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Cross-validation of bioelectrical impedance analysis for the assessment of body composition in a representative sample of 6- to 13-year-old children

Abstract

Background/Objectives: (1) To cross-validate tetra- (4-BIA) and octopolar (8-BIA) bioelectrical impedance analysis vs dual-energy X-ray absorptiometry (DXA) for the assessment of total and appendicular body composition and (2) to evaluate the accuracy of external 4-BIA algorithms for the prediction of total body composition, in a representative sample of Swiss children.

Subjects/Methods: A representative sample of 333 Swiss children aged 6–13 years from the Kinder-Sportstudie (KISS) (ISRCTN15360785). Whole-body fat-free mass (FFM) and appendicular lean tissue mass were measured with DXA. Body resistance (R) was measured at 50 kHz with 4-BIA and segmental body resistance at 5, 50, 250 and 500 kHz with 8-BIA. The resistance index (RI) was calculated as height2/R. Selection of predictors (gender, age, weight, RI4 and RI8) for BIA algorithms was performed using bootstrapped stepwise linear regression on 1000 samples. We calculated 95% confidence intervals (CI) of regression coefficients and measures of model fit using bootstrap analysis. Limits of agreement were used as measures of interchangeability of BIA with DXA.

Results: 8-BIA was more accurate than 4-BIA for the assessment of FFM (root mean square error (RMSE)=0.90 (95% CI 0.82–0.98) vs 1.12 kg (1.01–1.24); limits of agreement 1.80 to -1.80 kg vs 2.24 to -2.24 kg). 8-BIA also gave accurate estimates of appendicular body composition, with RMSE 0.10 kg for arms and 0.24 kg for legs. All external 4-BIA algorithms performed poorly with substantial negative proportional bias (r0.48, P<0.001).

Conclusions: In a representative sample of young Swiss children (1) 8-BIA was superior to 4-BIA for the prediction of FFM, (2) external 4-BIA algorithms gave biased predictions of FFM and (3) 8-BIA was an accurate predictor of segmental body composition.

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Acknowledgements

KISS is supported by research grants from the Swiss Federal Office of Sports and the Swiss National Foundation.

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Correspondence to S Kriemler.

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Guarantors: S Kriemler and G Bedogni.

Contributors: SK and LZ coordinated the study and contributed to the final version of the manuscript; JP and RR were main investigators of the study and contributed to the final version of the manuscript; CB-F supervised the study and gave important inputs for the content of the manuscript; GB performed statistical analysis and wrote the first draft of the article.

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Kriemler, S., Puder, J., Zahner, L. et al. Cross-validation of bioelectrical impedance analysis for the assessment of body composition in a representative sample of 6- to 13-year-old children. Eur J Clin Nutr 63, 619–626 (2009). https://doi.org/10.1038/ejcn.2008.19

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Keywords

  • epidemiology
  • body composition
  • bioelectrical impedance analysis
  • dual-energy X-ray absorptiometry
  • prediction equations

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