SPECIAL COMMUNICATIONS

Methods

Comparison of the BOD POD with the fourcompartment model in adult females
DAVID A. FIELDS, G. DENNIS WILSON, L. BRUCE GLADDEN, GARY R. HUNTER, DAVID D. PASCOE, and
MICHAEL I. GORAN
Division of Physiology and Metabolism, Department of Nutrition Sciences, and Department of Human Studies, University
of Alabama at Birmingham, Birmingham, AL; Department of Health and Human Performance, Auburn University,
Auburn, AL; Department of Preventive Medicine, Institute for Preventive Research, University of Southern California, Los
Angeles, CA; and Department of Internal Medicine, Center for Human Nutrition, Washington University, St. Louis, MO

ABSTRACT
FIELDS, D. A., G. D. WILSON, L. B. GLADDEN, G. R. HUNTER, D. D. PASCOE, and M. I. GORAN. Comparison of the BOD
POD with the four-compartment model in adult females. Med. Sci. Sports Exerc., Vol. 33, No. 9, 2001, pp. 16051610. Purpose: This
study was designed to compare the accuracy and bias in estimates of total body density (Db) by hydrostatic weighing (HW) and the
BOD POD, and percent body fat (%fat) by the BOD POD with the four-compartment model (4C model) in 42 adult females.
Furthermore, the role of the aqueous and mineral fractions in the estimation of body fat by the BOD POD was examined. Methods:
Total body water was determined by isotope dilution (2H20) and bone mineral was determined by dual-energy x-ray absorptiometry.
Db and %fat were determined by the BOD POD and HW. The 4C model of Baumgartner was used as the criterion measure of body
3
3
fat. Results: HW Db (1.0352 gcm ) was not statistically different (P 0.35) from BOD POD Db (1.0349 gcm ). The regression
between Db by HW and the BOD POD significantly deviated from the line of identity (Db by HW 0.90 Db by BOD POD
0.099; R2 0.94). BOD POD %fat (28.8%) was significantly lower (P 0.01) than %fat by the 4C model (30.6%). The regression
between %fat by the 4C model and the BOD POD significantly deviated from the line of identity (%fat by 4C model 0.88 %fat
by BOD POD 5.41%; R2 0.92). BOD POD Db and %fat showed no bias across the range of fatness. Only the aqueous fraction
of the fat-free mass (FFM) had a significant correlation with the difference in %fat between the 4C model and the BOD POD.
Conclusion: These data indicate that the BOD POD underpredicted body fat as compared with the 4C model, and the aqueous fraction
of the FFM had a significant effect on estimates of %fat by the BOD POD. Key Words: BODY COMPOSITION, PLETHYSMOGRAPHY, BODY DENSITY

iting its usefulness. In 1995, Dempster and Aitkens (7)

demonstrated an alternative technique (BOD POD) derived
from plethysmographic principles developed by others
(9,12,14,15). Plethysmography determines body volume on
the basis of the pressure/volume relationship. Boyles law
explains this relationship in an isothermal testing chamber
as: PV k, where k is the proportionality constant (36). If
the testing chamber temperature is not constant (adiabatic),
Poissons law describes the pressure/volume relationship:
PV k, where is the ratio of the specific heat of the gas
at constant pressure to that at constant volume (32,33). The
literature comparing BOD POD and HW data is equivocal,
as four studies show no significant difference between the
line of identity and the regression between HW and the
BOD POD (3,11,24,25), whereas two studies report a significant difference between the line of identity and the
regression between the BOD POD and HW (5,22). To our
knowledge, no study has attempted to validate the BOD
POD with the four-compartment model (4C model) in
adults. Therefore, the purpose of this study was threefold:

he ability to accurately assess the level of fatness in

persons has major health consequences because of
the association between obesity and conditions such
as hypertension, insulin resistance, dyslipidemia, and hyperinsulinemia (26). A multicompartment approach would
be ideal in determining body composition because the individual constituents of the fat-free mass (FFM) are measured by independent techniques (1,19). However, the use of
a multicompartment approach is impractical for most research and clinical settings because of cost constraints. As a
result, most laboratories have used hydrostatic weighing
(HW). Unfortunately, HW is impractical in certain populations (children, obese, elderly), and for many subjects it is
considered to be time consuming (typically six to eight trials
of ~30 min) and intimidating (water submersion), thus lim0195-9131/01/3309-1605/$3.00/0
MEDICINE & SCIENCE IN SPORTS & EXERCISE
Copyright 2001 by the American College of Sports Medicine
Submitted for publication June 2000.
Accepted for publication November 2000.

