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Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Methodol. Mar 26, 2015; 5(1): 1-9
Published online Mar 26, 2015. doi: 10.5662/wjm.v5.i1.1
Measurement of body composition as a surrogate evaluation of energy balance in obese patients
Carlo Maria Rotella, Ilaria Dicembrini
Carlo Maria Rotella, Ilaria Dicembrini, Section of Endocrinology, Department of Biomedical, Experimental and Clinical Sciences, University of Florence Medical School, 50121 Firenze, Italy
Carlo Maria Rotella, Ilaria Dicembrini, Obesity Agency, Diabetes Agency, Careggi University Hospital, 50127 Florence, Italy
Ilaria Dicembrini, Diabetes Agency, Careggi University Hospital, 50127 Florence, Italy
Author contributions: Rotella CM and Dicembrini I contributed equally to this work.
Conflict-of-interest: No.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Carlo Maria Rotella, Professor, Section of Endocrinology, Department of Biomedical, Experimental and Clinical Sciences, University of Florence Medical School, viale Pieraccini 6, 50127 Florence, Italy. c.rotella@dfc.unfi.it
Telephone: +39-055-4271427 Fax: +39-055-4271474
Received: November 26, 2013
Peer-review started: November 26, 2013
First decision: January 8, 2014
Revised: February 18, 2015
Accepted: March 16, 2015
Article in press: March 18, 2015
Published online: March 26, 2015
Processing time: 483 Days and 12.2 Hours
Abstract

In clinical practice obesity is primarily diagnosed through the body mass index. In order to characterize patients affected by obesity the use of traditional anthropometric measures appears misleading. Beyond the body mass index, there are overwhelming evidences towards the relevance of a more detailed description of the individual phenotype by characterizing the main body components as free-fat mass, muscle mass, and fat mass. Among the numerous techniques actually available, bioelectrical impedance analysis seems to be the most suitable in a clinical setting because it is simple, inexpensive, noninvasive, and highly reproducible. To date, there is no consensus concerning the use of one preferred equation for the resting energy expenditure in overweight and/or obese population. Energy restriction alone is an effective strategy to achieve an early and significant weight loss, however it results in a reduction of both fat and lean mass therefore promoting or aggravating an unfavourable body composition (as sarcobesity) in terms of mortality and comorbidities. Therefore the implementation of daily levels of physical activity should be simultaneously promoted. The major role of muscle mass in the energy balance has been recently established by the rising prevalence of the combination of two condition as sarcopenia and obesity. Physical exercise stimulates energy expenditure, thereby directly improving energy balance, and also promotes adaptations such as fiber type, mitochondrial biogenesis, improvement of insulin resistance, and release of myokines, which may influence different tissues, including muscle.

Keywords: Obesity; Body composition; Bioelectrical impedance analysis; Energy expenditure; Sarcobesity

Core tip: There are overwhelming evidences towards the relevance of a more detailed description of the individual phenotype by characterizing the main body components as free-fat mass, muscle mass, and fat mass. Among the numerous techniques actually available, bioelectrical impedance analysis seems to be the most suitable in a clinical setting because it is simple, inexpensive, noninvasive, and highly reproducible. To date, there is no consensus concerning the use of one preferred equation for the resting energy expenditure in overweight and/or obese population.