Using bioelectrical impedance analysis in children and adolescents: Pressing issues | European Journal of Clinical Nutrition – Nature.com

  • 1.

    Kyle UG, Earthman CP, Pichard C, Coss-Bu JA. Body composition during growth in children: Limitations and perspectives of bioelectrical impedance analysis. Eur J Clin Nutr. 2015;69:1298–305.

    CAS  PubMed  Google Scholar 

  • 2.

    Mulasi U, Kuchnia AJ, Cole AJ, Earthman CP. Bioimpedance at the bedside: Current applications, limitations, and opportunities. Nutr Clin Pr. 2015;30:180–93.

    Google Scholar 

  • 3.

    Heymsfield SB, Wang Z, Baumgartner RN, Ross R. Human body composition: Advances in models and methods. Annu Rev Nutr. 1997;17:527–58.

    CAS  PubMed  Google Scholar 

  • 4.

    Earthman CP. Body composition tools for assessment of adult malnutrition at the bedside: A tutorial on research considerations and clinical applications. J Parenter Enter Nutr. 2015;39:787–822.

    Google Scholar 

  • 5.

    Jaffrin MY, Morel H. Body fluid volumes measurements by impedance: A review of bioimpedance spectroscopy (BIS) and bioimpedance analysis (BIA) methods. Med Eng Phys. 2008;30:1257–69.

    PubMed  Google Scholar 

  • 6.

    Lyons‐Reid J, Derraik JGB, Ward LC, Tint M, Kenealy T, Cutfield WS. Bioelectrical impedance analysis for assessment of body composition in infants and young children‐A systematic literature review. Clin Obes. 2021;11:e12441.

    PubMed  Google Scholar 

  • 7.

    Talma H, Chinapaw MJM, Bakker B, Hirasing RA, Terwee CB, Altenburg TM. Bioelectrical impedance analysis to estimate body composition in children and adolescents: A systematic review and evidence appraisal of validity, responsiveness, reliability and measurement error. Obes Rev. 2013;14:895–905.

    CAS  PubMed  Google Scholar 

  • 8.

    Orsso CE, Rubin DA, Silva MIB, Heymsfield SB, Gonzalez MC, Prado CM, et al. Assessment of body composition in pediatric overweight and obesity: A systematic review of the reliability and validity of common techniques. Obes Rev. 2020;21:e13041.

    PubMed  Google Scholar 

  • 9.

    Brantlov S, Jødal L, Lange A, Rittig S, Ward LC. Standardisation of bioelectrical impedance analysis for the estimation of body composition in healthy paediatric populations: A systematic review. J Med Eng Technol. 2017;41:460–79.

    PubMed  Google Scholar 

  • 10.

    Gonzalez MC. Using bioelectrical impedance analysis for body composition assessment: Sorting out some misunderstandings. J Parenter Enter Nutr. 2019;43:954–5.

    Google Scholar 

  • 11.

    Lyons-Reid J, Ward LC, Kenealy T, Cutfield W. Bioelectrical impedance analysis — An easy tool for quantifying body composition in infancy? Nutrients. 2020;12:920.

    PubMed Central  Google Scholar 

  • 12.

    Brantlov S, Ward LC, Jødal L, Rittig S, Lange A. Critical factors and their impact on bioelectrical impedance analysis in children: A review. J Med Eng Technol. 2017;41:22–35.

    PubMed  Google Scholar 

  • 13.

    Sun SS, Chumlea WC, Heymsfield SB, Lukaski HC, Schoeller D, Friedl K, et al. Development of bioelectrical impedance analysis prediction equations for body composition with the use of a multicomponent model for use in epidemiologic surveys. Am J Clin Nutr. 2003;77:331–40.

    CAS  PubMed  Google Scholar 

  • 14.

    Wells JCK, Williams JE, Chomtho S, Darch T, Grijalva-Eternod C, Kennedy K, et al. Pediatric reference data for lean tissue properties: Density and hydration from age 5 to 20 y. Am J Clin Nutr. 2010;91:610–8.

    CAS  PubMed  Google Scholar 

  • 15.

    Utczás K, Tróznai Z, Pálinkás G, Kalabiska I, Petridis L. How length sizes affect body composition estimation in adolescent athletes using bioelectrical impedance. J Sport Sci Med. 2020;19:577–84.

    Google Scholar 

  • 16.

