title: Is bioelectrical impedance accurate for use in large epidemiological studies?
abstract: Percentage of body fat is strongly associated with the risk of several chronic diseases but its accurate measurement is difficult. Bioelectrical impedance analysis (BIA) is a relatively simple, quick and non-invasive technique, to measure body composition. It measures body fat accurately in controlled clinical conditions but its performance in the field is inconsistent. In large epidemiologic studies simpler surrogate techniques such as body mass index (BMI), waist circumference, and waist-hip ratio are frequently used instead of BIA to measure body fatness. We reviewed the rationale, theory, and technique of recently developed systems such as foot (or hand)-to-foot BIA measurement, and the elements that could influence its results in large epidemiologic studies. BIA results are influenced by factors such as the environment, ethnicity, phase of menstrual cycle, and underlying medical conditions. We concluded that BIA measurements validated for specific ethnic groups, populations and conditions can accurately measure body fat in those populations, but not others and suggest that for large epidemiological studies with diverse populations BIA may not be the appropriate choice for body composition measurement unless specific calibration equations are developed for different groups participating in the study.
authors.affiliation: Population Health Research Institute, McMaster University, Hamilton, ON, Canada. mahshid@ccc.mcmaster.ca
authors.forename: Mahshid
authors.initials: M
authors.lastname: Dehghan
authors.forename: Anwar T
authors.initials: AT
authors.lastname: Merchant
mesh_terms: D000273:Adipose Tissue / Q000378:metabolism*; D000367:Age Factors; D001823:Body Composition / Q000502:physiology*; D017097:Electric Impedance; D016021:Epidemiologic Studies; D005006:Ethnicity; D005260:Female; D006801:Humans; D008297:Male; D008954:Models, Biological; D011237:Predictive Value of Tests; D012015:Reference Standards; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012737:Sex Factors
references.citation: Ann N Y Acad Sci. 2000 May;904:199-202
references.pmid: 10865738
references.citation: J Am Geriatr Soc. 1999 Dec;47(12):1403-8
references.pmid: 10591232
references.citation: J Nutr. 2005 May;135(5):1196-201
references.pmid: 15867303
references.citation: Br J Nutr. 1991 Mar;65(2):105-14
references.pmid: 2043597
references.citation: Ann N Y Acad Sci. 2000 May;904:317-26
references.pmid: 10865763
references.citation: Am J Clin Nutr. 1989 Nov;50(5):903-7
references.pmid: 2816797
references.citation: Nutrition. 2001 Mar;17(3):248-53
references.pmid: 11312069
references.citation: Am Heart J. 2005 Jan;149(1):54-60
references.pmid: 15660034
references.citation: Appl Radiat Isot. 1998 May-Jun;49(5-6):485-7
references.pmid: 9569522
references.citation: Eur J Appl Physiol. 2004 Apr;91(4):399-405
references.pmid: 14618332
references.citation: Int J Obes Relat Metab Disord. 1998 Mar;22(3):243-9
references.pmid: 9539193
references.citation: Curr Opin Clin Nutr Metab Care. 2001 Sep;4(5):377-83
references.pmid: 11568498
references.citation: Br J Nutr. 1977 Sep;38(2):271-84
references.pmid: 911746
references.citation: Ann N Y Acad Sci. 1999 Apr 20;873:105-11
references.pmid: 10372157
references.citation: Int J Obes Relat Metab Disord. 1999 Oct;23(10):1079-84
references.pmid: 10557029
references.citation: J Endocrinol Invest. 2002 Nov;25(10):884-92
references.pmid: 12508951
references.citation: Ann Hum Biol. 1995 Jul-Aug;22(4):315-20
references.pmid: 8849209
references.citation: Hum Biol. 1978 Sep;50(3):261-80
references.pmid: 721084
references.citation: J Am Diet Assoc. 1971 Jul;59(1):34-40
references.pmid: 5091624
references.citation: Arch Intern Med. 1991 Jan;151(1):97-102
references.pmid: 1985614
references.citation: Am J Clin Nutr. 2000 Jun;71(6):1392-402
references.pmid: 10837277
references.citation: Curr Opin Clin Nutr Metab Care. 2003 Jul;6(4):387-93
