Abstract
Background/Objectives:
To develop and cross-validate bioelectrical impedance analysis (BIA) prediction equations of total body water (TBW) and fat-free mass (FFM) for Asian pre-pubertal children from China, Lebanon, Malaysia, Philippines and Thailand.
Subjects/Methods:
Height, weight, age, gender, resistance and reactance measured by BIA were collected from 948 Asian children (492 boys and 456 girls) aged 8–10 years from the five countries. The deuterium dilution technique was used as the criterion method for the estimation of TBW and FFM. The BIA equations were developed using stepwise multiple regression analysis and cross-validated using the Bland–Altman approach.
Results:
The BIA prediction equation for the estimation of TBW was as follows: TBW=0.231 × height2/resistance+0.066 × height+0.188 × weight+0.128 × age+0.500 × sex−0.316 × Thais−4.574 (R2=88.0%, root mean square error (RMSE)=1.3 kg), and for the estimation of FFM was as follows: FFM=0.299 × height2/resistance+0.086 × height+0.245 × weight+0.260 × age+0.901 × sex−0.415 × ethnicity (Thai ethnicity =1, others = 0)−6.952 (R2=88.3%, RMSE=1.7 kg). No significant difference between measured and predicted values for the whole cross-validation sample was found. However, the prediction equation for estimation of TBW/FFM tended to overestimate TBW/FFM at lower levels whereas underestimate at higher levels of TBW/FFM. Accuracy of the general equation for TBW and FFM was also valid at each body mass index category.
Conclusions:
Ethnicity influences the relationship between BIA and body composition in Asian pre-pubertal children. The newly developed BIA prediction equations are valid for use in Asian pre-pubertal children.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 12 print issues and online access
$259.00 per year
only $21.58 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
Similar content being viewed by others
References
Baumgartner RN, Ross R, Heymsfield SB (1998). Does adipose tissue influence bioelectric impedance in obese men and women? J Appl Physiol 84, 257–262.
Bland J, Altman D (1986). Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 8, 307–310.
Bracco D, Thiébaud D, Chioléro RL, Landry M, Burckhardt P, Schutz Y (1996). Segmental body composition assessed by bioelectrical impedance analysis and DEXA in humans. J Appl Physiol 81, 2580–2587.
Dao HH, Frelut ML, Oberlin F, Peres G, Bourgeois P, Navarro J (2004). Effects of a multidisciplinary weight loss intervention on body composition in obese adolescents. Int J Obes 28, 290–299.
de Onis MOA, Borghi E, Siyam A, Nishida C, Siekmann J (2007). Development of a WHO growth reference for school-aged children and adolescents. Accessed 15 March, 2008, from http://www.who.int/growthref/growthref_who_bull/en/index.html.
Deurenberg P, Deurenberg-Yap M, Guricci S (2002a). Asians are different from Caucasians and from each other in their body mass index/body fat per cent relationship. Obes Res 3, 141–146.
Deurenberg P, Deurenberg-Yap M, Schouten F (2002b). Validity of total and segmental impedance measurements for prediction of body composition across ethnic groups. Eur J Clin Nutr 56, 214–220.
Deurenberg P, Kusters CSL, Smit HE (1990). Assessment of body composition by bioelectrical impedance of children and young adults is strongly age dependent. Eur J Clin Nutr 44, 261–268.
Deurenberg P, van der Kooy K, Leenen R, Weststrate JA, Seidell JC (1991). Sex and age specific prediction formulas for estimating body composition from bioelectrical impedance: a cross-validation study. Int J Obes 15, 17–25.
Deurenberg P, Yap MD, Wang J, Lin FP, Schmidt G (1999). The impact of body build on the relationship between body mass index and percent body fat. Int J Obes 23, 537–542.
Ellis KJ, Bell SJ, Chertow GM, Chumlea WC, Knox DP, Lukaski HC et al. (1999). Bioelectrical impedance methods in clinical research: a follow-up to the NIH Technology Assessment Conference. Nutrition 15, 874–880.
