Utility of multifrequency bioelectrical impedance compared with dual-energy x-ray absorptiometry for assessment of total and regional body composition varies between men and women
Abstract
Multifrequency bioelectrical impedance analysis of body composition may be an appropriate alternative to dual-energy x-ray absorptiometry. We hypothesized that there would be no significant differences between dual-energy x-ray absorptiometry and either the Biospace (Los Angeles, CA, USA) InBody 520 or 720 multifrequency bioelectrical impedance analysis devices for total lean body mass (LBM), appendicular lean mass (ALM), trunk lean mass (TM), and total fat mass (FM) in 25 men and 25 women (including lean, healthy, and obese individuals according to body mass index), age 18 to 49 years, weight of 73.6 ± 15.4 kg. Both devices overestimated LBM in women (~2.5 kg, P < .001) and underestimated ALM in men (~3.0 kg, P < .05) and women (~1.0 kg, P < .05). The 720 overestimated FM in men (1.6 kg, P < .05) and underestimated TM in women (0.6 kg, P ≤ .05). Regression analyses in men revealed R² (0.87-0.91), standard error of the estimate (SEE; 2.3-2.8 kg), and limits of agreement (LOAs; 4.5-5.7 kg) for LBM; R(2) (0.62-0.87), SEE (1.5-2.6 kg), and LOA (3.2-6.0 kg) for ALM; R² (0.52-0.71), SEE (2.4-3.0 kg), and LOA (4.6-6.1 kg) for TM; and R(2) (0.87-0.93), SEE (1.9-2.6 kg), and LOA (5.9-6.2 kg) for FM. Regression analyses in women revealed R² (0.87-0.88), SEE (1.8-1.9 kg), and LOA (4.1-4.2 kg) for LBM; R² (0.78-0.79), SEE (1.4-1.5 kg), and LOA (2.7-2.9 kg) for ALM; R² (0.76-0.77), SEE (1.0 kg), and LOA (2.2-2.3 kg) for TM; and R² (0.95), SEE (2.2 kg), and LOA (4.3-4.4 kg) for FM. The InBody 520 and 720 are valid estimators of LBM and FM in men and of LBM, ALM, and FM in women; the 720 and 520 are valid estimators of TM in men and women, respectively.
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A number of studies have demonstrated the validity of both single-frequency and multi-frequency devices, concluding that BIA may be used as an alternative to DXA for whole-body and segmental body composition assessment in large groups.
“A number of studies have demonstrated the validity of both single-frequency and multi-frequency devices, concluding that BIA may be used as an alternative to DXA for whole-body and segmental body composition assessment in large groups (see Figure 3) [53,54].”
From The Utility of Body Composition Assessment in Nutrition and Clinical Practice: An Overview of Current Methodology (2021) · cites this paper as [53]
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“5 (19, 65) 27 (19, 60) 39 (19, 61) 43 (25, 63) 36 (19, 65) Sex, n (%) Male 43 (24) 9 (20) 16 (36) 11 (25) 7 (16) Female 133 (76) 35 (80) 28 (64) 33 (75) 37 (84) Race White 162 (92) 37 (84) 42 (95) 42 (95) 41 (93) Asian 5 (3) 2 (5) 2 (5) 1 (2) 0 (0) Black 2 (1) 1 (2) 0 (0) 1 (2) 0 (0) >1 race 7 (4) 4 (9) 0 (0) 0 (0) 3…”
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“The Inbody 720 R © (JP Global Markets GmbH, Germany) device will be used to obtain weight, BMI, skeletal muscle mass and body fat (Anderson et al., 2012).”
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Evaluation of body adiposity index (BAI) to estimate percent body fat in an indigenous population
Kuhn, P. C., Filho, J. P. B. V., Franco, L. F., Dal-Fabbro, A. L., Franco, L. J., & Moisés, R. S. (2013) · Clinical Nutrition · doi:10.1016/j.clnu.2013.04.021 · Cited by 26 · see citing works
Chung, J., Kim, K., Hong, J.-Y., & Kong, H. (2017) · BMC Women s Health · doi:10.1186/s12905-017-0421-z · Cited by 27 · see citing works
“Whole-body BIA measurements were taken with the participant standing upright with bare feet on the scale and arms abducted 90° while holding the handle of the device [28, 29].”
