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Cited by 64Body Composition Measurement TechniquesNutrition and Health in AgingFrailty in Older Adults

Predicting appendicular lean and fat mass with bioelectrical impedance analysis in older adults with physical function decline – The PROVIDE study

Open access
Scafoglieri, Aldo, Clarys, Jan Pieter, Bauer, Jürgen M., Verlaan, Sjors, Van Malderen, Lien, Vantieghem, Stijn, Cederholm, Tommy, Sieber, Cornel C. +2 more·2017·Clinical Nutrition
DOI 10.1016/j.clnu.2016.04.026
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Abstract

Background & aims No generalizable formulas exist that are derived from bioelectrical impedance analysis (BIA) for predicting appendicular lean mass (ALM) and fat mass (AFM) in sarcopenic older adults. Since precision of regional body composition (BC) data in multicentre trials is essential, this study aimed to: 1) develop and cross-validate soft tissue BIA equations with GE Lunar and Hologic DXA systems as their reference 2) to compare our new ALM equation to two previously published models and 3) to assess the agreement between BIA- and DXA-derived soft tissue ratios as indicators of limb tissue quality. Methods Two-hundred and ninety-one participants with functional limitations (SPPB-score 4–9; sarcopenia class I or II, measured by BIA) were recruited from 18 study centres in six European countries. BIA equations, using DXA-derived ALM and AFM as the dependent variable, and age, gender, weight, impedance index and reactance as independent variables, were developed using a stepwise multiple linear regression approach. Results Cross-validation gave rise to 4 equations using the whole sample: ALM LUNAR (kg) = 1.821 + (0.168*height 2 /resistance) + (0.132*weight) + (0.017*reactance) − (1.931*sex) [R 2 = 0.86 and SEE = 1.37 kg] AFM LUNAR (kg) = −6.553 − (0.093* height 2 /resistance) + (0.272*weight) + (4.295*sex) [R 2 = 0.70 and SEE = 1.53 kg] ALM HOLOGIC (kg) = 4.957 + (0.196* height 2 /resistance) + (0.060*weight) − (2.554*sex) [R 2 = 0.90 and SEE = 1.28 kg] AFM HOLOGIC (kg) = −4.716 − (0.142* height 2 /resistance) + (0.316*weight) + (4.453*sex) − (0.040*reactance) [R 2 = 0.73 and SEE = 1.54 kg] Both previously published models significantly overestimated ALM in our sample with biases of −0.36 kg to −1.05 kg. For the ratio of ALM to AFM, a strong correlation (r = 0.82, P < 0.0001) was found between the mean estimate from BIA and the DXA models without significant difference (estimated bias of 0.02 and 95% LOA −0.62, 0.65). Conclusion We propose new BIA equations allowing the estimation of appendicular lean and fat mass. Our equations allow to accurately estimate the appendicular lean/fat ratio which might provide information regarding limb tissue quality, in clinical settings. Furthermore, these BIA equations can be applied to characterize sarcopenia with Hologic and Lunar reference values for BC. Previously published BIA-based models tend to overestimate ALM in sarcopenic older adults. Users of both GE Lunar and Hologic may now benefit from these equations in field research.

AI snapshot

Written from the paper’s full text.

TL;DR

This PROVIDE baseline study developed and cross-validated bioelectrical impedance analysis (BIA) equations for appendicular lean mass (ALM) and appendicular fat mass (AFM) in older adults with physical function decline, using Hologic and GE Lunar DXA as references. The new equations predicted ALM and AFM with good accuracy, and previously published ALM equations by Kyle et al. and Sergi et al. significantly overestimated ALM in this sample.

Key findings

  • Four final BIA equations were developed using the whole sample; cross-validation showed no significant differences between DXA-observed and BIA-predicted appendicular soft tissue masses, with mean biases lower than 100 g for ALM and about 250 g for AFM.
  • Limits of agreement ranged from 2.5 to 2.8 kg for ALM and from 3.3 to 3.8 kg for AFM; preliminary equations had R² values from 0.70 to 0.90.
  • The impedance index explained 77.2% and 85.2% of ALM variance in the final equations, while weight and sex together explained 68.2% and 69.3% of AFM variance.
  • Compared with the new ALM equation, Kyle et al. overestimated ALM with a bias of −1.05 kg (95% CI −1.40 to −0.69 kg; 95% LOA −4.61, 2.52 kg), and Sergi et al. overestimated ALM with a bias of −0.36 kg (95% CI −0.72 to 0.00 kg; 95% LOA −3.95, 3.23 kg). For ALM/AFM ratio, BIA and DXA estimates correlated strongly (r = 0.82, P < 0.0001) with an estimated bias of 0.02 and 95% LOA −0.62, 0.65.

