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Is a single bioelectrical impedance equation valid for children of wide ranges of age, pubertal status and nutritional status? Evidence from the 4-component model

Subjects

Abstract

Background/Objectives:

Bioelectrical impedance analysis (BIA) is widely used to predict body composition in paediatric research and clinical practice. Many equations have been published, but provide inconsistent predictions.

Aims:

To test whether a single equation for lean mass (LM) estimation from BIA is appropriate across wide ranges of age, pubertal status and nutritional status, by testing whether specific groups differ in the slope or intercept of the equation.

Subjects/Methods:

In 547 healthy individuals aged 4–24 years (240 males), we collected data on body mass (BM) and height (HT), and lean mass (LM) using the 4-component model. Impedance (Z) was measured using TANITA BC418MA instrumentation. LM was regressed on HT2/Z. Multiple regression analysis was conducted to investigate whether groups based on gender, age, pubertal status or nutritional status differed in the association of LM with HT2/Z.

Results:

BM ranged from 5 to 128 kg. HT2/Z was a strong predictor of LM (r2=0.953, s.e.e.=2.9 kg). There was little evidence of a sex difference in this relationship, however, children aged 4–7 years and 16–19 years differed significantly from other age groups in regression slopes and intercepts. Similar variability was encountered for pubertal stage, but not for nutritional status.

Conclusions:

No single BIA equation applies across the age range 4–24 years. At certain ages or pubertal stages, the slope and intercept of the equation relating LM to HT2/Z alters. Failure to address such age effects is likely to result in poor accuracy of BIA (errors of several kg) for longitudinal studies of change in body composition.

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Acknowledgements

Publication of this article was supported by a grant from seca Gmbh & Co. KG, Hamburg, Germany.

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Correspondence to J C K Wells.

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The authors declare no conflict of interest.

Additional information

Contributors: The study hypothesis was conceived by JCKW, MS and MSF. The data were collected and modelled by JEW and DH, under the supervision of MSF and JCKW. CM undertook the database preparation and statistical analyses, and wrote the first draft of the manuscript. All authors contributed to subsequent revisions of the manuscript.

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Montagnese, C., Williams, J., Haroun, D. et al. Is a single bioelectrical impedance equation valid for children of wide ranges of age, pubertal status and nutritional status? Evidence from the 4-component model. Eur J Clin Nutr 67, S34–S39 (2013). https://doi.org/10.1038/ejcn.2011.213

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  • DOI: https://doi.org/10.1038/ejcn.2011.213

Keywords

  • body composition
  • bioelectrical impedance analysis
  • lean mass
  • total body water
  • fat-free mass

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