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Background <p>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.</p> Objective <p>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.</p> Methods <p>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 (%BF<sub>DXA</sub>), bioelectrical impedance analysis (%BF<sub>BIA</sub>), and CBE using 3-site (Hodgdon, %BF<sub>HE</sub>) and 1-site (Taylor-McClung, %BF<sub>TM</sub>) equations. Results were stratified by race and sex, to evaluate differences in accuracy of estimated %BF (weighted root mean squared error from %BF<sub>DXA</sub>). Associations of BF and PF with MSKI risk were evaluated with logistic regression.</p> Results <p>CBE and BIA underestimated %BF compared to %BF<sub>DXA</sub>. %BF<sub>BIA</sub> differed from %BF<sub>DXA</sub> overall and by sex. %BF<sub>TM</sub> underestimation was uniform across both sex and R/E compared to %BF<sub>DXA</sub>. Mean differences from %BF<sub>DXA</sub> by sex (M;F) were lower when measured by %BF<sub>TM</sub> (4.38; 4.59) compared to %BF<sub>HE</sub> (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.</p> Conclusions <p>A single-site BF equation (%BF<sub>TM</sub>) 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.</p>

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

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年2月27日

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  • 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

摘要

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.