Abstract
Measurements of body composition are being made increasingly widely in pediatrics. Tetrapolar whole body impedance (BI) is particularly suitable as a method of estimating boyd composition in children and is therefore the subject of great interest at present. However, the ability of BI to accurately estimate fat-free mass (FFM) in children is unclear, and users of BI are faced with a growing choice of prediction equations for estimation of FFM. Studies in adults have suggested that choice of prediction equation can have a profound effect on the estimate obtained. The aim of the present study was to measure the ability of four published pediatric BI equations to predict FFM in 98 Caucasian prepubertal children (mean age 9.0 y). For three of the published equations, limits of agreement between predicted and reference FFM were wide and distinct biases were apparent. With mean FFM of 25 kg, the equation of L. Cordain et al. overestimated reference FFM (95% CI +2.1 to +3.1 kg), whereas those of P. Deurenberg et al. (95% CI -1.9 to -2.9 kg) and F. Schaefer et al. (95% CI -1.4 to -2.5 kg) systematically underestimated reference FFM. The equation of Houtkooper et al. (95% CI -0.2 to +0.8 kg) predicted FFM with negligible bias and had narrower limits of agreement relative to the reference method than the other three equations tested. We conclude that the ability of BI to predict body composition in children depends on the equation chosen and that the general applicability of BI equations cannot be safely assumed. Cross-validation of BI equations is recommended before they are used routinely for estimation of body composition in children.
Similar content being viewed by others
Log in or create a free account to read this content
Gain free access to this article, as well as selected content from this journal and more on nature.com
or
Abbreviations
- BI:
-
tetrapolar whole body impedance
- FFM:
-
fat-free mass
- RI:
-
resistance index (height(cm)2/resistance (ohms))
- CI:
-
confidence interval
References
Davies PSW 1994 Body composition assessment. Arch Dis Child 69: 337–338
Lohman TG 1993 Advances in Body Composition Assessment, Monograph No. 3. Human Kinetics Publishers, Champaign, IL
Lukaski HC, Bolonchuk WW, Hall CB, Siders WA 1986 Validation of tetrapolar bio-electrical impedance method to assess human body composition. J Appl Physiol 60: 1327–1332
Segal K, Van Loan M, Fitzgerald PI, Hodgson JA, Van Itallie TB 1988 Lean body mass estimation by bio-electrical impedance analysis: a four site cross-validation study. Am J Clin Nutr 47: 7–14
Fuller NJ, Jebb SA, Laskey MA, Coward MA, Elia M 1992 A four component model for the assessment of body composition in humans. Clin Sci 82: 687–693
Heitmann BL 1994 Impedance: a valid method in assessment of body composition?. Eur J Clin Nutr 48: 228–244
Reilly JJ, Murray LA, Wilson J, Durnin JVGA 1994 Measuring the body composition of elderly subjects: a comparison of methods. Br J Nutr 72: 33–44
Fuller NJ 1993 Comparison of abilities of various interpretations of bio-electrical impedance to predict reference method body composition assessment. Clin Nutr 12: 236–242
Deurenberg P, Kusters CS, Smith H 1990 Assessment of body composition by bio-electrical impedance in children and young adults is strongly age-dependent. Eur J Clin Nutr 44: 261–268
Schaefer F, Georgi M, Zieger A, Scharer K 1994 Usefulness of bio-electrical impedance and skinfold measurements in predicting fat-free mass derived from total body potassium in children. Pediatr Res 35: 617–624
Elia M 1993 The bio-impedance craze. Eur J Clin Nutr 47: 825–827
Westrate JA, Deurenberg P 1989 Body composition in children. Am J Clin Nutr 50: 1104–1115
White EM, Wilson AC, Greene SA, McCowan C, Thomas GE, Cairns AY, Ricketts IW 1995 Body mass index centile charts to assess fatness of British children. Arch Dis Child 72: 38–41