Methods

  • Baseline data from the PROVIDE study: 291 participants with evaluable DXA and BIA measurements, recruited from 18 study centres in six European countries; participants were older than 65 years, had SPPB scores 4–9, and had sarcopenia class I or II based on BIA-estimated skeletal muscle mass index.
  • Whole-body tetrapolar BIA at 50 kHz measured resistance and reactance; DXA was performed with Hologic or GE Lunar systems, and ALM, AFM, and ALM/AFM ratio were derived from standardized regional analysis.
  • Stepwise multiple linear regression developed equations with age, gender, weight, impedance index, and reactance as independent variables; data were split approximately two-thirds for validation and one-third for cross-validation, with Passing-Bablok and Bland-Altman analyses for comparisons.

Limitations

  • Stated: DXA cannot distinguish skeletal muscle from other lean components such as skin, connective tissue, and blood vessels; the equations apply to whole-body BIA devices producing raw data at 50 kHz and are not validated for segmental or multifrequency analyzers.
  • Stated: no direct measure of extracellular hydration was available, and no assessment of interrater reliability of BIA users was made, although the authors minimized this by using well-trained clinicians.
  • Stated and evident: Hologic and GE Lunar participants were similar but not identical, and body composition results from the two manufacturers should not be used interchangeably without correction; the analysis is cross-sectional baseline data, so longitudinal predictive performance is not established.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1016/j.clnu.2016.04.026

Cites

32 of 32 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

1 of 16 cited sources checked · 1 supported · 0 flagged

  • Findingcitation

    In the present study all subjects had a low skeletal muscle mass index measured by BIA (37% of men and 28% of women).

    “In the present study, all subjects had a low skeletal muscle mass index (i.e37% men and 28% women) measured by BIA [15].”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [15] Bauer, 2015, Effects of a Vitamin D and leucine-enriched whey protein nutritional supplement on measures of Sarcopenia in older adults, the provide study: a randomized, double-blind, placebo-controlled trial, J Am Med Dir Assoc source
  • Findingown data

    Limits of agreement for AFM ranged from 3.3 kg to 3.8 kg for GE Lunar and Hologic respectively.

    “For AFM the limits of agreement ranged from 3.3 kg to 3.8 kg for GE Lunar and Hologic respectively.”
    Quote in the paperNot a substantial claim
  • Findingown data

    Four BIA equations using the whole sample were developed.

    “Four BIA equations using the whole sample were developed (Table 3).”
    Quote in the paperSubstantial claim
  • Findingnone given

    Previously published BIA-based models tend to overestimate ALM in sarcopenic older adults.

    “Previously published BIA-based models tend to overestimate ALM in sarcopenic older adults.”
    Quote in the paperSubstantial claim
  • Findingnone given

    The proposed equations allow accurate estimation of the appendicular lean/fat ratio.

    “Our equations allow to accurately estimate the appendicular lean/fat ratio, which might provide information regarding limb tissue quality in clinical settings.”
    Quote in the paperSubstantial claim
  • May combine two claims. 23
  • Classified as probably not a substantial claim. 19

  • May combine two claims.

    Findingnone given

    The subjects assessed by Hologic and GE Lunar were similar but not identical.

    “Finally, the subjects assessed by Hologic and GE Lunar were similar but not identical.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Variables that contributed most to prediction of AFM were weight and sex, explaining together 68.2% and 69.3% of variance.

    “The variables that contributed the most to the prediction of AFM were weight and sex explaining together 68.2% and 69.3% of the variance.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    BIA equations with GE Lunar as reference all included weight and gender, but not reactance.

    “The equations with GE Lunar as their reference all included weight and gender, but not reactance.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    The estimated bias between ALM KYLE and ALM PROVIDE was -1.05 kg (95%CI -1.40 to -0.69 kg) and 95% limits of agreement were (-4.61 kg, 2.52 kg).

