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Using bioelectrical impedance analysis in children and adolescents: Pressing issues

European Journal of Clinical Nutrition volume 76, pages 659–665 (2022)Cite this article

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Abstract

Single- and multifrequency bioelectrical impedance analysis (BIA) has gained popularity as a tool to assess body composition and health status of children and adolescents, but many questions and misconceptions remain. This review addresses pressing issues researchers and health care providers may encounter when using BIA in the young population. The importance of choosing population-specific and device-specific equations to estimate body composition as well as the use of BIA in longitudinal analyses are discussed. When specific equations are not available, raw bioimpedance values (i.e., resistance, reactance, and impedance) can be used to compute bioimpedance parameters, such as phase angle, impedance ratio, and bioelectrical impedance vector analysis. As interpreting these parameters is challenging, suggestions are provided on the use of reference data, cut-off points, and adjustment factors. Furthermore, unsolved technical and analytical issues are listed. Based on existing issues and potential for future development, a greater interaction between industry and academic researchers to improve the validity of BIA measurements among children and adolescents across their developmental stages is encouraged.

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Fig. 1: Selected frequently asked questions about the use of bioelectrical impedance analysis in pediatrics.
Fig. 2: Assessment of bioimpedance parameters using standing devices is challenging in children across their developmental stages.
Fig. 3: A SWOT analysis for the use of bioelectrical impedance analysis (BIA) in children and adolescents.

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Acknowledgements

We thank Bianca Caroline Orsso for her assistance with the illustrations. A portion of this work has been funded by the generous support of the Stollery Children’s Hospital Foundation through the Women and Children’s Health Research Institute (RES0040520).

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Authors and Affiliations

  1. Human Nutrition Research Unit, Department of Agricultural, Food and Nutritional Science, University of Alberta, 4-002 Li Ka Shing Centre for Health Innovation, Edmonton, AB, T6G 2E1, Canada

    Camila E. Orsso & Carla M. Prado

  2. Postgraduate Program in Health and Behavior, Catholic University of Pelotas, R. Gonçalves Chaves 377, Pelotas, RS, 96010280, Brazil

    Maria Cristina Gonzalez

  3. Pennington Biomedical Research Center, LSU System, 6400 Perkins Road, Baton Rouge, LA, 70808, USA

    Maria Cristina Gonzalez

  4. Seca gmbh & co. kg., Hammer Steindamm 3-25, 22089, Hamburg, Germany

    Michael Johannes Maisch

  5. Department of Pediatrics & Department of Agricultural, Food and Nutritional Science, University of Alberta, 1C4 Walter C. Mackenzie Health Sciences Center, Edmonton, AB, T6G 2B7, Canada

    Andrea M. Haqq

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  1. Camila E. Orsso
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Contributions

CEO and CMP, designed research; CEO, conducted research; CEO, writing—original draft preparation; CEO, CMG, MJM, AMH, and CMP, writing—review and editing. All authors have read and approved the final paper.

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Correspondence to Camila E. Orsso.

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Competing interests

C.E.O declares no competing financial interests. MCG reports receiving honoraria from Abbott Nutrition and Nestle Health Science, outside the scope of the submitted work. MJM is employed by Seca gmbh & co. kg. AMH has received grant funding from Rhythm pharmaceuticals and Levo therapeutics outside the scope of the submitted work. CMP reports receiving honoraria and/or paid consultancy from Abbott Nutrition, Nutricia, Nestle Health Science, Fresenius Kabi, Pfizer, and Helsinn outside the scope of the submitted work.

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Orsso, C.E., Gonzalez, M.C., Maisch, M.J. et al. Using bioelectrical impedance analysis in children and adolescents: Pressing issues. Eur J Clin Nutr 76, 659–665 (2022). https://doi.org/10.1038/s41430-021-01018-w

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