We know that BMI is not an authentic measure of body fat. Hence, we need alternatives to rely on. One of the biggest reasons why BMI was used so frequently in the past decades is due to the convenience, ease of calculation, and no requirement for additional equipment/accessories. There are multiple options available these days that can help us measure body fat very easily, quickly, and conveniently. Let’s take a look at some of the most promising ones –
Body measurements using Tape
Measuring the body circumference, especially at areas likely to have fat deposition, can give a fair idea of the amount of body fat. It is a very simple method that can be performed anywhere and requires only a non-stretch, flexible measuring tape. Neck, upper arm, waist, abdomen, and hip measurements are usually the most preferred ones used. Due to differences in body shape and fat distribution, body circumference equations may not be accurate.
Waist circumference
Waist circumference is the circumference of the abdomen, measured at the natural waist, the belly button, or at the narrowest point of the mid-section. Several studies claim that waist circumference can be used as a screening tool to determine abdominal obesity and overweight categories as compared to the BMI. However, it is not the only diagnostic parameter of the body fatness or health of an individual. It consists of visceral fat, subcutaneous fat, muscle, intramuscular fat, viscera, and bone.
The waist circumference cut offs suggested by International Diabetes Federation for Asian population are as follows –
Gender Waist circumference
Male ≥ 90 cm
Female ≥ 80 cm
Studies suggest that abdominal obesity is strongly associated with an increased risk of type 2 diabetes, cardiovascular disease, and death, even after controlling for body mass index (BMI). However, the measurement procedures may not be standardized, which could lead to errors.
Bioelectrical Impedance Analysis or BIA
BIA is a small electrical alternating current that is imperceptible. It is passed through the human body, and the resistance to its flow is measured. The current faces more resistance while passing through fat in the body, while it is easier for the current to pass through the lean body mass and fluid compartment of the body. Equations are then used to estimate the body fat percentage and fat-free mass, which includes lean body mass as well. It is convenient and easy to use but quite expensive. It is portable and safe to use. The ratio of body fat to body water changes during illness and dehydration. It is also affected by food and fluid intake.
Skin fold measure using Skin fold calipers
Skin fold calipers measure the thickness of the subcutaneous fat that is right underneath the skin. It is specially measured around 4 skin folds
i. Biceps skinfold measurement (front side middle upper arm)
ii. Triceps skinfold measurement (back side middle upper arm)
iii. Subscapular skinfold measurement (under the lowest point of the shoulder blade)
iv. Suprailiac skinfold measurement (above the upper bone of the hip)
Of all the skinfold measurements, triceps skinfold is the most reliable and accurate one to assess because even in cases of fluid retention or edema, there are hardly any changes in the upper arm. However, it is essential that these measurements are taken by an expert, as the accuracy depends on the knowledge and skill of the person taking the measurements. This method is affordable and can be easily sourced.
Waist to Hip ratio
Waist-to-hip ratio is a commonly used parameter for measuring abdominal obesity. It is calculated by dividing the waist circumference by the hip circumference measured at the widest area of the hip. It is very well correlated with other accurate methods of measuring obesity. It is inexpensive and predicts the risk of developing diseases. However, it might be difficult to measure and less reliable in the case of individuals with a BMI greater than 35.
As per WHO, the waist to hip ratio cut offs are as follows -
Category Male Female
Normal <0.95 <0.80
At risk ≥0.95 ≥0.80
Body fat percentage using DEXA
Dual energy X-ray absorptiometry (DEXA) provides a detailed analysis of fat tissue (including differences between visceral and subcutaneous fat), bone, and lean mass in separate regions of the body. The scan is easy and requires about 15 minutes, after which results are demonstrated through pictures and graphs depicting ratios of different fat, muscle, and bone tissue. DEXA scans are not available everywhere. The equipment required is expensive; hence, the scans are expensive. They deliver a small amount of radiation during the scan. DEXA is typically used in a medical or research scenario. However, it provides more detailed and consistent results compared to other methods.
Underwater weighing
Underwater weighing, or hydrostatic weighing, is used to estimate the body’s composition based on density. This technique weighs individuals while they are submerged underwater after maximum exhalation. After that, the same individual is weighed on land, and the difference between the weights is used to estimate the air left in the lungs after the exhale.
The above data is put into equations and used to determine the density of the body, which then helps to predict the body fat percentage. It is accurate and quick; however, it might be inconvenient for individuals to stay underwater while holding their breath.
Some methods, such as body circumference measurements, skinfold measurements, and portable BIA devices, are inexpensive. They are easy to use and allow individuals the flexibility to be measured in any comfortable setup and as frequently as required. They are easily available online. Although they might not have the highest accuracy, the ease of use makes them the first choice for laymen. DEXA and hydrostatic weighing are more accurate, but they are expensive, not available everywhere, and require trained individuals to perform the test.
Regular assessment of body fat can help one understand their progress in the health journey and also figure out what works for them and what doesn’t. It empowers individuals to make modifications based on authentic data instead of just working with random assumptions or relying on incorrect parameters to determine good health and fitness.
Article by - Dt. Niti Dhulla, RD | PGD | BSc (FND)
(Registered Dietitian, Gold Medallist in Food, Nutrition and Dietetics from University of Mumbai, Certified Yoga Instructor and Internationally Certified Fitness Expert)
Owner and Founder at Online Nutrition Consultancy “NutriDietbyNitiDhulla”
Website – www.nutridietbynitidhulla.com | Instagram - @NutriDietByNitiDhulla
Facebook - NutriDietByNitiDhulla | Email - nutridietbynitidhulla@gmail.com
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