European Journal of Applied Physiology

, Volume 117, Issue 3, pp 567–574 | Cite as

The effect of hydration status on the measurement of lean tissue mass by dual-energy X-ray absorptiometry

  • Clodagh M. Toomey
  • William G. McCormack
  • Phil Jakeman
Original Article



Athletes cycle between exercise and recovery. Exercise invokes changes in total body water from thermal sweating, muscle and hepatic glycogen depletion and metabolic water loss. Recovery from exercise results in rehydration, substrate repletion, and possible glycogen supercompensation. Such changes may corrupt the measurement of hydrated tissues, such as lean tissue mass (LTM), by dual-energy X-ray absorptiometry (DXA). The purpose of this study was to determine the effect of exercise and thermal dehydration and subsequent glycogen supercompensation on DXA-based measurement of body composition.


Twelve active adult (18–29 years) males exercised at 70% VO2max on a cycle ergometer in a thermal environment (30 °C) to induce a 2.5% reduction in body mass. Participants subsequently underwent a glycogen supercompensation phase, whereby a high carbohydrate diet (8–12 g/kg body mass/day) was consumed for a 48-h period. Whole-body DXA measurement was performed at baseline, following exercise and supercompensation.


Following exercise, mean body mass decreased by −1.93 kg (95% CI −2.3, −1.5), while total LTM decreased by −1.69 kg (−2.4, −1.0). Supercompensation induced a mean body mass increase of 2.53 kg (2.0, 3.1) and a total LTM increase of 2.36 kg (1.8, 2.9). No change in total fat mass or bone mineral content was observed at any timepoint.


Training regimens that typically induce dehydration and nutrition regimens that involve carbohydrate loading can result in apparent changes to LTM measurement by DXA. Accurate measurement of LTM in athletes requires strict observation of hydration and glycogen status to prevent manipulation of results.


DXA Hydration Lean tissue mass Measurement Glycogen Athletes 



Analysis of variance


Body mass


Body mass index


Bone mineral content


Bone mineral density


Confidence interval


Dual-energy X-ray absorptiometry


Fat-free mass


Fat mass


Heart rate


Lean tissue mass


Least significant change


Physical activity readiness questionnaire


Region of interest


Total body water


Maximal oxygen uptake



The authors wish to acknowledge the assistance of Conor Hurley, Ross McGlynn, and Alexandra Cremona with data collection.

Compliance with ethical standards

Ethical approval

All procedures performed involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.