    Fomon SJ, Haschke F, Ziegler EE, Nelson SE. Body composition of reference children from birth to age 10 years. Am J Clin Nutr. 1982;35:1169–75.

    CAS  PubMed  Google Scholar 

  • 17.

    Thivel D, Verney J, Miguet M, Masurier J, Cardenoux C, Lambert C, et al. The accuracy of bioelectrical impedance to track body composition changes depends on the degree of obesity in adolescents with obesity. Nutr Res. 2018;54:60–68.

    CAS  PubMed  Google Scholar 

  • 18.

    Orsso CE, Tibaes JRB, Oliveira CLP, Rubin DA, Field CJ, Heymsfield SB, et al. Low muscle mass and strength in pediatrics patients: Why should we care? Clin Nutr. 2019;38:2002–15.

    PubMed  Google Scholar 

  • 19.

    Lazzer S, Bedogni G, Agosti F, De Col A, Mornati D, Sartorio A. Comparison of dual-energy X-ray absorptiometry, air displacement plethysmography and bioelectrical impedance analysis for the assessment of body composition in severely obese Caucasian children and adolescents. Br J Nutr. 2008;100:918–24.

    CAS  PubMed  Google Scholar 

  • 20.

    Steinberg A, Manlhiot C, Li P, Metivier E, Pencharz PB, McCrindle BW, et al. Development and validation of bioelectrical impedance analysis equations in adolescents with severe obesity. J Nutr. 2019;149:1288–93.

    PubMed  Google Scholar 

  • 21.

    Silva AM, Matias CN, Nunes CL, Santos DA, Marini E, Lukaski HC, et al. Lack of agreement of in vivo raw bioimpedance measurements obtained from two single and multi-frequency bioelectrical impedance devices. Eur J Clin Nutr. 2019;73:1077–83.

    PubMed  Google Scholar 

  • 22.

    Barbosa-Silva TG, Gonzalez MC, Bielemann RM, Santos LP, Menezes AMB. Think globally, act locally: The importance of population-specific bioelectrical impedance analysis prediction equations for muscle mass assessment. J Parenter Enter Nutr. 2020;44:1338–46.

    CAS  Google Scholar 

  • 23.

    Stroud DB. What does bioimpedance measure? Proc Int Conf Bioelectromagn. 1998;64:43.

    Google Scholar 

  • 24.

    Sheean P, Gonzalez MC, Prado CM, McKeever L, Hall AM, Braunschweig CA. American society for parenteral and enteral nutrition clinical guidelines: The validity of body composition assessment in clinical populations. J Parenter Enter Nutr. 2020;44:12–43.

    Google Scholar 

  • 25.

    Cleary J, Daniells S, Okely AD, Batterham M, Nicholls J. Predictive validity of four bioelectrical impedance equations in determining percent fat mass in overweight and obese children. J Am Diet Assoc. 2008;108:136–9.

    PubMed  Google Scholar 

  • 26.

    Fields DA, Goran MI. Body composition techniques and the four-compartment model in children. J Appl Physiol. 2000;89:613–20.

    CAS  PubMed  Google Scholar 

  • 27.

    Dung NQ, Fusch G, Armbrust S, Jochum F, Fusch C. Use of bioelectrical impedance analysis and anthropometry to measure fat-free mass in children and adolescents with Crohn disease. J Pediatr Gastroenterol Nutr. 2007;44:130–5.

    PubMed  Google Scholar 

  • 28.

    Gonzalez MC, Orlandi SP, Santos LP, Barros AJD. Body composition using bioelectrical impedance: Development and validation of a predictive equation for fat-free mass in a middle-income country. Clin Nutr. 2019;38:2175–9.

    PubMed  Google Scholar 

  • 29.

    Collins CT, Reid J, Makrides M, Lingwood BE, McPhee AJ, Morris SA, et al. Prediction of body water compartments in preterm infants by bioelectrical impedance spectroscopy. Eur J Clin Nutr. 2013;67:S47–S53.

    PubMed  Google Scholar 

  • 30.

    Ellis KJ, Wong WW. Human hydrometry: Comparison of multifrequency bioelectrical impedance with 2H2O and bromine dilution. J Appl Physiol. 1998;85:1056–62.

    CAS  PubMed  Google Scholar 

  • 31.

