Validity and accuracy of regional bioelectrical impedance devices to determine whole-body fatness

Lukaski, Henry C.; Siders, William A.

doi:10.1016/s0899-9007(03)00166-7

Cited by 73Body Composition Measurement TechniquesElectrical and Bioimpedance TomographyObesity, Physical Activity, Diet

Validity and accuracy of regional bioelectrical impedance devices to determine whole-body fatness

Lukaski, Henry C., Siders, William A.·2003·Nutrition

DOI 10.1016/s0899-9007(03)00166-7

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Abstract

Objective Growing emphasis on obesity as a risk factor for chronic diseases and commercial availability of impedance devices for the at-home assessment of body fatness have stimulated the need for a critical evaluation of the validity of these instruments. This study determined the reproducibility and accuracy of two commercial impedance devices that use upper (hand-to-hand) or lower (foot-to-foot) body contact electrode placements in adults with a wide range of body fatness. Methods Body composition was assessed with dual x-ray absorptiometry in apparently healthy adults (62 women and 48 men) ages 21 to 60 y, with a range in body mass index of 18.6 to 40.5 kg/m2. Variability in body fatness predicted with the regional body impedance devices was determined in 10 adults on 5 consecutive d. A 50-kHz, tetrapolar bioelectrical impedance plethysmograph with surface electrode placements on the upper and lower limbs was used to determine reference regional and whole-body impedance values. Results Variability in body mass (1%) over 5 d was less than body fatness predicted with the upper (2-10%) and lower (3-5%) body devices. Regional and whole-body impedance values were different (P < 0.05) in the women, whereas upper and lower body values were lower (P < 0.05) than whole-body impedance in the men. Dual x-ray absorptiometric determinations of body fatness were similar to predictions based on models derived from physical characteristics (age, stature, body mass, and sex) but significantly different (P < 0.05) from estimates from the impedance devices, which underestimated body fatness. Bias in predictions of body fatness with the regional devices was systematically (P < 0.0001) related to body fatness. Conclusion Use of regional impedance devices to assess body fatness is limited by a lack of precision and accuracy.

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Single-frequency devices and segmental measures demonstrate the largest differences when compared to DXA, with the inaccuracy increasing in conjunction with higher levels of BMI.
“However, single-frequency devices and segmental measures demonstrate the largest differences when compared to DXA, with the inaccuracy increasing in conjunction with higher levels of BMI [55,56,57,58].”
From The Utility of Body Composition Assessment in Nutrition and Clinical Practice: An Overview of Current Methodology (2021) · cites this paper as [58]

