Science behind policy: implementing a modern circumference-based body fat equation with a physical fitness threshold is associated with lower musculoskeletal injury risk.

IF 4.2 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM International Journal of Obesity Pub Date : 2025-02-27 DOI:10.1038/s41366-024-01701-5
Holly L McClung, P Matthew Bartlett, Barry A Spiering, Stephen A Foulis, Tyler E Oliver, Leila A Walker, Vy T Nguyen, Susan P Proctor, James P McClung, Kathryn M Taylor
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Abstract

Background: Body composition influences physical fitness (PF) and risk of musculoskeletal injury (MSKI). Assessing the relationship between body fat (BF), PF and MSKI risk in a large diverse military population may provide evidence basis informing health-care policies, practices, and programs for military and civilian populations.

Objective: Evaluate the validity of expedient methods to estimate BF (e.g., circumference-based equation (CBE) and bioelectrical impedance analysis (BIA)) and investigate relationships between BF and PF with MSKI risk in a large diverse population.

Methods: Participants were 1904 active-duty Soldiers (643 F) representing Army demographics sex, race/ethnicity (R/E), and age. PF, defined as the most recent Army Combat Fitness Test (ACFT) score and incidence of MSKI, were obtained from Army records. BF was determined by dual-energy x-ray absorptiometry (%BFDXA), bioelectrical impedance analysis (%BFBIA), and CBE using 3-site (Hodgdon, %BFHE) and 1-site (Taylor-McClung, %BFTM) equations. Results were stratified by race and sex, to evaluate differences in accuracy of estimated %BF (weighted root mean squared error from %BFDXA). Associations of BF and PF with MSKI risk were evaluated with logistic regression.

Results: CBE and BIA underestimated %BF compared to %BFDXA. %BFBIA differed from %BFDXA overall and by sex. %BFTM underestimation was uniform across both sex and R/E compared to %BFDXA. Mean differences from %BFDXA by sex (M;F) were lower when measured by %BFTM (4.38; 4.59) compared to %BFHE (5.88; 4.39). Individuals had a greater likelihood of MSKI if they failed BF standards (odds ratio 1.32). Scoring ≥ 540 total on ACFT exhibited a 31% (95% CI: 0.52, 0.92) lower MSKI risk during the following 12 months than those with a lower score.

Conclusions: A single-site BF equation (%BFTM) maintained similar accuracy across the Soldier population by sex, age, and R/E. Implementing a PF score threshold in lieu of passing Army BF standards was associated with lower MSKI risk.

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背景:身体成分影响体能(PF)和肌肉骨骼损伤(MSKI)风险。在大量不同的军人群体中评估体脂(BF)、体适能和肌肉骨骼损伤风险之间的关系可为军队和平民的医疗保健政策、实践和计划提供依据:评估估算 BF 的便捷方法(如基于周长的方程 (CBE) 和生物电阻抗分析 (BIA))的有效性,并调查大量不同人群中 BF 和 PF 与 MSKI 风险之间的关系:参与者为 1904 名现役士兵(643 名女性),代表了军队人口统计学中的性别、种族/民族(R/E)和年龄。PF(定义为最近的陆军战斗体能测试(ACFT)得分)和 MSKI 发病率均来自陆军记录。BF是通过双能量X射线吸收测定法(%BFDXA)、生物电阻抗分析法(%BFBIA)以及使用3部位(霍奇顿,%BFHE)和1部位(泰勒-麦克劳恩,%BFTM)方程的CBE测定的。结果按种族和性别进行了分层,以评估估计的 BF 百分比的准确性差异(%BFDXA 的加权均方根误差)。通过逻辑回归评估了BF和PF与MSKI风险的相关性:结果:与%BFDXA相比,CBE和BIA低估了%BF。BFBIA%与BFDXA%在总体和性别上存在差异。与%BFDXA相比,%BFTM的低估在性别和R/E上都是一致的。与%BFHE(5.88;4.39)相比,%BFTM(4.38;4.59)测量的性别(男;女)与%BFDXA的平均差异较低。如果 BF 未达标,则患 MSKI 的可能性更大(几率比 1.32)。ACFT总分≥540分的患者在接下来的12个月中MSKI风险比总分较低的患者低31% (95% CI: 0.52, 0.92):根据性别、年龄和R/E,单部位BF方程(%BFTM)在士兵人群中保持了相似的准确性。采用 PF 分数阈值代替通过陆军 BF 标准与降低 MSKI 风险有关。
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来源期刊
International Journal of Obesity
International Journal of Obesity 医学-内分泌学与代谢
CiteScore
10.00
自引率
2.00%
发文量
221
审稿时长
3 months
期刊介绍: The International Journal of Obesity is a multi-disciplinary forum for research describing basic, clinical and applied studies in biochemistry, physiology, genetics and nutrition, molecular, metabolic, psychological and epidemiological aspects of obesity and related disorders. We publish a range of content types including original research articles, technical reports, reviews, correspondence and brief communications that elaborate on significant advances in the field and cover topical issues.
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