MethodChen, Y., Hsieh, Y., Ho, J., Lin, T., & Lin, J. (2022) · Chinese Culture University Repository · Cited by 25 · see citing works
Osaka, T., Hashimoto, Y., Okamura, T., Fukuda, T., Yamazaki, M., Hamaguchi, M., & Fukui, M. (2019) · Journal of Clinical Medicine · doi:10.3390/jcm8122175 · Cited by 25 · see citing works
“Multifrequency impedance body composition measurements were correlated with dual energy X-ray absorptiometry and were validated [20,21].”
MethodPrado, C. M. M., Gonzalez, M. C., Norman, K., Orsso, C. E., Barazzoni, R., Cederholm, T., Compher, C. W., Jensen, G. L., Abe, T., Barbosa-Silva, T. G., et al. (2026) · American Journal of Clinical Nutrition · doi:10.1016/j.ajcnut.2026.101283 · Cited by 28 · see citing works
“Bioimpedance measurements are highly repeatable when using the same device and following a standardized procedure, with intraclass correlation coefficients (ICCs) ≥ 0.99 and 1% (cid:0) 2% variability between repeated impedance measurements [12,21,38].”
InfluentialLiao, C., Chen, H., Huang, S., & Liou, T. (2021) · Therapeutic Advances in Musculoskeletal Disease · doi:10.1177/1759720x21998508 · Cited by 25 · see citing works
Park, J., Kim, J. H., Lee, H. J., Park, S. J., Hong, S. P., Cheon, J. H., Kim, W. H., Park, J. S., Jeon, J. Y., & Kim, T. I. (2017) · Cancer Prevention Research · doi:10.1158/1940-6207.capr-17-0065 · Cited by 24 · see citing works
“Therefore, Inbody 720 could provide direct adiposity measurement by simultaneous measurements of muscle, bone mass, and body adiposity (46) and show to be useful as a more convenient substitute for CT when measuring visceral fat area (48, 49).”
BackgroundLi, L., Xia, Z., Zeng, X., Tang, A., Wang, L., & Su, Y. (2024) · Quantitative Imaging in Medicine and Surgery · doi:10.21037/qims-23-1089 · Cited by 24 · see citing works
“Previous studies also reported that BIA significantly overestimated (58,59) or underestimated (45,60) muscle mass in absolute terms.”
Sager, R., Güsewell, S., Rühli, F. J., Bender, N., & Staub, K. (2020) · PLoS ONE · doi:10.1371/journal.pone.0234552 · Cited by 22 · see citing works
Twerenbold, S., Hauser, C., Gander, J., Carrard, J., Gugleta, K., Hinrichs, T., Schmidt‐Trucksäss, A., Hanssen, H., & Streese, L. (2023) · Scandinavian Journal of Medicine and Science in Sports · doi:10.1111/sms.14343 · Cited by 23 · see citing works
Chang, J. S., Kim, T. H., Kim, H., Choi, E. H., Kim, N., & Kong, I. D. (2017) · Geriatrics & Gerontology International · doi:10.1111/ggi.12681 · Cited by 21 · see citing works
McLester, C. N., Dewitt, A. D., Rooks, R., & McLester, J. R. (2018) · European Journal of Sport Science · doi:10.1080/17461391.2018.1448458 · Cited by 23 · see citing works
“Strengths of this study design include body composition being analysed by multiple well-established methods (Anderson et al., 2012; Ball et al., 2014; Bilsborough et al., 2014; Clemente, Romano, Bifulco, & Cesarelli, 2014; De Lorenzo, Andreoli, & Candeloro, 1997; Dolezal et al., 2013; España Romero et al., 2009; Geisb…”
MethodInfluentialOzeki, Y., Masaki, T., Yoshida, Y., et al. (2018) · Nutrients · doi:10.3390/nu10101456 · Cited by 22 · see citing works
“The device uses six frequencies (1, 5, 50, 250, 500, and 1000 kHz) and produces 30 impedance values for five body segments: right and left upper extremities, trunk, and right and left lower extremities [15].”