    “The estimated bias was À1.05 kg (95%CI À1.40 to À0.69 kg) and 95% limits of agreement were (À4.61 kg, 2.52 kg).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Mean biases between DXA-observed and BIA-predicted appendicular soft tissue masses were lower than 100 g for ALM and about 250 g for AFM.

    “Cross-validation revealed no significant differences (P > 0.05) between DXA-observed and BIA-predicted appendicular soft tissue masses, with mean biases lower than 100 g for ALM and of about 250 g for AFM (Table 2).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Even though the predictive value of the impedance index was slightly higher in Hologic-derived equations compared to Lunar-derived ones, the error (SEE) for predicting ALM was similar in both DXA systems (9.1% for Hologic vs. 9.8% Lunar).

    “Even though the predictive value of the impedance index was slightly higher in the Hologic-derived equations compared to the Lunar-derived ones, the error (SEE) for predicting ALM was similar in both DXA systems (9.1% for Hologic vs. 9.8% Lunar).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Weight and sex are significant independent predictors of ALM HOLOGIC, but reactance is not.

    “Furthermore, our results indicate that weight and sex are significant independent predictors of ALM HOLOGIC , but not reactance.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingreasoning

    AFM prediction using BIA is less accurate compared to ALM, with coefficients of determination ranging from 0.70 to 0.73.

    “Although AFM may provide relevant information about limb BC quality, its prediction using BIA is less accurate compared to ALM, with coefficients of determination ranging from 0.70 to 0.73.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingcitation

    Only 5% of Sergi's sample had an SPPB score of 8 or less, compared with 62% in the present study.

    “Only 5% had an SPPB-score 8 in the former compared to 62% in our study.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [13] Sergi, 2015, Assessing appendicular skeletal muscle mass with bioelectrical impedance analysis in free-living Caucasian older adults, Clin Nutr source

  • May combine two claims.

    Findingown data

    ALM PROVIDE and ALM SERGI showed a high correlation (r=0.88, P<0.0001) with a significant difference (P=0.047).

    “ALM PROVIDE and ALM SERGI showed a high correlation (r ¼ 0.88, P < 0.0001) with a significant difference (P ¼ 0.047).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Each BIA equation contained two to four variables with R2-values ranging from 0.70 to 0.90.

    “Each equation contained two to four variables with R 2 -values ranging from 0.70 to 0.90.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    For the ratio of ALM to AFM, a strong correlation (r=0.82, P<0.0001) was found between the mean estimate from DXA and BIA without significant difference (estimated bias of 0.02 and 95% LOA -0.62, 0.65).

    “For the ratio of ALM to AFM, a strong correlation (r ¼ 0.82, P < 0.0001) was found between the mean estimate from DXA and BIA without significant difference (estimated bias of 0.02 and 95% limits of agreement À0.62, 0.65) (Fig. 2).”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The ALM/AFM ratio is an indicator of limb tissue quality.

  • May combine two claims.

    Findingcitation

    By the Health ABC sarcopenia definition (ALM index <5.67 kg/m2 for women and <7.23 kg/m2 for men), 62% of women and 54% of men in the Hologic group were sarcopenic, versus 33% and 14% respectively in the Lunar group.

    “However, according to the definition of sarcopenia proposed by the Health ABC Study (i.e.ALM index <5.67 kg/m 2 for women and <7.23 kg/m 2 for men) 62% of the women and 54% of the men in the Hologic group were sarcopenic, while only 33% and 14% in the Lunar group respectively [1].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [1] Newman, 2003, Health ABC study investigators. Sarcopenia: alternative definitions and associations with lower extremity function, J Am Geriatr Soc source

  • May combine two claims.

    Findingown data

    The estimated bias between ALM PROVIDE and ALM SERGI was -0.36 kg (95%CI -0.72 to 0.00 kg) and 95% limits of agreement were (-3.95 kg, 3.23 kg).

    “The estimated bias was À0.36 kg (95%CI À0.72 to 0.00 kg) and 95% limits of agreement were (À3.95 kg, 3.23 kg).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    All BIA equations with Hologic as criterion method included impedance index, weight and gender.

