Relevance of body mass index and bioelectrical impedance analysis vs. deuterium dilution technique to assess excess of fat among young adults

Development and validation of anthropometric predictive equations that estimate the total body water and fat-free mass in Tunisian adults

OBJECTIVE

To develop and validate equations that estimate total body water (TBW) and fat-free mass (FFM) in adults using anthropometric measurements.

METHODS

A cross-sectional study was conducted among 178 adults (77 men and 101 women; aged 18-59 years). Participants were distributed by sex and age groups, and then randomly assigned to equal two groups; the development (n = 89) and the validation (n = 89). The anthropometric measurements included height and weight. The deuterium dilution technique (DDT) estimated TBW and FFM. Linear regression models were used with the TBW and FFM as the dependent variable, and height and weight as the independent variables. Cross-validation was performed by Bland and Altman plot, and the new anthropometric equations were developed.

RESULTS

In the validation sample, the developed equations had high R2 of 94.4 for both TBW and FFM in all age groups, and low standard errors (RMSE: 1.80 kg for TBW and 2.44 kg for FFM). The pure error was 2.03 for the TBW equation and 2.71 for the FFM equation. The Bland-Altman plot illustrated the good level of concordance between the TBW and FFM predicted by the new equations as determined by DDT. The following developed equations showed a better agreement with the DDT: [Formula: see text]; [Formula: see text].

CONCLUSION

In this study, we developed and validated prediction equations for the estimation of TBW and FFM from DDT in healthy adult Tunisian population. The newly anthropometric prediction equations seem to be the most accurate for Tunisian adult.

Anthropometry-Based Prediction Equation of Body Composition in a Population Aged 12-88 Years

BACKGROUND

Direct anthropometric measurements to assess body composition have limited precision and/or specificity.

OBJECTIVES

The study aimed to develop a prediction equation based on anthropometric measurements for estimating total body water (TBW) in a healthy population.

METHODS

TBW was assessed using the deuterium dilution method in 398 Moroccan participants (235 women and 163 men) aged 11.6-88 y, then compared to the estimations made by previously published anthropometric equations. By sex, participants were randomly assigned into development (n = 199) and validation subgroups (n = 199). A new anthropometric equation was developed in the development subgroup from data obtained on body volume (BV), weight, and sex, where the BV was calculated from participants' height. Then the equation was validated in the validation subgroup using the Bland and Altman procedure, bias, and pure error. External validation was performed using a sample from Tunisia (n = 220, 51.8% female, 18-65 y).

RESULTS

Bias in predicting TBW showed unacceptable value for all previously published equations as it was significantly overestimated. The following new equation using anthropometric measurements [TBW (kg) = -5.249 + 107.502 BV (L) + 0.289 weight (kg) + 2.015 sex (male: 1, female: 0); (R² = 0.91, RMSE = 1.885 kg)] was developed, and its internal validation was confirmed. The generated bias and pure error values were 0.047 kg (95% CI: -0.235, 0.330) and 2.02 kg (95% CI: 1.73, 2.31), respectively. The external validation of the new TBW prediction equation on a Tunisian sample showed a bias and pure error values of 0.07 kg (95% CI: -0.289, 0.429) and 2.36 kg, respectively.

CONCLUSIONS

The results indicate that the new anthropometric-based prediction equation provides a good estimation of TBW and other body composition compartments. It could be recommended as an alternative method to assess body composition for epidemiological and clinical studies.