MethodMacfarlane, D. J., Chan, N. T.-Y., Tse, M. A., & Joe, G. M. (2015) · Journal of Sports Sciences · doi:10.1080/02640414.2015.1096416 · Cited by 21 · see citing works
“…some cross-sectional studies using healthy adults have shown acceptable levels of validity using single-frequency (Demura, Sato, & Kitabayashi, 2004) and multi-frequency devices (Anderson et al., 2012; Sun et al., 2005); however, others reported less favourable comparisons (Andreoli et al., 2002).”
BackgroundHamasaki, H., Kawashima, Y., Tamada, Y., Furuta, M., Katsuyama, H., Sako, A., & Yanai, H. (2015) · PLoS ONE · doi:10.1371/journal.pone.0132959 · Cited by 22 · see citing works
“The device uses six frequencies (1, 5, 50, 250, 500, and 1,000 kHz) and produces 30 impedance values for five body segments: right and left upper extremity, trunk, and right and left lower extremity [17].”
MethodTingelstad, H. C., Théoret, D., Spicovck, M., et al. (2016) · Military Medicine · doi:10.7205/milmed-d-15-00458 · Cited by 22 · see citing works
Orta-Duarte, M., Flores-Ruelas, Y., López-Alcaraz, F., et al. (2014) · PubMed · doi:10.3305/nh.2014.29.1.6992 · Cited by 21 · see citing works
Nutritional Assessment in Primary Care
Hurt, R. T., & McClave, S. A. (2016) · Medical Clinics of North America · doi:10.1016/j.mcna.2016.06.001 · Cited by 20 · see citing works
Takashi, Y., Ishizu, M., Mori, H., Miyashita, K., Sakamoto, F., Katakami, N., Matsuoka, T., Yasuda, T., Hashida, S., Matsuhisa, M., et al. (2019) · PLoS ONE · doi:10.1371/journal.pone.0216416 · Cited by 20 · see citing works
“The total fat mass and lean body mass evaluated by this device were validated by comparing the findings with those of dual-energy X-ray absorptiometry [33, 34].”
MethodImpact of Sarcopenia and Obesity on Gait Speed After Total Knee Replacement
Liao, C., Chen, H., Liou, T., Lin, C.-L., & Huang, S. (2022) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2022.01.056 · Cited by 20 · see citing works
Hamasaki, H., Kawashima, Y., Adachi, H., Moriyama, S., Katsuyama, H., Sako, A., & Yanai, H. (2015) · PeerJ · doi:10.7717/peerj.942 · Cited by 19 · see citing works
Harmouche-Karaki, M., Mahfouz, M., Mahfouz, Y., Fakhoury-Sayegh, N., & Helou, K. (2019) · Clinical Nutrition · doi:10.1016/j.clnu.2019.06.015 · Cited by 19 · see citing works
Wang, Y., & Luo, B. (2019) · Medicine · doi:10.1097/md.0000000000017576 · Cited by 19 · see citing works
“Some studies found that BIA had been highly correlatedwith doubly labeled watermethod,([32]) and dual-energy x-ray absorptiometry([33]) in measuring body composition.”
BackgroundLiu, J., & Chen, X. (2023) · Medicine · doi:10.1097/md.0000000000035250 · Cited by 18 · see citing works
“[23] However, it conflicts with Anderson et al findings that InBody720 underestimates ASM significantly for men (3 kg) and women (1 kg).[24] Similarly, Kim et al demonstrated that BIA is accurate in assessing whole-body LM in frail elderly women.”
