Implications of face mask use on body composition assessment by air-displacement plethysmography

• Published in: Clinical nutrition ESPEN Vol. 48; pp. 356 - 360
• Main Authors: DiNatale, J.C., Crowe-White, K.M., Ellis, A.C., Yang, X., Thaitrong, P.
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.04.2022
• Subjects: Adult; air; Air displacement plethysmography; BOD POD; Body Composition; body fat; clinical nutrition; COVID-19; COVID-19 infection; Cross-Sectional Studies; densitometry; face; Face masks; Female; females; filtration; Gastroenterology and Hepatology; Humans; lean body mass; Male; males; Masks; Pandemics; plethysmography; Plethysmography - methods; COVID-19; Face masks; BOD POD; Air displacement plethysmography; Body composition
• ISSN: 2405-4577; 2405-4577
• DOI: 10.1016/j.clnesp.2022.01.018

The BOD POD (COSMED USA Inc., Concord, CA) is a common instrument used to assess body composition by employing air displacement plethysmography and whole-body densitometry to determine body volume. This instrument requires isothermal conditions during testing; therefore, the introduction of outside isothermal air can impact testing results. With the COVID-19 pandemic introducing face mask mandates, it is unknown whether the use of a face mask during BOD POD testing may lead to erroneous measurement by introducing isothermal air. Thus, the purpose of this cross-sectional study was to investigate the impact of wearing a surgical face mask compared to not wearing a surgical face mask on body composition assessment among adults. During testing, female subjects were required to wear a swimsuit or form-fitting lycra shorts and a sports bra and male subjects were required to wear form-fitting lycra shorts. American Society for Testing and Materials (ASTM) level one surgical face masks (bacterial and particulate filtration efficiency of 95%) and standard swim caps were provided by researchers. Variables of interest included percent body fat, body fat, percent lean body mass, and lean body mass. Participants (n = 33) completed one test wearing a mask and one test without a mask back-to-back with conditions held constant. Dependent-sample sign tests, Bland–Altman Plots, and Passing-Bablok regression analyses were used to test mask-on versus mask-off differences and agreement between variables of interest. There were no significant median differences in any body composition results between face mask use and non-face mask use using dependent-sample sign tests. Bland–Altman Plots demonstrated acceptable agreement between mask usage and non-mask usage. No significant differences were seen in the slopes of the variables using Passing-Bablok regression. Results suggest that wearing a face mask does not appreciably impact body composition results. Therefore, ASTM level 1 disposable surgical face mask does not introduce a significant amount of isothermal air during BOD POD testing. •Surgical face mask usage in the BOD POD does not underestimate results.•With mask mandates, surgical face masks are not a concern with BOD POD use.•Other types of masks used during BOD POD testing may impact results.