    “All BIA equations with Hologic as the criterion method included impedance index, weight and gender.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Despite a high correlation (r=0.87, P<0.0001), ALM KYLE significantly overestimated ALM PROVIDE.

    “Despite a high correlation (r ¼ 0.87, P < 0.0001), ALM KYLE significantly (P < 0.0001) overestimated ALM PROVIDE (Fig. 1).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Compared to BIA equations using Lunar as reference standard, BIA equations based on Hologic showed higher coefficients of determination and lower SEEs.

    “Compared to the BIA equations using Lunar as reference standard, the BIA equations based on Hologic showed higher coefficients of determination and lower SEE's.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    The impedance index was the strongest independent predictor of ALM as measured by Hologic and GE Lunar, explaining 85% and 77% of the variability respectively.

    “The impedance index (height 2 /resistance) was the strongest independent predictor of ALM as measured by Hologic and GE Lunar, explaining 85% and 77% of the variability respectively.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductnone given

    Each DXA image was visually checked and pixels were manually adjusted when needed.

    “Each image was visually checked and pixels were manually adjusted when needed.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S1 (asserted), S4 (based).

    Interpretationreasoning

    BIA equations specifically generated from a sample of older subjects with physical function decline would predict ALM and AFM better than equations derived from an age-matched healthy sample population.

    “BIA equations specifically generated from a sample of older subjects with physical function decline would consequently predict ALM and AFM better than equations derived from an age-matched healthy sample population.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The 291 participants included in the analysis are representative of older adults with physical function decline.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Lean DXA in the limbs is significantly interrelated to muscle mass in older persons.

    “Although it has been shown that lean DXA in the limbs is significantly interrelated to muscle mass in older persons, variability in the distribution of water over different tissue compartments may have affected the accuracy of the prediction [29].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [29] Scafoglieri, 2013, Assessment of regional adipose tissue depots: a DXA and CT comparison in cadavers of elderly persons, Exp Gerontol source

  • Classified as probably not a substantial claim.

    Study design and conductnone given

    The scanning procedure was standardised across all study centres using a uniform protocol.

    “The scanning procedure was standardised across all study centres using a uniform protocol.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S4 (based).

    Interpretationnone given

    The ALM/AFM ratio can be used to explain the potential mismatch between lean mass and strength, through a progressive deterioration of muscle 'quality' mainly by fat infiltration around and within muscle fibers.

    “We propose that the ratio can be used to explain the potential mismatch between lean mass and strength because of a progressive deterioration of muscle 'quality' mainly by fatinfiltration around and within muscle fibers.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    Daily calibration of the densitometers was performed in accordance with the manufacturer's instructions.

    “Daily calibration of the densitometers was performed in accordance with the instructions provided by the manufacturer.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Interpretationreasoning

    Users of both GE Lunar and Hologic may benefit from these equations in field research.

    “Users of both GE Lunar and Hologic may now benefit from these equations in field research.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationreasoning

    Compartmental shifts in body water may influence BIA, since BIA equations rely on body tissue resistance.

    “Since BIA equations rely on body tissue resistance, compartmental shifts in body water may equally influence BIA.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    Normality of all data was confirmed using D'Agostino-Pearson tests.

    “Normality of all data was confirmed using D'Agostino-Pearson tests.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Study design and conductnone given

    All raw DXA data were centrally analysed by the same experienced investigator.

    “All raw DXA data were centrally analysed by the same experienced investigator.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Interpretationreasoning

    The proposed equations can be widely implemented in daily practice, because the majority of BIA devices used in clinical settings operate at a fixed frequency of 50 kHz.

    “However, the majority of BIA devices used in clinical settings operate at a fixed frequency of 50 kHz, and thus we expect that our proposed equations can be widely implemented in daily practice.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The majority of BIA devices used in clinical settings operate at a fixed frequency of 50 kHz.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    No direct measure of extracellular hydration was available in the study, so it is unknown whether this factor had any effect on the study outcome.

    “Unfortunately, no direct measure of extracellular hydration was available.Thus, we do not know whether this factor had any effect on the study outcome.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Interpretationreasoning

    The interpretation of the ALM/AFM ratio in relation to physical function decline is difficult.

    “This makes the interpretation of this ratio difficult in relation to physical function decline.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: No published data are available on the ALM/AFM ratio in older subjects.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationreasoning

    Overhydrated and underhydrated limbs may significantly differ in their lean/muscle ratio.

