Development and validation of a bioelectrical impedance prediction equation estimating fat free mass in Greek - Caucasian adult population
Abstract
Background and aims Excessive body fat accumulation is associated with adverse health effects; therefore its accurate and reliable assessment is of great significance. The aim of the study was to develop and validate an easy and applicable equation, based on bioelectrical impedance analysis, estimating fat free mass in Greek general population and compare it with those of the literature. Methods Anthropometric and bioelectrical impedance parameters were obtained from 694 Greek adults (429 women and 265 men) so as to develop and validate the equation, using DXA as reference method. The validation and the reliability of the equation were examined with Bland-Altman analysis and Intraclass Correlation Coefficient (ICC). Results The developed prediction equation was FFM (kg) = 12.299 + (0.164 * Weight (kg)) + (7.287 * Gender (0:female, 1:male)) - (0.116 * Resistance (ohm)/Height (m)2) + (0.365 * Reactance (ohm)/Height (m)2) + (21.570 * Height (m)) (R 2 = 0.944, p < 0.0001). Regarding the current population, the current equation presented the lowest bias (-0.069 kg, p = 0.707) and the highest ICC (0.985) compared to those of the literature. Conclusion The current prediction equation was found to be valid and reliable in a representative sample of the Caucasian Greek general population and its utilization for body composition assessment could be an alternative of using labor-intensive, expensive and time-consuming reference methods.
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The remaining adult studies involved European, Eastern Asian, and Australian populations with a balanced number of male and female participants.
“The remaining studies involved European [50, 52, 71, 77, 101], Eastern Asian [47, 78], and Australian [66] populations with a balanced number of male and female participants.”
From High-standard predictive equations for estimating body composition using bioelectrical impedance analysis: a systematic review (2024) · cites this paper as [71]
Cites
Increasing Prevalence of Overweight Among US Adults
Kuczmarski, R. J. (1994) · JAMA · doi:10.1001/jama.272.3.205 · Cited by 2,538 · see citing works
Validation of tetrapolar bioelectrical impedance method to assess human body composition
Lukaski, H. C., Bolonchuk, W. W., Hall, C. B., & Siders, W. A. (1986) · Journal of Applied Physiology · doi:10.1152/jappl.1986.60.4.1327 · Cited by 1,376 · see citing works
Methods for the assessment of human body composition: traditional and new
Lukaski, H. C. (1987) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/46.4.537 · Cited by 1,150 · see citing works
Lean body mass estimation by bioelectrical impedance analysis: a four-site cross-validation study
Segal, K., Van Loan, M., Fitzgerald, P., Hodgdon, A., & Van Itallie, T. (1988) · The American Journal of Clinical Nutrition · doi:10.1093/ajcn/47.1.7 · Cited by 881 · see citing works
Sun, S. S., Chumlea, W. C., Heymsfield, S. B., Lukaski, H. C., Schoeller, D., Friedl, K., Kuczmarski, R. J., Flegal, K. M., Johnson, C. L., & Hubbard, V. S. (2003) · The American Journal of Clinical Nutrition · doi:10.1093/ajcn/77.2.331 · Cited by 701 · see citing works
Advances in Body Composition Assessment
Lohman, T. G. (1993) · Medicine & Science in Sports & Exercise · doi:10.1249/00005768-199306000-00021 · Cited by 641 · see citing works
Single prediction equation for bioelectrical impedance analysis in adults aged 20–94 years
Kyle, U. G., Genton, L., Karsegard, L., Slosman, D. O., & Pichard, C. (2001) · Nutrition · doi:10.1016/s0899-9007(00)00553-0 · Cited by 573 · see citing works
Houtkooper, L. B., Going, S. B., Lohman, T. G., Roche, A. F., & Van Loan, M. (1992) · Journal of Applied Physiology · doi:10.1152/jappl.1992.72.1.366 · Cited by 348 · see citing works
Effect of obesity on bioelectrical impedance
Gray, D. S., Bray, G. A., Gemayel, N. S., & Kaplan, K. (1989) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/50.2.255 · Cited by 291 · see citing works
Applied body composition assessment
Pintauro, S. J. (2005) · American Journal of Human Biology · doi:10.1002/ajhb.20101 · Cited by 288 · see citing works
Anthropometry in Body Composition: An Overview
Wang, J., Thornton, J. C., KOLESNIK, S., & Pierson, R. N. (2000) · Annals of the New York Academy of Sciences · doi:10.1111/j.1749-6632.2000.tb06474.x · Cited by 276 · see citing works
Assessment of body composition by bioelectrical impedance in a population aged greater than 60 y
Deurenberg, P., van der Kooij, K., Evers, P., & Hulshof, T. G. (1990) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/51.1.3 · Cited by 242 · see citing works
Relationship Among Body Fat Percentage, Body Mass Index, and All-Cause Mortality: A Cohort Study
Padwal, R., Leslie, W. D., Lix, L. M., & Majumdar, S. R. (2016) · Annals of Internal Medicine · doi:10.7326/m15-1181 · Cited by 235 · see citing works
Applications of bioelectrical impedance analysis for body composition to epidemiologic studies
Roubenoff, R. (1996) · The American Journal of Clinical Nutrition · doi:10.1093/ajcn/64.3.459s · Cited by 139 · see citing works
Total body water data for white adults 18 to 64 years of age: The Fels Longitudinal Study
Chumlea, W. C., Guo, S. S., Zeller, C. M., Reo, N. V., & Siervogel, R. M. (1999) · Kidney International · doi:10.1046/j.1523-1755.1999.00532.x · Cited by 127 · see citing works
Guo, S. M., Roche, A. F., & HOUTKOOPER, L. B. (1989) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/50.3.435 · Cited by 122 · see citing works
Evaluation of body fat estimated from body mass index, skinfolds and impedance. A comparative study.
