Validation of tetrapolar bioelectrical impedance method to assess human body composition
Abstract
This study was conducted to validate the relationship between bioelectrical conductance (ht2/R) and densitometrically determined fat-free mass, and to compare the prediction errors of body fatness derived from the tetrapolar impedance method and skinfold thicknesses, relative to hydrodensitometry. One-hundred and fourteen male and female subjects, aged 18–50 yr, with a wide range of fat-free mass (34–96 kg) and percent body fat (4–41%), participated. For males, densitometrically determined fat-free mass was correlated highly (r = 0.979), with fat-free mass predicted from tetrapolar conductance measures using an equation developed for males in a previous study. For females, the correlation between measured fat-free mass and values predicted from the combined (previous and present male data) equation for men also was strong (r = 0.954). The regression coefficients in the male and female regression equations were not significantly different. Relative to hydrodensitometry, the impedance method had a lower predictive error or standard error of the estimates of estimating body fatness than did a standard anthropometric technique (2.7 vs. 3.9%). Therefore this study establishes the validity and reliability of the tetrapolar impedance method for use in assessment of body composition in healthy humans.
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The BIA equation developed in this study (R2 = 0.97; SRMSE = 1.99) was similar to or better than the Lukasky equation (R2 = 0.96; SEE = 3.06) and the Baumgartner equation (R2 = 0.91; SEE = 2.47).
“The BIA equation developed in this study (R2 = 0.97; SRMSE= 1.99) was similar to or better than those obtained with other equations designed with comparable sample sizes, such as that of Lukasky (84 males; 67 females) [27] based on hydrodensitometry (R2 = 0.96; SEE = 3.06), or of Baumgartner (35 males; 63 females)[28] based on a four compartment model (R2 = 0.91; SEE = 2.47).”
The body composition variables selected in the final model have been reported as the best predictors in BIA equations designed to estimate FFM.
“The body composition variables selected in the final model of this study have been reported as the best predictors in BIA equations designed to estimate FFM [25-27].”
Limb length and body weight are positively related to resistance, which is the main predictor of FFM estimated with BIA.
“The explanation for this could be that limb length and body weight are positively related to resistance, which is the main predictor of FFM estimated with BIA [27].”
There is limited information available regarding the EQ3 development sample; its subjects ranged in age from 19 to 50 years and had a mean FFM of 60.2 kg, notably higher than our sample.
“There is limited information available regarding EQ3 development sample.The subjects ranged in age from 19 to 50 years, and the mean FFM was 60.2 kg, which was notably higher than our sample (Lukaski et al., 1986).”
From External validation of bioelectrical impedance analysis equations for body composition against dual-energy X-ray absorptiometry in Mexican recreational runners (2025) · cites this paper as Lukaski et al., 1986
The Lukaski and Kushner equations gave estimates unaffected by body weight, but only Lukaski gave unbiased estimates.
“The Lukaski (22) and Kushner (21) equations provided estimates that were unaffected by the participants' body weight, but only the Lukaski equation ( 22) provided unbiased estimates.”
From Comparison of Body Composition Methods in Obese African‐American Women (2006) · cites this paper as [22]
BIA serves as a technique for estimating body composition in population and clinical research.
“Bio-electrical impedance analysis (BIA) is used in population and clinical studies as a technique for estimating body composition.”
From Prediction of fat-free mass using bioelectrical impedance analysis in young adults from five populations of African origin (2013) · cites this paper as [3]
BIA has served as a cheaper option for body composition estimation in adults and children.
“Bioelectrical impedance analysis (BIA) has been used as a less expensive alternative for estimating body composition in both adults and children (3).”
From Prediction of fat-free mass using bioelectrical impedance analysis in young adults from five populations of African origin (2013) · cites this paper as [3]
The BIA 101 Akern is a valid and reliable alternative to dual-energy X-ray absorptiometry for the assessment of body composition.
“The BIA 101 Akern is a valid and reliable alternative to dual-energy X-ray absorptiometry (DXA) for the assessment of body composition and has been used in various other studies [7,52–54].”