Anderson, L. J., Erceg, D. N., & Schroeder, E. T. (2014) · Nutrition & Dietetics · doi:10.1111/1747-0080.12130 · Cited by 18 · see citing works
Self-citationAnthropometry, Body Composition and Resting Energy Expenditure in Human
Tur, J. A., & Bibiloni, M. D. M. (2019) · MDPI eBooks · doi:10.3390/books978-3-03921-462-4 · Cited by 18 · see citing works
Liao, C., Tsauo, J., Hsiao, D.-J., Liou, T., Huang, S., & Lin, L. (2017) · PLoS ONE · doi:10.1371/journal.pone.0189150 · Cited by 17 · see citing works
Nickerson, B. S. (2018) · Nutrition Research · doi:10.1016/j.nutres.2018.03.003 · Cited by 17 · see citing works
Norheim, K. L., Bønløkke, J. H., Samani, A., Omland, Ø., & Madeleine, P. (2017) · JMIR Research Protocols · doi:10.2196/resprot.8196 · Cited by 16 · see citing works
“Several studies have found direct segmental multi-frequency BIA to be a valid tool for assessment of body composition in both young and older men and women [42,43].”
MethodLee, L.-C., Hsu, P.-S., Hsieh, K.-C., Chen, Y.-Y., Chu, L.-P., Lu, H.-K., Chiu, Y.-C., Li, L., & Lai, C.-L. (2021) · International Journal of General Medicine · doi:10.2147/ijgm.s281418 · Cited by 18 · see citing works
Anderson, L. J., Baker, L. L., & Schroeder, E. T. (2017) · Research Quarterly for Exercise and Sport · doi:10.1080/02701367.2017.1300229 · Cited by 15 · see citing works
Self-citationImproving Physical Activity and Body Composition in a Medical Workplace Using Brief Goal Setting
Nanda, S., Hurt, R. T., Croghan, I. T., Mundi, M. S., Gifford, S. L., Schroeder, D. R., Fischer, K. M., & Bonnes, S. L. R. (2019) · Mayo Clinic Proceedings Innovations Quality & Outcomes · doi:10.1016/j.mayocpiqo.2019.07.002 · Cited by 15 · see citing works
“4-y college degree 37 (27) 15 (34) 13 (28) 9 (20)”
Body fat and risk of colorectal cancer among postmenopausal women
Kabat, G. C., Heo, M., Wactawski‐Wende, J., Messina, C. R., Thomson, C. A., Wassertheil-Smoller, S. W., & Rohan, T. E. (2013) · Cancer Causes & Control · doi:10.1007/s10552-013-0199-8 · Cited by 14 · see citing works
Chiang, H.-H., Lee, P.-F., Chen, Y., Lin, C.-F., Xu, S., Lin, Y.-T., Lin, Y.-T., Su, Y., Shia, B., ChangChien, W.-S., et al. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19148858 · Cited by 14 · see citing works
Naka, M., Kadoya, M., Kosaka‐Hamamoto, K., Morimoto, A., Miyoshi, A., Kakutani, M., Shoji, T., & Koyama, H. (2020) · Endocrine Journal · doi:10.1507/endocrj.ej19-0478 · Cited by 14 · see citing works
“Skeletal muscle mass analyzed with this method is shown to be correlated with that measured by dual energy X-ray anal‐ ysis (DEXA) method [16, 17].”
MethodPescari, D., Mihuţa, M. S., Bena, A., & Stoian, D. (2024) · Nutrients · doi:10.3390/nu16193291 · Cited by 19 · see citing works
“Numerous studies have demonstrated the reliability of both single-frequency and multi-frequency BIA instruments, concluding that BIA can serve as a substitute for DXA in the analysis of whole-body and segmental body composition in large populations [107,108].”
BackgroundLee, Y., & Shin, S. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19031171 · Cited by 13 · see citing works
“The bioelectrical resistance method is useful in body composition research because the electrode in contact with the human body measures the resistance value (impedance) of the body through electrical current [36].”
MethodSpecific characterization of regional storage fat in upper and lower limbs of young healthy adults
Yamauchi, J., Kurihara, T., Yoshikawa, M., et al. (2015) · SpringerPlus · doi:10.1186/s40064-015-1181-6 · Cited by 13 · see citing works
“1988) and is an alternative to using dual-energy X-ray absorptiometry (DEXA), the “gold standard” reference method, for assessments of regional body composition (Anderson et al. 2012; Esco et al. 2014; Leahy et al. 2012; Shafer et al. 2009).”