Fomon SJ, Haschke F, Zeigler EE, Nelson SE (1982). Body composition of reference children from birth to age 10 years. Am J Clin Nutr 35, 1169–1175.
Freedman DS, Wang J, Maynard LM, Thornton JC, Mei Z, Pierson RN et al. (2005). Relation of BMI to fat and fat-free mass among children and adolescents. Int J Obes 29, 1–8.
Gallagher D, Visser M, Sepulveda D, Pierson RN, Harris T, Heymsfield SB (1996). How useful is body mass index for comparison of body fatness across age, sex, and ethnic groups? Am J Epidemiol 143, 228–239.
Going S, Nichols J, Loftin M, Stewart D, Lohman T, Tuuri G et al. (2006). Validation of bioelectrical impedance analysis (BIA) for estimation of body composition in Black, White and Hispanic adolescent girls. Int J Body Compos Res 4, 161–167.
Gurrici S, Hartriyanti Y, Hautvast J, Deurenberg P (1999). Differences in the relationship between body fat and body mass index between two different Indonesian ethnic groups: The effect of body build. Eur J Clin Nutr 53, 468–472.
Haroun D, Taylor SJC, Viner RM, Hayward RS, Darch TS, Eaton S et al. (2010). Validation of bioelectrical impedance analysis in adolescents across different ethnic groups. Obesity 18, 1252–1259.
Heyward V, Stolarczyk L (1996). Applied Body Composition Assessment. Human Kinetics: Champaign, IL, p 16.
Heyward VH (1998). Practical body composition assessment for children, adults, and older adults. Int J Sports Nutr 8, 285–307.
Jürimäe T, Hills A (2001). Body Composition Assessment in Children and Adolescents, vol. 44. Medicine and Sport Science. S Karger AG: Basel.
Kriemler S, Puder J, Zahner L, Roth R, Braun-Fahrländer C, Bedogni G (2009). 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.
Kyle UG, Bosaeus I, De Lorenzo AD, Deurenberg P, Elia M, Gomez JM et al. (2004). Bioelectrical impedance analysis--part I: review of principles and methods. Clin Nutr 23, 1226–1243.
Li Y, Schouten EG, Hu X, Cui Z, Luan D, Ma G (2008). Obesity prevalence and time trend among youngsters in China, 1982–2002. Asia Pac J Clin Nutr 17, 131–137.
Lobstein T, Baur L, Uauy R (2004). Obesity in children and young people: a crisis in public health. Obes Rev 5 (Suppl 1), 4–85.
Lohman T, Caballero B, Himes J, Davis CE, Stewart D, Houtkooper L et al. (2000). Estimation of body fat from anthropometry and bioelectrical impedance in Native American children. Int J Obes 24, 982–988.
Lohman TG (1986). Applicability of body composition techniques and constants for children and youths. Exerc Sport Sci Rev 14, 325–357.
Lohman TG (1992). Advances in Body Composition Assessment. Human Kinetics: Champaign, IL.
Mallows CL (1973). Some comments on Cp. Technometrics 15, 661–675.
McClanahan BS, Stockton MB, Lanctot JQ, Relyea G, Klesges RC, Slawson DL et al. (2009). Measurement of body composition in 8–10-year-old African-American girls: A comparison of dual-energy X-ray absorptiometry and foot-to-foot bioimpedance methods. Int J Pediatric Obes 4, 389–396.
Nielsen BM, Dencker M, Ward L, Linden C, Thorsson O, Karlsson MK et al. (2007). Prediction of fat-free body mass from bioelectrical impedance among 9-to 11-year-old Swedish children. Diabetes Obes Metab 9, 521–539.
Norgan NG (1994). Interpretation of low body mass indices: Australian Aborigines. Am J Phys Anthropol 94, 229–237.
Ritz P, Vol S, Berrut G, Tack I, Arnaud MJ, Tichet J (2008). Influence of gender and body composition on hydration and body water spaces. Clin Nutr 27, 740–746.
Roubenoff R, Dallal G, Wilson P (1995). Predicting body fatness: the body mass index vs estimation by bioelectrical impedance. Am J Public Health 85, 726–728.
