Validation of bioelectrical impedance analysis for body composition assessment in children with obesity aged 8-14y

Abstract

Background & aims: The aim was to generate a predictive equation to assess body composition (BC) in children with obesity using bioimpedance (BIA), and avoid bias produced by different density levels of fat free mass (FFM) in this population. Methods: This was a cross-sectional validation study using baseline data from a randomized intervention trial to treat childhood obesity. Participants were 8 to 14y (n ¼ 315), underwent assessments on anthropometry and BC through Air Displacement Plethysmography (ADP), Dual X-Ray Absorptiometry and BIA. They were divided into a training (n ¼ 249) and a testing subset (n ¼ 66). In addition, the testing subset underwent a total body water assessment using deuterium dilution, and thus obtained results for the 4-compartment model (4C). A new equation to estimate FFM was created from the BIA outputs by comparison to a validated model of ADP adjusted by FFM density in the training subset. The equation was validated against 4C in the testing subset. As reference, the outputs from the BIA device were also compared to 4C. Results: The predictive equation reduced the bias from the BIA outputs from 14.1% (95%CI: 12.7, 15.4) to 4.6% (95%CI: 3.8, 5.4) for FFM and from 18.4% (95%CI: 16.9, 19.9) to 6.4% (95% CI: 5.3, 7.4) for FM. Bland eAltman plots revealed that the new equation significantly improved the agreement with 4C; furthermore, the observed trend to increase the degree of bias with increasing FM and FFM also disappeared. Conclusion:The new predictive equation increases the precision of BC assessment using BIA in children with obesity.

The Use of Bioelectrical Impedance Analysis Measures for Predicting Clinical Outcomes in Critically Ill Children

“…The multivariate regression analysis did not show an association between BMI and 90-day mortality, but rather between PhA and mortality in our study. Some studies showed that BIA measurements are better than anthropometry and blood biochemical analysis in the nutritional assessment of patients ( 4 , 13 – 15 ). These findings emphasize the importance of body composition analysis to anthropometry in the ability of the nutrition assessment and predicting clinical outcomes.…”

BMI-based obesity classification misses children and adolescents with raised cardiometabolic risk due to increased adiposity

“…Body density was calculated by ADP (Bod-Pod ® , COSMED, Albano Laziale, Italy). Data for calculation of body fat by this plethysmographic technique has been published to agree closely with the classic gold standard underwater weighing (hydrodensitometry) in children [ 20 , 22 ] and has been used as the reference method to validate other body composition measurements in children [ 23 ]. The Siri equation was used to calculate BF% from body density.…”

Intensity Dependent Effects of Interval Resistance Training on Myokines and Cardiovascular Risk Factors in Males With Obesity

“…A bio-impedance analyzer (BIA) (Medigate Company Inc., Dan-dong Gunpo, Korea) was used to assess fat mass and muscle mass. There is acceptable validity (>0.85) and correlation (r=0.73-0.96) of BIA results with reference methods such as underwater weighing, Air displacement plethysmography (ADP), and dual-energy x-ray absorptiometry (DXA) that has been validated in healthy persons (39), athletes (40), patients (41) and obese children (42).…”