references.pmid: 12806211
references.citation: Br J Nutr. 2000 Feb;83(2):115-22
references.pmid: 10743490
references.citation: Clin Nutr. 2004 Dec;23(6):1430-53
references.pmid: 15556267
references.citation: J Appl Physiol (1985). 1986 Apr;60(4):1327-32
references.pmid: 3700310
references.citation: Am J Clin Nutr. 1996 Sep;64(3 Suppl):436S-448S
references.pmid: 8780360
references.citation: Hum Biol. 1987 Apr;59(2):257-69
references.pmid: 3596566
references.citation: J Appl Physiol (1985). 1994 Aug;77(2):647-52
references.pmid: 8002510
references.citation: Med Sci Sports Exerc. 1988 Oct;20(5):489-91
references.pmid: 3193865
references.citation: Curr Opin Clin Nutr Metab Care. 2005 May;8(3):311-7
references.pmid: 15809535
references.citation: Curr Opin Clin Nutr Metab Care. 2005 May;8(3):329-32
references.pmid: 15809537
references.citation: Eur J Clin Nutr. 1988 Dec;42(12):1017-22
references.pmid: 3234328
references.citation: Am J Clin Nutr. 1991 Jul;54(1):26-9
references.pmid: 2058583
references.citation: Asia Pac J Clin Nutr. 2002;11(1):1-7
references.pmid: 11890632
references.citation: J Sports Sci. 2002 Feb;20(2):153-64
references.pmid: 11811572
references.citation: Int J Sport Nutr. 1998 Sep;8(3):285-307
references.pmid: 9738136
references.citation: Homo. 2002;53(1):1-16
references.pmid: 12365353
references.citation: Am J Clin Nutr. 1996 Sep;64(3 Suppl):489S-497S
references.pmid: 8780369
references.citation: Fertil Steril. 1995 Nov;64(5):963-8
references.pmid: 7589642
references.citation: Eur J Clin Nutr. 1989 Feb;43(2):129-37
references.pmid: 2707216
references.citation: Am J Clin Nutr. 1996 Sep;64(3 Suppl):423S-427S
references.pmid: 8780358
references.citation: Am J Clin Nutr. 2001 Oct;74(4):474-8
references.pmid: 11566645
references.citation: Eur J Clin Nutr. 2002 Mar;56(3):214-20
references.pmid: 11960296
references.citation: Br J Nutr. 2002 Aug;88(2):205-10
references.pmid: 12144724
references.citation: J Sports Med Phys Fitness. 1993 Jun;33(2):172-7
references.pmid: 8412053
references.citation: Am J Clin Nutr. 2005 Sep;82(3):651-6
references.pmid: 16155280
references.citation: Clin Nutr. 2004 Oct;23(5):1226-43
references.pmid: 15380917
references.citation: J Appl Physiol (1985). 1996 Aug;81(2):838-45
references.pmid: 8872654
references.citation: Acta Diabetol. 2003 Oct;40 Suppl 1:S317-9
references.pmid: 14618504
references.citation: Miner Electrolyte Metab. 1996;22(1-3):76-8
references.pmid: 8676831
references.citation: Int J Obes Relat Metab Disord. 1995 Nov;19(11):793-7
references.pmid: 8589780
references.citation: Int J Obes Relat Metab Disord. 2001 Apr;25(4):502-11
references.pmid: 11319654
references.citation: Curr Hypertens Rep. 2005 Oct;7(5):330-6
references.pmid: 16157073
references.citation: Acta Diabetol. 2005 Apr;42 Suppl 1:S3-8
references.pmid: 15868117
references.citation: Eur J Clin Nutr. 1990 Jul;44(7):545-6
references.pmid: 2401285
references.citation: Lancet. 2004 Sep 11-17;364(9438):937-52
references.pmid: 15364185
references.citation: Am J Clin Nutr. 1994 Dec;60(6):843-8
references.pmid: 7985622
references.citation: Nutr Clin Pract. 2004 Oct;19(5):433-46
references.pmid: 16215137
references.citation: Int J Obes Relat Metab Disord. 2000 Aug;24(8):1011-7
references.pmid: 10951540
references.citation: Am J Clin Nutr. 1988 May;47(5):789-92
references.pmid: 3364394
references.citation: Am J Clin Nutr. 1997 Jul;66(1):8-17
references.pmid: 9209163
references.citation: Int J Obes Relat Metab Disord. 1999 Nov;23(11):1178-83
references.pmid: 10578208
references.citation: Br J Nutr. 1993 May;69(3):657-64
references.pmid: 8329342
references.citation: Eur J Clin Nutr. 1989 Nov;43(11):779-91
references.pmid: 2627926
references.citation: Basic Life Sci. 1993;60:331-2
references.pmid: 8110141
references.citation: Am J Phys Anthropol. 1956 Dec;14(4):589-609
references.pmid: 13411180
references.citation: Int J Obes Relat Metab Disord. 2003 Jun;27(6):669-76
references.pmid: 12833110