BackgroundMethodKönigstein, K., Klenk, C., Rossmeissl, A., Baumann, S., Infanger, D., Hafner, B., Hinrichs, T., Hanssen, H., & Schmidt‐Trucksäss, A. (2017) · Obesity · doi:10.1002/oby.22078 · Cited by 12 · see citing works
“reported that the overestimation of LBM might be more distinct in women with obesity than in men with obesity (26).”
BackgroundMethodInfluentialHamasaki, H. (2017) · Journal of Diabetes Research · doi:10.1155/2017/2303467 · Cited by 11 · see citing works
Predictors of Step Length from Surface Electromyography and Body Impedance Analysis Parameters
Park, J., Baek, S., Sung, J. H., & Kim, B. (2022) · Sensors · doi:10.3390/s22155686 · Cited by 10 · see citing works
Ankle kinematics and kinetics during gait in healthy and rheumatoid arthritis post-menopausal women
Aleixo, P., Patto, J. V., Cardoso, A., et al. (2019) · Somatosensory & Motor Research · doi:10.1080/08990220.2019.1634536 · Cited by 10 · see citing works
“This machine is a valid tool for assessing total body and segmental body composition (Anderson et al. 2012), particularly for the quantification of lean body mass (Ling et al. 2011).”
MethodVisceral fat is associated with cirrhotic portal vein thrombosis
Hernández‐Conde, M., Llop, E., Fernández‐Carrillo, C., Perelló, C., López-Gómez, M., Abad, J., Porras, J. L. M., Fernández-Puga, N., & Calleja, J. L. (2019) · Expert Review of Gastroenterology & Hepatology · doi:10.1080/17474124.2019.1651644 · Cited by 10 · see citing works
Ushio, K., Mikami, Y., Obayashi, H., Fujishita, H., Fukuhara, K., Sakamitsu, T., Hirata, K., Ikuta, Y., Kimura, H., & Adachi, N. (2021) · Journal of Clinical Medicine · doi:10.3390/jcm10112272 · Cited by 10 · see citing works
“However, values evaluated with multifrequency bioelectrical impedance analysis have been verified to correlate well with those obtained via dual energy X-ray absorptiometry [34,35].”
MethodOptimal BMI cutoff points in obesity screening for Chinese college students
Wang, Z., Wang, J., Shi, Y., Fang, Q., Tan, Q., Wang, M., & Li, J. (2022) · Frontiers in Psychology · doi:10.3389/fpsyg.2022.1017645 · Cited by 10 · see citing works
“Compared with previous research which selected bioelectrical impedance analysis of body composition and dualenergy x-ray absorptiometry as the gold standard (Anderson et al., 2012), the current study chose Vervaeck index which was convenient to use in clinical practice.”
Result
- Authors
- Anderson, L. J., Erceg, D. N., & Schroeder, E. T.
- Affiliations
- University of Southern California (US)
- Corresponding author
- Schroeder, E. Todd
- Venue
- Nutrition Research
- Publisher
- Elsevier BV
- Published
- 2012-07
- Volume
- 32
- Issue
- 7
- Pages
- 479-485
- ISSN
- 0271-5317 (ISSN-L)
- OpenAlex
- W2127203065
- Semantic Scholar
- 1d06d88277af333f9be138316c6d4e1e889b0aaf
- Cited by
- 167
- References
- 28
- Citations by year
- 2026: 3 · 2025: 6 · 2024: 10 · 2023: 10 · 2022: 12 · 2021: 16 · 2020: 13 · 2019: 18 · 2018: 15 · 2017: 17 · 2016: 10 · 2015: 16 · 2014: 12 · 2013: 8 · 2012: 1
- FWCI
- 7.93
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Nutrition Research (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 › Orthopedics and Sports Medicine › Bone health and osteoporosis research
- Keywords
- multifrequency bioelectrical impedance analysis, dual-energy X-ray absorptiometry, body composition, lean body mass, fat mass, regional body composition, sex differences, measurement agreement, obesity, healthy young adults, trunk lean mass, appendicular lean mass, fat-free mass index, fat mass index, body mass index
- MeSH terms
- Adolescent, Adult, Body Composition, Body Weight, Female, Humans, Male, Middle Aged, Obesity, Reference Values, Absorptiometry, Photon, Body Mass Index, Linear Models, Electric Impedance, Young Adult
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