Examining Race-Related Error in Two-Compartment Models of Body Composition Assessment: A Systematic Review and Meta-Analysis

Michael V. Fedewa, Brett S. Nickerson, Grant M. Tinsley, Michael R. Esco, Elisabeth G. Dunbar, Abigail G. Boucher, Ricardo M. DeLeon

Research output: Contribution to journalReview articlepeer-review

3 Scopus citations


Background: The Brozek and Siri formulas estimate relative adiposity (%Fat) from total body density (Db) using a 2-compartment (2C) model. Racial/ethnic differences in Db have been reported, along with subsequent errors in estimated %Fat. Objective: The primary aim of this systematic review and meta-analysis was to examine potential race/ethnic differences in the accuracy of the Brozek and Siri 2C formulas using aggregate-level data. Methods: Peer-reviewed studies available in English that provided 2C and 4C estimates of %Fat were located using searches of the PubMed (n = 150), Scopus (n = 170), and Web of Science (n = 138) online electronic databases. Random-effects models were used to determine potential differences between racial groups using a mean ES and 95% confidence intervals. Results: The cumulative results from 78 effects indicate that the relative accuracy of the Brozek equation did not vary between racial groups (between group p = 0.053). In contrast, the Siri equation slightly underestimated %Fat for Asian adults (ESWMD = −1.40%, 95%CI –2.33% to −0.46%; p = 0.004) and Black adults (ESWMD = –1.10%, 95%CI −2.11% to −0.08%; p = 0.034), with no significant differences observed in Hispanic adults (ESWMD = 0.64%, 95%CI −1.02% to 2.31%; p = 0.448) and White adults (ESWMD = 0.08%, 95%CI −0.42% to 0.57%; p = 0.766) (between group p = 0.019). Conclusion: Small, but statistically significant, error was found between racial groups when estimating %Fat using the 2C Siri equation when compared to 4C models. However, the observed error due to race/ethnicity appears to be of little clinical or practical significance when using either equation.

Original languageEnglish
Pages (from-to)156-168
Number of pages13
JournalJournal of Clinical Densitometry
Issue number1
StatePublished - Jan 1 2021


  • 2-compartment
  • Body composition
  • body density
  • race differences


Dive into the research topics of 'Examining Race-Related Error in Two-Compartment Models of Body Composition Assessment: A Systematic Review and Meta-Analysis'. Together they form a unique fingerprint.

Cite this