  1. Ahlborg B, Bergstrom J, Ekelund L-, Hultman E (1967) Muscle glycogen and muscle electrolytes during prolonged physical exercise. Acta Physiol Scand 70:129–142CrossRefGoogle Scholar
  2. Armstrong LE, Pumerantz AC, Fiala KA et al (2010) Human hydration indices: acute and longitudinal reference values. Int J Sport Nutr Exerc Metab 20:145–153CrossRefPubMedGoogle Scholar
  3. Bartlett JD, Hawley JA, Morton JP (2015) Carbohydrate availability and exercise training adaptation: too much of a good thing? Eur J Sport Sci 15:3–12. doi: 10.1080/17461391.2014.920926 CrossRefPubMedGoogle Scholar
  4. Bergstrom J, Hermansen L, Hultman E, Saltin B (1967) Diet, muscle glycogen and physical performance. Acta Physiol Scand 71:140–150. doi: 10.1111/j.1748-1716.1967.tb03720.x CrossRefPubMedGoogle Scholar
  5. Clark RR, Sullivan JC, Bartok CJ, Carrel AL (2007) DXA provides a valid minimum weight in wrestlers. Med Sci Sports Exerc 39:2069–2075. doi: 10.1249/mss.0b013e31814fb423 CrossRefPubMedGoogle Scholar
  6. Fairchild TJ, Fletcher S, Steele P, Goodman C, Dawson B, Fournier PA (2002) Rapid carbohydrate loading after a short bout of near maximal-intensity exercise. Med Sci Sports Exerc 34:980–986CrossRefPubMedGoogle Scholar
  7. Going SB, Massett MP, Hall MC et al (1993) Detection of small changes in body composition by dual-energy X-ray absorptiometry. Am J Clin Nutr 57:845–850PubMedGoogle Scholar
  8. Hackett DA, Johnson NA, Chow CM (2013) Training practices and ergogenic aids used by male bodybuilders. J Strength Cond Res 27:1609–1617. doi: 10.1519/JSC.0b013e318271272a CrossRefPubMedGoogle Scholar
  9. Hangartner TN, Warner S, Braillon P, Jankowski L, Shepherd J (2013) The official positions of the international society for clinical densitometry: acquisition of dual-energy X-ray absorptiometry body composition and considerations regarding analysis and repeatability of measures. J Clin Densitom 16:520–536. doi: 10.1016/j.jocd.2013.08.007 CrossRefPubMedGoogle Scholar
  10. Hawley JA, Burke LM (2010) Carbohydrate availability and training adaptation: effects on cell metabolism. Exerc Sport Sci Rev 38:152–160. doi: 10.1097/JES.0b013e3181f44dd9 CrossRefPubMedGoogle Scholar
  11. Hew-Butler T, Holexa BT, Fogard K, Stuempfle KJ, Hoffman MD (2015) Comparison of body composition techniques before and after a 161-km ultramarathon using DXA, BIS and BIA. Int J Sports Med 36:169–174. doi: 10.1055/s-0034-1387777 PubMedGoogle Scholar
  12. Jensen J, Rustad PI, Kolnes AJ, Lai YC (2011) The role of skeletal muscle glycogen breakdown for regulation of insulin sensitivity by exercise. Front Physiol 2. doi: 10.3389/fphys.2011.00112
  13. Lohman TG, Harris M, Teixeira PJ, Weiss L (2000) Assessing body composition and changes in body composition. Another look at dual-energy X-ray absorptiometry. Ann N Y Acad Sci 904:45–54CrossRefPubMedGoogle Scholar
  14. Meyer NL, Sundgot-Borgen J, Lohman TG et al (2013) Body composition for health and performance: a survey of body composition assessment practice carried out by the Ad Hoc Research Working Group on Body Composition, Health and Performance under the auspices of the IOC Medical Commission. Br J Sports Med 47:1044–1053. doi: 10.1136/bjsports-2013-092561 CrossRefPubMedGoogle Scholar
  15. Moore FD, Boyden CM (1963) Body cell mass and limits of hydration of the fat-free body: their relation to estimated skeletal weight. Ann N Y Acad Sci 110:62–71CrossRefPubMedGoogle Scholar
  16. Mueller SM, Anliker E, Knechtle P, Knechtle B, Toigo M (2013) Changes in body composition in triathletes during an Ironman race. Eur J Appl Physiol 113:2343–2352. doi: 10.1007/s00421-013-2670-3 CrossRefPubMedGoogle Scholar
  17. Nana A, Slater GJ, Hopkins WG, Burke LM (2012) Effects of daily activities on dual-energy X-ray absorptiometry measurements of body composition in active people. Med Sci Sports Exerc 44:180–189. doi: 10.1249/MSS.0b013e318228b60e CrossRefPubMedGoogle Scholar
