Estimation of total body water and extracellular water with bioimpedance in athletes: A need for athlete-specific prediction models

High-standard predictive equations for estimating body composition using bioelectrical impedance analysis: a systematic review

The appropriate use of predictive equations in estimating body composition through bioelectrical impedance analysis (BIA) depends on the device used and the subject's age, geographical ancestry, healthy status, physical activity level and sex. However, the presence of many isolated predictive equations in the literature makes the correct choice challenging, since the user may not distinguish its appropriateness. Therefore, the present systematic review aimed to classify each predictive equation in accordance with the independent parameters used. Sixty-four studies published between 1988 and 2023 were identified through a systematic search of international electronic databases. We included studies providing predictive equations derived from criterion methods, such as multi-compartment models for fat, fat-free and lean soft mass, dilution techniques for total-body water and extracellular water, total-body potassium for body cell mass, and magnetic resonance imaging or computerized tomography for skeletal muscle mass. The studies were excluded if non-criterion methods were employed or if the developed predictive equations involved mixed populations without specific codes or variables in the regression model. A total of 106 predictive equations were retrieved; 86 predictive equations were based on foot-to-hand and 20 on segmental technology, with no equations used the hand-to-hand and leg-to-leg. Classifying the subject's characteristics, 19 were for underaged, 26 for adults, 19 for athletes, 26 for elderly and 16 for individuals with diseases, encompassing both sexes. Practitioners now have an updated list of predictive equations for assessing body composition using BIA. Researchers are encouraged to generate novel predictive equations for scenarios not covered by the current literature.Registration code in PROSPERO: CRD42023467894.

Problems and Opportunities in the use of Bioelectrical Impedance Analysis for Assessing Body Composition During Ketogenic Diets: A Scoping Review

PURPOSE OF THE REVIEW

The use of bioelectrical impedance analysis (BIA) for monitoring body composition during the ketogenic diet has experienced a rapid surge. This scoping review aimed to assess the validity of procedures applying BIA in the ketogenic diet and to suggest best practices for optimizing its utilization.

RECENT FINDINGS

We conducted a systematic scoping review of peer-reviewed literature involving BIA for assessing body composition in individuals adhering to a ketogenic diet. Searches of international databases yielded 1609 unique records, 72 of which met the inclusion criteria and were reviewed. Thirty-five studies used foot-to-hand technology, 34 used standing position technology, while 3 did not declare the technology used. Raw bioelectrical parameters were reported in 21 studies. A total of 196 body mass components were estimated, but predictive equations were reported in only four cases. Most research on BIA during ketogenic diets did not report the equations used for predicting body composition, making it impossible to assess the validity of BIA outputs. Furthermore, the exceedingly low percentage of studies reporting and analyzing raw data makes it challenging to replicate methodologies in future studies, highlighting that BIA is not being utilized to its full potential. There is a need for more precise technology and device characteristics descriptions, full report of raw bioelectrical data, and predictive equations utilized. Moreover, evaluating raw data through vectorial analysis is strongly recommended. Eventually, we suggest best practices to enhance BIA outcomes during ketogenic diets.

Fat-free mass predictive equation using multifrequency bioelectrical impedance data in adolescent soccer athletes: development and cross-validation

OBJECTIVES

This study aimed to develop and cross-validate a fat-free mass (FFM) predictive equation using multifrequency bioelectrical impedance analysis (BIA) data in adolescent soccer athletes.

METHODS

Male adolescent soccer athletes (n = 149; 13-19 y old) were randomly sorted using Excel and independently selected for development group (n = 100) or cross-validation group (n = 49). The FFM reference values were determined using dual-energy X-ray absorptiometry. Single-frequency BIA was used to plot tolerance ellipses. Multifrequency-BIA raw data were used as independent variables in regression models. Student's independent t-test was used to compare development and cross-validation groups. Stepwise multiple regression was used to develop the FFM predictive equation. Bland-Altman plots, Lin's concordance correlation coefficient, according to McBride criteria, precision, accuracy, and standard error of estimate (SEE) were calculated to evaluate the concordance and reliability of estimates. Bioelectrical impedance vector analysis was plotted to assess hydration status.

RESULTS

No differences (P > 0.05) were observed between development and validation groups in chronological age, anthropometric data, bioelectrical impedance data, and FFM values obtained using dual-energy X-ray absorptiometry. Bioelectrical impedance vector analysis tolerance showed that all participants presented adequate hydration status compared to the reference population. The new FFM predictive equation developed and validated: FFM (kg) = -7.064 + 0.592 × chronological age (y) + 0.554 × weight (kg) + 0.365 × height²/resistance (cm²/Ω), presented R² = 0.95; SEE = 1.76 kg; concordance correlation coefficient = 0.95, accuracy = 0.98, and strength of concordance = 0.99.

CONCLUSIONS

The present study developed and cross-validated an FFM predictive equation based on multifrequency bioelectrical data providing substantial FFM accuracy for male adolescent soccer athletes.

Somatotype and bioelectrical impedance vector analysis of Italian CrossFit® practitioners

Objectives

CrossFit® is a high-intensity sport characterized by various workouts that require strength, speed, endurance, or agility, impacting participants' body composition. This observational study aimed to determine the morphological (anthropometrical and bioelectrical) profile of CrossFit® athletes and to compare them with other athletic populations.

Methods

Anthropometrical measurements and bioelectrical vector analysis (classic and specific approaches) were performed on 145 CrossFit® practitioners (107 men aged 30.7 ± 8.4 years and 38 women aged 28.1 ± 6.7 years). Each participant's relative somatotype was calculated and compared between sexes and with a Spanish CrossFit® athletes' group. Resistance-reactance graphs and Hotelling's T2 test were applied to characterize the sample, compare them with an athletes' reference population, and identify differences between somatotype groups.

Results

The most represented somatotype in both groups was the balanced mesomorph (male 3.5-5.2 - 1.7 and female 4.4-4.5 - 1.8). Compared with Spanish CrossFit® athletes, significant differences were denoted for men but not women (SAD = 2.3). The bioelectrical graphs indicated that the distribution of CrossFit® athletes is quite heterogeneous and within average values for the athlete's reference. The mesomorphic and endomorphic components were associated with a higher phase angle.

Conclusions

CrossFit® practitioners predominantly present a mesomorphic component and show a body type like other power athletes, although with less pronounced characteristics. The somatotype may influence the vector's position in the RXc graphs. This study provided the bioelectrical tolerance ellipses for CrossFit® practitioners in classic and specific approaches for the first time.