Heitmann, B. L. (1990) · PubMed · Cited by 120 · see citing works
Stolarczyk, L., Heyward, V., Hicks, V., & Baumgartner, R. (1994) · The American Journal of Clinical Nutrition · doi:10.1093/ajcn/59.5.964 · Cited by 79 · see citing works
Jakicic, J., Wing, R., & Lang, W. (1998) · International Journal of Obesity · doi:10.1038/sj.ijo.0800576 · Cited by 73 · see citing works
Haapala, I., Hirvonen, A., Niskanen, L., Uusitupa, M., Kröger, H., Alhava, E., & Nissinen, A. (2002) · Clinical Physiology and Functional Imaging · doi:10.1046/j.1475-097x.2002.00447.x · Cited by 46 · see citing works
Comparison of different techniques to measure body composition in moderately active adolescents.
LORENZO, A. D., Bertini, I., Candeloro, N., Iacopino, L., Andréoli, A., & Loan, M. D. V. (1998) · British Journal of Sports Medicine · doi:10.1136/bjsm.32.3.215 · Cited by 39 · see citing works
Relationship Among Body Fat Percentage, Body Mass Index, and All-Cause Mortality
Padwal, R. S., Majumdar, S. R., & Leslie, W. D. (2016) · Annals of Internal Medicine · doi:10.7326/l16-0334 · Cited by 38 · see citing works
Does body mass index reflect adequately the body fat content in perimenopausal women?
Kontogianni, M. D., Panagiotakos, D. B., & Skopouli, F. N. (2005) · Maturitas · doi:10.1016/j.maturitas.2004.08.014 · Cited by 37 · see citing works
Practical techniques for assessing body composition in middle-aged and older adults
WILLIAMS, D. P., GOING, S. B., MILLIKEN, L. A., HALL, M. C., & LOHMAN, T. G. (1995) · Medicine & Science in Sports & Exercise · doi:10.1249/00005768-199505000-00022 · Cited by 28 · see citing works
Kanellakis, S., Kourlaba, G., Moschonis, G., Vandorou, A., & Manios, Y. (2010) · Maturitas · doi:10.1016/j.maturitas.2009.10.012 · Cited by 25 · see citing works
Self-citationKanellakis, S., Skoufas, E., Khudokonenko, V., Apostolidou, E., Gerakiti, L., Andrioti, M., Bountouvi, E., & Μanios, Y. (2017) · Obesity · doi:10.1002/oby.21736 · Cited by 21 · see citing works
Self-citationAssessment of fat-free mass in teen-agers: use of TOBEC methodology
Loan, M. V. (1990) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/52.4.586 · Cited by 19 · see citing works
Flagged first, then by citations
3 of the 30 references couldn’t be matched to a known paper.
Cited by
Sorted by citations
Campa, F., Coratella, G., Cerullo, G., Noriega, Z., Francisco, R., Charrier, D., Irurtia, A., Lukaski, H., Silva, A. M., & Paoli, A. (2024) · Journal of Translational Medicine · doi:10.1186/s12967-024-05272-x · Cited by 80 · see citing works
“A total of 14,912 males, 17,362 females, and 534 subjects without any sex designated were included in 14 studies [34, 42, 47, 50, 52, 54, 61, 66, 71, 77–82] aimed to develop predictive equations for adults (from 18 to 65 years old) from the general population.”
