Bioelectrical impedance analysis to assess body composition in obese adult women: The effect of ethnicity
Abstract
Objective To examine whether the accuracy of bioelectrical impedance analysis (BIA) to estimate body composition in overweight women is affected by the ethnicity of the individuals. Design Cross-sectional design to compare body composition estimated by BIA to body composition measured by dual energy x-ray absorptiometry (DEXA), which was the reference method. Subjects One hundred twenty three overweight women participated in this study, of which 43 women were African-American (aged 37.2+/-5.6 y; BMI, 32.3+/-4.9 kg/m2) and 80 were Caucasian (aged 36.1+/-5.7 y; BMI, 31.9+/-3.5 kg/m2). Measurements Body composition was estimated from BIA using both a generalized and an obesity-specific equation. These estimations were compared to body composition measured by DEXA, which was the reference method. Results The generalized BIA equation underestimated lean body mass (LBM) by 2.6+/-3.1 kg in Caucasian women and 0.4+/-3.2 kg in African-American women, with the difference between the ethnic groups being significant (P < 0.001). The obesity-specific equation underestimated LBM in Caucasians by 0.9+/-3.1 kg and overestimated LBM in African-Americans by 1.2+/-2.8 kg (P < 0.001). An ethnic-specific equation is proposed, and cross-validation of this equation indicates that it provides a reasonable estimate of body composition in overweight women. Conclusions The accuracy of BIA to estimate body composition appears to be affected by the ethnicity of the individual. Therefore, an ethnic-specific equation for overweight women is proposed. However, further validation of this prediction model in an ethnically diverse population is necessary.
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Risk of bias was high in two 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 [34]
Most studies on adults (n = 4) were conducted in the USA.
“Although most of the studies (n = 4) were conducted in the USA [34, 42, 54, 82], the largest participant number occurred in one Chinese study [81].”
From High-standard predictive equations for estimating body composition using bioelectrical impedance analysis: a systematic review (2024) · cites this paper as [34]
Out of the 26 available equations for adults, 22 were developed with foot-to-hand technology.
“Out of the 26 available equations, 22 were developed with foot to hand technology [34, 42, 47, 50, 52, 54, 61, 66, 71, 77, 78, 102], and four with segmental technology”
From High-standard predictive equations for estimating body composition using bioelectrical impedance analysis: a systematic review (2024) · cites this paper as [34]
Concerning foot-to-hand technology for adults, two equations are suitable for females only.
“Concerning foot to hand technology, 17 equations are available for both sexes [42, 47, 52, 54, 61, 66, 71, 77, 102], while one is suitable for males [78] and two are suitable for females only [34, 50].”
From High-standard predictive equations for estimating body composition using bioelectrical impedance analysis: a systematic review (2024) · cites this paper as [34]
Regarding foot-to-hand technology for adults, six equations are suitable for estimating FFM in females.
“Regarding foot-to-hand technology, five equations are suitable for estimating FFM in males [47, 52, 66, 71, 78] and six in females [34, 47, 50, 52, 66, 71].”
From High-standard predictive equations for estimating body composition using bioelectrical impedance analysis: a systematic review (2024) · cites this paper as [34]
Body composition assessment by bioelectrical impedance can be improved when the specific equations used are validated against reference methods and for a specific population.
“Body composition assessment by bioelectrical impedance can be improved when the specific equations used are validated against reference methods and for a specific population [7,8].”
The Kushner and Lukaski equations estimated %BF more accurately than an obese-specific equation and two equations developed from African-American samples.
“These equations more accurately estimated %BF than an equation that was developed specifically for use with obese participants (3) and two others (4,9) that were developed from African-American samples.”
From Comparison of Body Composition Methods in Obese African‐American Women (2006) · cites this paper as [4]
Neither ethnicity-specific nor obese-specific equations provided better estimates than two generalized equations.
“Our findings show that neither ethnicity-specific [Jakicic (4) and Wang (9)] nor obese-specific [Segal (3) and Jakicic (4)] equations provided better estimates than two generalized equations (21,22).”
From Comparison of Body Composition Methods in Obese African‐American Women (2006) · cites this paper as [4]
Jakicic's equation provided biased estimates.
“It is also somewhat surprising that Jakicic's equation (4) provided biased estimates because it was developed on a similar sample of obese African-American adult women.”
From Comparison of Body Composition Methods in Obese African‐American Women (2006) · cites this paper as [4]
Several researchers developed BIA equations specifically for adult obese populations.
“several researchers have developed equations specifically for use with adult obese populations (3,4).”
From Comparison of Body Composition Methods in Obese African‐American Women (2006) · cites this paper as [4]
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Pavlović, M., Linarić, P., Vazdar, L., Vuger, A. T., Jakšić, P., & Šeparović, R. (2024) · Libri Oncologici Croatian Journal of Oncology · doi:10.20471/lo.2023.51.02-03.16
Machado, J. F., Conceição, F. L., Carneiro, J. R. I., Bráulio, V. B., & Filho, J. F. (2023) · Revista de Salud Pública · doi:10.15446/rsap.v25n2.105516
“In this context, in addition to being widely applied to non-obese individuals (11-13), bioimpedance is a more accessible method for the evaluation of obese individuals, with none of the aforementioned operational limitations, as results are obtained through the resistance of an electric current to…”
Pinhel, M. A. D. S., Pires, I. F., Watanabe, L. M., et al. (2026) · Nutrición Hospitalaria · doi:10.20960/nh.06238
- Authors
- Jakicic, J., Wing, R., & Lang, W.
- Affiliations
- University of Pittsburgh (US)
- Venue
- International Journal of Obesity
- Published
- 1998-03
- Volume
- 22
- Issue
- 3
- Pages
- 243-249
- ISSN
- 0307-0565 (ISSN-L)
- 1476-5497
- OpenAlex
- W2321125708
- Cited by
- 73
- References
- 16
- Citations by year
- 2026: 2 · 2024: 3 · 2023: 3 · 2022: 5 · 2021: 1 · 2020: 3 · 2019: 3 · 2018: 1 · 2017: 6 · 2016: 4 · 2015: 2 · 2014: 5 · 2013: 4 · 2012: 3
- FWCI
- 0.40
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- International Journal of Obesity (publishedVersion)
- PubMed (publishedVersion)
- 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, obesity, overweight women, ethnicity, African American women, white women, lean body mass
- MeSH terms
- Adult, Black or African American, Body Composition, Cross-Sectional Studies, Female, Humans, Obesity
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