Tracking Body Composition Over a Competitive Season in Elite Soccer Players Using Laboratory- and Field-Based Assessment Methods

ABSTRACT

Bongiovanni, T, Lacome, M, Rodriguez, C, and Tinsley, GM. Tracking body composition over a competitive season in elite soccer players using laboratory- and field-based assessment methods. J Strength Cond Res 38(3): e104-e115, 2024-The purpose of this study was to describe body composition changes in professional soccer players over the course of a competitive playing season and compare the ability of different assessment methods to detect changes. Twenty-one elite male soccer players (age: 23.7 ± 4.8 years; height: 185.0 ± 5.2 cm; body mass: 80.7 ± 5.5 kg; body fat: 12.8 ± 2.2%) playing for an Italian national second league (Serie B) championship team were assessed at 4 time points throughout a competitive season: T0 (mid-October), T1 (mid-December), T2 (mid-February), and T3 (end of April). Dual-energy x-ray absorptiometry (DXA), skinfolds (SKF), and bioelectrical impedance analysis were performed at each time point, and multiple SKF-based equations were applied. A modified 4-compartment (4C) model was also produced. Data were analyzed using repeated measures analysis of variance, relevant post hoc tests, and Pearson's correlations. Dual-energy x-ray absorptiometry, 4C, and the SKF-based equations of Reilly and Civar detected differences in fat-free mass (FFM) between time points, with the most differences observed for DXA. Fat-free mass increased from T0 values to a peak at T2, followed by a decrease by T3, although FFM values remained higher than T0. Fat-free mass gain was primarily driven by increases in the lower limbs. Fat-free mass changes between all methods were significantly correlated, with correlation coefficients of 0.70-0.97. No significant differences between time points were observed for absolute fat mass or body fat percentage, although significant correlations between several methods for change values were observed. Select laboratory and field methods can detect changes in FFM over the course of a season in elite, professional soccer athletes, with a more limited ability to detect changes in adiposity-related variables. For SKF in this population, the equation of Reilly is recommended.

Peak Week Carbohydrate Manipulation Practices in Physique Athletes: A Narrative Review

BACKGROUND

Physique athletes are ranked by a panel of judges against the judging criteria of the corresponding division. To enhance on-stage presentation and performance, competitors in certain categories (i.e. bodybuilding and classic physique) achieve extreme muscle size and definition aided by implementing acute "peaking protocols" in the days before competition. Such practices can involve manipulating nutrition and training variables to increase intramuscular glycogen and water while minimising the thickness of the subcutaneous layer. Carbohydrate manipulation is a prevalent strategy utilised to plausibly induce muscle glycogen supercompensation and subsequently increase muscle size. The relationship between carbohydrate intake and muscle glycogen saturation was first examined in endurance event performance and similar strategies have been adopted by physique athletes despite the distinct physiological dissimilarities and aims between the sports.

OBJECTIVES

The aim of this narrative review is to (1) critically examine and appraise the existing scientific literature relating to carbohydrate manipulation practices in physique athletes prior to competition; (2) identify research gaps and provide direction for future studies; and (3) provide broad practical applications based on the findings and physiological reasoning for coaches and competitors.

FINDINGS

The findings of this review indicate that carbohydrate manipulation practices are prevalent amongst physique athletes despite a paucity of experimental evidence demonstrating the efficacy of such strategies on physique performance. Competitors have also been observed to manipulate water and electrolytes in conjunction with carbohydrate predicated on speculative physiological mechanisms which may be detrimental for performance.

CONCLUSIONS

Further experimental evidence which closely replicates the nutritional and training practices of physique athletes during peak week is required to make conclusions on the efficacy of carbohydrate manipulation strategies. Quasi-experimental designs may be a feasible alternative to randomised controlled trials to examine such strategies due to the difficulty in recruiting the population of interest. Finally, we recommend that coaches and competitors manipulate as few variables as possible, and experiment with different magnitudes of carbohydrate loads in advance of competition if implementing a peaking strategy.

Body fluids and muscle changes in trail runners of various distances

Background

This study aims to investigate body fluids and muscle changes evoked by different trail races using anthropometric, bioelectrical, and creatine kinase (CK) measurements.

Methods

A total of 92 subjects (55 men, 37 women) participating in three different races of 14, 35, and 52 km were evaluated before (PRE) and after (POST) the races. Classic bioelectrical impedance vector analysis was applied at the whole-body level (WB-BIVA). Additionally, muscle-localized bioelectrical assessments (ML-BIVA) were performed in a subgroup of 11 men (in the quadriceps, hamstrings, and calves). PRE-POST differences and correlations between bioelectrical values and CK, running time and race distance were tested.

Results

Changes in whole-body vectors and phase angles disclosed an inclination towards dehydration among men in the 14, 35, and 52 km groups (p < 0.001), as well as among women in the 35 and 52 km groups (p < 0.001). PRE Z/H was negatively correlated with running time in the 35 km men group and 14 km women group (r = -0.377, p = 0.048; r = -0.751, p = 0.001; respectively). POST Z/H was negatively correlated with running time in the 14 km women group (r = -0.593, p = 0.02). CK was positively correlated with distance in men and women (p < 0.001) and negatively correlated with reactance and vector length in the 14 km men group (p < 0.05). ML-BIVA echoed the same tendency as the WB-BIVA in the 35 and 52 km runners, with the most notable changes occurring in the calves (p < 0.001).

Conclusions

WB-BIVA and CK measurements underscored a conspicuous trend towards post-race dehydration and muscle damage, displaying a weak association with performance. Notably, ML-BIVA detected substantial alterations primarily in the calves. The study underscores the utility of BIVA as a technique to assess athlete's body composition changes.

The bioelectrical impedance analysis (BIA) international database: aims, scope, and call for data

BACKGROUND

Bioelectrical impedance analysis (BIA) is a technique widely used for estimating body composition and health-related parameters. The technology is relatively simple, quick, and non-invasive, and is currently used globally in diverse settings, including private clinicians' offices, sports and health clubs, and hospitals, and across a spectrum of age, body weight, and disease states. BIA parameters can be used to estimate body composition (fat, fat-free mass, total-body water and its compartments). Moreover, raw measurements including resistance, reactance, phase angle, and impedance vector length can also be used to track health-related markers, including hydration and malnutrition, and disease-prognostic, athletic and general health status. Body composition shows profound variability in association with age, sex, race and ethnicity, geographic ancestry, lifestyle, and health status. To advance understanding of this variability, we propose to develop a large and diverse multi-country dataset of BIA raw measures and derived body components. The aim of this paper is to describe the 'BIA International Database' project and encourage researchers to join the consortium.

METHODS

The Exercise and Health Laboratory of the Faculty of Human Kinetics, University of Lisbon has agreed to host the database using an online portal. At present, the database contains 277,922 measures from individuals ranging from 11 months to 102 years, along with additional data on these participants.

CONCLUSION

The BIA International Database represents a key resource for research on body composition.

Prediction of body water compartments by raw bioelectrical impedance parameters in athletes: Comparison between series and parallel measurements

BACKGROUND

The aim of this study was to determine the predictive role of series and parallel bioelectrical impedance-derived parameters in predicting total body (TBW), intracellular (ICW), and extracellular water (ECW) in athletes.