BackgroundMethodInfluentialThe bioelectrical impedance analysis (BIA) international database: aims, scope, and call for data
Silva, A. M., Campa, F., Stagi, S., Gobbo, L. A., Buffa, R., Toselli, S., Silva, D. A. S., Gonçalves, E. M., Langer, R. D., Guerra‐Júnior, G., et al. (2023) · European Journal of Clinical Nutrition · doi:10.1038/s41430-023-01310-x · Cited by 58 · see citing works
Segmentation and Linear Measurement for Body Composition Analysis using Slice-O-Matic and Horos
Steele, S., Lin, F., Le, T., Medline, A., Higgins, M. I., Sandberg, A., Evans, S., Hong, G., Williams, M. A., Bilen, M. A., et al. (2021) · Journal of Visualized Experiments · doi:10.3791/61674 · Cited by 29 · see citing works
Bolasco, P. (2020) · Nutrients · doi:10.3390/nu12061773 · Cited by 20 · see citing works
“Bioelectrical impedance analysis (BIA) is a method used to measure body composition based on the rate at which an electrical current travel through the body [52].”
MethodSegmentation and Linear Measurement for Body Composition Analysis using Slice-O-Matic and Horos
Steele, S., Lin, F., Le, T., et al. (2021) · Journal of Visualized Experiments · doi:10.3791/61674-v · Cited by 11 · see citing works
Jiménez‐Sánchez, A., Soriano-Redondo, M. E., Roque-Cuéllar, M. D. C., García-Rey, S., Valladares‐Ayerbes, M., Cunill, J. L. P., & García‐Luna, P. P. (2024) · Nutrients · doi:10.3390/nu16244312 · Cited by 10 · see citing works
Moroni, A., Gasparri, C., Perna, S., Rondanelli, M., & Cremasco, M. M. (2024) · Nutrients · doi:10.3390/nu16223897 · Cited by 7 · see citing works
Kampo, D., Závodná, E., & Vondra, V. (. (2025) · Physiological Research · doi:10.33549/physiolres.935758 · Cited by 5 · see citing works
Sampieri, A., Spinello, G., Franchi, M. V., Campa, F., Paoli, A., Moro, T., & Casolo, A. (2025) · Scientific Reports · doi:10.1038/s41598-025-24966-w · Cited by 3 · see citing works
“After skin preparation, two adhesive electrodes (Biatrodes Akern Srl, Firenze, Italy) were placed on the dorsal surface of the right foot and two on the dorsal surface of the right hand, spaced 5 cm apart, according to previous studies 42,43 ( Fig.”
Hydration and Fat EstimatesPreprint
Farina, G. L., Orlandi, C., Gori, N., Nescolarde, L., & Lukaski, H. C. (2023) · Preprints.org · doi:10.20944/preprints202308.0812.v2
Cretescu, I., Munteanu, O., Mocanu, V., & Horhat, R. (2026) · Applied Sciences · doi:10.3390/app16021082
Development and Validation of a Simple Equation to Predict Fat-Free Mass in the Adult Population
Saboor, M., Samadani, M., Javid, A. Z., Kazemi, P., Sharifat, M., Behbahani, H. B., & Cheraghian, B. (2023) · Iranian Journal of Public Health · doi:10.18502/ijph.v52i2.11892
“Most studies (20-22) have used resistance or reactance to obtain the FFM estimation equation, which requires the use of bio-impedance to measure it, so these equations are sophisticated.”
BackgroundBioimpedance: From Body Composition Assessment to Emerging Technologies in Clinical Nutrition
Pita, R. N., Fernández, I. M., Martínez, O., & Miranda, J. M. (2026) · Nutrients · doi:10.3390/nu18172889
- Authors
- Kanellakis, S., Skoufas, E., Karaglani, E., Ziogos, G., Koutroulaki, A., Loukianou, F., Michalopoulou, M., Gkeka, A., Marikou, F., & Manios, Y.
- Affiliations
- Harokopio University of Athens (GR)
- Corresponding author
- Kanellakis, Spyridon
- Venue
- Clinical Nutrition ESPEN
- Publisher
- Elsevier BV
- Published
- 2020-04
- Volume
- 36
- Pages
- 166-170
- ISSN
- 2405-4577 (ISSN-L)
- OpenAlex
- W3005852177
- Cited by
- 15
- References
- 30
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 4 · 2023: 3 · 2021: 2 · 2020: 1
- FWCI
- 0.76
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Nutrition ESPEN (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Body Composition Measurement Techniques
- Physical Sciences › Engineering › Electrical and Electronic Engineering › Electrical and Bioimpedance Tomography
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Keywords
- bioelectrical impedance analysis, fat-free mass, prediction equations, body composition assessment, equation validation, Greek adults, Caucasian population, anthropometry
- MeSH terms
- Adipose Tissue, Adolescent, Adult, Aged, Aged, 80 and over, Anthropometry, Body Composition, Body Weight, Female
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