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OBJECTIVES: It is imperative to accurately estimate whole body fat percentage (%fat) in order to understand the deleterious nature of excess adiposity on cardiometabolic disease risk. However, cost and accessibility often preclude the use of advanced assessment methods. Relative fat mass (RFM), an emerging estimator of whole body %fat based upon waist circumference, height, and biological sex, has yet to be evaluated in an older adult population. The purpose of this study was to examine the relationship between RFM and gold standard measures of adiposity among older adults, and to evaluate whether changes in RFM reflected changes in %fat following a 12-month lifestyle intervention. METHODS: This study was ancillary to a randomized controlled trial investigating the effects of a lifestyle intervention with and without intentional energy restriction. (Clinicaltrials.gov #NCT00955903). Older adults with obesity (N = 163, 37.4% male, 70.3 ± 4.7 years) were randomized to one of three groups: exercise only, exercise + nutrient-dense weight maintenance diet, or exercise + nutrient-dense energy restriction of 500 kcal/d. Total and regional adiposity were determined by dual-energy X-ray absorptiometry (DXA) at baseline and 12 months. Data were analyzed using Spearman's correlations, Wilcoxon, Kruskal-Wallis, and linear regression tests. RESULTS: At baseline, significant correlations were observed between RFM and DXA whole body %fat (r = 0.751, P |