METHODS

This cross-sectional study analyzed 134 male (21.33 ± 5.11 years) and 64 female (20.45 ± 5.46 years) athletes. Using dilution techniques, TBW and ECW were determined while ICW was the difference between both. Raw and standardized for height (/H) bioelectrical resistance (R), reactance (Xc), and impedance (Z) values were obtained using a phase-sensitive device at a single frequency in a series array (s). These were mathematically transformed in a parallel array (p) and capacitance (CAP). Fat-free mass (FFM) was assessed by dual-energy X-ray absorptiometry.

RESULTS

Multiple regressions adjusted for age and FFM show that R/Hs, Z/Hs, R/Hp, and Z/Hp were significant predictors of TBW (p < 0.001 in females and males). While Xc/Hs did not predict ICW, Xc/Hp was a predictor (p < 0.001 in females and Males). In females, R/H and Z/H predicted similarly TBW, ICW, and ECW. In males, R/Hs was considered a better predictor than R/Hp for TBW and ICW, and the Xc/Hp was considered the best predictor for ICW. Another significant predictor of ICW was CAP (p < 0.001 in females and males).

CONCLUSION

This study highlights the potential value of parallel bioelectrical impedance values to identify fluid compartments in athletes as an alternative to the regularly used series measurements. Moreover, this study supports Xc in parallel, and ultimately CAP, as valid indicators of cell volume.

Validation of skinfold equations and alternative methods for the determination of fat-free mass in young athletes

Intoduction

To cross-validate skinfold (SKF) equations, impedance devices, and air-displacement plethysmography (ADP) for the determination of fat-free mass (FFM).

Methods

Male and female youth athletes were evaluated (n = 91[mean ± SD] age: 18.19 ± 2.37 year; height: 172.1 ± 9.8 cm; body mass: 68.9 ± 14.5 kg; BMI: 23.15 ± 3.2 kg m-2; body fat: 19.59 ± 6.9%) using underwater weighing (UWW), ADP, and SKF assessments. A 3-compartment (3C) model (i.e., UWW and total body water) served as the criterion, and alternate body density (Db) estimates from ADP and multiple SKF equations were obtained. Validity metrics were examined to establish each method's performance. Bioelectrical impedance analysis (BIA), bioimpedance spectroscopy (BIS), and the SKF equations of Devrim-Lanpir, Durnin and Womersley, Jackson and Pollock (7-site), Katch, Loftin, Lohman, Slaughter, and Thorland differed from criterion.

Results

For females, Pearson's correlations between the 3C model and alternate methods ranged from 0.51 to 0.92, the Lin's concordance correlation coefficient (CCC) ranged from 0.41 to 0.89, with standard error of the estimate (SEE) ranges of 1.9-4.6 kg. For SKF, the Evans 7-site and J&P 3 Site equations performed best with CCC and SEE values of 0.82, 2.01 kg and 0.78, 2.21 kg, respectively. For males, Pearson's correlations between the 3C model and alternate methods ranged from 0.50 to 0.95, CCC ranges of 0.46-0.94, and SEE ranges of 3.3-7.6 kg. For SKF, the Evans 3-site equation performed best with a mean difference of 1.8 (3.56) kg and a CCC of 0.93.

Discussion

The Evans 7-site and 3-site SKF equations performed best for female and male athletes, respectively. The field 3C model can provide an alternative measure of FFM when necessary.

Bioelectrical, Anthropometric, and Hematological Analysis to Assess Body Fluids and Muscle Changes in Elite Cyclists during the Giro d’Italia

This study aimed to characterize and monitor the body fluid and muscle changes during the Giro d’Italia in nine elite cyclists via bioelectrical (whole-body and muscle-localized) anthropometric and hematological analysis. There were three checkpoint assessments: at the beginning, middle, and end of the race. The Wilcoxon signed-rank test was used to compare the data at baseline and follow up. The Spearman correlation was used to explore relationships between variables. Hotelling’s T2 test was used to determine bioelectrical differences in the complex vector. Bodyweight did not change during the competition, despite bioelectrical and hematological data indicating that at the first half of the race, there was a fluid gain, and in the second half a fluid loss occurred, reaching baseline values. These changes were especially prevalent in the extracellular water compartment. Significant correlations between whole-body bioelectrical vector changes and red blood cell parameter changes were reported. The muscle group most sensitive to changes were the calves. Quadriceps, hamstrings, and calves reported a PhA decrease trend during the first half of the race, and an increase during the second half. Bioelectrical impedance vector analysis appears to be sensitive enough to detect hydration and cellular integrity adaptions induced by competitions as demanding as the Giro d’Italia.

Fat-free mass estimation in male elite futsal players: Development and validation of a new bioelectrical impedance-based predictive equation

OBJECTIVES

The present study aimed to develop and cross-validate a futsal-specific bioelectrical equation for estimating fat-free mass (FFM) in male players.

METHODS

A total of 66 futsal players (age 23.3 ± 5.4 years) from the Major Portuguese Futsal League "LIGA PLACARD" and from the 2nd and 3rd National Futsal Leagues were included in this cross-sectional, observational study. The participants underwent a foot-to-hand bioelectrical impedance analysis (BIA) at 50 kHz and completed a dual-energy X-ray absorptiometry (DXA) scan for reference body composition data. The sport-specific model was developed by stepwise multiple regression using bioelectrical raw parameters [resistance (R) and reactance (Xc)] as independent variables. Validation was performed using the PRESS approach, least squares regression, concordance correlation coefficient (CCC) and Bland-Altman analyses.

RESULTS

A BIA-based model was developed for FFM [FFM (kg) = -8.865 + 0.437 * Body Mass (kg) + 0.186 * Xc + 0.415 * stature (cm)²/R (R² = 0.89, standard error of estimation = 2.38 kg)]. Results showed a substantial strength of agreement (CCC = 0.953), an r² of 0.88 with a standard error of estimation equal to 2.31 kg, no mean bias (0.04 kg, p>0.05), low limits of agreement (ranged from -4.5 to 4.6 kg), and no trend (r = -0.170, p = 0.172).

CONCLUSIONS

The present equation is the first to allow for a valid, accurate, and sport-specific assessment of FFM in male futsal players.

A new prediction model for total body water estimation by BIA in children with normal and excessive weight

BACKGROUND

Various methods, including bioelectrical impedance analysis (BIA), are used for total body water (TBW) estimation. The objective of our study by BIA was to develop a new predication model based on corrected TBW for normal adult BMI, a concept similar to the standardization of glomerular filtration rate by relating it to the average adult body surface area.

METHOD

We measured TBW by BIA in 335 children 3-21 years old with normal or excessive body weight. Based on our data, we derived a new prediction model for TBW (L) for females {[(72.784 + 0.4093 × weight)∗Corrected TBW]/100} and males {[(57.944 + 0.6551 × weight)∗Corrected TBW]/100}. For validation, we compared our prediction model with three other models on TBW by BIA and dilution methods.