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Method
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Background
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“Another similarity between the present study and Lukaski and Siders (2003) is that both studies reported the bias toward lower body fat estimates from the Omron BIA was more pronounced in individuals with higher body fat percentages.”
BackgroundMethodResultInfluential
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“However, the use of regional impedance devices to assess body fatness is often limited by poor precision and accuracy [23].”
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Validity of electrical impedance myography to estimate percent body fat: comparison to bio-electrical impedance and dual-energy X-ray absorptiometry
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“Waist-to-height ratio was a better predictor of hard CHD events when compared with waist circumference and was slightly better than FM and FFM.”
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Effectiveness of a 16-month multi-component and environmental school-based intervention for recovery of poor income overweight/obese children and adolescents: study protocol of the health multipliers program
Patriota, P., Filgueiras, A. R., de Almeida, V. B. P., Alexmovitz, G. A. C., da Silva, C. E., de Carvalho, V. F. F., Carvalho, N. D. S., de Albuquerque, M. P., Domene, S. M. Á., do Prado, W. L., et al. (2017) · BMC Public Health · doi:10.1186/s12889-017-4715-8 · Cited by 10 · see citing works
Estimativa da composição corporal e análise de concordância entre analisadores de impedância bioelétrica bipolar e tetrapolar
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“Diferente dos analisadores de IB tetrapolares de corpo inteiro (TCI), nos quais a impedância e a água corporal total são estimadas por meio da passagem de uma corrente elétrica entre o pé e a mão direita do avaliado na posição supinada(5), nos analisadores de IB bipolares, a corrente elétrica é transmitida por sensore…”
Background
The validity and accuracy in foot-to-foot bioelectrical impedance analysis measuring models referenced by dual-energy X-ray absorptiometry in body composition in standing position
Chang, H. K., Kuan, L. H., Hao, C. C., Rong, J. T., Yawn, C. Y., & Feng, K. M. (2011) · AFRICAN JOURNAL OF BIOTECHNOLOGY · doi:10.5897/ajb10.1132 · Cited by 10 · see citing works
“…the body composition measurements by BIA with stainless electrodes in standing position should become more and more important issues, especially, the predictive equations established in machines were not published for the commercial secrets’ sakes (Lukaski and Siders, 2003; Kushner et al., 1996).”
Background
Composición corporal en escolares: comparación entre métodos antropométricos simples e impedancia bioeléctrica
Tovar-Gálvez, M. I., González‐Jiménez, E., Martí‐García, C., & Schmidt‐RioValle, J. (2017) · Endocrinología Diabetes y Nutrición · doi:10.1016/j.endinu.2017.05.011 · Cited by 9 · see citing works
Fluid-Dependent Single-Frequency Bioelectrical Impedance Fat Mass Estimates Compared to Digital Imaging and Dual X-ray Absorptiometry
Nescolarde, L., Orlandi, C., Farina, G. L., Gori, N., & Lukaski, H. C. (2023) · Nutrients · doi:10.3390/nu15214638 · Cited by 8 · see citing works
“Additionally, regional BIA measurements using different electrode placements, such as foot-to-foot and hand-to-hand, yield discordant estimates of body composition compared to whole-body measurements [42].”
BackgroundSelf-citation
Body composition in a population of school adolescents: A comparison of simple anthropometric methods and bioelectrical impedance
Tovar-Gálvez, M. I., González‐Jiménez, E., Martí‐García, C., & Schmidt‐RioValle, J. (2017) · Endocrinología Diabetes y Nutrición (English ed ) · doi:10.1016/j.endien.2017.10.005 · Cited by 7 · see citing works
Validation of hand-held bioelectrical impedance analysis for the assessment of body fat in young and old adults
Wheeler, L. A. (2012) · UWM Digital Commons (University of Wisconsin–Milwaukee) · Cited by 6 · see citing works
Avaliação da composição corporal na criança por métodos não invasivos
Pinto, E. C. B., de Oliveira, A. R. S., Alencastre, H., & Lopes, C. M. M. (2005) · Portuguese National Funding Agency for Science, Research and Technology (RCAAP Project by FCT) · Cited by 6 · see citing works
Relationship Between Physical Measures of Anthropometry and Bioimpedance Measures
Serrano, M. D. M., de Espinosa, M. G. M., & Zamorano, E. M. (2012) · Springer eBooks · doi:10.1007/978-1-4419-1788-1_25 · Cited by 5 · see citing works
Diyet ve Fiziksel Aktivitenin İndirekt Kalorimetrik Yöntemle Ölçülen Dinlenme Metabolizma Hızı (DMH) ve Dual-Enerji X-ray Absorpsiyometresi (DXA) ile Ölçülen Vücut Bileşimine Etkisi
... (2012) · Türkiye Fiziksel Tıp ve Rehabilitasyon Dergisi · doi:10.4274/tftr.88156 · Cited by 5 · see citing works
Bioimpedance spectroscopy measurement method based on multisine excitation and integer-period undersampling
Li, W., Shi, H., Zhang, L., Bai, W., Wu, S., Zhang, F., & Yang, Y. (2023) · Measurement Science and Technology · doi:10.1088/1361-6501/ace7e7 · Cited by 4 · see citing works
“According to the literature [38, 39], the whole-body impedance of the human body is about 500 Ω, and the measurement range is about 200–800Ω.”