  18. Nana A, Slater GJ, Hopkins WG, Burke LM (2013) Effects of exercise sessions on DXA measurements of body composition in active people. Med Sci Sports Exerc 45:178–185. doi: 10.1249/MSS.0b013e31826c9cfd CrossRefPubMedGoogle Scholar
  19. Nana A, Slater GJ, Stewart AD, Burke LM (2015) Methodology review: using dual-energy X-ray absorptiometry (DXA) for the assessment of body composition in athletes and active people. Int J Sport Nutr Exerc Metab 25:198–215. doi: 10.1123/ijsnem.2013-0228 CrossRefPubMedGoogle Scholar
  20. Olsson KE, Saltin B (1970) Variation in total body water with muscle glycogen changes in man. Acta Physiol Scand 80:11–18. doi: 10.1111/j.1748-1716.1970.tb04764.x CrossRefPubMedGoogle Scholar
  21. Rauch LH, Rodger I, Wilson GR et al (1995) The effects of carbohydrate loading on muscle glycogen content and cycling performance. Int J Sport Nutr 5:25–36CrossRefPubMedGoogle Scholar
  22. Roubenoff R, Kehayias JJ, Dawson-Hughes B, Heymsfield SB (1993) Use of dual-energy X-ray absorptiometry in body-composition studies: not yet a “gold standard”. Am J Clin Nutr 58:589–591PubMedGoogle Scholar
  23. Rouillier MA, David-Riel S, Brazeau AS, St-Pierre DH, Karelis AD (2015) Effect of an acute high carbohydrate diet on body composition using DXA in young men. Ann Nutr Metab 66:233–236. doi: 10.1159/000435840 CrossRefPubMedGoogle Scholar
  24. Santos DA, Silva AM, Matias CN, Fields DA, Heymsfield SB, Sardinha LB (2010) Accuracy of DXA in estimating body composition changes in elite athletes using a four compartment model as the reference method. Nutr Metab (Lond) 7:22-7075-7-22. doi: 10.1186/1743-7075-7-22 CrossRefGoogle Scholar
  25. Sawka MN (1992) Physiological consequences of hypohydration: exercise performance and thermoregulation. Med Sci Sports Exerc 24:657–670PubMedGoogle Scholar
  26. Sawka MN, Burke LM, Eichner ER, Maughan RJ, Montain SJ, Stachenfeld NS (2007) American College of Sports Medicine position stand. Exercise and fluid replacement. Med Sci Sports Exerc 39:377–390. doi: 10.1249/mss.0b013e31802ca597 CrossRefPubMedGoogle Scholar
  27. Schoeller DA (1989) Changes in total body water with age. Am J Clin Nutr 50:1176–1181 (discussion 1231–1235) PubMedGoogle Scholar
  28. Shiose K, Yamada Y, Motonaga K et al (2016) Segmental extracellular and intracellular water distribution and muscle glycogen after 72-h carbohydrate loading using spectroscopic techniques. J Appl Physiol (1985) 121:205–211. doi: 10.1152/japplphysiol.00126.2016 CrossRefGoogle Scholar
  29. Shirreffs SM (2003) Markers of hydration status. Eur J Clin Nutr 57(Suppl 2):S6–S9. doi: 10.1038/sj.ejcn.1601895 CrossRefPubMedGoogle Scholar
  30. Toombs RJ, Ducher G, Shepherd JA, De Souza MJ (2012) The impact of recent technological advances on the trueness and precision of DXA to assess body composition. Obesity (Silver Spring) 20:30–39. doi: 10.1038/oby.2011.211 CrossRefGoogle Scholar
  31. Toomey CM, Cremona C, Hughes K, Norton C, Jakeman P (2015) A review of body composition measurement in the assessment of health. Topics Clin Nutr 30:16–32CrossRefGoogle Scholar
  32. Wang Z, Deurenberg P, Wang W, Pietrobelli A, Baumgartner RN, Heymsfield SB (1999) Hydration of fat-free body mass: new physiological modeling approach. Am J Physiol 276:E995–E1003PubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2017

Authors and Affiliations

  • Clodagh M. Toomey
    • 1
    • 2
  • William G. McCormack
    • 2
  • Phil Jakeman
    • 2
  1. 1.Sport Injury Prevention Research Centre, Faculty of KinesiologyUniversity of CalgaryCalgaryCanada
  2. 2.Department of Physical Education and Sport Sciences, Faculty of Education and Health SciencesUniversity of LimerickLimerickIreland

Personalised recommendations