RESULTS

Our model's error size to predict TBW showed lower cross-validated root mean square error (CV-RMSE) as compared to three other models versus our dataset by BIA and two other datasets by dilution methods. Our model also showed a smaller error (2.059) in CV-RMSE as compared to other models by dilution methods (2.126, 2.873, and 4.384) for normal and excessive weight combined. This implies that our model is more robust when excessive weight individuals are included in the data..

CONCLUSION

Our prediction model for TBW estimation by BIA performs better as compared to some other models based on BIA and dilution method datasets. Furthermore, our prediction model is the only one that is devised to be applicable to children and young adults with both normal as well as excessive weight.

Agreement and Precision of Deuterium Dilution for Total Body Water and Multicompartment Body Composition Assessment in Collegiate Athletes

BACKGROUND

Deuterium oxide (D2O) dilution is the criterion method for total body water (TBW) measurement, but results may vary depending on the specimen type, analysis method, and analyzing laboratory. Bioelectrical impedance (BIA) estimates TBW, but results may vary by device make and model.

OBJECTIVES

We investigated the accuracy and precision of TBW estimates and how measurement conditions affected the accuracy of body composition using multicompartment body composition models.

METHODS

Eighty collegiate athletes received duplicate TBW measures acquired from 3 BIA devices (S10, SFB7, and SOZO) and from unique D2O combinations of specimen type (saliva, urine), analysis methodology [Fourier transform infrared spectrophotometry (FTIR), isotope-ratio mass spectrometry (IRMS)], and 3 different laboratories. TBW measures were substituted into 2-compartment (2C) and 5-compartment (5C) body composition models. Criterion measures were compared using Lin's concordance correlation coefficient cutoff of poor (<0.90), moderate (0.90-0.95), substantial (0.95-0.99), and almost perfect (>0.99).

RESULTS

Fifty-one participants (26 female) completed the protocol. Using IRMS saliva as the criterion TBW, all other measures produced a substantial or almost perfect agreement, except for SFB7 (poor) and SOZO (moderate). The 2C body composition measures using D2O and BIA produced poor agreement except for moderate agreement for lab 3 FTIR saliva. The 5C body composition measures using D2O produced a substantial agreement, whereas the BIA device S10 and SOZO had a moderate agreement, while the SFB7 had a poor agreement to the criterion. Test-retest precision varied between techniques from 0.3% to 1.2% for TBW.

CONCLUSIONS

Small differences in TBW measurement led to significant differences in 2C models. The 5C models partially mitigate differences seen in 2C models when different TBW measures are used. Interchanging TBW measures in multicompartment models can be problematic and should be performed with these considerations.

Training History, Cardiac Autonomic Recovery from Submaximal Exercise and Associated Performance in Recreational Runners

This study investigated the effect of prolonged exertion on cardiac parasympathetic (cPS) reorganization and associated aerobic performance in response to repeated short-lasting submaximal exercise bouts (SSE) performed for 7 days following prolonged exertion. In 19 recreational runners, heart rate (HR) and HR variability (HRV) indices (lnRMSSD, lnHF, and lnLF/HF) were monitored pre- and post-submaximal graded cycling performed on consecutive days following a half-marathon (HM) and compared with the baseline, pre-HM values. Additionally, HR recovery (HRR), aerobic performance, and rate of perceived exertion (RPE) were determined. HR, HRV indices, and HRR were tested for correlation with exercise performance. A significant time effect was found in HR, HRR, and HRV indices as well as in aerobic performance and RPE during the study period. Most of the measured parameters differed from their baseline values only on the same day following HM. However, HRR and HR measured in recovery after SSE were additionally affected one day following the half-marathon yet in opposite directions to those recorded on the same day as the HM. Thus, postSSE HR and HRR exhibited a bivariate time response (postSSE HR: 102 ± 14 bpm; p < 0.001; 82 ± 11 bpm; p = 0.007 vs. 88 ± 11 bpm; HRR in 30 s after SSE cessation: 14.9 ± 4.9 bpm; p < 0.001; 30.1 ± 13.3 bpm; p = 0.006 vs. 24.4 ± 10.8 bpm), potentially indicating a cPS dysfunction phase on the same day and cPS rebound phase one day following HM reflected also in consecutive changes in aerobic power. Correlations were found between the changes in measured cardiac indices with respect to baseline and the changes in aerobic performance indices throughout the study period. The effect of exercise history on cPS reorganization is more pronounced in response to SSE than at rest. Accordingly, we conclude that SSE performed repeatedly on a daily basis following prolonged exertion offers a noninvasive tool to evaluate the impact of training history on cPS recovery and associated aerobic power output in recreational athletes.

Effect of resistance training on bioelectrical phase angle in older adults: a systematic review with Meta-analysis of randomized controlled trials

Resistance training has been proposed as a valid practice to counteract the aging effect on body mass and its components, which can be easily evaluated though the bioelectrical impedance analysis. This study aimed to achieve a systematic review with meta-analysis on the impact of resistance training on bioelectrical proprieties in older adults.A literature review was done in four electronic databases up to 1 January 2022. The inclusion criteria were: (i) participants aged ≥ 60 years; (ii) resistance training lasted ≥ 8 weeks; (iii) measurement of raw bioelectrical parameters in randomized controlled study designs.The outcomes of the trial had to be bioelectrical phase angle (PhA), resistance (R), and reactance (Xc). The methodological quality was assessed using the Rosendal scale.Overall, seven studies with a total of 344 participants were eligible for the analysis. The quality assessment yielded a score of 71.3%. Bioelectrical PhA (0.52 degree [95%CI 0.32, 0.71], p < 0.001) and Xc (3.58 ohms [95%CI 1.97, 5.19], p < 0.001) increased, whereas R decreased (-28.50 ohms [95%CI -41.39, -15.60], p < 0.001) after the resistance training programs.In this meta-analysis, resistance training promoted increases of PhA, which result from an increase in Xc concomitant with a reduction in R. According to the bioimpedance vector analysis, resistance-trained people experienced a beneficial leftward vector displacement, whilst inactivity induced a rightward vector displacement within the R-Xc graph. In future, more sophisticated and rigorous studies that address specific criteria, methods and targeted designs are required to identify which equipment and protocols allow for an optimization of the resistance training effects.Registration code in PROSPERO: CRD42020168057.

Regional Lean Soft Tissue and Intracellular Water Are Associated with Changes in Lower-Body Neuromuscular Performance: A Pilot Study in Elite Soccer Players

The assessment of body composition over a competitive season provides valuable information that can help sports professionals to evaluate the efficacy of training and nutritional strategies, as well as monitoring athletes’ health status. The purpose of this study was to examine the association of changes in body composition and hydration status with changes in lower-body neuromuscular performance in soccer. Twenty-two male professional soccer players (mean ± SD; age: 26.4 ± 4.8 years; height: 184.3 ± 5.7 cm; body mass: 81.1 ± 6.5 kg; body fat: 11.6 ± 1.5%) took part in the study, for which they were tested at the initial and final stage of the competitive season. Total (whole body) and regional (arms and legs) lean soft tissue (LST) were estimated to obtain the body composition profile. Total body water (TBW) content, including extracellular (ECW) and intracellular (ICW) water, was obtained to monitor players’ hydration status. Countermovement jump (CMJ) height, power, and strength were used to derive players’ lower-body neuromuscular performance. The results showed that changes in legs LST and ICW significantly (p < 0.01) explained (r2 = 0.39) the improvements in CMJ height, power, and strength from the initial to the final stage of the season. Given the high demand imposed on the lower limbs during a soccer season, being more susceptible to change compared to whole-body LST, assessing regional LST and ICW would be more appropriate to provide extended information on players’ readiness.

