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Body composition, energy expenditure, and physical activity

Validity of quantitative ultrasound and bioelectrical impedance analysis for measuring bone density and body composition in children

European Journal of Clinical Nutrition volume 75, pages 66–72 (2021)Cite this article

Subjects

Abstract

Background/objectives

Using dual X-ray absorptiometry (DXA) to assess body composition in children has limitations including expense, lack of portability, and exposure to radiation. The aims of this study were to examine: (1) validity of quantitative ultrasound (QUS) against DXA for measuring bone density and (2) the validity of in-built algorithm of bioelectrical impedance analysis (BIA) for measuring body composition in children (8–13 years) living in New Zealand.

Subjects/methods

Total body less head (TBLH), bone mineral content (BMC), bone mineral density (BMD), and body composition were measured with DXA (QDR Discovery A, Hologic, USA); calcaneal BMD and stiffness index (SI) with QUS (Sahara QUS, Hologic, USA), and BIA on the InBody 230 (Biospace Ltd., Seoul, Korea). Relative validity was assessed using Pearson’s and Lin’s concordance correlation coefficients (CCC), and Bland–Altman plots.

Results

In 124 healthy children, positive correlations between QUS SI and DXA (BMC and BMD) were observed (range = 0.30–0.45, P < 0.01). Results from Lin’s CCC test showed almost perfect correlations between BIA and DXA fat free mass (0.96), fat mass (0.92), and substantial correlation for percentage of fat mass (0.75) (P < 0.05).

Conclusion

Although BIA results were not as accurate as DXA and DXA remains the gold standard method for clinical assessment, BIA can be an alternative method for investigating body composition among children in large cohort field studies. Calcaneal QUS and DXA are not interchangeable methods for measuring bone density in children similar to our study population.

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Fig. 1: Bland–Altman plots demonstrating agreement between DXA and BIA FFM measurements (total population).

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Acknowledgements

We would like to sincerely thank all participants in this study for their time and commitment to the research.

Funding

The study was funded by the Massey University Research Fund.

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Authors and Affiliations

  1. College of Health, Massey University, Auckland, New Zealand

    Maryam Delshad, Kathryn L. Beck, Cathryn A. Conlon, Owen Mugridge, Marlena C. Kruger & Pamela R. von Hurst

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  1. Maryam Delshad
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  2. Kathryn L. Beck
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Contributions

All authors contributed to data collection. MD was responsible for checking, entering, and analysing the data and drafted the paper. PRvH was responsible for study design, acquisition of funding and obtaining ethical approval. CAC, KLB, and MCK advised on the statistical analysis. All authors were involved in data interpretation, critical revisions of the paper and read and approved the final paper.

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Correspondence to Pamela R. von Hurst.

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Delshad, M., Beck, K.L., Conlon, C.A. et al. Validity of quantitative ultrasound and bioelectrical impedance analysis for measuring bone density and body composition in children. Eur J Clin Nutr 75, 66–72 (2021). https://doi.org/10.1038/s41430-020-00711-6

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