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Son JW, Han BD, Bennett JP, Heymsfield S, Lim S. Development and clinical application of bioelectrical impedance analysis method for body composition assessment. Obes Rev 2025; 26:e13844. [PMID: 39350475 DOI: 10.1111/obr.13844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 07/20/2024] [Accepted: 09/11/2024] [Indexed: 12/19/2024]
Abstract
Obesity, which is characterized by excessive body fat, increases the risk of chronic diseases, such as type 2 diabetes, cardiovascular diseases, and certain cancers. Sarcopenia, a decline in muscle mass, is also associated with many chronic disorders and is therefore a major concern in aging populations. Body composition analysis is important in the evaluation of obesity and sarcopenia because it provides information about the distribution of body fat and muscle mass. It is also useful for monitoring nutritional status, disease severity, and the effectiveness of interventions, such as exercise, diet, and drugs, and thus helps assess overall health and longevity. Computed tomography, magnetic resonance imaging, and dual-energy X-ray absorptiometry are commonly used for this purpose. However, they have limitations, such as high cost, long measurement time, and radiation exposure. Instead, bioelectrical impedance analysis (BIA), which was introduced several decades ago and has undergone significant technological advancements, can be used. It is easily accessible, affordable, and importantly, poses no radiation risk, making it suitable for use in hospitals, fitness centers, and even at home. Herein, we review the recent technological developments and clinical applications of BIA to provide an updated understanding of BIA technology and its strengths and limitations.
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Affiliation(s)
- Jang Won Son
- Department of Internal Medicine, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Byoung-Duck Han
- Department of Family Medicine, Korea University College of Medicine, Seoul, South Korea
| | | | - Steve Heymsfield
- Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
| | - Soo Lim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
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de Borba EL, Wichbold C, Ceolin J, Gonçalves MR, Cañon-Montañez W, Padoin AV, Mattiello R. Exploring the association between phase angle of bioimpedance at 50 kHz and cardiovascular risk. BMC Cardiovasc Disord 2024; 24:606. [PMID: 39472787 PMCID: PMC11520785 DOI: 10.1186/s12872-024-04211-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Accepted: 09/19/2024] [Indexed: 11/02/2024] Open
Abstract
BACKGROUND Cardiovascular diseases are characterized by chronic inflammation, leading to increased inflammatory markers that can cause cell damage and death. Phase angle has emerged as a marker of cellular health. It is considered a prognostic factor in various acute and chronic conditions. However, few studies have examined its association with cardiovascular disease risk measures. This study aims to investigate the relationship between phase angle, the general Framingham risk score, and the HEARTS cardiovascular risk score. METHODS This cross-sectional study included a convenience sample of adult patients of 2 primary health care services. Phase angle was measured using multifrequency bioimpedance analysis at 50 kHz. The risk of cardiovascular events was calculated using the Framingham and HEARTS risk scores. Statistical analysis included generalized linear regression models, unadjusted and adjusted according to sex and age, to determine the association between scores, risk factors, and phase angle. RESULTS The study included 164 individuals with a mean age 52.2 (SD 17.9). According to the HEARTS score, low-risk patients had higher phase angle values than those with high or very high risk [ß = -0.57 (95% CI -0.95; -0.19), P = 0.003]. Framingham scores showed a trend toward significance for higher mean phase angle values in low-risk than high-risk patients [ß = -0.43 (95% CI -0.88 to 0.02), P = 0.06]. CONCLUSION Phase angle values were lower in high and very high-risk patients than in low-risk patients, which shows that phase angle is a promising risk predictor for patients with cardiovascular diseases.
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Affiliation(s)
- Evandro Lucas de Borba
- Medical School, Pontifícia Universidade Católica do Rio Grande do Sul, PUCRS, Porto Alegre, Brazil
- Medical School, Universidade do Vale do Rio dos Sinos, UNISINOS, São Leopoldo, Brazil
| | - Cristina Wichbold
- Faculty of Nursing, Centro Universitário Metodista - IPA, Porto Alegre, Brazil
| | - Jamile Ceolin
- Medical School, Pontifícia Universidade Católica do Rio Grande do Sul, PUCRS, Porto Alegre, Brazil
| | - Marcelo Rodrigues Gonçalves
- Medical School, Universidade Federal do Rio Grande do Sul, UFRGS, R. Ramiro Barcelos, 2400 - Santa Cecília, Porto Alegre, RS, 90035-002, Brazil
| | | | | | - Rita Mattiello
- Medical School, Universidade Federal do Rio Grande do Sul, UFRGS, R. Ramiro Barcelos, 2400 - Santa Cecília, Porto Alegre, RS, 90035-002, Brazil.
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Steinberg N, Elbaz L, Eliakim A, Nemet D, Bar-Sella S, Peleg S, Dar G. Tendon structure, clinical tests, and pain during-loading in young female competitive gymnasts. J Sports Sci 2024; 42:1605-1616. [PMID: 39299935 DOI: 10.1080/02640414.2024.2403290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2024] [Accepted: 09/04/2024] [Indexed: 09/22/2024]
Abstract
To examine the relationship between Achilles-tendon (AT) and patellar-tendon (PT) structure, clinical-examination and tendon pain in young gymnasts; and, to explore the associations between these factors and age, maturation, and training-load. Two hundred and seventy-four female gymnasts (aged 12.1±1.9 yrs) were assessed for anthropometric measures, pubertal-stage, and training-load. They had clinical-tests (pain-on-palpation for AT and pain-on-palpation and Royal-London Hospital-Test for PT), were asked about tendon-pain during-loading and were assessed for tendon-structure. Gymnasts with positive clinical-tests (with and without pain during-loading) presented a significantly higher prevalence of disorganized AT and PT compared to gymnasts with negative clinical-tests (with and without pain during-loading) (p<0.05). A significant pubertyXpositive clinical-test interaction was found for disorganized PT structure, whereby a disorganized structure was more prevalent among post-pubertal gymnasts with positive clinical-tests compared to pre-pubertal participants with negative clinical-tests (F(1, 263)=9.436, p=0.002). In gymnasts with positive clinical-tests, significant correlations were found between disorganized AT and PT structures and age, and training-load (p<0.05). An increased prevalence of disorganized tendon structure (regardless of pain during-loading) was seen in participants with positive clinical-tests. This disorganized tendon-structure was found to be significantly related to increased age, post-pubertal stage, and higher training hours in gymnasts with positive clinical-tests.