Can Bodybuilding Peak Week Manipulations Favorably Affect Muscle Size, Subcutaneous Thickness, and Related Body Composition Variables? A Case Study

Background: The purpose of this case study was to implement an evidence-based dietary approach to peaking for a bodybuilding competition and monitor its impact on body composition, muscle thickness (MT), intra-to-extra-cellular fluid shifts, subcutaneous thickness (ST), and hydration status. Secondarily, to document any adverse events of this peak week approach in a small, controlled setting. Methods Dietary practices were recorded, and laboratory testing was conducted throughout peak week, including competition morning. Assessments included: dual-energy X-ray absorptiometry (DEXA) for body composition, B-mode ultrasound for MT and ST, bioimpedance spectroscopy (BIS) for total body water (TBW)/intracellular water (ICW)/extracellular water (ECW), and raw BIS data (i.e., resistance, reactance, and phase angle), urine specific gravity (USG) for hydration status, and subjective fullness. Sequential dietary manipulations were made (i.e., CHO depletion/fat loading, CHO/water loading, and a refinement phase) with specific physiological goals. This was reflected in changes observed across all assessments throughout the peak week. Results: From the carbohydrate-depleted state (three days out) to competition day, we observed increases in lean body mass, MT, TBW (primarily ICW), and subjective fullness. Kendall’s Tau B revealed a strong relationship between carbohydrate intake and ∑MT (τ = 0.733, p = 0.056). Additionally, novel ST data demonstrated a 10% reduction for the summation of all seven sites, with some drastic changes in specific regions (e.g., −43% for triceps ST) from three days out to competition day. Conclusions: These data suggest that the prototypical goals of bodybuilders’ peak week (i.e., increasing muscle fullness, decreasing subcutaneous thickness) to enhance their aesthetics/muscularity presented can be achieved with a drug-free protocol involving dietary manipulations.

Discussion on Protein Metabolism and Requirement of Aerobics Athletes during Training Based on Multisensor Data Fusion

Competitive aerobics has emerged as a highly competitive sport beyond its own physical limit. Modern competitive aerobics competition is very fierce; athletes cannot only rely on a specific competitive skill to achieve good results. Protein is the physical basis of life activity. The life activity of human body is closely related to protein, and protein is closely related to human exercise ability. This article aims to study protein metabolism and demand of aerobics athletes during training based on multisensor data fusion. A total of 26 female aerobics athletes were randomly divided into two groups: exercise group and exercise + nutrition group. According to the characteristics of human motion, a comprehensive measurement acquisition sensor system for collecting human motion information is designed and implemented, and the system is used to monitor the subject's protein condition in real time. The subjects took protein nutrient solution before breakfast every day. The dynamic recognition algorithm designed in this paper also has shortcomings, and the monitoring protein method based on gait and other signs is not completely correct. The experiment lasted for 7 weeks. The results showed that the level of serum transferrin receptor decreased significantly in the quiet + nutrition group for 4 weeks, which was significantly different from that at 0 and 3 weeks in the same group (P < 0.01) and was significantly different from that in the same group at 7 weeks (P < 0.05). In the exercise group, the level of serum transferrin receptor increased significantly at 5 weeks, compared with the same group at 0 and 3 weeks (P < 0.05).

Changes in Intra-to-Extra-Cellular Water Ratio and Bioelectrical Parameters from Day-Before to Day-Of Competition in Bodybuilders: A Pilot Study

The present study analyzed the effects from day-before to day-of bodybuilding competition on intracellular water (ICW), extracellular water (ECW), total body water (TBW), and bioimpedance analysis (BIA) parameters (resistance, R; reactance, Xc; and derived scores) in bodybuilding athletes. We assessed anthropometry and BIA (foot-to-hand; tetrapolar; 50 kHz) in 11 male bodybuilders (29 ± 4 year-old; 81 ± 8 kg; 172 ± 7 cm; 27 ± 2 kg/m²) both on the pre-competition day and on the contest day. Results revealed significant increases in ICW (31.6 ± 2.9 to 33.1 ± 2.8 L), with concomitant decreases in ECW (19.8 ± 1.8 to 17.2 ± 1.4 L) and TBW (51.4 ± 4.6 to 50.3 ± 4.2 L) from the day-before competition to contest day, which resulted in relatively large increases in the ICW/ECW ratio (1.60 ± 0.03 to 1.92 ± 0.01 L). Moreover, significant increases in R (391 ± 34 to 413 ± 33 ohm), Xc (64 ± 7 to 70 ± 6 ohm), and phase angle (9.3 ± 0.6 to 9.6 ± 0.7 degree) were observed between time periods. The phase angle scores reported on show-day of 9.6 and 11.2 appear to be the highest group mean and individual values observed in the literature to date. In conclusion, the strategies carried out on the final day of peak-week bodybuilding preparation lead to changes in BIA parameters and body water, with fluids shifting from the extra- to the intracellular compartment.

The Influence of Menstrual Cycle on Bioimpedance Vector Patterns, Performance, and Flexibility in Elite Soccer Players

PURPOSE

To examine whether menstrual cycle affects body composition and bioimpedance vector analysis (BIVA) patterns, jumping and sprinting ability, and flexibility in elite soccer players.

METHODS

A total of 20 elite female soccer players (age: 23.8 [3.4] y, height: 1.63 [0.04] m, body mass: 61.4 [5.9] kg, and body mass index: 22.5 [2.4] kg/m2) were monitored during the early follicular and ovulatory phase across 2 consecutive menstrual cycles. Bioimpedance analysis was performed using foot-to-hand technology, and total body water and fat mass were determined by specific equations developed for athletes. Bioelectrical resistance and reactance were adjusted according to the BIVA procedures and plotted as a vector within the resistance-reactance graph. In addition, countermovement jump, 20-m sprint, and sit and reach were assessed.

RESULTS

A time effect (P < .05) was found for body mass, total body water, bioelectrical resistance and reactance, and flexibility. Specifically, body mass increased (P = .021) along with a gain in total body water (P = .001) from the ovulatory to the early follicular phase, while it decreased from the early follicular to the ovulatory phase during the second menstrual cycle. The BIVA vector shortened during the early follicular phases (P < .001). No change in jumping and sprinting capacity was observed (P > .05). Flexibility was impaired during the early follicular phases (P < .05).