    “It is also to be expected that overhydrated vs. underhydrated limbs may significantly differ in their lean/muscle ratio.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    Fat is poorly conductive and thus is excluded from the current flow of BIA.

    “This makes sense since fat is poorly conductive and thus is excluded from the current flow of BIA [24].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [24] Foster, 1996, Whole-body impedance–what does it measure?, Am J Clin Nutr source

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductreasoning

    No assessment of interrater reliability of the users of BIA was made in the study.

    “In our study no assessment of interrater reliability of the users of BIA was made.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationreasoning

    Hologic and GE Lunar use different hardware and software equations to estimate body composition.

    “It is therefore suggested that Hologic and GE Lunar use different hardware and software equations to estimate BC.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductnone given

    The study protocol was approved by local ethical committees at each location and registered under the Dutch trials register with identifier NTR2329.

    “The study protocol was approved by the local ethical committees at each location and registered under the Dutch trials register with the identifier: NTR2329 (http://www.trialregister.nl/trialreg).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    The study procedures were in accordance to the World Medical Association's Declaration of Helsinki.

    “The study procedures were in accordance to the World Medical Association's Declaration of Helsinki.”
    Quote in the paperNot a substantial claim
37 of 37

  • The paper relies on this without support.

    The ALM/AFM ratio is an indicator of limb tissue quality.

    “to assess the agreement between BIA-and DXA-derived soft tissue ratios as indicators of limb tissue quality.”

  • The paper relies on this without support.

    The 291 participants included in the analysis are representative of older adults with physical function decline.

    “Out of the 380 recruited participants 291 subjects having both an evaluable DXA and BIA measurement on baseline have been included in this analysis (see Table 1).”

  • The paper relies on this without support.

    No published data are available on the ALM/AFM ratio in older subjects.

    “As a result, no published data are available on the ALM/AFM ratio in older subjects.”

  • The paper relies on this without support.

    The majority of BIA devices used in clinical settings operate at a fixed frequency of 50 kHz.

    “However, the majority of BIA devices used in clinical settings operate at a fixed frequency of 50 kHz, and thus we expect that our proposed equations can be widely implemented in daily practice.”
4 of 4

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Out of the 16 available equations for people with diseases, eight were developed using segmental technology.

    “Out of the 16 available equations, 14 were developed with foot to hand technology [40, 64, 98] and eight using segmental technology [40, 41, 56, 64, 65, 98, 99].”

    From High-standard predictive equations for estimating body composition using bioelectrical impedance analysis: a systematic review (2024) · cites this paper as [40]

    Section 2.3 describes a whole-body BIA device, not segmental technology. Section 4.1 explicitly says the study’s equations are not validated for segmental BIA devices. The paper also does not establish the citing sentence’s count of eight segmental equations. (LLM, conf=0.90)

    Checked by a reasoning model — may be wrong.

    Experimental — accuracy not yet measured

  • Risk of bias was unclear in six studies.

    “Risk of bias was high in two [34, 35] and unclear in six [36–41] studies due to the low to moderate (R2 < 80%) coefficient of determination (R2) resulted from the multiple regression models.”

    From High-standard predictive equations for estimating body composition using bioelectrical impedance analysis: a systematic review (2024) · cites this paper as [40]

    Table 3 reports multiple-regression R² values below 0.80 for the appendicular fat-mass equations, supporting part of the stated rationale. The paper does not assess its own risk of bias as “unclear” or classify six studies; that is the citing authors’ assessment, not a finding reported by this source. (LLM, conf=0.84)

    Experimental — accuracy not yet measured

  • Seven equations for people with diseases were developed using single frequency devices at 50 kHz.

    “Seven equations were developed using single frequency devices at 50 kHz [35, 40, 98], while 9 equations were made with multifrequency devices involving measures obtained at 50 [41, 64, 65, 99] and 100 kHz [56].”

    From High-standard predictive equations for estimating body composition using bioelectrical impedance analysis: a systematic review (2024) · cites this paper as [40]

    Section 3.3 reports four BIA equations developed in this study, and Section 4.1 says they apply to whole-body devices operating at a single frequency of 50 kHz. The paper does not account for all seven equations attributed to the cited group. Section 2.1 describes participants with functional limitations and sarcopenia, but says people with specified chronic diseases were excluded, so describing this study as involving people with diseases is imprecise. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • Out of the 16 available equations for people with diseases, 14 were developed with foot-to-hand technology.