1605

TABLE 1. Testing schedule.

Activity

Time (Begin)

Time (End)

Collect baseline urine

Administration of deuterium
DXA
Collect 45-min urine sample
BOD POD
Hydrostatic weighing
Collect 1 urine
Collect 1 urine

6:00 a.m.
6:10 a.m.
6:20 a.m.
6:55 a.m.
7:15 a.m.
8:00 a.m.
9:10 a.m.
10:10 a.m.

6:05 a.m.
6:15 a.m.
6:50 a.m.
7:05 a.m.
7:45 a.m.
8:45 a.m.
9:15 a.m.
10:15 a.m.

first, to compare body density (Db) from the BOD POD

against Db from HW; second, to compare percent body fat
(%fat) by the BOD POD against %fat by the 4C model; and
third, to investigate how variations in the aqueous and
mineral factions of the FFM affect %fat estimates of the
BOD POD.

METHODS
Experimental Design
An overview of the study design is presented in Table 1.
All subjects came to the Division of Physiology and Metabolism at the University of Alabama at Birmingham
(UAB) at 6:00 a.m. in a fasted state. After a baseline urine
sample was obtained, the subjects were asked to ingest a
container that had ~10 g of deuterium. The %fat was then
determined by either dual-energy x-ray absorptiometry
(DXA) or the BOD POD (the order was randomized). After
the first test (either DXA or BOD POD, depending on the
order), a 45-min urine sample was obtained. HW was always performed after the DXA and the BOD POD because
preliminary data have suggested that an increase in body
temperature and moisture can affect %fat estimates by the
BOD POD. After the completion of HW, the subjects were
asked to wait quietly so a 3- and 4-h urine sample could be
obtained.
The study sample included 42 adult females, of whom 39
were Caucasian and 3 were African American from the
Birmingham area. All subjects gave their informed consent
before participation in the study. Subjects who indicated
apprehension about head submersion in the hydrostatic
weighing tank before testing were excluded from the study.
Approval for the use of human subjects was obtained from
the Institutional Human Subject Review Board from both
Auburn University and UAB.
Protocol
Assessment of bone mineral content. DXA was
used to measure bone mineral content (BMC) (Lunar
DPX-L densitometer, Lunar Radiation Corp., Madison,
WI). The total dose of radiation to the subject was less than
a typical chest radiograph. Whole-body scans were analyzed
using the adult medium mode for all subjects (DPX-L version 3.6z). The repeat measures between days for BMC
derived from DXA in eight healthy females had an intraclass
correlation of R 0.99 and a standard deviation of 48 g.
Assessment of total body density by HW. Db was
estimated by HW with simultaneous measurement of residual
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Official Journal of the American College of Sports Medicine

lung volume by using the closed-circuit oxygen dilution technique (35). Underwater weight was measured to the nearest
50 g in a stainless steel tank in which the subject was suspended from a LCL 20 Shear Beam Load Cell (Omega, Stanford, CT) calibrated from 0 to 10,000 g. After one practice trial,
underwater weight and residual lung volume were measured
simultaneously in five consecutive trials.
The average of mul3
tiple trial densities within 0.001 gcm were used. The repeat
measures between days for Db derived from HW in eight
healthy females had an intraclass correlation
of R 0.99 and
3
a standard deviation of 0.002 gcm .
Assessment of total body density and %fat by
plethysmography (BOD POD). Whole-body air displacement was evaluated with the BOD POD version 1.69
(Body Composition System, Life Measurement Instruments,
Concord, CA). The BOD POD is a single, egg-shaped unit
consisting of two chambers: a testing chamber where the
subject sits, and a reference chamber where the breathing
circuit, pressure transducers, and electronics are stored (7).
The testing procedure involved several steps. First, calibration was conducted before the subjects entry into the BOD
POD. Calibration involved the computation of the ratio of
the pressure amplitudes (reference chamber and testing
chamber) for an empty chamber and a known volume
(49.860 L). The software calculated a regression equation
between the testing chamber volume and the ratio of the
pressure amplitudes (7). Essentially, the relationship is linear for any testing chamber volume and the ratio of the
pressure amplitudes (7,33). After the calibration was completed and the procedures fully explained, the subject was
given a nose clip and swim cap (worn to minimize isothermal air trapped within the hair). The subject entered the
BOD POD for two trials of approximately 45 s each. During
this stage, the subjects uncorrected body volume (Vbraw)
was determined with the testing chamber door being opened
between trials. If both volumes were within 150 mL, then
the two trials were averaged. However, if the volumes were
not within 150 mL, a third trial was performed and the two
volumes that were the closest were averaged. The last step
involved the measurement of the thoracic gas volume (VTG).
This stage required the subject to sit quietly in the BOD
POD and breathe through a disposable tube and filter that
was connected to the reference chamber in the rear of the
BOD POD. After four or five normal breaths, the airway
was occluded during midexhalation and the subject was
instructed to make two quick light pants. VTG was considered successful when the four criteria were met. First, the
merit had to be 1. The merit is a theoretical value that
demonstrates subject compliance during the measurement of
the VTG. A merit of 1 indicates perfect agreement between chamber pressure and the airway pressure in the tube,
with a merit 1 demonstrating poor compliance (usually
because of leaking of air around the mouth) (7). Second,
airway pressure had to be below 35 cm H2O. Third, tidal
volume had to be between 0.40 and 0.70 L. Finally, the
measured VTG had to be within 0.70 L of the predicted VTG
(27). Db from the BOD POD was calculated as follows: Db
M/(Vbraw 0.40VTG SAA), where SAA and 0.40VTG
http://www.acsm-msse.org