CONCLUSIONS

Specific bioelectrical impedance analysis and BIVA procedures are able to detect menstrual cycle-induced changes in body composition in elite soccer players. The early follicular phase resulted in fluid accumulations and BIVA vector shortening. In addition, while menstrual cycle did not affect performance, a fluctuation in flexibility was observed.

Generalized bioelectric impedance-based equations underestimate body fluids in athletes

The current study aimed: (i) to external validate total body water (TBW) and extracellular water (ECW) derived from athlete and non‐athlete predictive equations using radioisotope dilution techniques as a reference criterion in male and female athletes; (ii) in a larger sample, to determine the agreement between specific and generalized equations when estimating body fluids in male and female athletes practicing different sports. A total of 1371 athletes (men: n = 921, age 23.9 ± 1.4 y; women: n = 450, age 27.3 ± 6.8 y) participated in this study. All athletes underwent bioelectrical impedance analyses, while TBW and ECW were assessed with dilution techniques in a subgroup of 185 participants (men: n = 132, age 21.7 ± 5.1 y; women: n = 53, age 20.3 ± 4.5 y). Two specific and eight generalized predictive equations were tested. Compared to the criterion methods, no mean bias was observed using the athlete‐specific equations for TBW and ECW (−0.32 to 0.05, p > 0.05) and the coefficient of determination ranged from R² = 0.83 to 0.94. The majority of the generalized predictive equations underestimated TBW and ECW (p < 0.05); R² ranged from 0.66 to 0.89. In the larger sample, all the generalized equations showed lower TBW and ECW values (ranging from −6.58 to −0.19, p < 0.05) than specific predictive equations; except for TBW in female power/velocity (one equation) athletes and team sport (two equations). The use of generalized BIA‐based equations leads to an underestimation of TBW, and ECW compared to athlete‐specific predictive equations. Additionally, the larger sample indicates that generalized equations overall provided lower TBW and ECW compared to the athlete‐specific equations.

Bioimpedance Vector Patterns according to Age and Handgrip Strength in Adolescent Male and Female Athletes

Bioelectric Impedance Vector Analysis (BIVA) can be used to qualitatively compare individuals’ hydration and cell mass independently of predictive equations. This study aimed to analyze the efficiency of BIVA considering chronological age and handgrip strength in adolescent athletes. A total of 273 adolescents (male; 59%) engaged in different sports were evaluated. Bioelectrical impedance (Z), resistance (R), reactance (Xc), and phase angle (PhA) were obtained using a single-frequency bioelectrical impedance analyzer. Fat-free mass (FFM) and total body water were estimated using bioimpedance-based equations specific for adolescents. Female showed higher values of R (5.5%, p = 0.001), R/height (3.8%, p = 0.041), Z (5.3%, p = 0.001), and fat mass (53.9%, p = 0.001) than male adolescents. Male adolescents showed higher values of FFM (5.3%, p = 0.021) and PhA (3.1%, p = 0.033) than female adolescents. In both stratifications, adolescents (older > 13 years or stronger > median value) shifted to the left on the R-Xc graph, showing patterns of higher hydration and cell mass. The discrimination of subjects older than 13 years and having higher median of handgrip strength values was possibly due to maturity differences. This study showed that BIVA identified age and strength influence in vector displacement, assessing qualitative information and offering patterns of vector distribution in adolescent athletes.

Assessment of Body Composition in Athletes: A Narrative Review of Available Methods with Special Reference to Quantitative and Qualitative Bioimpedance Analysis

Body composition is acknowledged as a determinant of athletic health and performance. Its assessment is crucial in evaluating the efficiency of a diet or aspects related to the nutritional status of the athlete. Despite the methods traditionally used to assess body composition, bioelectric impedance analysis (BIA) and bioelectric impedance vector analysis (BIVA) have recently gained attention in sports, as well as in a research context. Only until recently have specific regression equations and reference tolerance ellipses for athletes become available, while specific recommendations for measurement procedures still remain scarce. Therefore, the present narrative review summarizes the current literature regarding body composition analysis, with a special focus on BIA and BIVA. The use of specific technologies and sampling frequencies is described, and recommendations for the assessment of body composition in athletes are provided. Additionally, the estimation of body composition parameters (i.e., quantitative analysis) and the interpretation of the raw bioelectrical data (i.e., qualitative analysis) are examined, highlighting the innovations now available in athletes. Lastly, it should be noted that, up until 2020, the use of BIA and BIVA in athletes failed to provide accurate results due to unspecific equations and references; however, new perspectives are now unfolding for researchers and practitioners. In light of this, BIA and especially BIVA can be utilized to monitor the nutritional status and the seasonal changes in body composition in athletes, as well as provide accurate within- and between-athlete comparisons.

Body Composition in Elite Soccer Players from Youth to Senior Squad

There is a strong relationship between body composition and performance in male soccer players. This study aimed to display an optimal body height and weight, and body composition profile of male soccer players for four competitive age groups. This cross-sectional study included four groups: U-15 (n = 152), U-17 (n = 154), U-19 (n = 61), and seniors (n = 27). Body height and weight were measured under standard conditions, and the bioelectrical impedance analyzer (BIA) analyzed body composition. On average, soccer players in the U-15 group had significantly lower body height, weight, body mass index, skeletal muscle mass, fat-free mass, total body water and basal metabolic rate than U-17, U-19 and seniors, but a higher percentage of body fat than U-17 and U-19, p < 0.05. In addition, the results show significant non-linear increases in body height, weight and body composition as the age of soccer players increases, with the exception of the percentage of body fat mass, which tends to significantly decrease with age. The main findings of this study are that body fat mass remains stable and similar across all age groups, including in the senior squad.

Validity of water compartments estimated using bioimpedance spectroscopy in athletes differing in hydration status

We aimed to validate bioelectrical impedance spectroscopy (BIS), compared with tracer dilution measurements, for assessing total body water (TBW), intracellular water (ICW), and extracellular water (ECW) in athletes differing in hydration status. A total of 201 athletes participated. Reference TBW and ECW were determined by deuterium and bromide dilution methods, respectively; ICW was calculated as TBW-ECW. Water compartments were estimated by BIS. Urine specific gravity (USG) classified athletes into well-hydrated (WH) (USG < 1.023), euhydrated (EH) (USG:1.024-1.026), and dehydrated (DH) (USG>1.027). No significant differences were found between BIS and the reference methods for WH, EH, and DH athletes for TBW, ICW nor ECW (p>0.05). Concordance of TBW and its compartments by method was significant (p < 0.001) with coefficients of determination ranging by hydration classification [EH:52-96%;DH:56-98%;WH:71-96%]. Bland-Altman analyses showed no trend for TBW and its compartments with the exception of ICW in the WH athletes. The 95% confidence BIS intervals for the WH group ranged from -3.08 to 2.68 kg for TBW, -4.28 to 4.14 kg for ICW, and -3.29 to 3.02 kg for ECW. For the EH athletes, the 95% confidence intervals ranged from -2.78 to 2.24 kg for TBW, -4.10 to 3.94 kg for ICW, and -3.44 to 3.06 kg for ECW. In DH group, TBW ranged between -1.99 and 2.01 kg, ICW between -3.78 and 6.34 kg, and ECW between -6.22 and 3.74 kg. These findings show that BIS is useful at a group level in assessing water compartments in athletes differing in hydration status. However, the usefulness of BIS is limited at an individual level, especially in dehydrated athletes.

