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Pediatrics

Body composition references, sarcopenia cutoffs, and prevalence in youth using bioelectrical impedance analysis

International Journal of Obesity volume 50, pages 319–328 (2026)Cite this article

Subjects

Abstract

Background/objectives

Reference data for bioelectrical impedance analysis (BIA) parameters remain limited in youth, making sarcopenia assessment challenging. This study aimed to establish BIA reference values and determine sarcopenia cutoff points and prevalence in youth.

Subjects/methods

This cross-sectional study analyzed 1451 youth aged 10–25 years who underwent BIA using data from a nationwide survey. Reference values for body composition were established using the least mean squares method, which estimates age-specific percentiles. Sarcopenia was defined using skeletal muscle mass index (SMI), fat-free mass-to-fat ratio (FFM-MFR), and appendicular skeletal muscle mass-to-fat ratio (ASM-MFR) with age- and sex-specific cutoff values.

Results

Muscle-related parameters, including fat-free mass, fat-free mass index, ASM, and SMI, increased during puberty in both sexes, with a more pronounced increase in males, followed by a plateau or gradual increase after adolescence. Fat-related parameters, including fat mass, fat mass index, and percentage body fat, decreased until age 14 years in males before increasing, whereas in females, they increased until adolescence and declined after early adulthood. The prevalence of sarcopenia was 2.05% in males and 1.04% in females based on SMI, 5.21% in males and 6.38% in females based on FFM-MFR, and 5.06% in males and 5.79% in females based on ASM-MFR.

Conclusions

This study established BIA-based body composition reference values for youth using nationally representative data, identified age- and sex-specific sarcopenia cutoff points and prevalence estimates, and highlighted age- and sex-specific differences. These findings provide a valuable resource for the early identification and management of sarcopenia in youth.

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Fig. 1: Percentile curve of muscle-related parameters with optimal change points in males.
Fig. 2: Percentile curve of muscle-related parameters with optimal change points in females.
Fig. 3: Percentile curve of fat-related parameters with optimal change points.

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Data availability

Data can be made available upon request to the corresponding author.

Code availability

The SAS and R scripts used for the analysis are available from the corresponding author upon reasonable request.

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Author information

Authors and Affiliations

  1. Department of Pediatrics, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul, Republic of Korea

    Kyungchul Song, Hana Lee, Joon Young Kim, Youngha Choi & Hyun Wook Chae

  2. Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, Republic of Korea

    Eunju Lee & Hye Sun Lee

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  1. Kyungchul Song
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Contributions

Kyungchul Song: Conceptualization, Methodology, Formal analysis, Investigation, and Writing–original draft; Eunju Lee, Hye Sun Lee, and Hana Lee: Resources, Data curation and Formal analysis; Joon Young Kim and Youngha Choi: Methodology; and Hyun Wook Chae: Conceptualization, Methodology, Writing–review & editing, and Supervision.

Corresponding author

Correspondence to Hyun Wook Chae.

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All authors declare no conflicts of interest.

Ethics approval and consent to participate

All methods were performed in accordance with the relevant guidelines and regulations, including the principles of the Declaration of Helsinki. This study was approved by the Institutional Review Board of Yonsei University Gangnam Severance Hospital (IRB No. 3-2024-0467). Written informed consent was obtained from all participants.

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Song, K., Lee, E., Lee, H.S. et al. Body composition references, sarcopenia cutoffs, and prevalence in youth using bioelectrical impedance analysis. Int J Obes 50, 319–328 (2026). https://doi.org/10.1038/s41366-025-01892-5

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