are used to correct for the isothermic conditions within the

chamber and M is the mass of the subject. The %fat was
then calculated using the Siri equation (31). The repeat
measures between consecutive days for Db derived from the
BOD POD in eight healthy females (all wearing a one-piece
swimsuit) had an intraclass correlation
of R 0.98 and a
3
standard deviation of 0.006 gcm .
Assessment of total body water by isotope dilution. Total body water (TBW) was determined using 2H20
(deuterated water). The dosing procedure followed the technique developed by Schoeller (29) and Schoeller et al. (30).
After an initial urine sample was collected (baseline), the
subject was weighed in minimal clothing and a 10-g dose of
2
H20 was given. Approximately 45 min later the subject
voided, and 3- and 4-h postdosing urine samples were then
obtained. Deuterium was prepared by the zinc reduction
method described by Kendall and Coplen (21). All samples
were analyzed on an OPTIMA (Micromass, Inc., Beverly,
MA) mass spectrometer in triplicate. The calculation of
2
H2O dilution space was calculated from the enrichment of
2
H2O in the body at zero time by extrapolation of the log
enrichment versus time plots back to zero time (6) using the
following equation (29): Dilution space (L) d/20.02
18.02 1/R E, where d is grams of 2H2O given, R is the
standard ratio of 2H/1H (0.00015576), and E is enrichment
of 2H2O at the extrapolated zero time (the percent above
background). Total body water was determined by taking
the mean of the zero-time isotope dilution space for 2H2O
and dividing by 1.04 (to correct for the exchange with
nonaqueous tissues) (30).
Calculation of %fat using the 4C model. The %fat
by the 4C model was determined by the Baumgartner et al.
(1) equation: % body fat 205 (1.34/Db 0.35 A 0.56
M 1), where Db is total body density from HW, and A and
M are the fractions of body mass that are aqueous and
mineral, respectively. Although the derivation of this model
came from subjects 6594 yr of age, 4C model equations are
(almost) free of assumptions and are theoretically derived. It
would be almost impossible to derive new 4C model equations for every population group, and we cannot think of any
reason why the equation by Baumgartner et al. (1) would not
be applicable to our study population.

TABLE 2. Descriptive characteristics for subjects and body composition variables.

Variable

Mean SD

Range

Age (yr)
Body weight (kg)
Height (cm)
Body density (gcm3)
HW
BOD POD
4C model % fat
BOD POD % fat*
Total body water (L)
Bone mineral (kg)
Mineral fraction of FFM
Aqueous fraction of FFM

32.8 11.0
63.4 13.0
167.5 7.0

1954
43.6115.0
147.2183.4

1.0352 0.019
1.0349 0.021
30.6 9.2
28.8 10.1
30.8 4.4
2.5 0.5
0.056 0.005
0.714 0.042

0.9921.073
0.9931.094
15.950.5
5.251.3
22.942.9
1.83.6
0.0470.072
0.6390.821

* Significantly different from 4C model % fat (P 0.01).

residual plots. This analysis examines the discrepancy between techniques across the range of fatness. Also, the R2
and the standard error of the estimate (SEE) for Db and %fat
by the BOD POD were calculated. Paired t-tests were used
to compare group means. Additionally, the difference between estimates of %fat by the BOD POD and estimates of
%fat by the 4C model were calculated and regressed on the
aqueous (AFFM) and mineral (MFFM) fractions of the DXA
FFM. The pure or total error between the BOD POD and
HW with the 4C model was also calculated:

Y nY )
1

(1)

where Y1 is %fat assessed by the 4C model and Y2 is %fat

assessed by either the BOD POD or HW (20). Statistical
significance was set at P 0.05.