    Ellis KJ, Shypailo RJ, Wong WW. Measurement of body water by multifrequency bioelectrical impedance spectroscopy in a multiethnic pediatric population. Am J Clin Nutr. 1999;70:847–53.

    CAS  PubMed  Google Scholar 

  • 32.

    Ward LC, Isenring E, Dyer JM, Kagawa M, Essex T. Resistivity coefficients for body composition analysis using bioimpedance spectroscopy: Effects of body dominance and mixture theory algorithm. Physiol Meas. 2015;36:1529–49.

    CAS  PubMed  Google Scholar 

  • 33.

    Van Eyck A, Eerens S, Trouet D, Lauwers E, Wouters K, De Winter BY, et al. Body composition monitoring in children and adolescents: Reproducibility and reference values. Eur J Pediatr 2021. https://doi.org/10.1007/s00431-021-03936-0.

  • 34.

    Meredith-Jones KA, Williams SM, Taylor RW. Bioelectrical impedance as a measure of change in body composition in young children. Pediatr Obes. 2015;10:252–9.

    CAS  PubMed  Google Scholar 

  • 35.

    Lewy V, Danadian K, Arslanian S. Determination of body composition in African-American children: Validation of bioelectrical impedence with dual energy X-ray absorptiometry. J Pediatr Endocrinol Metab. 1999;12:443–8.

    CAS  PubMed  Google Scholar 

  • 36.

    Suprasongsin C, Kalhan S, Arslanian S. Determination of body composition in children and adolescents: Validation of bioelectrical impedance with isotope dilution technique. J Pediatr Endocr Met. 1995;8:103–9.

    CAS  Google Scholar 

  • 37.

    Elberg J, McDuffie J, Sebring N, Salaita C, Keil M, Robotham D, et al. Comparison of methods to assess change in children’s body composition. Am J Clin Nutr. 2004;80:64–69.

    CAS  PubMed  Google Scholar 

  • 38.

    Roche S, Lara-Pompa NE, Macdonald S, Fawbert K, Valente J, Williams JE, et al. Bioelectric impedance vector analysis (BIVA) in hospitalised children; predictors and associations with clinical outcomes. Eur J Clin Nutr. 2019;73:1431–40.

    CAS  PubMed  Google Scholar 

  • 39.

    Brantlov S, Jødal L, Andersen RF, Lange A, Rittig S, Ward LC. An evaluation of phase angle, bioelectrical impedance vector analysis and impedance ratio for the assessment of disease status in children with nephrotic syndrome. BMC Nephrol. 2019;20:331.

    PubMed  PubMed Central  Google Scholar 

  • 40.

    Azevedo ZMA, Santos Junior BD, Ramos EG, Salú MDS, Mancino da Luz Caixeta D, Lima-Setta F, et al. The importance of bioelectrical impedance in the critical pediatric patient. Clin Nutr. 2020;39:1188–94.

    PubMed  Google Scholar 

  • 41.

    Marino LV, Meyer R, Johnson M, Newell C, Johnstone C, Magee A, et al. Bioimpedance spectroscopy measurements of phase angle and height for age are predictive of outcome in children following surgery for congenital heart disease. Clin Nutr. 2018;37:1430–6.

    CAS  PubMed  Google Scholar 

  • 42.

    Bourdon C, Bartels RH, Chimwezi E, Kool J, Chidzalo K, Perot L, et al. The clinical use of longitudinal bio-electrical impedance vector analysis in assessing stabilization of children with severe acute malnutrition. Clin Nutr. 2021;40:2078–90.

    PubMed  Google Scholar 

  • 43.

    Girma T, Kæstel P, Mølgaard C, Ritz C, Andersen GS, Michaelsen KF, et al. Utility of bio-electrical impedance vector analysis for monitoring treatment of severe acute malnutrition in children. Clin Nutr. 2021;40:642–631.

    Google Scholar 

  • 44.

    Hauschild DB, Barbosa E, Moreira EAM, Ludwig Neto N, Platt VB, Piacentini Filho E, et al. Nutrition status parameters and hydration status by bioelectrical impedance vector analysis were associated with lung function impairment in children and adolescents with cystic fibrosis. Nutr Clin Pr. 2016;31:378–86.

    Google Scholar 

  • 45.

    Calcaterra V, Cena H, Manuelli M, Sacchi L, Girgenti V, Larizza C, et al. Body hydration assessment using bioelectrical impedance vector analysis in neurologically impaired children. Eur J Clin Nutr. 2019;73:1649–52.

