All participants had their height measured using the same portable stadiometer (Seca version 216, Seca, Chino, CA, USA) with precision 0.1 cm and body weight with the same electronic scale (Seca Clara 803, Seca, Chino, CA, USA) with a precision of 0.1 kg, with the participant barefoot and in minimum clothing. BMI was calculated by dividing the individual's weight by height squared (kg/m2).
Body composition assessment was done using the Discovery A System (Hologic, Waltham, MA, USA), in accordance with published guidelines by the International Society for Clinical Densitometry [27 (link)]. Participants were placed centered on the scanning field in a supine position, with palms down and arms at sides, slightly separated from the trunk. Regions of interest (ROIs) were defined by the analytical program and included total body, trunk, head, pelvis, upper limbs, and lower limbs. For each region, DXA scanned weight of total, fat, and lean body mass. For the actual study, three lean mass measures were used: appendicular lean mass (ALM), calculated by the addition of the four limbs lean mass; ALM index (ALMI), computed as the ratio of ALM over height squared; and ALM divided by body mass index (ALM/BMI).
Body composition assessment was done using the Discovery A System (Hologic, Waltham, MA, USA), in accordance with published guidelines by the International Society for Clinical Densitometry [27 (link)]. Participants were placed centered on the scanning field in a supine position, with palms down and arms at sides, slightly separated from the trunk. Regions of interest (ROIs) were defined by the analytical program and included total body, trunk, head, pelvis, upper limbs, and lower limbs. For each region, DXA scanned weight of total, fat, and lean body mass. For the actual study, three lean mass measures were used: appendicular lean mass (ALM), calculated by the addition of the four limbs lean mass; ALM index (ALMI), computed as the ratio of ALM over height squared; and ALM divided by body mass index (ALM/BMI).