RESULTS
The physical characteristics and group mean estimates of
%fat by the different techniques for the 42 females are
presented in Table 2. The AFFM is similar to what was
reported by Hewitt et al. (16) (71%) and Bergsma-Kadijk et
al. (2) (72%), but not work by Visser et al. (34) (74%). The
MFFM in this study (5.6%) is lower than the 6.8% and 7.5%
reported in the same population (2,34).

Statistical Analysis
To determine the accuracy of Db and %fat estimates by
the BOD POD, linear regression analysis was used. The
accuracy of Db by the BOD POD was determined by Db
measured by the BOD POD as the independent variable and
Db by HW as the dependent variable. The accuracy of %fat
by the BOD POD was evaluated with %fat by the BOD
POD as the independent variable and %fat measured by the
4C model as the dependent variable. If the slope was not
significantly different from 1 and the intercept not significantly different from 0, the estimates of Db and %fat derived from the BOD POD were not considered significantly
different from the dependent variable. Potential bias in Db
and %fat estimates by the BOD POD were examined using
FOUR-COMPARTMENT MODEL IN ADULT FEMALES

FIGURE 1The regression of Db by the BOD POD against Db by HW

in the total sample of 42 subjects. The dotted line is the line of identity
(regression slope 1 and regression intercept 0). The slope was
significantly different from 1 and the intercept was significantly different from 0.
Medicine & Science in Sports & Exercise

1607

FIGURE 2The residual plot where the middle dashed line represents
the mean difference between Db by BOD POD Db by HW and the
upper and lower dashed lines represents 2 SD from the mean. No bias
between the techniques was observed, as indicated by a nonsignificant
P value.

The total error for both the BOD POD and HW was 2.3%
body fat and 2.4% body fat, respectively. Paired t-test results revealed no significant
difference (P 0.35) between
3
HW Db
(1.0352
gcm
)
and BOD POD Db (1.0349
3
gcm ); this represents a difference of 0.14% body fat. The
regression for Db by HW versus Db by the BOD POD
significantly deviated from the line of identity because of an
intercept significantly different from 0 and a slope significantly different from 1, where Db by HW 0.099 0.90
(Db by BOD POD) (Fig. 1). Db by the BOD POD
explained 94% of the variance
in Db by HW, whereas the
3
SEE was 0.005 gcm . A residual plot was performed to
determine if bias existed between the Db by the BOD POD
and the Db by HW (Fig. 2). The Db by the BOD POD
showed no bias across the range of fatness as indicated by
a nonsignificant correlation (r 0.26; P 0.09). The
accuracy of the %fat from the BOD POD was examined by
regression analysis in each individual. The regression of
%fat assessed by the 4C model versus %fat assessed by the
BOD POD significantly deviated from the line of identity
because of an intercept that was significantly different from

FIGURE 3The regression of %fat by the BOD POD against %fat by

the 4C model in the total sample of 42 subjects. The dotted line is the
line of identity (regression slope 1 and regression intercept 0). The
slope was significantly different from 1 and the intercept was significantly different from 0.

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Official Journal of the American College of Sports Medicine

FIGURE 4 The residual plot where the middle dashed line represents
the mean difference between %fat by the BOD POD %fat by the 4C
model and the upper and lower dashed lines represent 2 SD from the
mean. No bias between the techniques was observed, as indicated by a
nonsignificant P value.

0 and a slope significantly different from 1, where %fat by

the 4C model 5.41 0.88 (%fat from the BOD POD)
(Fig. 3). The %fat by the BOD POD explained 95% of the
variance in %fat by the 4C model, whereas the SEE was
2.7% body fat. A residual plot was performed to determine
if bias existed between estimates in %fat between the BOD
and the 4C model (Fig. 4). BOD POD %fat did not exhibit
any bias across the range of body fatness as indicated by a
nonsignificant correlation (r 0.27; P 0.09).
The magnitudes of the difference between the BOD POD
and 4C model estimates of %fat had a significantly positive
correlation (r 0.51; P 0.01) with the fraction of FFM
that was water (AFFM), as shown in Figure 5. However, the
fraction of the FFM that was mineral (MFFM) had a negative
association with the difference between the BOD POD and
4C model estimates of %fat (r 0.17; P 0.27) (Fig. 6).
Additionally, HW showed the same trends (not presented).

