Asia Pacific J Clin Nutr (1995) 4: 77-78
Technology in body composition:
considerations for a traditional, elderly Indonesian population
Fadil Oenzil MD (Andalas), PhD
(Deakin), Dip Nut (SEAMEO TropMed)
Department of Biochemistry, Faculty of Medicine,
Andalas University, Padang, West Sumatra, Indonesia.
Body composition has been measured in a group of
elderly people living in nursing home care in West Sumatra, Indonesia.
Anthropometric techniques were used to measure height, weight, waist
and hip circumference, and skinfolds at four sites (triceps, biceps,
suprailiac and subscapula). Body fat was determined with the equations
of Durnin and Womersley, although difficulties were encountered
because of the age and leanness of some of the subjects. The average
age of the subjects was 73.0± 7.5 years (n=20) and 73.4± 5.4 (n= 15) for males and females respectively. The average body
mass index (BMI) was 18.2 kg/m2 for both groups. The
mean total body fat and waist/hip ratio for the males was 8.8 kg
and 0.86; corresponding results for the females were 12.3 kg and
0.77. The results demonstrate the limitations of these techniques,
when they are applied to an elderly population for which appropriate
standards are not available.
Introduction
The changes of body composition associated with aging
are well documented1,2 and they include decreased height
(stooped posture secondary to increased kyphosis), decreased weight,
increased fat-to-lean body mass ratio and decreased total body water.
While information on these effects is readily available in many European
and North American populations, there is very little information available
on such populations in Indonesia.
Durnin3 has recently argued that skinfold
measurements are adequate for most purposes concerned with field studies.
The most widely used method for converting skinfold measurements to
% body fat is that of Durnin and Womersley4; however, their
table does not show values for subjects over the age of 60 or for
subjects whose sum of four skinfolds is less than 15mm.
Other methods are available for assessing body composition,
but these also have their limitations, especially when applied to
an elderly population. For example, weight-for-height tables are widely
used when assessing subjects who are over-weight; the criteria generally
depend on age and are generally limited to people up to the age of
about 60 years. Roe5 has adapted data from the Department
of Health, Education and Welfare in the United States so that weight-for-height
can be assessed in persons 65 years and older. Another technique for
assessing fat has been demonstrated by McArdle6 who used
three girth measurements (abdomen, thigh and forearm) in their determination.
Unfortunately, they have only applied it to two age groups, 18-26
and 27-50.
However, all of these techniques suffer from the disadvantage
that they have been calibrated for ethnic groups in other countries
and many authors have commented on the problems arising from this
limitation2. In this work, anthropometric and skinfold
data have been acquired on a group of elderly West Sumatran subjects
and it was decided that the results would be interpreted according
to the method of Durnin and Womersley. A major advantage in using
the Durnin and Womersley table is that their work is the most widely
accepted standard in the medical field. It is therefore easier to
make comparisons with other work when the same conversions have been
used by all authors.
Subjects and methods
The subjects for this study were 20 male and 15 female
elderly people living in a nursing home in Sicincin, West Sumatra,
Indonesia.
Body weight was measured to the nearest 0.1 kg using
digital scales. Height was determined using a 'microtoise' with readings
from a window device. Waist and hip circumference were taken with
a non-stretch tape. The waist circumference was measured at the umbilicus
and the hip was measured at the level of the maximum gluteal protuberance.
Skinfold thicknesses were measured at the triceps,
biceps, supra-iliac and sub-scapular positions using a Harpenden caliper
(John Bull, British Indicators Ltd). The sub-scapula skinfold was
measured 5 cm below the scapula and at 45°
to the vertical.
Results and discussion
The average age of the males was found to be 73.0±
7.5 years (n=20) and for the females it was 73.4± 5.4 years (n=15). The average BMI
was found to be the same for both males and females, ie 18.2. See
Table 1.
Table 1. Age, height, weight and body mass
index (BMI) (mean ± standard deviation).
| |
Males (n=20) |
Females (n=15) |
| Age |
73.0± 7.5 |
73.4± 5.4 |
| Height (cm) |
154.6± 4.9 |
143.9± 7.2 |
| Weight (kg) |
43.6± 5 .8 |
37.7:± 8.8 |
| BMI (kg/m2) |
1 8.2± 2.4 |
18.2± 3.8 |
Averaged results of the skinfold measurements are
shown in Table 2. The mean total body fat was 8.8 kg for males and
almost 50% greater for females, 12.3 kg.