Rush EC, Puniani K, Valencia ME, Davies PSW, Plank LD (2003). Estimation of body fatness from body mass index and bioelectrical impedance: comparison of New Zealand European, Maori and Pacific Island children. Eur J Clin Nutr 57, 1394.
Sampei MA, Novo NF, Yuliano Y, Sigulem DM (2001). Comparison of the body mass index to other methods of body fat evaluation in ethnic Japanese and Caucasian adolescent girls. Int J Obes 25, 400–408.
Sartorio A, Malavolti M, Agosti F, Marinone PG, Caiti O, Battistini N et al. (2005). Body water distribution in severe obesity and its assessment from eight-polar bioelectrical impedance analysis. Eur J Clin Nutr 59, 155–160.
Sluyter JD, Schaaf D, Scragg RKR, Plank LD (2009). Prediction of fatness by standing 8-electrode bioimpedance: A multiethnic adolescent population. Obesity 18, 183–189.
Snijder MB, Kuyf BEM, Deurenberg P (1999). Effect of body build on the validity of predicted body fat from body mass index and bioelectrical impedance. Ann Nutr Metab 43, 277–285.
Sun SM, Chumlea WC, Heymsfield SB, Lukaski HC, Schoeller D, FriedL K et al. (2003). Development of bioelectrical impedance analysis prediction equations for body composition with the use of a multicomponent model for use in epidemiologic surveys. Am J Clin Nutr 77, 331–340.
Tanner J, Whitehouse R (1976). Clinical longitudinal standards for height, weight, height velocity, weight velocity, and stages of puberty. Arch Dis Child 51, 170–179.
Wang J, Pierson Jr RN (1976). Disparate hydration of adipose and lean tissue require a new model for body water distribution in man. J Nutr 106, 1687–1693.
Wickramasinghe VP, Cleghorn GJ, Edmiston KA, Murphy AJ, Abbott RA, Davies PSW (2005). Validity of BMI as a measure of obesity in Australian white Caucasian and Australian Sri Lankan children. Ann Hum Biol 32, 60–71.
Wickramasinghe VP, Lamabadusuriya SP, Cleghorn GJ, Davies PS (2008). Assessment of body composition in Sri Lankan children: validation of a bioelectrical impedance prediction equation. Eur J Clin Nutr 62, 1170–1177.
Acknowledgements
We would like to acknowledge Connie Wishart for her work in the analysis of urine samples. This work was supported by the International Atomic Energy Agency (RAS/6/050). AL contributed to data collection in China, data analysis and drafted the manuscript. APH contributed to the design, interpretation of data and revising the manuscript. NMB contributed to the design, interpretation of data and revising the manuscript. MK contributed to the analysis of samples and revising the manuscript. GM, LN, TPT KK, and MNI were the principal investigators in their respective countries and contributed to data collection and interpretation and revising the manuscript. BKP contributed to data collection and interpretation in Malaysia and revising the manuscript.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Competing interests
The authors declare no conflict of interest.
Rights and permissions
About this article
Cite this article
Liu, A., Byrne, N., Ma, G. et al. Validation of bioelectrical impedance analysis for total body water assessment against the deuterium dilution technique in Asian children. Eur J Clin Nutr 65, 1321–1327 (2011). https://doi.org/10.1038/ejcn.2011.122
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1038/ejcn.2011.122
Keywords
This article is cited by
-
A century of exercise physiology: concepts that ignited the study of human thermoregulation. Part 3: Heat and cold tolerance during exercise
European Journal of Applied Physiology (2024)
-
Body composition analysis and references in children: clinical usefulness and limitations
European Journal of Clinical Nutrition (2019)
-
Proposal of new body composition prediction equations from bioelectrical impedance for Indonesian men
European Journal of Clinical Nutrition (2016)
-
Evaluation of a comprehensive intervention with a behavioural modification strategy for childhood obesity prevention: a nonrandomized cluster controlled trial
BMC Public Health (2015)
-
Body composition during growth in children: limitations and perspectives of bioelectrical impedance analysis
European Journal of Clinical Nutrition (2015)