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Affiliation(s)
- Nili Steinberg
- The Academic College Levinsky-Wingate, Wingate Campus, Netanya, Israel
| | - Liav Elbaz
- The Academic College Levinsky-Wingate, Wingate Campus, Netanya, Israel
| | - Alon Eliakim
- Child Health and Sport Center, Pediatrics, Meir Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Dan Nemet
- Child Health and Sport Center, Pediatrics, Meir Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Shelly Bar-Sella
- The Academic College Levinsky-Wingate, Wingate Campus, Netanya, Israel
| | - Smadar Peleg
- The Academic College Levinsky-Wingate, Wingate Campus, Netanya, Israel
| | - Gali Dar
- Department of Physical Therapy, Faculty of Social Welfare and Health Studies, University of Haifa, Haifa, Israel
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Matusik E. Usefulness of bioelectrical impedance analysis in multiple sclerosis patients-the interrelationship to the body mass index. Front Neurol 2024; 15:1409038. [PMID: 39022735 PMCID: PMC11253598 DOI: 10.3389/fneur.2024.1409038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Accepted: 06/10/2024] [Indexed: 07/20/2024] Open
Abstract
Background Patients with multiple sclerosis (MS) have many potential factors (disease duration, spasticity, immobilization, or glucocorticoid use) that can deteriorate their nutritional status and impact both the progression and prognosis of the disease. Body mass index (BMI), the most widely used nutritional status assessment tool, has important limitations because it does not provide any data on body composition. Aim This study aimed to assess the interrelationship between nutritional status assessment by both body mass index (BMI) and body composition using bioelectrical impedance analysis (BIA) and the consistency of diagnosis for underweight/underfat, normal weight/healthy, overweight/overfat, and obesity/obese MS patients. Methods Anthropometric [BMI and waist-to-height ratio (WHtR)] and body composition (BIA) data were evaluated in 176 patients with MS. Patients were categorized into four nutritional status subgroups (underweight, normal weight, overweight, obese according to BMI, and underfat, healthy, overfat, and obese according to fat mass% by BIA). The median Expanded Disability Status Scale score was 4.5. Patients were then divided according to EDSS score as mild (EDSS 1.0-4.0) or moderate (EDSS 4.5-6.5) disability subgroups. Results Based on BIA assessment, there was a significantly higher prevalence of overfat than of overweight based on BMI [n = 50 (28.41%) vs. n = 38 (21.59%); p < 0.05]. However, the prevalence of obesity did not differ significantly regardless of the mode of diagnosis and was not significantly lower when assessed using BIA [n = 26 (14.77%) vs. n = 30 (17.05%), respectively]. The overall compatibility rates (CR) of diagnoses made using both BMI and BIA were 75.6, 77.0, and 70.1% for all patients with MS and the mild and moderate subgroups, respectively. The lowest CR was observed in the overweight group. Adiposity significantly underestimated BMI in all subgroups. In the moderate MS subgroup, BMI significantly overcategorized patients with MS as having a normal weight (p < 0.05). Stratification for abdominal obesity (WHtR > 0.5) showed that BMI significantly underestimated the prevalence of MS in overweight and obese vs. overfat and obese patients, as assessed using BIA (60.5 vs. 67%; p < 0.05). Clinical status (EDSS and ΔEDSS) was more closely related to the nutritional status categorized by FAT% assessed using BIA than using BMI cutoff points. However, the relationship was not statistically significant. Conclusion Using the BMI cutoff point for nutritional status assessment in patients with MS is associated with a significant underestimation of excess fat mass. BIA-based FAT% based on BIA have a better relationship with abdominal obesity and disability status than with BMI in patients with MS. The highest rate of false-negative diagnoses was based on the BMI in patients with MS and moderate disability. Adiposity assessment using BIA appears to be a useful method for proper nutritional status assessment in the patients group.
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Affiliation(s)
- Edyta Matusik
- Department of Rehabilitation, Faculty of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland
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Park TY, Choi MY, Kim DS, Yeo JK, Rajasekaran M, Park MG. Correlation Analysis between Hypogonadal Symptoms and Changes in Body Composition and Physical Fitness after Testosterone Treatment in Men with Testosterone Deficiency. World J Mens Health 2024; 42:178-187. [PMID: 37118963 PMCID: PMC10782131 DOI: 10.5534/wjmh.220274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 01/29/2023] [Accepted: 02/09/2023] [Indexed: 04/30/2023] Open
Abstract
PURPOSE This study analyzed changes in body composition and physical fitness in men with testosterone deficiency (TD) after testosterone treatment (TT) and examined the correlations of body composition and physical fitness with serum testosterone levels and hypogonadal symptoms. MATERIALS AND METHODS Seventy patients with TD were divided into control (group I, n=23) and experimental (group II, n=47) groups. Patients in the experimental group were administered intramuscular testosterone enanthate (250 mg) for six months. The aging males symptom scale (AMS) score, international prostate symptom score (IPSS), body mass index, waist circumference, and serum laboratory values were measured at baseline and at the end of the study. Bioelectrical impedance analysis was used to assess the patients' body composition. Seven types of basic exercise tests were used to evaluate the patients' physical fitness. RESULTS After six months, there were no significant differences in group I, while group II had significantly improved IPSS and AMS scores; increased hemoglobin, hematocrit, prostate-specific antigen, and testosterone levels and skeletal muscle mass; and waist circumference, and body fat mass. All elements of the physical fitness test were significantly improved in group II, with the exceptions of flexibility and endurance. Decreased waist circumference was correlated with changes in testosterone levels in group II, and the IPSS, cardiorespiratory fitness, and agility were correlated with improved hypogonadal symptoms. CONCLUSIONS TT improved the hypogonadal and lower urinary tract symptoms in patients with TD and improved body composition, physical fitness, and metabolic syndrome parameters. Increased testosterone and improved hypogonadal symptoms were correlated with a decrease in waist circumference and an improvement in cardiorespiratory fitness and agility. As such, when implementing TT, we should consider whether these areas may be improved, as this can help to predict the effect.
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Affiliation(s)
- Tae Yong Park
- Department of Medicine, Graduate School, Korea University, Seoul, Korea
- Department of Urology, Uijeongbu Eulji Medical Center, Eulji University School of Medicine, Uijeongbu, Korea
| | - Moon Young Choi
- Sports Medical Center and Sports Medicine Research Institute, Inje University Seoul Paik Hospital, Seoul, Korea
| | - Dong Soo Kim
- Department of Urology, Kyung Hee University Medical Center, School of Medicine, Kyung Hee University, Seoul, Korea
| | - Jeong Kyun Yeo
- Department of Urology, Inje University Seoul Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - Mahadevan Rajasekaran
- Department of Medicine, VA San Diego Health Care System, University of California, San Diego, CA, USA
| | - Min Gu Park
- Department of Urology, Inje University Seoul Paik Hospital, Inje University College of Medicine, Seoul, Korea.
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Ohara K, Nakamura H, Kouda K, Fujita Y, Mase T, Momoi K, Nishiyama T. Similarities and discrepancies between commercially available bioelectrical impedance analysis system and dual-energy X-ray absorptiometry for body composition assessment in 10-14-year-old children. Sci Rep 2023; 13:17420. [PMID: 37833453 PMCID: PMC10576075 DOI: 10.1038/s41598-023-44217-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 10/05/2023] [Indexed: 10/15/2023] Open
Abstract
A variety of easy-to-use commercial bioelectrical impedance appliances are available. The aim of this study was to examine the usefulness of a commercially available body composition meter using bioelectrical impedance analysis (BIA) by comparing its measurement results with those obtained from dual-energy X-ray absorptiometry (DXA). The participants were 443 children aged from 10 to 14 years (226 boys and 217 girls). Fat mass, fat-free mass, lean body mass, percentage of body fat, and bone mineral contents were evaluated for all participants using BIA and DXA. The agreement in the anthropometric data obtained from both devices was analyzed using correlation analysis, intraclass correlation coefficient (ICC), Lin's concordance correlation coefficient (CCC), Bland-Altman plots, and ordinary least products regression analysis. Equivalence between both devices was tested by two one-sided t-test. All measured indicators showed strong linear correlations between the two measurement systems (r, 0.853-1.000). Fat mass, fat-free mass, and lean body mass showed absolute concordance (ICC, 0.902-0.972; Lin's CCC, 0.902-0.972). BIA overestimated bone mineral content (62.7-66.5%) and underestimated percentage of body fat (- 8.9 to - 0.8%), lean body mass (- 3.5 to - 1.8%), and body mass (- 0.8 to - 0.5%). For fat mass and fat-free mass, the overestimate or underestimate varied according to the sex and statistical analysis test. Bland-Altman analysis and ordinary least products analysis showed fixed bias and proportional bias in all indicators. Results according to quartiles of body mass index showed poor agreement for fat mass and percentage of body fat in both boys and girls in the lowest body mass index quartile. The present results revealed strong linear correlations between BIA and DXA, which confirmed the validity of the present single-frequency BIA-derived parameters. Our results suggest that BIA cannot provide the exact same values as DXA for some body composition parameters, but that performance is sufficient for longitudinal use within an individual for daily health management and monitoring.