Durnin JVGA, Womersley J 1974 Body fat assessed from total body density and its estimation from skinfold thickness measurements in 481 men and women aged 16-72 years. Br J Nutr 32: 77–97
Smye SW, Sutcliffe J, Pitt E 1993 A comparison of four commerical systems used to measure whole body bio-electrical impedance. Physiol Meas 14: 473–478
Houtkooper LB, Going SB, Lohman TG, Roche AF, Van Loan M 1992 Bio-electrical impedance estimation of fat-free body mass in children and youth: a cross-validation study. J Appl Physiol 72: 366–373
Deurenberg P, Van der Kooy K, Leenan R, Westrate JC, Seidell JC 1991 Sex and age specific prediction formulas for estimating body composition. Int J Obesity 15: 17–24
Cordain L, Whicker RG, Johnson JE 1988 Body composition determination in children using bio-electrical impedance. Growth Dev Aging 52: 37–40
Bland JM, Altman DG 1986 Statistical methods for assessing agreement between two methods of clinical measurement. Lancet I: 307–310
Davies PSW, Joughin C 1992 Assessment of body composition in Prader-Willi syndrome using bio-electrical impedance. Am J Med Genet 44: 75–78
Fomon SJ, Haschke F, Ziegler EE, Nelson SE 1982 Body composition of reference children from birth to age 10 years. Am J Clin Nutr 35: 1169–1175
Lohman TG, Going SB, Slaughter MH, Boileau RA 1989 Concept of chemical immaturity in body composition estimates. Am J Hum Biol 1: 201–204
Hewitt MJ, Going SB, Williams DP, Lohman TG 1993 Hydration of fat-free body in children and adults: implications for body composition assessment. Am J Physiol 265:E88–E95
Siri WE 1961 Body composition from fluid spaces and density: analysis of methods. In: Brozek J, Henschel A (eds) Techniques for Measuring Body Composition. National Academy of Science, Washington, DC, pp 223–244
Kim HK, Tanaka K, Nakadomo F, Watanabe K 1994 Fat free mass in Japanese boys predicted from bio-electrical impedance and anthropometric variables. Eur J Clin Nutr 48: 482–489
Hammond J, Rona RJ, Chinn S 1994 Estimation in community surveys of total body fat of children using bio-electrical impedance or skinfold thickness measurements. Eur J Clin Nutr 48: 164–171
Jebb SA, Murgatroyd PR, Coward WA, Goldberg GR, Prentice AM 1993 In vivo measurement of changes in body composition. Am J Clin Nutr 58: 455–462
Acknowledgements
The authors thank the volunteers and their families, and the Institute of Physiology University of Glasgow for providing access to their laboratory facilities. Lawrence Weaver kindly commented on an earlier draft of the manuscript.
Author information
Authors and Affiliations
Additional information
Supported by a grant from the Scottish Office Home and Health Department.
Rights and permissions
About this article
Cite this article
Reilly, J., Wilson, J., McColl, J. et al. Ability of Biolectric Impedance to Predict Fat-Free Mass in Prepubertal Children. Pediatr Res 39, 176–179 (1996). https://doi.org/10.1203/00006450-199601000-00029
Received:
Accepted:
Issue date:
DOI: https://doi.org/10.1203/00006450-199601000-00029
This article is cited by
-
Body composition during growth in children: limitations and perspectives of bioelectrical impedance analysis
European Journal of Clinical Nutrition (2015)
-
Development of bioelectrical impedance-derived indices of fat and fat-free mass for assessment of nutritional status in childhood
European Journal of Clinical Nutrition (2008)
-
Validity of Six Field and Laboratory Methods for Measurement of Body Composition in Boys
Obesity Research (2003)
-
Segmental bioelectrical impedance analysis in children aged 8–12 y: 1. The assessment of whole-body composition
International Journal of Obesity (2002)
-
Foot-to-foot bioelectrical impedance analysis: a valuable tool for the measurement of body composition in children
International Journal of Obesity (2001)