From How reliable is the labeling of a commercial phytosteroid product? A 12-week randomized double-blind training study (2025) · cites this paper as [53]
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Body Composition Measurement: A Review of Hydrodensitometry, Anthropometry, and Impedance Methods
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Luke, A., Durazo-Arvizu, R., Rotimi, C., Prewitt, T. E., Forrester, T., Wilks, R., Ogunbiyi, O. J., Schoeller, D. A., McGee, D., & Cooper, R. S. (1997) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a009159 · Cited by 186 · see citing works
Ott, M., Lembcke, B., Fischer, H., Jäger, R., Polat, H., Geier, H., Rech, M., Staszeswki, S., Helm, E., & Caspary, W. F. (1993) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/57.1.15 · Cited by 182 · see citing works
Das, S. K., Roberts, S. B., Kehayias, J. J., Wang, J., Hsu, L. K. G., Shikora, S. A., Saltzman, E., & McCrory, M. A. (2003) · American Journal of Physiology-Endocrinology and Metabolism · doi:10.1152/ajpendo.00185.2002 · Cited by 183 · see citing works
“(25) provided mean %BF values that were closest to the %BF measured by the reference method at both time points.”
BackgroundMethodInfluentialKyle, U. G., Earthman, C. P., Pichard, C., & Coss-Bu, J. A. (2015) · European Journal of Clinical Nutrition · doi:10.1038/ejcn.2015.86 · Cited by 183 · see citing works
Percent Body Fat and Prediction of Surgical Site Infection
Waisbren, E. C., Rosen, H., Bader, A. M., Lipsitz, S. R., Rogers, S. O., & Eriksson, E. K. (2010) · Journal of the American College of Surgeons · doi:10.1016/j.jamcollsurg.2010.01.004 · Cited by 182 · see citing works
Lee, S. Y., Ahn, S., Kim, Y. J., Ji, M. J., Kim, K. M., Choi, S. H., Jang, H. C., & Lim, S. K. (2018) · Nutrients · doi:10.3390/nu10060738 · Cited by 175 · see citing works
“Resistance was measured at four surface tactile electrodes placed on the dorsal surface of the hand and foot by the BIA generator; the formula V = $χ height2/resistance was used to derive muscle mass mathematically [30].”
Weight Change and Body Composition in Patients With Parkinson's Disease
BEYER, P. L., PALARINO, M. Y., Michalek, D. K., Busenbark, K. L., & Koller, W. C. (1995) · Journal of the American Dietetic Association · doi:10.1016/s0002-8223(95)00269-3 · Cited by 173 · see citing works
Jung, M. E., Bray, S. R., & Ginis, K. A. M. (2008) · Journal of American College Health · doi:10.3200/jach.56.5.523-530 · Cited by 169 · see citing works
Predicting body fatness: the body mass index vs estimation by bioelectrical impedance.
Roubenoff, R., Dallal, G. E., & Wilson, P. W. F. (1995) · American Journal of Public Health · doi:10.2105/ajph.85.5.726 · Cited by 169 · see citing works
Hommes, M., Romijn, J., Endert, E., et al. (1991) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/54.2.311 · Cited by 165 · see citing works
“One of the best available estimates of the metabolically active body mass is the FFM (16), which can be accurately measured with the body-impedance analyzer (9).”
Piccoli, A., Brunani, A., Savia, G., Pillon, L., Favaro, E., Berselli, M. E., & Cavagnini, F. (1998) · International Journal of Obesity · doi:10.1038/sj.ijo.0800551 · Cited by 161 · see citing works
Lundgren, M., Burén, J., Ruge, T., Myrnäs, T., & Eriksson, J. W. (2004) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2003-031157 · Cited by 163 · see citing works
Segmental body composition assessed by bioelectrical impedance analysis and DEXA in humans
Bracco, D., Thiébaud, D., Chioléro, R. L., Landry, M., Burckhardt, P., & Schütz, Y. (1996) · Journal of Applied Physiology · doi:10.1152/jappl.1996.81.6.2580 · Cited by 159 · see citing works
“ASSESSMENT OF BODY COMPOSITION plays an important role in nutritional evaluation, and bioelectrical impedance analysis (BIA), which has been known for more than 50 years, has become widely used in clinical settings during the last 10 years (10, 13, 14).”
BackgroundBody composition in growth hormone deficient adults
Binnerts, A., Deurenberg, P., Swart, G., Wilson, J., & Lamberts, S. W. J. (1992) · The American Journal of Clinical Nutrition · doi:10.1093/ajcn/55.5.918 · Cited by 159 · see citing works
Lactate release from the subcutaneous tissue in lean and obese men.