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Affiliation(s)
- Kumiko Ohara
- Department of Hygiene and Public Health, Kansai Medical University, 2-5-1 Shin-machi, Hirakata, Osaka, 573-1010, Japan
- Graduate School of Human Development and Environment, Kobe University, 3-11 Tsurukabuto, Nada, Kobe, Hyogo, 657-8501, Japan
| | - Harunobu Nakamura
- Department of Hygiene and Public Health, Kansai Medical University, 2-5-1 Shin-machi, Hirakata, Osaka, 573-1010, Japan.
- Graduate School of Human Development and Environment, Kobe University, 3-11 Tsurukabuto, Nada, Kobe, Hyogo, 657-8501, Japan.
| | - Katsuyasu Kouda
- Department of Hygiene and Public Health, Kansai Medical University, 2-5-1 Shin-machi, Hirakata, Osaka, 573-1010, Japan
| | - Yuki Fujita
- Center for Medical Education, Kindai University Faculty of Medicine, 377-2 Oono-Higashi, Osaka-Sayama, Osaka, 589-8511, Japan
| | - Tomoki Mase
- Faculty of Human Development and Education, Kyoto Women's University, 35 Imagumanokitahiyoshi-cho, Higashiyama, Kyoto, Kyoto, 605-8501, Japan
| | - Katsumasa Momoi
- Faculty of Human Development and Education, Kyoto Women's University, 35 Imagumanokitahiyoshi-cho, Higashiyama, Kyoto, Kyoto, 605-8501, Japan
| | - Toshimasa Nishiyama
- Department of Hygiene and Public Health, Kansai Medical University, 2-5-1 Shin-machi, Hirakata, Osaka, 573-1010, Japan
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Baş D, Arıbal ME, Vardareli E, Sönmez Ö, Oyan B, Özden BÇ, Sonkaya A. Validation of bioelectrical impedance analysis in the evaluation of body composition in patients with breast cancer. Nutr Clin Pract 2022. [PMID: 36579726 DOI: 10.1002/ncp.10947] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 11/15/2022] [Accepted: 11/26/2022] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND The evaluation of body composition is an essential parameter for preventing obesity and sarcopenic obesity, which are prognostic factors in breast cancer. This study aims to validate the bioelectrical impedance analysis (BIA) of women who are breast cancer survivors by using the dual-energy x-ray absorptiometry (DXA) measurement method. METHODS This validation study included 104 women without metastasis between 32 and 72 years old (mean 47.03 ± 8.59) whose treatment was completed 6 months prior. Body composition analysis was performed sequentially using both measurements and when participants were hungry. RESULTS Meaningful differences were found in fat-free mass (FFM) (BIA: 46.57 ± 5.54 kg; DXA: 41.06 ± 5.11 kg), body fat percentage (%BF) (BIA: 34.28% ± 6.24%; DXA: 43.91% ± 5.58%), body fat mass (FM) (BIA: 25.37 ± 8.84 kg; DXA: 31.24 ± 9.09 kg), and lean soft tissue mass (LSTM) (BIA: 4.42 ± 5.66 kg; DXA: 38.75 ± 4.98 kg) (P < 0.001). Powerful associations for body FM and strong associations for other parameters were seen. A constant and/or proportional error was found between the two devices within the direction of strong and solid components. Compared with DXA, the BIA measurement gives a lower estimate of %BF and FM and a higher estimate of LSTM and FFM. CONCLUSIONS By the mathematical relationship between the two measurement methods, it seems possible to adapt the body composition parameters obtained from BIA of patients with breast cancer to DXA results. In the future, there will be a need to evaluate these two devices with more extensive studies.
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Affiliation(s)
- Dilşat Baş
- Health Sciences Institute, Acıbadem Mehmet Ali Aydınlar University, Istanbul, Turkey.,Department of Nutrition and Dietetics, Acıbadem Altunizade Hospital, Istanbul, Turkey.,Department of Nutrition and Dietetics, School of Health Sciences, İstanbul Galata University, İstanbul, Turkey
| | - Mustafa Erkin Arıbal
- Department of Radiology, Acıbadem Mehmet Ali Aydınlar University School of Medicine, Istanbul, Turkey
| | - Erkan Vardareli
- Department of Nuclear Medicine, Acıbadem Mehmet Ali Aydınlar University School of Medicine, Istanbul, Turkey
| | - Özlem Sönmez
- Department of Medical Oncology, Acıbadem Mehmet Ali Aydınlar University School of Medicine, Istanbul, Turkey
| | - Başak Oyan
- Department of Medical Oncology, Acıbadem Mehmet Ali Aydınlar University School of Medicine, Istanbul, Turkey
| | | | - Alper Sonkaya
- Department of Medical Oncology, Acıbadem Mehmet Ali Aydınlar University School of Medicine, Istanbul, Turkey
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Body Composition in Multiple Sclerosis Patients and Its Relationship to the Disability Level, Disease Duration and Glucocorticoid Therapy. Nutrients 2022; 14:nu14204249. [PMID: 36296931 PMCID: PMC9610927 DOI: 10.3390/nu14204249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 09/14/2022] [Accepted: 10/10/2022] [Indexed: 11/17/2022] Open
Abstract
Background: Patients with multiple sclerosis (MS) have many potential factors (spasticity, immobilization, glucocorticoids use) for the deterioration of body composition. Aim: To assess the nutritional status (by classical anthropometry and by bioelectrical impedance analysis (BIA)) in MS patients and to correlate it with clinical state, MS duration time and the presence of glucocorticoid therapy in anamnesis (ever used). Methods: Anthropometrical (BMI and waist and hip circumferences, waist-to-height ratio (W/HtR), and waist-to-hip ratio (WHR)) and body composition (BIA) data were evaluated in 176 patients with MS. Fat mass (FM), and fat-free mass (FFM) were expressed as kilograms (kg), percentage (%) and indexes (FMI: fat mass index, FFMI: fat-free mass index) expressed in kg/m2. The median Expanded Disability Status Scale score was 4.5. Patients were then divided according to EDSS score as mild (EDSS 1.0−4.0) or moderate (EDSS 4.5−6.5) disability subgroup. Results: Waist c., WHtR, WHR, and FM% were significantly higher in the moderate MS group (p < 0.01; p < 0.001; p < 0.001; and p < 0.05, respectively). Whilst, FFM% was significantly lower (p < 0.05). BMI did not correlate significantly with any disability status score and MS time. Significant correlations were observed between EDSS, ΔEDSS and MS time and Waist c., WHtR, WHR, FM% and FFM%. WHtR had the strongest significance (p < 0.0001 vs. EDSS; p < 0.0001 vs. ΔEDSS; and p < 0.01 vs. MS time, respectively). After the adjustment to the MS time, only FM% was no longer significantly related to both EDSS and ΔEDSS. MS duration time, EDSS, ΔEDSS, WHtR, FM(kg), FM%, and FMI were significantly higher in the patients with a positive history of glucocorticoid therapy (all p < 0.05). Whilst, FFM% was significantly lower in MS patients treated with glucocorticoids (p < 0.01). Conclusions: Greater disability in MS patients is strongly related to lower fat-free mass and higher fat mass, especially with the abdominal distribution, irrespective of the duration time of the disease. Oral glucocorticoid therapy seems to have a negative impact on the body composition of MS patients. However, further prospective multifactorial studies in this field have to be done. For the proper assessment of nutritional status in MS patients, Waist c., WHtR, WHR, or body composition parameters seem to be of greater use than BMI.
