips, waist, and neck. These measurements are then looked up in published tables, with the
individual's height as an additional parameter. This method is used because it is a cheap and convenient way to implement a body fat test
throughout an entire service.

Methods using circumference have little acceptance outside the Department of Defense due to their negative reputation in comparison to other
methods. The method's accuracy becomes an issue when comparing people with different body compositions, those with larger necks artificially
generate lower body fat percentage calculations than those with smaller necks.

From BMI
Body fat can be estimated from body mass index (BMI), a person's mass in kilograms divided by the square of the height in meters; if weight is
measured in pounds and height in inches, the result can be converted to BMI by multiplying by 703.[22] There are a number of proposed
formulae that relate body fat to BMI. These formulae are based on work by researchers published in peer-reviewed journals, but their correlation
with body fat are only estimates; body fat cannot be deduced accurately from BMI.

Body fat may be estimated from the body mass index by formulae derived by Deurenberg and co-workers. When making calculations, the
relationship between densitometrically determined body fat percentage (BF%) and BMI must take age and sex into account. Internal and
external cross-validation of the prediction formulas showed that they gave valid estimates of body fat in males and females at all ages. In obese
subjects, however, the prediction formulas slightly overestimated the BF%. The prediction error is comparable to the prediction error obtained
with other methods of estimating BF%, such as skinfold thickness measurements and bioelectrical impedance. The formula for children is
different; the relationship between BMI and BF% in children was found to differ from that in adults due to the height-related increase in BMI in
children aged 15 years and younger.[23]

where sex is 0 for females and 1 for males.

However – contrary to the aforementioned internal and external cross-validation –, these formulae definitely proved unusable at least for adults
and are presented here illustratively only.

Still, the following formula designed for adults proved to be much more accurate at least for adults:[24]

where, again, gender (sex) is 0 if female and 1 if male to account for the lower body fat percentage of men.

Other indices may be used; the body adiposity index was said by its developers to give a direct estimate of body fat percentage, but statistical
studies found this not to be so.[25]

See also
Adipose tissue
Andreas Münzer
Body fat meter
Body water
Classification of obesity
Lizzie Velásquez, a woman with "zero percent body fat"
Relative Fat Mass (RFM)
Human heart age
CUN-BAE, Clínica Universidad de Navarra - Body Adiposity Estimator, estimates BF% based on age, BMI and gender

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External links
Gallagher D, Heymsfield SB, Heo M, Jebb SA, Murgatroyd PR, Sakamoto Y (September 2000). "Healthy percentage body fat ranges: an
approach for developing guidelines based on body mass index". The American Journal of Clinical Nutrition. 72 (3): 694–701.
doi:10.1093/ajcn/72.3.694 (https://doi.org/10.1093%2Fajcn%2F72.3.694). PMID 10966886 (https://www.ncbi.nlm.nih.gov/pubmed/1096688
6).

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