Jansson, P., Larsson, A., Smith, U., & Lönnroth, P. (1994) · Journal of Clinical Investigation · doi:10.1172/jci116951 · Cited by 159 · see citing works
Leisure Time Activity and Physical Fitness in Patients with Epilepsy
Steinhoff, B. J., Neusiiss, K., Thegeder, H., & Reimers, C. D. (1996) · Epilepsia · doi:10.1111/j.1528-1157.1996.tb00557.x · Cited by 154 · see citing works
Body Size and Composition and Colon Cancer Risk in Men
MacInnis, R. J., English, D. R., Hopper, J. L., Haydon, A. M., Gertig, D. M., & Giles, G. G. (2004) · Cancer Epidemiology Biomarkers & Prevention · doi:10.1158/1055-9965.553.13.4 · Cited by 154 · see citing works
Insulin sensitivity and insulin clearance in human immunodeficiency virus-infected men
Hommes, M. J. T., Romijn, J. A., Endert, E., Schattenkerk, J. K. M. E., & Sauerwein, H. P. (1991) · Metabolism · doi:10.1016/0026-0495(91)90059-6 · Cited by 150 · see citing works
Li, R., Chen, X., Yan, H., Deurenberg, P., Garby, L., & Hautvast, J. (1994) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/59.4.908 · Cited by 151 · see citing works
Evaluation of nutritional status in advanced metastatic cancer
Sarhill, N., Mahmoud, F., Walsh, D., Nelson, K., Komurcu, S., Davis, M. P., Legrand, S., Abdullah, O., & Rybicki, L. (2003) · Supportive Care in Cancer · doi:10.1007/s00520-003-0486-0 · Cited by 147 · see citing works
Belza, A., Frandsen, E., & Kondrup, J. (2006) · International Journal of Obesity · doi:10.1038/sj.ijo.0803351 · Cited by 149 · see citing works
LACTATIONAL AMENORRHOEA IN WELL-NOURISHED TOBA WOMEN OF FORMOSA, ARGENTINA
Valeggia, C. R., & Ellison, P. T. (2004) · Journal of Biosocial Science · doi:10.1017/s0021932003006382 · Cited by 147 · see citing works
Comparison of body composition methods: a literature analysis
Fogelholm, M., & Lichtenbelt, W. V. M. (1997) · European Journal of Clinical Nutrition · doi:10.1038/sj.ejcn.1600448 · Cited by 147 · see citing works
“Using the individual data, the difference of 3Cm, Norland XR-26, BIA equations by Lukaski et al (1985, 1986) and RJL Systems, and skinfold equations by Durnin & Womersley (1974), against UWW, was signi®cantly associated (P 0.001) with the size of measurement (Table 3).”
BackgroundMethodInfluentialThe influence of flexibility on the economy of walking and jogging
Gleim, G. W., Stachenfeld, N. S., & Nicholas, J. A. (1990) · Journal of Orthopaedic Research® · doi:10.1002/jor.1100080606 · Cited by 144 · see citing works
Pichard, C., Kyle, U. G., Bracco, D., Slosman, D. O., Morabia, A., & Schütz, Y. (2000) · Nutrition · doi:10.1016/s0899-9007(00)00256-2 · Cited by 144 · see citing works
Chumlea, W., Baumgartner, R., & Roche, A. (1988) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/48.1.7 · Cited by 144 · see citing works
Read, J. A., Beale, P. J., Volker, D. H., Smith, N. F., Childs, A., & Clarke, S. J. (2006) · Supportive Care in Cancer · doi:10.1007/s00520-006-0153-3 · Cited by 140 · see citing works
“Fat-free mass (FFM), fat mass (FM) and total body water (TBW) were calculated according to the Lukaski algorithm [19], and FFMwas used as the measure of LBM.”
MethodComparing different methods of assessing body composition in end-stage renal failure
Cooper, B. A., Aslani, A., Ryan, M., Zhu, F. Y.-P., Ibels, L. S., Allen, B., & Pollock, C. A. (2000) · Kidney International · doi:10.1046/j.1523-1755.2000.00180.x · Cited by 140 · see citing works
Eriksson, J. W., Jansson, P., Carlberg, B., Hägg, A., Kurland, L., Svensson, M. K. E., Ahlström, H. K., Ström, C., Lönn, L., Öjbrandt, K., et al. (2008) · Hypertension · doi:10.1161/hypertensionaha.108.119404 · Cited by 140 · see citing works
Metabolic effects of oral contraceptives in women with polycystic ovary syndrome.
Korytkowski, M. T., Mokan, M., Horwitz, M. J., & Berga, S. L. (1995) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.80.11.7593446 · Cited by 140 · see citing works
Applications of bioelectrical impedance analysis for body composition to epidemiologic studies
Roubenoff, R. (1996) · The American Journal of Clinical Nutrition · doi:10.1093/ajcn/64.3.459s · Cited by 139 · see citing works
“The validation method for the published equation was hydrodensitometry (2).”