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Effects of age and gender on body composition indices as predictors of mortality in middle-aged and old people. Sci Rep 2022; 12:7912. [PMID: 35551227 PMCID: PMC9098413 DOI: 10.1038/s41598-022-12048-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 04/26/2022] [Indexed: 11/08/2022] Open
Abstract
To determine whether body composition indices interact with age and gender as a predictor of all-cause mortality, 1200 participants at least 40 years of age were recruited in 2009 and 2010. A multi-frequency bioelectrical impedance analysis device was used to measure each participant's body composition indices, including the fat mass index (FMI), fat free mass index (FFMI), skeletal muscle mass index (SMMI), and visceral fat area index (VFAI). A baseline questionnaire was used to collect demographic information about lifestyle habits, socioeconomic status, and medical conditions. All claimed records of death from 2009 to 2018 in the National Health Insurance Research Databank were identified. The all-cause mortality rate was 8.67% after a mean follow-up period of 5.86 ± 2.39 person-years. The Cox proportional hazard model analysis showed significantly negative associations between FFMI or SMMI with all-cause mortality in the total group and those aged ≥ 65 y/o. The FFMI and SMMI were negative predictors of mortality in both genders. The FMI and VFAI were positive predictors of mortality exclusively in females. In conclusion, the SMMI is a better predictor of mortality than the BMI, FMI, and FFMI, especially in older adults. A higher fat mass or visceral fat distribution may predict higher mortality in females.
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Holmes CJ, Racette SB, Symonds L, Arbeláez AM, Cao C, Granados A. Comparison of Bioelectrical Impedance Analysis with DXA in Adolescents with Cystic Fibrosis before and after a Resistance Training Intervention. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:4037. [PMID: 35409718 PMCID: PMC8997924 DOI: 10.3390/ijerph19074037] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 03/24/2022] [Accepted: 03/26/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND The purpose of this pilot study was to compare body composition metrics obtained by two portable bioelectrical impedance analysis (BIA) devices with dual-energy X-ray absorptiometry (DXA) among adolescents with cystic fibrosis (CF) before and after a resistance exercise training program. METHODS Participants with CF were assessed using DXA, single-frequency BIA (SFBIA), and multiple-frequency BIA (MFBIA) to quantify percent body fat (%Fat), fat mass (FM), and fat-free mass (FFM) at baseline and after a home-based resistance training intervention comprised of 36, 1 h sessions completed in 12-14 weeks. Repeated measures analysis of variance, paired samples t-tests, Cohen's d effect sizes, and Pearson's correlations were used to compare differences between and within methods at baseline and post-intervention. RESULTS Ten participants (15.8 ± 2.2 yr, 60.1 ± 15.1 kg) completed the assessments. At baseline, both SFBIA and MFBIA scales significantly underestimated %Fat and FM and overestimated FFM, with small to moderate effect sizes. Post-intervention, small, non-significant differences were found between DXA and both BIA scales for all body composition metrics. Significant changes in %Fat and FFM were observed with DXA. MFBIA displayed less constant error than SFBIA when compared to DXA for pre- and post-intervention assessments for %Fat (MFBIA: pre and post -2.8 and -0.8 vs. SFBIA: -4.6 and -2.0), FM (-0.4 and -0.4 vs. -3.0 and -1.1), and FFM (+0.8 and +0.6 vs. +3.1 and +1.3). Near-perfect correlations were observed at both time points between DXA and each BIA scale. Conclusions: Portable BIA results should be interpreted with caution, and further validation studies in CF patients are needed prior to clinical use.
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Affiliation(s)
- Clifton J. Holmes
- Program in Physical Therapy, Washington University School of Medicine, St. Louis, MO 63108, USA; (S.B.R.); (C.C.)
- Center for Human Nutrition, Department of Medicine, Washington University School of Medicine, St. Louis, MO 63108, USA
| | - Susan B. Racette
- Program in Physical Therapy, Washington University School of Medicine, St. Louis, MO 63108, USA; (S.B.R.); (C.C.)
- Center for Human Nutrition, Department of Medicine, Washington University School of Medicine, St. Louis, MO 63108, USA
| | - Leslie Symonds
- Department of Pediatrics, Washington University School of Medicine, St. Louis, MO 63108, USA; (L.S.); (A.M.A.)
| | - Ana Maria Arbeláez
- Department of Pediatrics, Washington University School of Medicine, St. Louis, MO 63108, USA; (L.S.); (A.M.A.)
| | - Chao Cao
- Program in Physical Therapy, Washington University School of Medicine, St. Louis, MO 63108, USA; (S.B.R.); (C.C.)
| | - Andrea Granados
- Nicklaus Children’s Hospital, Division of Pediatric Endocrinology and Metabolism, Miami, FL 33155, USA;
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Torres-Costoso A, Martínez-Vizcaíno V, Fernández-Rodríguez R, Sequí-Dominguez I, Reina-Gutiérrez S, Núñez de Arenas-Arroyo S, Garrido-Miguel M. Dietary Calcium Intake and Fat Mass in Spanish Young Adults: The Role of Muscle Strength. Nutrients 2021; 13:nu13124498. [PMID: 34960051 PMCID: PMC8705271 DOI: 10.3390/nu13124498] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 12/07/2021] [Accepted: 12/13/2021] [Indexed: 01/01/2023] Open
Abstract
Obesity is declared as a chronic multifaceted health problem, and young adults may be particularly vulnerable to weight gain. This study aims to identify the role of dietary calcium intake and the muscle strength index in handling excess of fat mass in young adults and to examine if the relationship between dietary calcium intake and fat mass percentage is mediated by muscle strength. A cross-sectional study including 355 Spanish college students (aged 21.05 ± 3.11) was performed during the 2017–2018 academic year. Pearson correlation coefficients were estimated to determine the relationship between dietary calcium intake, fat mass percentage, body mass index, muscle strength components, and total energy intake. ANCOVA models were used to analyze the differences in the muscle strength index by total dietary calcium intake categories, as well as the differences in % fat mass by total dietary calcium intake and muscle strength index categories, controlling for different sets of confounders. A mediator analysis was conducted to test if the relationship between dietary calcium intake and fat mass percentage was explained by muscle strength. Data on the fat mass percentage, dietary calcium intake, and muscle strength index as the sum of the standardized z-score of the standing long jump and z-score of handgrip/weight were collected. The muscle strength index was significantly better in young adults with higher dietary calcium intake. Moreover, the fat mass percentage was significantly lower in those with a higher dietary calcium intake and a better muscle strength index. Finally, the relationship between dietary calcium intake and fat mass percentage was fully mediated by muscle strength (z = −1.90; p < 0.05), explaining 33.33% of this relationship. This study suggests that both a major dietary calcium intake and muscle strength are associated with fat mass percentage. Moreover, muscle strength mediates the link between dietary calcium intake and fat mass percentage. Therefore, both high dietary calcium intake and exercise activities aimed at improving muscle strength levels may help to prevent the cardiometabolic risk associated with an excess of fat mass in young people.
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Affiliation(s)
- Ana Torres-Costoso
- Facultad de Fisioterapia y Enfermería, Universidad de Castilla-La Mancha, 45071 Toledo, Spain;
- Centro de Estudios Socio-Sanitarios, Universidad de Castilla-La Mancha, 16071 Cuenca, Spain; (R.F.-R.); (I.S.-D.); (S.R.-G.); (S.N.d.A.-A.); (M.G.-M.)
| | - Vicente Martínez-Vizcaíno
- Centro de Estudios Socio-Sanitarios, Universidad de Castilla-La Mancha, 16071 Cuenca, Spain; (R.F.-R.); (I.S.-D.); (S.R.-G.); (S.N.d.A.-A.); (M.G.-M.)
- Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Talca 3467987, Chile
- Correspondence: ; Tel.: +34-969179100
| | - Rubén Fernández-Rodríguez
- Centro de Estudios Socio-Sanitarios, Universidad de Castilla-La Mancha, 16071 Cuenca, Spain; (R.F.-R.); (I.S.-D.); (S.R.-G.); (S.N.d.A.-A.); (M.G.-M.)
| | - Irene Sequí-Dominguez
- Centro de Estudios Socio-Sanitarios, Universidad de Castilla-La Mancha, 16071 Cuenca, Spain; (R.F.-R.); (I.S.-D.); (S.R.-G.); (S.N.d.A.-A.); (M.G.-M.)
| | - Sara Reina-Gutiérrez
- Centro de Estudios Socio-Sanitarios, Universidad de Castilla-La Mancha, 16071 Cuenca, Spain; (R.F.-R.); (I.S.-D.); (S.R.-G.); (S.N.d.A.-A.); (M.G.-M.)
| | - Sergio Núñez de Arenas-Arroyo
- Centro de Estudios Socio-Sanitarios, Universidad de Castilla-La Mancha, 16071 Cuenca, Spain; (R.F.-R.); (I.S.-D.); (S.R.-G.); (S.N.d.A.-A.); (M.G.-M.)
| | - Miriam Garrido-Miguel
- Centro de Estudios Socio-Sanitarios, Universidad de Castilla-La Mancha, 16071 Cuenca, Spain; (R.F.-R.); (I.S.-D.); (S.R.-G.); (S.N.d.A.-A.); (M.G.-M.)
- Facultad de Enfermería de Albacete, Universidad de Castilla-La Mancha, 02006 Ciudad Real, Spain
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12
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Howe CA, Corrigan RJ, Djalali M, McManaway C, Grbcich A, Aidoo GS. Feasibility of Using Bioelectrical Impedance Analysis for Assessing Youth Weight and Health Status: Preliminary Findings. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:10094. [PMID: 34639395 PMCID: PMC8507857 DOI: 10.3390/ijerph181910094] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 09/21/2021] [Accepted: 09/23/2021] [Indexed: 12/02/2022]
Abstract
Background. This study assessed the accuracy of bioimpedance analysis (BIA) for measuring body composition and resting metabolic rate (RMR) in fasted and non-fasted state and the prospect of using phase angle (PA) to indicate cellular health in youth. Methods. BIA body composition, RMR, and hydration measures were compared to dual-energy x-ray absorptiometry (DXA), MedGem metabolic analyzer, and urine specific gravity, respectively, at baseline in a fasted state using one-way ANOVAs. Repeated BIAs at 0, 30, 60, 90, and 120 min post-prandial were compared to baseline using repeated-measures ANOVA. Correlations were used to assess the relationship among PA and health (blood lipids and glucose, resting BP) and fitness (grip strength and a 3 min step test) measures. Results. BIA scans (N = 58; 11.4 ± 2.9 y) measured lower body fat % (BF%) in healthy weight youth (BMI < 85th percentile; 16.4 ± 1.1 vs. 25.1 ± 1.0%) and lower visceral adipose tissue (VAT) in males (44.5 ± 2.9 vs. 34.1 ± 6.0 cm2) than DXA and higher RMR in all youth (1244 ± 41 vs. 1104 ± 39 kcals/day), healthy weight (1231 ± 48 vs. 1049 ± 44 kcals/day), and teens (1541 ± 62 vs. 1234 ± 72 kcals/day) than MedGem. Compared to baseline, immediate post-prandial values were significantly higher for BF% (21.4 ± 1.4 vs. 22.0 ± 1.4%) and VAT (45.4 ± 6.1 vs. 46.2 ± 6.2 cm2). PA was significantly correlated with BF% (r = -0.33; p = 0.01), fat-free mass (r = 0.59; p < 0.001), grip strength (r = 0.56; p < 0.001). Conclusions. While more data are needed to confirm these preliminary findings, the results suggest caution is necessary in using BIA to assess aspects of youth health and weight status, especially in males, healthy weight, and teens. However, these preliminary findings do indicate that phase angle maybe be a valuable, non-invasive tool for identifying youth who are heading towards obesity and/or obesity-related health consequences.
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Affiliation(s)
- Cheryl A. Howe
- School of Applied Health Sciences and Wellness, Ohio University, Athens, OH 45701, USA; (C.M.); (A.G.); (G.S.A.)
| | - Riley J. Corrigan
- Honors Tutorial College, Ohio University, Athens, OH 45701, USA; (R.J.C.); (M.D.)
| | - Maya Djalali
- Honors Tutorial College, Ohio University, Athens, OH 45701, USA; (R.J.C.); (M.D.)
| | - Chris McManaway
- School of Applied Health Sciences and Wellness, Ohio University, Athens, OH 45701, USA; (C.M.); (A.G.); (G.S.A.)
| | - Alexandra Grbcich
- School of Applied Health Sciences and Wellness, Ohio University, Athens, OH 45701, USA; (C.M.); (A.G.); (G.S.A.)
| | - Grace Sam Aidoo
- School of Applied Health Sciences and Wellness, Ohio University, Athens, OH 45701, USA; (C.M.); (A.G.); (G.S.A.)
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13
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The Utility of Body Composition Assessment in Nutrition and Clinical Practice: An Overview of Current Methodology. Nutrients 2021; 13:nu13082493. [PMID: 34444653 PMCID: PMC8399582 DOI: 10.3390/nu13082493] [Citation(s) in RCA: 156] [Impact Index Per Article: 39.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 07/08/2021] [Accepted: 07/20/2021] [Indexed: 12/31/2022] Open
Abstract
Body composition is a key component for maintaining good general health and longevity. It can be influenced by a variety of factors, including genetics, environment, and lifestyle choices. The assessment of body composition is an essential tool for nutrition specialists to effectively evaluate nutritional status and monitor progression during dietary interventions. As humans age, there is a natural increase in fat mass coupled with a gradual decline in lean mass, specifically in bone and muscle mass. Individuals with a high body fat percentage are at a greater risk of cardiovascular diseases, type 2 diabetes, several types of cancer, and early mortality. Significant decreases in bone mineral density signify osteopenia and osteoporosis, while reductions in skeletal muscle mass increase the risk of developing sarcopenia. Moreover, undernutrition exacerbates the effects of many medical conditions and is important to address. Though weight tracking and calculation of BMI are used commonly by clinicians and dietitians, these measures do not provide insight on the relative contributions of fat mass and fat-free mass or the changes in these compartments that may reflect disease risk. Therefore, it is important that healthcare professionals have a critical understanding of body composition assessment and the strengths and limitations of the methods available.