DISCUSSION
This study examined the accuracy of and bias in measurements of %fat as assessed by the BOD POD relative to

FIGURE 5The regression between the difference in the %fat by the

BOD POD and estimates of %fat by the 4C model against the aqueous
fraction of the FFM. The solid line represents the regression for the
BOD POD (r 0.51; P < 0.01).
http://www.acsm-msse.org

FIGURE 6 The regression between the difference in the %fat by the

BOD POD and estimates of %fat by the 4C model against the mineral
fraction of the FFM. The solid line represents the regression for the
BOD POD (r 0.17; P 0.27).

the 4C model in 42 females. Additionally, the relative fractions of the FFM that are water and mineral and its effect on
%fat estimates using the BOD POD was investigated. This
is significant because this is the first study to compare the
BOD POD with the 4C model in adults. However, Fields
and Goran (10) demonstrated that the BOD POD could
accurately, precisely, and without bias estimate %fat in
children 9 14 yr old using the 4C model as the criterion
method.
Four studies have demonstrated excellent agreement between the BOD POD and HW, with the mean difference in
%fat ranging from 0.051.0% (3,11,24,25). However, three
studies have shown that the BOD POD significantly underpredicted %fat by ~2% as compared with HW (5,8,22).
Caution should be used in interpreting these results
(3,5,8,11,22,24,25) because the BOD POD and HW are
derived from two-compartment model (2C model) assumptions; thus, the BOD POD was not validated against a
multicompartment approach.
The major finding of this study is that the BOD POD
underestimated %fat in females of varying age and fatness
when compared with the 4C model. Our data comparing the
estimates of %fat by the BOD POD with the 4C model and
data making the same comparisons with HW and the 4C
model are somewhat similar (1,4,13,34). This would be
reasonable because both methods measure total body density; essentially the only difference is that HW measures
body volume by water displacement and the BOD POD
measures body volume by air displacement. Group mean
estimates in %fat by the BOD POD were 1.8% lower than
the 4C model, whereas regression analysis indicated a moderate degree of agreement (2.7%) on an individual basis
(SEE). Others have found group mean estimates in fatness
between HW and the 4C model to be relatively small

(~1.5%) and %fat estimates on an individual basis to be

somewhat higher (~4%) (4,13,34). Additionally, studies in
children (16,28) and older females have shown these group
mean differences to be somewhat larger (6 10%). This
large discrepancy in %fat in these two populations most
likely is attributable to deviations from the basic assumptions in the 2C model (1,16,17,23). To date, this is the first
study to compare BOD POD estimates of %fat with the 4C
model in an adult population.
The difference in estimates of %fat between the BOD
POD and the 4C model were significantly related to the
aqueous fraction of the FFM. Visser et al. (34) and Baumgartner et al. (1) found the measurement of the aqueous and
mineral fractions of the FFM increased the accuracy of the
4C model while taking into account biological variation
resulting from aging, disease, ethnicity, and training status.
However, the mineral fraction in those two studies contributed minimally to the model. Our data showed a statistically
significant positive relationship between the difference in
%fat by the BOD POD and the 4C model and the aqueous
fraction of the FFM. This is in agreement with other studies
(2,16), but not work by Baumgartner et al. (1) and Visser et
al. (34). Our data demonstrated a negative relationship between the mineral fraction of the FFM and the difference
between %fat by the BOD POD and the 4C model; this has
been observed by others making the comparison with HW
and the 4C model (2). However, not all studies have reported a negative relationship (1,34). The role of the aqueous and mineral fractions of the FFM and their relationships
in explaining differences between %fat by a 2C model and
the 4C model are debatable; however, it would appear the
4C model does increase accuracy in estimating body composition in a wide range of populations (1,4,13,18,26,33).

CONCLUSION
The BOD POD demonstrated a moderate degree of individual variation in %fat estimates as compared with the 4C
model in adult females. Additionally, %fat estimates by the
BOD POD were affected by the aqueous fraction of the
FFM, thus highlighting the importance of a multicompartment approach in the evaluation of body composition
analysis.
We would like to thank the Division of Physiology and Metabolism, Department of Nutrition Sciences at the University of Alabama
at Birmingham for making available lab equipment and lab
resources.
Address for correspondence: David A. Fields, Ph.D., Department
of Internal Medicine, Center for Human Nutrition, Washington University, Campus Box 8031, St. Louis, MO 63110-1010; E-mail:
dfields@im.wush.edu.

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