Abstract
Bioelectrical impedance analysis (BIA) is an affordable, non-invasive, easy-to-operate, and fast alternative method to assess body composition. However, BIA tends to overestimate the percent body fat (%BF) in lean elderly and underestimate %BF in obese elderly people. This study examined whether proximal electrode placement eliminates this problem. Forty-two elderly men and women (64–96 years) who had a wide range of BMI [22.4 ± 3.3 kg/m2 (mean ± SD), range 16.8–33.9 kg/m2] and %BF (11.3–44.8%) participated in this study. Using 2H and 18O dilutions as the criterion for measuring total body water (TBW), we compared various BIA electrode placements; wrist-to-ankle, arm-to-arm, leg-to-leg, elbow-to-knee, five- and nine-segment models, and the combination of distal (wrists or ankles) and proximal (elbows or knees) electrodes. TBW was most strongly correlated with the square height divided by the impedance between the knees and elbows (H 2/Z proximal; r = 0.965, P < 0.001). In the wrist-to-ankle, arm-to-arm, leg-to-leg, and five-segment models, we observed systematic errors associated with %BF (P < 0.05). After including the impedance ratio of the proximal to distal segments (P/D) as an independent variable, none of the BIA methods examined showed any systematic bias against %BF. In addition, all methods were able to estimate TBW more accurately (e.g., in the wrist-to-ankle model, from R 2 = 0.90, SEE = 1.69 kg to R 2 = 0.94, SEE = 1.30 kg). The results suggest that BIA using distal electrodes alone tends to overestimate TBW in obese and underestimate TBW in lean subjects, while proximal electrodes improve the accuracy of body composition measurements.
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Acknowledgments
The authors would like to express their thanks to Prof. Dale A. Schoeller (Nutritional Sciences, University of Wisconsin, Madison) for his helpful discussions and editing of the entire manuscript. The authors also thank all of the individuals who participated in this study. This study was supported by a research grant awarded to MK from the Japanese Ministry of Education, Culture, Sports, Science, and Technology (18300218) and a research fellowship awarded to YY from the Japan Society for the Promotion of Science for Young Scientists (19-1440).
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Yamada, Y., Masuo, Y., Yokoyama, K. et al. Proximal electrode placement improves the estimation of body composition in obese and lean elderly during segmental bioelectrical impedance analysis. Eur J Appl Physiol 107, 135–144 (2009). https://doi.org/10.1007/s00421-009-1106-6
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DOI: https://doi.org/10.1007/s00421-009-1106-6