MethodCastizo-Olier, J., Irurtia, A., Jemni, M., Carrasco‐Marginet, M., Fernández, R., & Rodríguez, F. A. (2018) · PLoS ONE · doi:10.1371/journal.pone.0197957 · Cited by 138 · see citing works
Fat-free mass estimation by the two-electrode impedance method
Boulier, A., Fricker, J., Thomasset, A., & Apfelbaum, M. (1990) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/52.4.581 · Cited by 136 · see citing works
Horlick, M., Arpadi, S. M., Bethel, J., Wang, J., Moye, J., Cuff, P. A., Pierson, R. N., & Kotler, D. P. (2002) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/76.5.991 · Cited by 137 · see citing works
“BIA estimation is based on the assumption that the body is a cylindrical ionic conductor in which the extracellular and intracellular fat-free compartments act as resistors and capacitors, respectively (2, 3).”
BackgroundIndirect estimates of body composition are useful for groups but unreliable in individuals
Piers, L., Soares, M. J., Frandsen, S., & O’Dea, K. (2000) · International Journal of Obesity · doi:10.1038/sj.ijo.0801387 · Cited by 134 · see citing works
Creutzberg, E. C., Schols, A. M. W. J., Bothmer-Quaedvlieg, F. C. M., & Wouters, E. F. �. (1998) · European Journal of Clinical Nutrition · doi:10.1038/sj.ejcn.1600571 · Cited by 135 · see citing works
“FFM was assessed using the equations of Lukaski et al (1986) for the control subjects and the equation of Schols et al (1991b) for the patients with COPD.”
MethodPellmé, F., Smith, U., Funahashi, T., Matsuzawa, Y., Brekke, H. K., Wiklund, O., Taskinen, M., & Jansson, P. (2003) · Diabetes · doi:10.2337/diabetes.52.5.1182 · Cited by 134 · see citing works
“Body fat was calculated from the bioelectrical impedance method (BIA103; RJL Systems, Detroit, MI) (19).”
MethodRush, E. C., Puniani, K., Valencia, M. E., Davies, P. S. W., & Plank, L. D. (2003) · European Journal of Clinical Nutrition · doi:10.1038/sj.ejcn.1601701 · Cited by 134 · see citing works
“Equations for estimating FFM and body fat using this tool, with appropriate cross-validation, have been developed in adults (Lukaski et al, 1986; Segal et al, 1988; Heitmann, 1990; Deurenberg et al, 1991; Kyle et al, 2001) and, in a few instances, in children (Guo et al, 1990; Deurenberg et al,…”
MethodMeasurements of total body and extracellular water in cirrhotic patients with and without ascites
McCullough, A. J., Mullen, K. D., & Kalhan, S. C. (1991) · Hepatology · doi:10.1002/hep.1840140626 · Cited by 135 · see citing works
- Authors
- Lukaski, H. C., Bolonchuk, W. W., Hall, C. B., & Siders, W. A.
- ORCID
- Lukaski, H. C.
- Venue
- Journal of Applied Physiology
- Publisher
- American Physiological Society
- Published
- 1986-04-01
- Volume
- 60
- Issue
- 4
- Pages
- 1327-1332
- ISSN
- 0161-7567 (ISSN-L)
- 8750-7587
- 1522-1601
- OpenAlex
- W2103844937
- Cited by
- 1,376
- References
- 23
- Citations by year
- 2026: 20 · 2025: 24 · 2024: 21 · 2023: 36 · 2022: 54 · 2021: 35 · 2020: 42 · 2019: 35 · 2018: 38 · 2017: 35 · 2016: 35 · 2015: 38 · 2014: 50 · 2013: 28 · 2012: 39
- FWCI
- 10.43
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Applied Physiology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Body Composition Measurement Techniques
- Physical Sciences › Engineering › Electrical and Electronic Engineering › Electrical and Bioimpedance Tomography
- Physical Sciences › Engineering › Biomedical Engineering › Non-Invasive Vital Sign Monitoring
- Keywords
- body composition, fat-free mass, body fat percentage, hydrodensitometry, skinfold thickness, prediction error, anthropometry, method validation
- MeSH terms
- Adult, Anthropometry, Body Composition, Densitometry, Electric Conductivity, Evaluation Studies as Topic, Female, Humans, Male
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