Generalized bioelectric impedance‐based equations underestimate body fluids in athletes
Open accessAbstract
The current study aimed: (i) to external validate total body water (TBW) and extracellular water (ECW) derived from athlete and non‐athlete predictive equations using radioisotope dilution techniques as a reference criterion in male and female athletes; (ii) in a larger sample, to determine the agreement between specific and generalized equations when estimating body fluids in male and female athletes practicing different sports. A total of 1371 athletes (men: n = 921, age 23.9 ± 1.4 y; women: n = 450, age 27.3 ± 6.8 y) participated in this study. All athletes underwent bioelectrical impedance analyses, while TBW and ECW were assessed with dilution techniques in a subgroup of 185 participants (men: n = 132, age 21.7 ± 5.1 y; women: n = 53, age 20.3 ± 4.5 y). Two specific and eight generalized predictive equations were tested. Compared to the criterion methods, no mean bias was observed using the athlete‐specific equations for TBW and ECW (−0.32 to 0.05, p > 0.05) and the coefficient of determination ranged from R2 = 0.83 to 0.94. The majority of the generalized predictive equations underestimated TBW and ECW (p < 0.05); R2 ranged from 0.66 to 0.89. In the larger sample, all the generalized equations showed lower TBW and ECW values (ranging from −6.58 to −0.19, p < 0.05) than specific predictive equations; except for TBW in female power/velocity (one equation) athletes and team sport (two equations). The use of generalized BIA‐based equations leads to an underestimation of TBW, and ECW compared to athlete‐specific predictive equations. Additionally, the larger sample indicates that generalized equations overall provided lower TBW and ECW compared to the athlete‐specific equations.
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The use of predictive equations developed in the general population results in an underestimation of FFM components when applied to athletes.
“Particularly, the use of predictive equations developed in the general population results in an underestimation of FFM components when applied to athletes [22].”
From Athletic bioimpedance-based equations underestimate fat free mass components in male elite soccer players: development and validation of new soccer-specific predictive models (2023) · cites this paper as [22]
The Discussion (page unavailable) reports that generalized equations generally underestimated total body water and extracellular water in athletes. These are FFM components, but the paper does not establish underestimation of FFM components more broadly, and it reports exceptions for some equations and athlete groups. (LLM, conf=0.84)
Experimental — accuracy not yet measuredUnderestimation of FFM components from generalized equations was already shown when equations for the normal population were applied to athletes.
“The underestimation of FFM components from generalized equations was already showed when equations for the normal population were applied on athletes [22].”
The appropriate use of predictive equations in estimating body composition through BIA depends on the device used and the subject's age, geographical ancestry, health status, physical activity level and sex.
“The appropriate use of predictive equations in estimating body composition through bioelectrical impedance analysis (BIA) depends on the device used and the subject’s age, geographical ancestry, healthy status, physical activity level and sex.”
From High-standard predictive equations for estimating body composition using bioelectrical impedance analysis: a systematic review (2024) · cites this paper as [26]
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“Therefore, biased results can be obtained when applying these equations to athletes, as the FFM and fluid compartments often differ significantly from the general population (Campa et al. , 2021; Coratella et al. , 2021).”
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Self-citation
- Authors
- Coratella, G., Campa, F., Matias, C. N., Toselli, S., Koury, J. C., Andreoli, A., Sardinha, L. B., & Silva, A. M.
- Affiliations
- University of Milan (IT)
- University of Bologna (IT)
- Universidade Lusófona (PT)
- Universidade do Estado do Rio de Janeiro (BR)
- Department of Systems Medicine University of Tor Vergata Rome Italy
- University of Lisbon (PT)
- Corresponding author
- Campa, Francesco
- ORCID
- Venue
- Scandinavian Journal of Medicine & Science in Sports
- Publisher
- Wiley
- Published
- 2021-08-19
- Volume
- 31
- Issue
- 11
- Pages
- 2123-2132
- ISSN
- 0905-7188 (ISSN-L)
- 1600-0838
- PMC
- PMC9292858
- OpenAlex
- W3190488261
- Cited by
- 45
- References
- 35
- Citations by year
- 2026: 1 · 2025: 13 · 2024: 9 · 2023: 9 · 2022: 11 · 2021: 2
- FWCI
- 4.85
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Scandinavian Journal of Medicine and Science in Sports (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Archivio istituzionale della ricerca (Alma Mater Studiorum Università di Bologna) (submittedVersion, cc-by)
- Padua Research Archive (University of Padova) (submittedVersion, cc-by)
- Archivio Istituzionale della Ricerca (Universita Degli Studi Di Milano) (submittedVersion, other-oa)
- Cineca Institutional Research Information System (Tor Vergata University) (submittedVersion, cc-by)
- Topics
- Health Sciences › Medicine › Physiology › Body Composition Measurement Techniques
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Sports Performance and Training
- Health Sciences › Medicine › Physiology › Thermoregulation and physiological responses
- Keywords
- bioelectrical impedance analysis, total body water, extracellular water, equation validation, radioisotope dilution, sex differences, sport
- MeSH terms
- Adolescent, Adult, Body Composition, Body Water, Cross-Sectional Studies, Female, Humans, Male, Electric Impedance, Young Adult, Athletes
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.
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.
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