Come Back Skinfolds, All Is Forgiven: A Narrative Review of the Efficacy of Common Body Composition Methods in Applied Sports Practice

Whilst the assessment of body composition is routine practice in sport, there remains considerable debate on the best tools available, with the chosen technique often based upon convenience rather than understanding the method and its limitations. The aim of this manuscript was threefold: (1) provide an overview of the common methodologies used within sport to measure body composition, specifically hydro-densitometry, air displacement plethysmography, bioelectrical impedance analysis and spectroscopy, ultra-sound, three-dimensional scanning, dual-energy X-ray absorptiometry (DXA) and skinfold thickness; (2) compare the efficacy of what are widely believed to be the most accurate (DXA) and practical (skinfold thickness) assessment tools and (3) provide a framework to help select the most appropriate assessment in applied sports practice including insights from the authors' experiences working in elite sport. Traditionally, skinfold thickness has been the most popular method of body composition but the use of DXA has increased in recent years, with a wide held belief that it is the criterion standard. When bone mineral content needs to be assessed, and/or when it is necessary to take limb-specific estimations of fat and fat-free mass, then DXA appears to be the preferred method, although it is crucial to be aware of the logistical constraints required to produce reliable data, including controlling food intake, prior exercise and hydration status. However, given the need for simplicity and after considering the evidence across all assessment methods, skinfolds appear to be the least affected by day-to-day variability, leading to the conclusion 'come back skinfolds, all is forgiven'.

Cell integrity indicators in university athletes: comparison among playing positions in indoor football

BACKGROUND

The aim of this study was to compare cell integrity indicators according to the playing position in university indoor football athletes.

METHODS

The sample consisted of 34 university athletes (20 female and 14 male). Dependent variables were cell integrity indicators: total body water (TBW), intracellular water (ICW), extracellular water (ECW), ECW/ICW ratio, body cell mass (BCM), ECW/BCM ratio, phase angle (PhA), resistance (R), Xc (reactance) and impedance (Z), evaluated by the electrical bioimpedance method. Independent variable was the playing position: goalkeeper (a), defender (a), winger (left and right) and pivot collected through questionnaire. Control variables were age, time of sport practice, participation in competitions per year and training load obtained by applying the anamnesis form, and body fat and fat and bone-free mass were obtained through dual emission X-ray absorptiometry (DXA). Covariance analysis (ANCOVA) was used, with post-roc Tukey's test, to identify difference between groups, with p <0.05.

RESULTS

In the adjusted analysis, female athletes in the defense position had BCM values (31.1 ±2.1) higher than those in the wing position (25.8 ±1.1) (p <0.01). In males, pivots showed higher ICW values (31.47 ±0.77) when compared to defenders (25.7 ±0.8) (p = 0.02). In addition, goalkeepers had higher TBW values (52.7 ±2.5) compared to wingers (42.3 ±1.2) (p = 0.03).

CONCLUSIONS

Cell integrity indicators may vary according to the playing position in indoor football.

Bioimpedance to Assess the Body Composition of High-performance Karate Athletes: Applications, Advantages and Perspectives

Karate, a millennial martial art, was recently inserted among traditional Olympic combat sports for the Olympic Games in Japan. The aim of the present study is to determine, through bioimpedance analysis, the body composition of high-performance athletes participating in the São Paulo Olympic Karate Project. Participants were 22 athletes of both sexes, average age of 23.6 (6.0) years old, body mass of 66.6 (13.5) kg and fat percentage of 16.6 (5.5)%. Bioimpedance test indicated significant differences between sexes related to sexual dysmorphia, which had an impact on bioelectrical variables. Through comparative evaluation between male and female athletes, this study contributes to body composition analysis, indicating that, in the future, related bioimpedance tests should be used beyond their classical application, including phase angle, muscle function and other attributes.

Prediction of Somatotype from Bioimpedance Analysis in Elite Youth Soccer Players

The accurate body composition assessment comprises several variables, causing it to be a time consuming evaluation as well as requiring different and sometimes costly measurement instruments. The aim of this study was to develop new equations for the somatotype prediction, reducing the number of normal measurements required by the Heath and Carter approach. A group of 173 male soccer players (age, 13.6 ± 2.2 years, mean ± standard deviation; body mass index, BMI, 19.9 ± 2.5 kg/m²), members of the academy of a professional Italian soccer team participating in the first division (Serie A), participated in this study. Bioelectrical impedance analysis (BIA) was performed using the single frequency of 50 kHz and fat-free mass (FFM) was calculated using a BIA specific, impedance based equation. Somatotype components were estimated according to the Heath-Carter method. The participants were randomly split into development (n = 117) and validation groups (n = 56). New anthropometric and BIA based models were developed (endomorphy = −1.953 − 0.011 × stature²/resistance + 0.135 × BMI + 0.232 × triceps skinfold, R² = 0.86, SEE = 0.28; mesomorphy = 6.848 + 0.138 × phase angle + 0.232 × contracted arm circumference + 0.166 × calf circumference − 0.093 × stature, R² = 0.87, SEE = 0.40; ectomorphy = −5.592 − 38.237 × FFM/stature + 0.123 × stature, R² = 0.86, SEE = 0.37). Cross validation revealed R² of 0.84, 0.80, and 0.87 for endomorphy, mesomorphy, and ectomorphy, respectively. The new proposed equations allow for the integration of the somatotype assessment into BIA, reducing the number of collected measurements, the instruments used, and the time normally required to obtain a complete body composition analysis.

Total body water is the preferred method to use in forensic blood-alcohol calculations rather than ethanol's volume of distribution

During the prosecution and defence of drink-driving cases, forensic practitioners are often required to engage in various blood-alcohol calculations, such as whether or not the statutory limit was exceeded (e.g. 80mg/100mL, 0.08g/100mL or 0.80g/L). For this purpose, most forensic scientists utilize the Widmark equation, or some modification thereof, to calculate a person's blood alcohol concentration (BAC) based on information about the amount of ethanol consumed and the pattern of drinking. This equation comes in two main forms; one of which incorporates the apparent volume of distribution of ethanol (V) and the other a person's total body water (TBW). In this study, we utilised two independent data sets, one involving the determination of V for ethanol in 173 men and 63 women, and the other TBW determined for 582 men and 884 women. Those subjects included in the TBW group represented various racial groups (Caucasians, African Americans, Hispanics, Asians and Puerto Ricans), with body mass index (BMI) ranging from 17 to 80kg/m². Both versions of the Widmark equation were evaluated in relation to their accuracy and precision in predicting TBW and/or V using the two most common anthropometric equations; those of Watson et al. and Forrest. Both anthropometric equations exhibited good accuracy (<4.3%) for the prediction of both TBW and V. However, the root mean square error was lower TBW was used for prediction (9.09-12.84%) rather than V (11.72-15.08%). Overall, this study has demonstrated (a) that blood-alcohol calculations are more reliable using TBW rather than V (b) that both equations (Watson et al. and Forrest) are applicable to ethnic groups other than Caucasians and (c) the Forrest equation predicts TBW in men and women with BMI from 17 to 35kg/m² and that the Watson et al. equation works for those with more extreme BMI; females (17-80kg/m²) and males (17-67kg/m²).

