Use of balance methods for assessment of short-term changes in body composition

Balance methods reveal changes in body energy, nitrogen, macro‐ and micronutrients as well as fluid in response to different feeding regimens. Under metabolic ward conditions, where physical activity is restricted and activity and food intake are controlled, the errors of estimates of energy intake, energy expenditure, and energy losses are about 2, 4, and 2%, respectively. Balance techniques can be used to validate techniques of in vivo body composition analysis (BCA). This is necessary since immediate and transient changes in body composition in response to a change in diet adversely affect the validity of techniques by violating the assumptions underlying standard methods (i.e., a constant composition or hydration of lean mass). Using two compartment reference methods, like densitometry, dual X‐ray absorptiometry (DXA) or deuterium dilution, changes in fat mass with caloric restriction and overfeeding can be measured with a minimal detectable change (MDC) of 1.0–2.0 kg. However, when compared against balance data, the validity of these techniques to measure short‐term changes in body composition is poor. The noninvasive and rapid new quantitative magnetic resonance (QMR) technique has a high precision with a MDC of 0.18 kg of fat mass. The validity of QMR to assess short‐term changes in fat mass is challenged by comparison to balance data. Today, techniques used for in vivo BCA should be related to steady state conditions only, while in the nonsteady state, the use of balance methods is recommended to assess short‐term changes in body composition.