Validation of bioelectrical impedance analysis for body composition assessment in children with obesity aged 8-14y
Open accessAbstract
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 = 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 = 249) and a testing subset (n = 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-Altman 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.
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Out of the 19 equations for under 18 years old, seven were developed using segmental technology.
“Out of the 19 equations, 12 were developed using foot to hand technology [37, 55, 58, 59, 72, 73, 75, 76, 100] and seven equations were developed using segmental technology [43–45, 57, 74].”
From High-standard predictive equations for estimating body composition using bioelectrical impedance analysis: a systematic review (2024) · cites this paper as [45]
The Methods (p. 3) say this paper developed a predictive equation using an octopolar TANITA device with footplates and hand grips, which supports citing it as an example of that technology. The paper does not establish that seven of the citing document’s 19 equations used segmental technology; it says its own equation used raw whole-body impedance. (LLM, conf=0.78)
Experimental — accuracy not yet measuredRegarding segmental technology for under 18 years old, five equations are suitable for both sexes.
“Regarding segmental technology, five are suitable for both sexes [43–45, 57, 74].”
From High-standard predictive equations for estimating body composition using bioelectrical impedance analysis: a systematic review (2024) · cites this paper as [45]
The Methods (p. 3) describe an octopolar TANITA device, but say the new equation uses raw whole-body impedance, not segment-specific measurements. The Results (p. 4) show that the equation includes gender for males and females. This paper supports one equation for children aged 8–14 with obesity; it does not establish suitability across all under-18s or account for all five equations in the citing sentence. (LLM, conf=0.86)
Experimental — accuracy not yet measuredConcerns with applicability were high in 19 studies.
“Concerns with applicability were high in 19 studies [37, 42–59] and unclear [41, 50, 60–69] in 12 studies due to the restricted sample size.”
From High-standard predictive equations for estimating body composition using bioelectrical impedance analysis: a systematic review (2024) · cites this paper as [45]
Considering segmental technology for under 18 years old, five equations are available for estimating FFM in both sexes.
“Considering segmental technology, five equations are available for estimating FFM in both sexes [43–45, 57, 74].”
From High-standard predictive equations for estimating body composition using bioelectrical impedance analysis: a systematic review (2024) · cites this paper as [45]
The remaining 12 studies on subjects under 18 years old were performed in different countries around the world and included both sexes.
“Two of these studies were conducted in the USA, where no female participants were involved [55, 76], while the remaining 12 studies were performed in different countries around the world with both sexes included [37, 43–45, 57–59, 72–75, 100].”
From High-standard predictive equations for estimating body composition using bioelectrical impedance analysis: a systematic review (2024) · cites this paper as [45]
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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
“Regarding segmental technology, five are suitable for both sexes [43–45, 57, 74].”
BackgroundMethodResultInfluential
- Authors
- Gutiérrez-Marín, D., Escribano, J., Closa-Monasterolo, R., Ferré, N., Venables, M., Singh, P., Wells, J. C., Muñoz-Hernando, J., Zaragoza-Jordana, M., Gispert-Llauradó, M., Rubio-Torrents, C., Alcázar, M., Núñez-Roig, M., Feliu, A., Basora, J., González-Hidalgo, R., Diéguez, M., Salvadó, O., Pedraza, A., & Luque, V.
- Affiliations
- MRC Elsie Widdowson Laboratory (GB)
- University College London (GB)
- Institut de Recerca Biomèdica Catalunya Sud (ES)
- Hospital Universitari Sant Joan de Reus (ES)
- Institut Català de la Salut (ES)
- ORCID
- Venue
- Clinical Nutrition
- Publisher
- Elsevier BV
- Published
- 2021-06
- Volume
- 40
- Issue
- 6
- Pages
- 4132-4139
- ISSN
- 0261-5614 (ISSN-L)
- OpenAlex
- W3128723327
- Cited by
- 28
- References
- 51
- Citations by year
- 2026: 5 · 2025: 9 · 2024: 5 · 2023: 6 · 2022: 2 · 2021: 1
- FWCI
- 2.20
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Clinical Nutrition (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Funders
- Carlos III Health Institute
- Topics
- Health Sciences › Medicine › Physiology › Body Composition Measurement Techniques
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Physical Sciences › Engineering › Electrical and Electronic Engineering › Electrical and Bioimpedance Tomography
- Keywords
- bioelectrical impedance analysis, body composition, childhood obesity, fat-free mass, fat mass, prediction equations, air displacement plethysmography, dual-energy X-ray absorptiometry, deuterium dilution, four-compartment model, method validation
- MeSH terms
- Adolescent, Anthropometry, Body Composition, Body Water, Child, Cross-Sectional Studies, Female, Humans, Indicator Dilution Techniques, Male, Plethysmography, Predictive Value of Tests, Reproducibility of Results, Absorptiometry, Photon, Randomized Controlled Trials as Topic, Electric Impedance, Pediatric Obesity
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