Page 42 - JSOM Summer 2022

TABLE 1 Longitudinal Monitoring of Body Composition During 5 Months of Working With a Human Performance Program Dietitian
November 2016 December 2016 February 2017 March 2017
Body mass (kg) 88.1 86.8 85.8 82.2
Adipose mass (kg) 19.2 (21.8%) 17.8 (20.5%) 16.3 (18.9%) 15.3 (18.6%)
Muscle mass (kg) 46.5 (52.8%) 47.1 (54.3%) 47.3 (55.1%) 45.6 (55.5%)
Residual mass (kg) 10.1 (11.4%) 9.7 (11.2%) 10.0 (11.7%) 9.2 (11.2%)
Bone mass (kg) 8.5 (9.6%) 8.3 (9.6%) 8.4 (9.9%) 8.4 (10.2%)
Skin mass (kg) 3.9 (4.4%) 3.8 (4.4%) 3.8 (4.5%) 3.7 (4.5%)
Muscle:bone ratio 5.48 5.67 5.58 5.43
Sum of six Skinfolds (mm) 78.2 72.3 60.9 56.2
Body fat (%) 15.7 14.8 13.0 12.3
2
BMI (kg/m ) 28.1 27.7 27.4 26.2
Changes observed over 5 months of working with Human Performance Program Dietitian following an individualized nutrition protocol. Oper-
ator reduced body mass and BMI but maintained high muscle mass throughout training.
BMI = body mass index.

protocol to monitor Operator health during weight loss peri- movement patterns and thus increase the likelihood of injury
odization to minimize loss of lean body mass. at another anatomical location. Similar to Case 3, sensitive
body composition changes in muscle and adipose tissue can
Case Presentation 4 be monitored throughout the rehabilitation process. The ISAK
Full ISAK profile was completed by a level 3 anthropometrist profile allows for specific monitoring during injury rehabili-
on a male Special Forces Green Beret with an above the wrist tation that could be utilized by multiple disciplines form the
amputation: aged 43 years, body mass 87 kg (adjusted body Human Performance Program.
mass 88.3 kg), height 175 cm, and adjusted BMI 28.8kg/m .
2
Due to his amputation, traditional body composition meth-
ods such as DXA, bioelectrical impedance, and air displace- Conclusions and Practical Applications
ment plethysmography would not provide accurate estimates. As evidenced from the case series presented in this review, the
Kinanthropometry provides an alternative method to assess ISAK profile offers a portable comprehensive assessment for
and monitor Operator body composition throughout training, cross-sectional and longitudinal body composition tracking in
as we were able to adjust his body mass by 1.5% to account a military setting. With proper training and certification, ISAK
for the amputation. Using the ISAK profile and adjusted body results have high reliability and repeatability, which limits er-
mass, the Operator’s muscle:bone ratio was 6.0, sum of six rors in body composition reporting. Results may be used to
skinfolds was 65.8 mm, and body fat 13.8% using the Yuhasz help Operators determine an individually optimal body mass
formula. Full five-way fractional results are presented in Fig- without predisposing them to injury by a muscle–bone imbal-
13
ure 3. ance. Furthermore, monitoring injured Operators’ progress
and changes in specific muscle girths and skinfold thickness
FIGURE 3 Five-way fractionation of above left wrist amputee
Operator based on his adjusted body mass (+1.5%). provides a clear picture of injury recovery to guide nutrition,
physical therapy, and strength and conditioning recommenda-
tions. Finally, building a database of physiological character-
istics essential to military task-specific performance outcomes
will help medical providers determine sustainable body com-
position goals to support health and reduce risk of injury.

Acknowledgments
We would like to extend a thank you of appreciation to the
Soldiers, Sailors, and Airmen who get just as excited about
(A) Muscle mass contributed more than half of Operator total body body composition assessment as we do. Without their quest
mass. (B) Muscle mass and residual mass were nearly 4 standard de- for knowledge, we would have no one to pinch.
viations above phantom human reference, yet adipose mass was >1
standard deviation below reference. Overall body mass was about
2 standard deviations above phantom reference, while bone mass was Disclosures
near the reference. A high muscle:bone ratio resulted from a combina- P. Webb is a contractor Human Performance Specialist and K.
tion of high muscular and slightly below average bone mass. A high Burks is a contractor with KBR Wyle working as Performance
residual mass is not concerning in this population, as it is composed Dietitian under the SOCOM POTFF contract. Each partici-
of vital organs, viscera, and remaining tissues and fluids not included
in other compartments. 15 pant included has signed a consent form releasing his informa-
tion for the case reports.
Authors regularly use the ISAK profile for monitoring mus-
cle atrophy of a specific segment and asymmetries between References
like-segments during the recovery process from an injury. This 1. Daigle KA, Logan CM, Kotwal RS. Comprehensive performance
is accomplished by measuring girths and skinfolds preinjury (if nutrition for Special Operations Forces. J Spec Oper Med. 2015;15
previously obtained), postinjury, preoperation, postoperation, (4):40–53.
and at various points during the rehabilitation phases. Asym- 2. Friedl KE. Body composition and military performance: many
things to many people. J Strength Cond Res. 2012;26 Suppl 2:
metries may create imbalances that result in in compensating S87–S100.

40 | JSOM Volume 22, Edition 2 / Summer 2022