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Więch P, Chmiel Z, Bazaliński D, Sobolewski M, Sałacińska I. Body Composition and Selected Nutritional Indicators in Healthy Adults-A Cross-Sectional Study. Glob Adv Health Med 2021; 10:21649561211021794. [PMID: 34158999 PMCID: PMC8182172 DOI: 10.1177/21649561211021794] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 05/09/2021] [Accepted: 05/12/2021] [Indexed: 12/25/2022] Open
Abstract
Background Body mass composition is subject to constant change and is multifactorially
determined. Its analysis in different age groups allows a better
understanding of the determinants of the human organism in health and
disease. Aim The study was aimed to conduct cross-sectional assessment of body composition
and selected nutritional indicators in healthy adults. Methods The cross-sectional study carried out from March 2016 to April 2018 was
preceded by a monthly pilot study. All 1333 adults (women 795, 59.6%) aged
20–59 included in the study were from the urban and rural area of the
Podkarpackie Province (Poland). These adults were classified into four
10-year age bands. To obtain reliable assessment, selected screening
(anthropometry) and in-depth (bioelectrical impedance including phase angle
and bioelectrical impedance vector analysis) methods were used. Results In women, the proportion of individuals affected by overweight and obesity
increases significantly with age, with a less pronounced trend in men, as
reflected in the observed differences in individual body composition
components. A slight (0.45–0.60) correlation was also observed between body
mass index (BMI) and percentage of fat mass (FM %) among men with an
increasing strength of the association with age, decreasing in the
50–59 years group. In the female group, the correlations described are at a
much higher level (0.80 or higher). The described changes in body
composition were reflected in body type from athletic to obese, measured by
means of the bioelectrical impedance vector analysis (BIVA) method. Conclusions Age and gender significantly differentiate body composition of the adult
human body. The body composition analysis should be considered as complement
screening assessment method, especially as a support for the assessment of
nutritional status expressed by BMI.
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Affiliation(s)
- Paweł Więch
- Institute of Health Sciences, College of Medical Sciences, University of Rzeszów, Rzeszów, Poland
| | - Zdzisława Chmiel
- Institute of Health Sciences, College of Medical Sciences, University of Rzeszów, Rzeszów, Poland
| | - Dariusz Bazaliński
- Institute of Health Sciences, College of Medical Sciences, University of Rzeszów, Rzeszów, Poland
| | - Marek Sobolewski
- Faculty of Management, Rzeszów University of Technology, Rzeszów, Poland
| | - Izabela Sałacińska
- Institute of Health Sciences, College of Medical Sciences, University of Rzeszów, Rzeszów, Poland
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15
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Zwierzchowska A, Celebańska D, Rosołek B, Gawlik K, Żebrowska A. Is body mass index (BMI) or body adiposity index (BAI) a better indicator to estimate body fat and selected cardiometabolic risk factors in adults with intellectual disabilities? BMC Cardiovasc Disord 2021; 21:119. [PMID: 33653276 PMCID: PMC7927267 DOI: 10.1186/s12872-021-01931-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 02/23/2021] [Indexed: 12/05/2022] Open
Abstract
Background The BMI index cannot always be used in people with intellectual disabilities due to neuromuscular coordination disorders and psychological barriers that may hinder conventional body weight measurement. The study aimed to assess the usefulness of BMI and BAI in estimating obesity and body fat in people with intellectual disabilities.
Methods The first stage of the research involved 161 people with profound intellectual disabilities. Somatic parameters (BM, BH, WC, HC) were measured and BMI, BAI, WHR were calculated. Fifty seven persons with above-normal BMI and BAI were included in the second stage of the study and biochemical parameters were determined (TC, LDL-cholesterol, HDL-cholesterol, TG, GL). Results According to both BMI and BAI classifications, most people were overweight or obese. A high correlation of %BF with BMI and BAI indices was observed (r = 0.78). The sensitivity of both indices was 95.65%. In groups with above-normal BMI and BAI, an upward trend was found for mean values of TC, LDL, TG, and GL, with a simultaneous downward trend for HDL. Statistically significant intergroup differences were recorded for TG and GL (p < 0.05) for both indices (BMI and BAI). Conclusions Our research demonstrated that BAI is complementary to BMI and can be recommended for the estimation of body fat and cardiometabolic risks in people with intellectual disabilities. Due to the ease of measurement, BAI has high utility value.
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Affiliation(s)
- Anna Zwierzchowska
- Institute of Sport Sciences, The Jerzy Kukuczka Academy of Physical Education in Katowice, ul. Mikołowska 72a, 40-065, Katowice, Poland
| | - Diana Celebańska
- Institute of Sport Sciences, The Jerzy Kukuczka Academy of Physical Education in Katowice, ul. Mikołowska 72a, 40-065, Katowice, Poland.
| | - Barbara Rosołek
- Institute of Sport Sciences, The Jerzy Kukuczka Academy of Physical Education in Katowice, ul. Mikołowska 72a, 40-065, Katowice, Poland
| | - Krystyna Gawlik
- Physiotherapy Department, The Pope John Paul II State School of Higher Education in Biala Podlaska, Sidorska 95/97, 21-500, Biała Podlaska, Poland
| | - Aleksandra Żebrowska
- Institute of Sport Sciences, The Jerzy Kukuczka Academy of Physical Education in Katowice, ul. Mikołowska 72a, 40-065, Katowice, Poland
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16
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Neufeld EV, Seltzer RA, Sazzad T, Dolezal BA. A Multidomain Approach to Assessing the Convergent and Concurrent Validity of a Mobile Application When Compared to Conventional Methods of Determining Body Composition. SENSORS 2020; 20:s20216165. [PMID: 33138133 PMCID: PMC7663304 DOI: 10.3390/s20216165] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 10/27/2020] [Accepted: 10/28/2020] [Indexed: 11/16/2022]
Abstract
Determining body composition via mobile application may circumvent limitations of conventional methods. However, the accuracy of many technologies remains unknown. This investigation assessed the convergent and concurrent validity of a mobile application (LS) that employs 2-dimensional digital photography (LS2D) and 3-dimensional photonic scanning (LS3D). Measures of body composition including circumferences, waist-to-hip ratio (WHR), and body fat percentage (BF%) were obtained from 240 healthy adults using LS and a diverse set of conventional methods-Gulick tape, bioelectrical impedance analysis (BIA), and skinfolds. Convergent validity was consistently high-indicating these methods vary proportionally and can thus reliably detect changes despite individual measurement differences. The span of the Limits of Agreement (LoA) using LS were comparable to the LoA between conventional methods. LS3D exhibited high agreement relative to Gulick tape in the measurement of WHR, despite poor agreement with individual waist and hip circumferences. In BF%, LS2D exhibited high agreement with BIA and skinfold methods, whereas LS3D demonstrated low agreement. Interestingly, the low inferred bias between LS3D and DXA using existing data suggests that LS3D may have high agreement with dual-energy x-ray absorptiometry. Overall, the suitability of LS2D and LS3D to replace conventional methods must be based on an individual user's criteria.
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Affiliation(s)
- Eric V. Neufeld
- Airway & Exercise Physiology Research Laboratory, David Geffen School of Medicine, Los Angeles, CA 90095, USA; (E.V.N.); (T.S.); (B.A.D.)
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hofstra University, Hempstead, NY 11549, USA
| | - Ryan A. Seltzer
- Airway & Exercise Physiology Research Laboratory, David Geffen School of Medicine, Los Angeles, CA 90095, USA; (E.V.N.); (T.S.); (B.A.D.)
- School of Medicine, Stanford University, Stanford, CA 94305, USA
- Correspondence:
| | - Tasnim Sazzad
- Airway & Exercise Physiology Research Laboratory, David Geffen School of Medicine, Los Angeles, CA 90095, USA; (E.V.N.); (T.S.); (B.A.D.)
| | - Brett A. Dolezal
- Airway & Exercise Physiology Research Laboratory, David Geffen School of Medicine, Los Angeles, CA 90095, USA; (E.V.N.); (T.S.); (B.A.D.)