    “Out of the 16 available equations, 14 were developed with foot to hand technology [40, 64, 98] and eight using segmental technology [40, 41, 56, 64, 65, 98, 99].”

    From High-standard predictive equations for estimating body composition using bioelectrical impedance analysis: a systematic review (2024) · cites this paper as [40]

    Section 2.3 describes hand and foot electrode placement for the whole-body BIA device used to develop this study’s equations, supporting its inclusion as a foot-to-hand example. The paper does not establish the citing sentence’s aggregate count of 14 out of 16 available equations. (LLM, conf=0.85)

    Experimental — accuracy not yet measured

  • Regarding foot-to-hand technology for people with diseases, four equations are for appendicular FM and FFM in functionally limited male and female individuals.

    “Regarding the foot to hand technology, there is one equation suitable for assessing FFM in overweight and obese postmenopausal females [98], four for appendicular FM and FFM in functionally limited male and female individuals [40], four for assessing FFM in amputee males [41], one for predicting TBW in anorexic females [56], and three for appendicular LSM in frail [64], chronic kidney [65], or hem”

    From High-standard predictive equations for estimating body composition using bioelectrical impedance analysis: a systematic review (2024) · cites this paper as [40]

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Lunar AFM impedance coefficients have opposite signs

    Major

    The Lunar AFM model likewise gives a positive unstandardized impedance-index coefficient and a negative standardized coefficient for the same predictor.

  • Hologic AFM impedance coefficients have opposite signs

    Major

    Table 3 gives a positive unstandardized impedance-index coefficient but a negative standardized coefficient for the same predictor. Standardization cannot reverse a regression coefficient's sign.

2 of 2

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Related

Authors
Scafoglieri, A., Clarys, J. P., Bauer, J. M., Verlaan, S., Van Malderen, L., Vantieghem, S., Cederholm, T., Sieber, C. C., Mets, T., & Bautmans, I.
Affiliations
  • Vrije Universiteit Brussel (BE)
  • Universitair Ziekenhuis Brussel (BE)
  • Carl von Ossietzky Universität Oldenburg (DE)
  • Nutricia Research (Netherlands) (NL)
  • Uppsala University Hospital (SE)
  • Friedrich-Alexander-Universität Erlangen-Nürnberg (DE)
Corresponding author
  • Scafoglieri, Aldo
  • Clarys, Jan Pieter
  • Bauer, Jürgen M.
  • Verlaan, Sjors
  • Vantieghem, Stijn
  • Cederholm, Tommy
  • Sieber, Cornel C.
  • Mets, Tony
  • Bautmans, Ivan
ORCID
Venue
Clinical Nutrition
Publisher
Elsevier BV
Published
2017-06
Volume
36
Issue
3
Pages
869-875
ISSN
0261-5614 (ISSN-L)
DOI
10.1016/j.clnu.2016.04.026
OpenAlex
W2344811987
Cited by
64
References
35
Citations by year
2026: 1 · 2025: 5 · 2024: 8 · 2023: 5 · 2022: 6 · 2021: 11 · 2020: 4 · 2019: 6 · 2018: 12 · 2017: 3 · 2016: 1 · 2012: 1
FWCI
5.07
Type
journal article
Language
en
Open access
Licence
Locations
  • Clinical Nutrition (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • KTH Publication Database DiVA (KTH Royal Institute of Technology) (submittedVersion, other-oa)
  • VUBIR (Vrije Universiteit Brussel) (submittedVersion)
Funders
Nutricia
Topics
  • Health Sciences › Medicine › Physiology › Body Composition Measurement Techniques
  • Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
  • Health Sciences › Medicine › Geriatrics and Gerontology › Frailty in Older Adults
Keywords
appendicular lean mass, bioelectrical impedance analysis, sarcopenia, older adults, physical function decline, body composition, reactance, resistance
MeSH terms
Aged, Aged, 80 and over, Body Composition, Body Weight, Europe, Female, Humans, Male, Absorptiometry, Photon

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-07.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-07.

Cited sources are checked by gpt-6-sol.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

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