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Body composition, energy expenditure and physical activity

Development and validation of bioelectrical impedance analysis equations for prediction total body water and fat-free mass using D2O technique in Moroccan children aged between 8 and 11 years old

European Journal of Clinical Nutrition volume 72, pages 1663–1672 (2018)Cite this article

Subjects

Abstract

Background/objectives

Estimating body composition using bioelectric impedance analysis (BIA) requires specific prediction equations. The purpose of our study was to examine the validity of published BIA equations for assessing total body water (TBW) and fat-free mass (FFM) using deuterium oxide dilution (D2O) as a reference method and to develop new FFM and TBW BIA equations if needed for Moroccan pre-pubertal children.

Subjects/methods

Data were collected from 247 schoolchildren aged 8–11 years old. Children were sorted by gender and age group and assigned in development and validation groups. D2O dilution was used as reference method for estimating TBW and FFM. Bland and Altman test, effect size, pure error, and proportional bias were used to assess the reliability of previous published equations. Cross-validation was performed by Bland and Altman test and BIA new equations were developed by linear regression.

Results

Previously published equations were tested and showed significant bias values indicating that if used they would provide biased values of TBW and FFM. The new prediction equations developed were:

\(\mathrm{TBW}_{\mathrm{D}_{2}{\mathrm{O}}}\) (l) = 0.269 + 0.292 Ht2/R (cm2/Ω) + 0.221 weight (kg) + 0.824 sex (boys = 1, girls = 0) + 0.291 age (years) (R2 = 0.91, RMSE = 1.54 kg);

\(\mathrm{FFM}_{\mathrm{D}_{2}{\mathrm{O}}}\) (kg) = −0.450 + 0.380 Ht2/R (cm2/Ω) + 0.291 weight (kg) + 1.294 sex (boys = 1, girls = 0) + 0.446 age (years) (R2 = 0.91, RMSE = 1.97 kg).

These equations provide better values of proportional bias, agreement, and pure error than the other tested equations.

Conclusions

The new BIA prediction equations seem to be the most accurate for Moroccan pre-pubertal children.

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Acknowledgements

The authors would like to gratefully acknowledge the contributions of schoolchildren who participated in this study, their parents, teachers, directors, and other support staff. This study was performed with the support of the International Atomic Energy Agency (Project RAF/06/42).

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Author notes

  1. Imane El Harchaoui and Asmaa El Hamdouchi contributed equally to this work.

Authors and Affiliations

  1. Unité Mixte de Recherche Nutrition et Alimentation, CNESTEN—Université Ibn Tofail URAC 39, Regional Designated Center of Nutrition Associated with AFRA/IAEA, Rabat, Morocco

    Imane El Harchaoui, Asmaa El Hamdouchi, Issad Baddou, Imane El Menchawy, Kaoutar Benjeddou, Naima Saeid, Mohammed El Mzibri, Khalid El Kari & Hassan Aguenaou

  2. Hôpital d’Instruction Militaire Mohammed V, Rabat, Morocco

    Hakim Belghiti

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Correspondence to Asmaa El Hamdouchi.

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El Harchaoui, I., El Hamdouchi, A., Baddou, I. et al. Development and validation of bioelectrical impedance analysis equations for prediction total body water and fat-free mass using D2O technique in Moroccan children aged between 8 and 11 years old. Eur J Clin Nutr 72, 1663–1672 (2018). https://doi.org/10.1038/s41430-018-0093-2

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