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17
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Liao YS, Li HC, Lu HK, Lai CL, Wang YS, Hsieh KC. Comparison of Bioelectrical Impedance Analysis and Dual Energy X-ray Absorptiometry for Total and Segmental Bone Mineral Content with a Three-Compartment Model. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:2595. [PMID: 32290133 PMCID: PMC7177846 DOI: 10.3390/ijerph17072595] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 04/07/2020] [Accepted: 04/08/2020] [Indexed: 12/12/2022]
Abstract
Modern bioelectrical impedance analysis (BIA) provides a wide range of body composition estimates such as fat mass (FM), lean body mass (LBM), and body water, using specific algorithms. Assuming that the fat free mass (FFM) and LBM can be accurately estimated by the 8-electrode BIA analyzer (BIA8MF; InBody230, Biospace), the bone mineral content (BMC) may be calculated by subtracting the LBM from the FFM estimates based on the three-compartment (3C) model. In this cross-sectional study, 239 healthy Taiwanese adults (106 male and 133 female) aged 20-45 years were recruited for BIA and dual-energy X-ray absorptiometry (DXA) measurements of the whole body and body segments, with DXA as the reference. The results showed a high correlation between BIA8MF and DXA in estimating total and segmental LBM, FM and percentage body fat (r = 0.909-0.986, 0.757-0.964, and 0.837-0.936, respectively). For BMC estimates, moderate to high correlations (r = 0.425-0.829) between the two methods were noted. The percentage errors and pure errors for BMC estimates between the methods ranged from 33.9% to 93.0% and from 0.159 kg to 0.969 kg, respectively. This study validated that BIA8MF can accurately assesses LBM, FM and body fat percentage (BF%). However, the estimation of segmental BMC based on the difference between FFM and LBM in body segments may not be reliable by BIA8MF.
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Affiliation(s)
- Yu-San Liao
- Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Yunlin 638, Taiwan;
- Department of Nursing, Chang Gung University of Science and Technology, Chiayi 613, Taiwan
- Department of Chemistry and Biochemistry, National Chung Cheng University, Chiayi 621, Taiwan
| | - Hung-Chou Li
- Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Chiayi 613, Taiwan;
| | - Hsueh-Kuan Lu
- General Education Center, National Taiwan University of Sport, Taichung 404, Taiwan;
| | - Chung-Liang Lai
- Department of Physical Medicine and Rehabilitation, Puzi Hospital, Ministry of Health and Welfare, Chiayi 613, Taiwan;
- Department of Occupational Therapy, Asia University, Taichung 413, Taiwan
| | - Yue-Sheng Wang
- Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Chiayi613, Taiwan;
| | - Kuen-Chang Hsieh
- Fundamental Education Center, National Chin-Yi University of Technology, Taichung 411, Taiwan
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Fang WH, Yang JR, Lin CY, Hsiao PJ, Tu MY, Chen CF, Tsai DJ, Su W, Huang GS, Chang H, Su SL. Accuracy augmentation of body composition measurement by bioelectrical impedance analyzer in elderly population. Medicine (Baltimore) 2020; 99:e19103. [PMID: 32049818 PMCID: PMC7035056 DOI: 10.1097/md.0000000000019103] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Bioelectrical impedance analysis (BIA) is currently the most commonly used method in clinical practice to measure body composition. However, the bioelectrical impedance analyzer is not designed according to different countries, races, and elderly populations. Because different races may have different body compositions, a prediction model for the elderly population in Taiwan should be developed to avoid population bias, thereby improving the accuracy of community evaluation surveys.Dual energy X-ray absorptiometry (DXA) was used as a standard method for comparison, and impedance analysis was used for the development of a highly accurate predictive model that is suitable for assessing the body composition of elderly people.This study employed a cross-sectional design and recruited 438 elderly people who were undergoing health examinations at the health management center in the Tri-Service General Hospital as study subjects. Basic demographic variables and impedance analysis values were used in four predictive models, namely, linear regression, random forest, support vector machine (SVM), and eXtreme Gradient Boosting (XGBoost) models, to predict DXA body composition. The data from 354 study subjects were used to develop the predictive model, while the data from 84 study subjects were used to validate the accuracy of the predictive model.The body composition of elderly people as estimated by InBody 720 was highly correlated with that estimated by DXA. The correlation coefficient between InBody 720 and DXA for muscle mass was 0.969, and that for fat mass was 0.935. Consistency analysis results showed that InBody 720 tends to underestimate muscle mass and fat mass. A comparison of the accuracy of the linear regression, random forest, SVM, and XGBoost models showed that the linear regression has the highest accuracy. The correlation coefficient between the new model and DXA for muscle mass and fat mass were 0.977 and 0.978, respectively.The new predictive model can be used to monitor the nutrition status of elderly people and identify people with sarcopenia in the community.
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Affiliation(s)
- Wen-Hui Fang
- Department of Family and Community Medicine, Tri-Service General Hospital
| | - Jie-Ru Yang
- School of Public Health, National Defense Medical Center, Taipei
| | | | - Po-Jen Hsiao
- Department of Internal Medicine, Taoyuan Armed Forces General Hospital, Taoyuan
| | - Ming-Yu Tu
- Department of Orthopedics, Kaohsiung Armed Forces General Hospital Gangshan Branch, Kaohsiung
| | - Chien-Fu Chen
- Department of Orthopedics, Taichung Armed Forces General Hospital, Taichung
| | - Dung-Jang Tsai
- School of Public Health, National Defense Medical Center, Taipei
- Graduate Institute of Life Sciences, National Defense Medical Center
| | | | - Guo-Shu Huang
- Department of Radiology, Tri-Service General Hospital
| | - Hung Chang
- Department of Physiology and Biophysics, National Defense Medical Center
- Division of Thoracic Surgery, Tri-Service General Hospital, Taipei, Taiwan, ROC
| | - Sui-Lung Su
- School of Public Health, National Defense Medical Center, Taipei
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Molina-Luque R, Romero-Saldaña M, Álvarez-Fernández C, Bennasar-Veny M, Álvarez-López Á, Molina-Recio G. Equation Córdoba: A Simplified Method for Estimation of Body Fat (ECORE-BF). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16224529. [PMID: 31731813 PMCID: PMC6888348 DOI: 10.3390/ijerph16224529] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 11/13/2019] [Accepted: 11/15/2019] [Indexed: 12/16/2022]
Abstract
BACKGROUND Many methods for measuring body fat have been developed, but applications in clinical settings are limited. For this reason, researchers have tried to identify different formulas for its estimation but most of are hard to incorporate into daily work due to the variability in population and difficulty of use. The aim of this study was to develop and validate a new equation for the simplified estimation of body fat using the Clínica Universidad de Navarra - Body Adiposity Estimator (CUN-BAE) as a reference. METHODS This research was conducted in two phases. In the first, the new body fat estimation equation was developed. The developed equation was validated in the second phase. Pearson's linear correlation, raw and adjusted linear regressions, the intraclass correlation coefficient, and Bland-Altman graphs were used. RESULTS The variables that best adjusted the body fat percentage were age, sex, and the Napierian logarithm of Body Mass Index (LnBMI), forming the Equation Córdoba for Estimation of Body Fat (ECORE-BF) model. In its validation, the model presented correlation values of 0.994, an intraclass correlation coefficient of 0.960, with the Bland-Altman graph indicating means differences of 1.82 with respect to the estimation with the CUN-BAE. Nevertheless, although the aim was to simplify the CUN-BAE, the main limitation of this study is that a gold standard, such as air displacement plethysmography (ADP) or dual-energy X-ray absorptiometry (DXA), was not used. CONCLUSIONS The proposed equation (ECORE-BF) simplified the CUN-BAE and provided a precise method, respecting the principle of parsimony, for the calculation of body fat.