Assessment of Plasma Resistivity as a Surrogate for Extracellular Fluid Resistivity: Analytical Performance and Impact of Fluid Composition
Schotman, J. M., van Borren, M. M. G. J., Wetzels, J. F. M., Kloke, H. J., Reichert, L. J. M., & de Boer, H. (2019) · Annals of Biomedical Engineering · doi:10.1007/s10439-019-02246-9 · Cited by 4 · see citing works
Utility of Bioelectrical Impedance Analysis for Body Composition Assessment
Lim, S. K. (2022) · Journal of Korean Diabetes · doi:10.4093/jkd.2022.23.2.106 · Cited by 3 · see citing works
“미국에서는 성 인의 70% 이상이 BMI에 따라 과체중 또는 비만으로 분류되 며, 비만과 관련된 의료비로 연간 1,000억 달러 이상이 지출 되는 것으로 알려져 있다[4].”
Influential
Accuracy of Plantar Electrodes Compared with Hand and Foot Electrodes in Fat‐free‐mass Measurement
Jaffrin, M. Y., & Bousbiat, S. (2014) · Journal of Healthcare Engineering · doi:10.1260/2040-2295.5.2.123 · Cited by 3 · see citing works
“However, several authors [21, 23] have pointed out that the trunk longitudinal resistance accounts for only 4 to 6 % of hand-to-foot resistance, while the trunk represents about half of body FFM.”
Background
Estimation of segmental fat free mass in Taiwanese elderly females by bioelectrical impedance analysis with new mathematical model
Hsieh, K.-C. (2011) · AFRICAN JOURNAL OF BIOTECHNOLOGY · doi:10.5897/ajb11.2289 · Cited by 3 · see citing works
“The applicable utility of BIA was limited by the reliable validity, especially challenged in clinical usage (Lukaski and Siders, 2003).”
Background
Estimativa da Composição Corporal e Análise de Concordância Entre Analisadores de Impedância Bioelétrica Bipolar e Tetrapolar Body Composition Estimation and Agreement Analysis Between Bipolar and Tetrapolar Bioelectrical Impedance Analyzers
Filho, J. C. J., Cyrino, E. S., Gurjão, A. L. D., Braz, I. A., Gonçalves, R., & Gobbi, S. (2010) · Cited by 1 · see citing works
Development and cross-validation of aerobic capacity prediction models in adolescent youth
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Rodriguez, P. N., Bermudez, E. F., Gabriela Salazar, R., Spina, M. A., Zeni, S. N., Friedman, S., & Exeni, R. A. (2008) · Cited by 1 · see citing works
Bioelectrical Impedance Vector Analysis (BIVA) in Exercise and Sports Practice
Castizo-Olier, J. (2018) · LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) · doi:10.13140/rg.2.2.23653.24803 · Cited by 1 · see citing works
Fluid Imbalance Clarifies Differences in Fat Estimated with Bio-Electrical Impedance Analysis Compared to Dual-Energy X-ray Absorptiometry and Single Lateral Standing Digital Image Analy-SisPreprint
Farina, G. L., Orlandi, C., Gori, N., Nescolarde, L., & Lukaski, H. C. (2023) · Preprints.org · doi:10.20944/preprints202308.0812.v1
Self-citation
Hydration and Fat EstimatesPreprint
Farina, G. L., Orlandi, C., Gori, N., Nescolarde, L., & Lukaski, H. C. (2023) · Preprints.org · doi:10.20944/preprints202308.0812.v3
Self-citation
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Porto, R. W. (2009) · Americanae (AECID Library) · Cited by 1 · see citing works
Valoración de la respuesta a las recomendaciones higiénico-dietéticas en niños y adolescentes obesos en una consulta de endocrinología infantil de un hospital
Santos, L. R. (2015) · doi:10.18002/10612/4581
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Convergent Validity of Skinfold Thickness and the Hand-held Bioelectrical Impedance Analyzer using Current FITNESSGRAM Standards
Burns, R. D., Hannon, J. C., Allen, B. M., & Brusseau, T. A. (2013) · International Journal of Sports Science
Influence of elbow angle on the reliability and validity of bioelectrical impedance analysis
Pettitt, R. W., Mehrhoff, J. B., Mandeville, D. S., Pettitt, C. D., & Murray, S. R. (2017) · Journal of Sports Medicine and Therapy · doi:10.29328/journal.jsmt.1001019
Dietary total antioxidant capacity, cardiovascular risk, and anthropometric obesity indices in hemodialysis patients: A case-control study
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Agreement Between Bioelectrical Impedance Analysis and Ultrasound for Measuring Body Composition in Women with Breast Cancer
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Authors: Lukaski, H. C., & Siders, W. A.
Affiliations: Agricultural Research Service (US)
Corresponding author: Lukaski, Henry C.
ORCID: Lukaski, Henry C.
Venue: Nutrition
Publisher: Elsevier BV
Published: 2003-10
Volume: 19
Issue: 10
Pages: 851-857
ISSN: 0899-9007 (ISSN-L)
DOI: 10.1016/s0899-9007(03)00166-7
OpenAlex: W1998236052
Cited by: 73
References: 26
Citations by year: 2026: 1 · 2025: 2 · 2024: 2 · 2023: 4 · 2022: 4 · 2021: 3 · 2019: 2 · 2018: 2 · 2017: 5 · 2016: 3 · 2015: 7 · 2014: 3 · 2013: 2 · 2012: 5
FWCI: 1.54
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Nutrition (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 › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
Keywords: bioimpedance, adiposity, device validity, measurement accuracy, reproducibility, body composition, obesity, dual-energy X-ray absorptiometry
MeSH terms: Adipose Tissue, Adult, Body Composition, Electric Conductivity, Electrodes, Female, Humans, Male, Middle Aged, Obesity, Sensitivity and Specificity, Reproducibility of Results, Absorptiometry, Photon, Electric Impedance

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Validity and accuracy of regional bioelectrical impedance devices to determine whole-body fatness

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