Table 2. Skinfolds, % fat and waist-to-hip
ratio. Values are means ± sd: ( ) = n.
| |
Males
|
Females
|
| Triceps skinfolds (mm)
|
7.5 ± 2.8 (20)
|
10.3 ± 4.9 (15)
|
| Biceps skinfolds (mm) |
5.8 ± 1.5 (20)
|
7. 1 ± 2.9 (15)
|
| Suprailiac skinfolds
(mm) |
9.7 ± 5.4 (20)
|
1.95 ± 11.8 (15)
|
| Subscapular skinfolds
(mm) |
8.2 ± 3.0 (20)
|
7.7 ± 3.4 (15)
|
| Total skinfolds (mm)
|
31.1 ± 11.3 (20)
|
44.5 ± 20.5 (15)
|
| % body fat |
19.8 ± 4.0 (18)
|
31.3 ± 5.8 (14)
|
| Total body fat (kg)
|
8.8 ± 2.8 (18)
|
12.3 ± 4.8 (14)
|
| Waist circumference
(cm) |
70.2 ± 6.6(18)
|
63.2 ± 8.7 (15)
|
| Hip circumference (cm)
|
81.6 ± 5.4 (18)
|
81.9 ± 7.4 (15)
|
| Waist-to-hip ratio |
0.86 ± 0.06(18)
|
0.77 ± 0.06(15)
|
Difficulties arise with the tables of Durnin and Womersley4
because they do not show values of percent fat for subjects whose
sum of four skinfolds is less than 15 mm. As indicated by the reduced
numbers at the bottom of Table 2, two males and one female were omitted
because their skinfolds summed to less than 15 mm. A further difficulty
arises because Durnin and Womersley show their oldest age group to
be for 50 to 70 years. Eleven of the males and ten of the females
in the study were over 70 years of age, but their skinfolds were still
interpreted with the figures given for 50 70-year-olds.
The mean waist-to-hip ratio was determined to be 0.86
for males and 0.77 for females. (Table 2).
Comparative data on Indonesian adults is available
in two recent papers7,8. Oenzil7 studied 102
West Sumatran adult rural and urban Indonesian males as two separate
groups. Prijatmoko and Strauss8 have presented data on
122 adults from Jember, 71 males and 51 females. The data from both
papers are summarized in Table 3.
Table 3. Comparative data.
| |
Oenzil7
|
Prijatmoko et al8
|
| |
Urban (n=52)
|
Rural (n=50)
|
Males (n=71)
|
Females (n=51)
|
| Age |
25-39
|
25 -39
|
40.2 ± 8.7
|
36.5 ± 7.2
|
| Height (cm) |
161.8 ± 7.7
|
157.4 ± 2.3
|
163.6 ± 5.5
|
152.6 ± 5.2
|
| Weight (kg) |
56.4 ± 10.8
|
53.2 ± 7.3
|
61.3 ± 5.5
|
53.4 ± 9.1
|
| BMI (kg/m~) |
21.2 ± 3.4
|
20.4 ± 2.9
|
22.6 ± 4.4
|
22.3 ± 4.8
|
| % body fat |
--
|
--
|
18.5 ± 6.8
|
27.2 ± 9.6
|
| Total body fat |
13.4 ± 5.3
|
9.1 ± 3.5
|
--
|
--
|
| Waist-to-hip ratio |
0.90 ± 0.06
|
0.88 ± 0.04
|
0.84 ± 0.1
|
0.75 ± 0.1
|
Conclusion
The subjects included in this study were all residents
of a nursing home. This is unusual for Indonesia because most elderly
Indonesians live with their children. The comparative data shown in
Table 3 show that the elderly are shorter, have a lower weight, a
lower BMI and less fat than their younger countrymen. Steen2
has recently emphasized the need for body fat equations to be created
and validated from skinfolds of the same age group, but in this group
there is the added complication that the equations have been derived
on a very different ethnic group. Another short coming of the present
study is the techniques were not available for the measurement of
total body water. This measurement is very important in the elderly
because of their reduced total body water and their correspondingly
greater susceptibility to dehydration.
Despite the limitations of the equipment, the present
study demonstrates that the measurement of anthropometry and skinfolds
can be usefully applied in survey work and the results are indicative
of the changes normally observed in an ageing population.
References
- Kane RL, Ouslander JG, Abrass IB. Essentials of
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- Steen B, Gause-Nilsson 1, Bosaeus 1. Body composition
and the aged - what needs to be measured? Asia Pacific Nutr 1994;3:
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- Roe DA. Geriatric Nutrition. 3rd Edn. New York:
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- McArdle WD, Katch Fl, Katch Vl. Exercise Physiology:
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- Oenzil E Coronary risk in West Sumatran men. Asia
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- Prijatmoko D, Strauss BJG. Health surveillance
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Copyright © 1996 [Asia Pacific Journal of Clinical
Nutrition]. All rights reserved.
Revised:
January 19, 1999
.
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