    PubMed  Google Scholar 

  • 46.

    Jensen B, Braun W, Both M, Gallagher D, Clark P, González DL, et al. Configuration of bioelectrical impedance measurements affects results for phase angle. Med Eng Phys. 2020;84:10–15.

    PubMed  Google Scholar 

  • 47.

    Lyons-Reid J, Ward LC, Tint MT, Kenealy T, Godfrey KM, Chan SY, et al. The influence of body position on bioelectrical impedance spectroscopy measurements in young children. Sci Rep. 2021;11:10346.

    CAS  PubMed  PubMed Central  Google Scholar 

  • 48.

    Norman K, Stobäus N, Pirlich M, Bosy-Westphal A. Bioelectrical phase angle and impedance vector analysis – Clinical relevance and applicability of impedance parameters. Clin Nutr. 2012;31:854–61.

    PubMed  PubMed Central  Google Scholar 

  • 49.

    Kuchnia AJ, Teigen LM, Cole AJ, Mulasi U, Gonzalez MC, Heymsfield SB, et al. Phase angle and impedance ratio: Reference cut-points from the United States National Health and Nutrition Examination Survey 1999–2004 from bioimpedance spectroscopy data. J Parenter Enter Nutr. 2017;41:1310–5.

    Google Scholar 

  • 50.

    Farias CLA, Campos DJ, Bonfin CMS, Vilela RM. Phase angle from BIA as a prognostic and nutritional status tool for children and adolescents undergoing hematopoietic stem cell transplantation. Clin Nutr. 2013;32:420–5.

    PubMed  Google Scholar 

  • 51.

    Impedimed. SOZO System – Instructions for use. 2019. http://impedimed.com/wp-content/uploads/2019/07/LBL-537-en-SOZO-App-and-System-IFU-OUS.pdf (accessed 28 Jul 2021).

  • 52.

    Wells JCK, Williams JE, Quek RY, Fewtrell MS. Bio-electrical impedance vector analysis: testing Piccoli’s model against objective body composition data in children and adolescents. Eur J Clin Nutr. 2019;73:887–95.

    PubMed  Google Scholar 

  • 53.

    Kriemler S, Puder J, Zahner L, Roth R, Braun-Fahrländer C, Bedogni G. Cross-validation of bioelectrical impedance analysis for the assessment of body composition in a representative sample of 6- to 13-year-old children. Eur J Clin Nutr. 2009;63:619–26.

    CAS  PubMed  Google Scholar 

  • 54.

    Fuller NJ, Fewtrell MS, Dewit O, Elia M, Wells JCK. Segmental bioelectrical impedance analysis in children aged 8–12y: 1. The assessment of whole-body composition. Int J Obes. 2002;26:684–91.

    CAS  Google Scholar 

  • 55.

    Fuller NJ, Fewtrell MS, Dewit O, Elia M, Wells JCK. Segmental bioelectrical impedance analysis in children aged 8–12y: 2. The assessment of regional body composition and muscle mass. Int J Obes. 2002;26:692–700.

    CAS  Google Scholar 

  • 56.

    Wells JC, Williams JE, Ward LC, Fewtrell MS. Utility of specific bioelectrical impedance vector analysis for the assessment of body composition in children. Clin Nutr. 2021;40:1147–54.

    CAS  PubMed  PubMed Central  Google Scholar 

  • 57.

    Bosy-Westphal A, Jensen B, Braun W, Pourhassan M, Gallagher D, Müller MJ. Quantification of whole-body and segmental skeletal muscle mass using phase-sensitive 8-electrode medical bioelectrical impedance devices. Eur J Clin Nutr. 2017;71:1061–7.

    CAS  PubMed  PubMed Central  Google Scholar 

  • 58.

    NIH Consensus Statement: Bioelectrical impedance analysis in body composition measurement. 1996. https://doi.org/10.1016/S0899-9007(97)85179-9.

  • 59.

    Gallagher D, Andres A, Fields DA, Evans WJ, Kuczmarski R, Lowe WL, et al. Body composition measurements from birth through 5 Years: Challenges, gaps, and existing & emerging technologies—A national institutes of health workshop. Obes Rev. 2020;21:e13033.

    PubMed  PubMed Central  Google Scholar