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Affiliation(s)
- Rafael Molina-Luque
- Department of Nursing, Faculty of Medicine and Nursing, University of Córdoba, Avd Menéndez Pidal No/No, 14004 Córdoba, Spain; (R.M.-L.); (G.M.-R.)
| | - Manuel Romero-Saldaña
- Department of Occupational Safety and Health, Córdoba City Hall, Huerto de San Pedro el Real, 1, 14003 Córdoba, Spain;
- Correspondence: ; Tel.: +34-686460989
| | - Carlos Álvarez-Fernández
- Department of Occupational Safety and Health, Córdoba City Hall, Huerto de San Pedro el Real, 1, 14003 Córdoba, Spain;
| | - Miquel Bennasar-Veny
- Nursing and Physiotherapy Department, Research Group on Evidence, Lifestyles & Health, Research Institute on Health Sciences (IUNICS), Universitat Illes Balears, Carretera de Valldemossa, 5, 07122 Palma, Illes Balears, Spain;
| | - Álvaro Álvarez-López
- Hospital Infanta Cristina, Extremadura Health Service, Av. de Elvas, No/No, 06080 Badajoz, Spain;
| | - Guillermo Molina-Recio
- Department of Nursing, Faculty of Medicine and Nursing, University of Córdoba, Avd Menéndez Pidal No/No, 14004 Córdoba, Spain; (R.M.-L.); (G.M.-R.)
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Song J, Shin SM, Kim H. Efficacy and safety of HT048 and HT077 for body fat and weight loss in overweight adults: A study protocol for a double-blind, randomized, placebo-controlled trial. Medicine (Baltimore) 2019; 98:e17922. [PMID: 31702673 PMCID: PMC6855614 DOI: 10.1097/md.0000000000017922] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND The prevalence of excessive body weight has rapidly increased worldwide over the past decades; however, medications are intended for moderately and severely obese patients and are associated with side effects. As an alternative approach, the use of traditional herbal medicines has gained increasing popularity among overweight individuals in recent years in East Asia. HT048 is an herbal extract of Citrus unshiu and Crataegus pinnatifida, and HT077 is an herbal extract of Nelumbo nucifera and Prunus persica. These 4 herbs have been used widely for body weight reduction in China and Korea. The aims of this trial are to investigate whether HT048 and HT077 are effective at reducing body fat and weight in overweight adults, and to determine the safety of HT048 and HT077. METHODS/DESIGN A double-blind, randomized, placebo-controlled, 3-arm parallel group trial will be conducted in adults with a body mass index (BMI) of 25 to <30 kg/m. A total of 120 eligible participants will be randomized in a 1:1:1 ratio to receive either HT048 (1000 mg), HT077 (400 mg), or matching placebo twice daily for 12 weeks, and will be monitored for an additional 4-week follow-up period after the treatment. All participants will be assessed for efficacy and safety of the investigational product at baseline and weeks 4, 8, 12, and 16. The primary endpoint is the change in body fat mass and percent body fat measured by dual-energy X-ray absorptiometry at week 12 from the baseline. The secondary efficacy variables are abdominal fat area measured by computed tomography, body fat mass and percent body fat measured by bioelectrical impedance analysis, body weight, BMI, and serum lipids and adipocytokines concentrations. Safety will be evaluated on the basis of reported adverse events, abnormal laboratory results, vital signs, and physical examination findings. DISCUSSION This is a first-in-human trial of HT048 and HT077 to assess the efficacy and safety in overweight subjects. The results will provide high-quality evidence of the therapeutic benefits of HT048 and HT077 for weight management and the prevention of obesity. TRIAL REGISTRATION Korean Clinical Research Information Service (KCT0004271) Registered September 2, 2019.
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Affiliation(s)
- Jungbin Song
- Department of Herbal Pharmacology, Kyung Hee University College of Korean Medicine, Dongdaemun-gu, Seoul
| | - Seon-mi Shin
- Department of Internal Medicine, Semyung University College of Korean Medicine, Jecheon-si, Chungcheongbuk-do, Republic of Korea
| | - Hocheol Kim
- Department of Herbal Pharmacology, Kyung Hee University College of Korean Medicine, Dongdaemun-gu, Seoul
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Xue J, Li S, Zhang Y, Hong P. Accuracy of Predictive Resting-Metabolic-Rate Equations in Chinese Mainland Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16152747. [PMID: 31374849 PMCID: PMC6695646 DOI: 10.3390/ijerph16152747] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 07/27/2019] [Accepted: 07/31/2019] [Indexed: 01/03/2023]
Abstract
Accurate measurement of the resting metabolic rate (RMR) is necessary when we make energy requirements and nutrition suggestions in clinical. However, indirect calorimetry is not always available. The objectives of this study were to make a comparison between RMR measured by indirect calorimetry and RMR predicted by different kinds of equations, and to develop new predictive equations for Chinese mainland adults. In this study, 315 Chinese mainland adults from different provinces all over China were recruited. Subjects underwent half a day of testing, which consisted of anthropometric assessment and RMR measurement. Measured and predicted RMR were compared; new optimal equations for Chinese mainland adults were developed and tested by splitting the subjects into a development and validation group. The measured RMR was in the range of 831–2776 kcal/day (mean 1651 ± 339 kcal/day). Our findings indicated that, except for the Harris–Benedict and Schofield equations, three Chinese equations and two fat-free mass (FFM) modeling equations all significantly underestimated RMR compared to the measured value (all p < 0.01). There were no significant differences between predicted and measured RMR using the new equations for females and males. Of the pre-existing equations, Schofield’s is the most suitable for Chinese mainland adults. However, the two new equations developed in this study seem to be more effective for predicting the RMR of Chinese mainland adults, and need to be validated by a larger independent sample with different physiological and anthropometric characteristics.
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Affiliation(s)
- Jingjing Xue
- China Institute of Sport Science, Beijing 100061, China
| | - Shuo Li
- School of Sport Science, Shanghai University of Sport, Shanghai 200438, China
| | - Yong Zhang
- Tianjin Key Laboratory of Exercise Physiology and Sports Medicine, Tianjin University of Sport, Tianjin 301617, China
| | - Ping Hong
- Winter Sports Administrative Center, General Administration of Sport of China, Beijing 100044, China.
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Assessment of Body Composition in Health and Disease Using Bioelectrical Impedance Analysis (BIA) and Dual Energy X-Ray Absorptiometry (DXA): A Critical Overview. CONTRAST MEDIA & MOLECULAR IMAGING 2019; 2019:3548284. [PMID: 31275083 PMCID: PMC6560329 DOI: 10.1155/2019/3548284] [Citation(s) in RCA: 214] [Impact Index Per Article: 35.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Accepted: 05/05/2019] [Indexed: 12/18/2022]
Abstract
The measurement of body composition (BC) represents a valuable tool to assess nutritional status in health and disease. The most used methods to evaluate BC in the clinical practice are based on bicompartment models and measure, directly or indirectly, fat mass (FM) and fat-free mass (FFM). Bioelectrical impedance analysis (BIA) and dual energy X-ray absorptiometry (DXA) (nowadays considered as the reference technique in clinical practice) are extensively used in epidemiological (mainly BIA) and clinical (mainly DXA) settings to evaluate BC. DXA is primarily used for the measurements of bone mineral content (BMC) and density to assess bone health and diagnose osteoporosis in defined anatomical regions (femur and spine). However, total body DXA scans are used to derive a three-compartment BC model, including BMC, FM, and FFM. Both these methods feature some limitations: the accuracy of BIA measurements is reduced when specific predictive equations and standardized measurement protocols are not utilized whereas the limitations of DXA are the safety of repeated measurements (no more than two body scans per year are currently advised), cost, and technical expertise. This review aims to provide useful insights mostly into the use of BC methods in prevention and clinical practice (ambulatory or bedridden patients). We believe that it will stimulate a discussion on the topic and reinvigorate the crucial role of BC evaluation in diagnostic and clinical investigation protocols.
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