Body Water Content and Morphological Characteristics Modify Bioimpedance Vector Patterns in Volleyball, Soccer, and Rugby Players

Background: Bioimpedance vector analysis (BIVA) is a widely used method based on the interpretation of raw bioimpedance parameters to evaluate body composition and cellular health in athletes. However, several variables contribute to influencing BIVA patterns by militating against an optimal interpretation of the data. This study aims to explore the association of morphological characteristics with bioelectrical properties in volleyball, soccer, and rugby players. Methods: 164 athletes belonging to professional teams (age 26.2 ± 4.4 yrs; body mass index (BMI) 25.4 ± 2.4 kg/m²) underwent bioimpedance and anthropometric measurements. Bioelectric resistance (R) and reactance (Xc) were standardized for the athlete's height and used to plot the vector in the R-Xc graph according to the BIVA approach. Total body water (TBW), phase angle (PhA), and somatotype were determined from bioelectrical and anthropometric data. Results: No significant difference (p > 0.05) for age and for age at the start of competition among the athletes was found. Athletes divided into groups of TBW limited by quartiles showed significant differences in the mean vector position in the R-Xc graph (p < 0.001), where a higher content of body fluids resulted in a shorter vector and lower positioning in the graph. Furthermore, six categories of somatotypes were identified, and the results of bivariate and partial correlation analysis highlighted a direct association between PhA and mesomorphy (r = 0.401, p < 0.001) while showing an inverse correlation with ectomorphy (r = -0.416, p < 0.001), even adjusted for age. On the contrary, no association was observed between PhA and endomorphy (r = 0.100, p = 0.471). Conclusions: Body fluid content affects the vector length in the R-Xc graph. In addition, the lateral displacement of the vector, which determines the PhA, can be modified by the morphological characteristics of the athlete. In particular, higher PhA values are observed in subjects with a high mesomorphic component, whereas lower values are found when ectomorphy is dominant.

Fat-free Mass Bioelectrical Impedance Analysis Predictive Equation for Athletes using a 4-Compartment Model

Bioelectrical impedance analysis equations for fat-free mass prediction in healthy populations exist, nevertheless none accounts for the inter-athlete differences of the chemical composition of the fat-free mass. We aimed to develop a bioimpedance-based model for fat-free mass prediction based on the four-compartment model in a sample of national level athletes; and to cross-validate the new models in a separate cohort of athletes using a 4-compartment model as a criterion. There were 142 highly trained athletes (22.9±5.0 years) evaluated during their respective competitive seasons. Athletes were randomly split into development (n=95) and validation groups (n=47). The criterion method for fat-free mass was the 4-compartment model. Resistance and reactance were obtained with a phase-sensitive 50 kHz bioimpedance device. Athletic impedance-based models were developed (fat-free mass=- 2.261+0.327*Stature²/Resistance+0.525*Weight+5.462*Sex, where stature is in cm, Resistance is in Ω, Weight is in kg, and sex is 0 if female or 1 if male). Cross validation revealed R² of 0.94, limits of agreement around 10% variability and no trend, as well as a high concordance correlation coefficient. The new equation can be considered valid thus affording practical means to quantify fat-free mass in elite adult athletes.

Bioimpedance Vector Patterns Changes in Response to Swimming Training: An Ecological Approach

BACKGROUND AND AIM

Monitoring bioelectric phase angle (PhA) provides important information on the health and the condition of the athlete. Together with the vector length, PhA constitutes the bioimpedance vector analysis (BIVA) patterns, and their joint interpretation exceeds the limits of the evaluation of the PhA alone. The present investigation aimed to monitor changes in the BIVA patterns during a training macrocycle in swimmers, trying to ascertain if these parameters are sensitive to training load changes across a 13-week training period.

METHODS

Twelve national and international level swimmers (four females; eight males; 20.9 ± 1.9 years; with a competitive swimming background of 11.3 ± 1.8 years; undertaking 16-20 h of pool training and 4-5 h of dry-land training per week and 822.0 ± 59.0 International Swimming Federation (FINA) points) were evaluated for resistance (R) and reactance (Xc) using a single frequency phase sensitive bioimpedance device at the beginning of the macrocycle (M1), just before the beginning of the taper period (M2), and just before the main competition of the macrocycle (M3). At the three-time assessment points, swimmers also performed a 50 m all-out first stroke sprint with track start (T50 m) while time was recorded.

RESULTS

The results of the Hotelling T2 test showed a significant vector displacement due to simultaneous R and Xc changes (p < 0.001), where shifting from top to bottom along the major axis of the R-Xc graph from M1 to M2 was observed. From M2 to M3, a vector displacement up and left along the minor axis of the tolerance ellipses resulted in an increase in PhA (p < 0.01). The results suggest a gain in fluid with a decrease in cellular density from M1 to M2 due to decrements in R and Xc. Nevertheless, the reduced training load characterizing taper seemed to allow for an increase in PhA and, most importantly, an increase of Xc, thus demonstrating improved cellular health and physical condition, which was concomitant with a significant increase in the T50 m performance (p < 0.01).

CONCLUSIONS

PhA, obtained by bioelectrical R and Xc, can be useful in monitoring the condition of swimmers preparing for competition. Monitoring BIVA patterns allows for an ecological approach to the swimmers' health and condition assessment without resorting to equations to predict the related body composition variables.

BIA-assessed cellular hydration and muscle performance in youth, adults, and older adults

BACKGROUND & AIMS

Alterations in body hydration can have an impact on muscle performance, with consequences not only at a sporting level, but on overall health and daily functional competence. Given that the estimation of body water from BIA is based on prediction equations involving assumptions on tissue hydration and body geometry, it is unclear if phase angle (PhA), which is not influenced by assumptions, is a better marker of muscle performance than the BIA estimated parameters of body water. Therefore, the aims of this investigation were to analyze the relationships of BIA-estimated body water compartments with muscle performance among youth, adults, and older adults, and to assess the added value of PhA as a marker of muscle performance.

METHODS

BIA assessments were completed on 263 youth (ages 6-17), 249 adults (ages 18-64), and 75 older adults (ages 65+). Muscle performance was assessed by jumping mechanography (power and force) and handgrip strength. Partial correlations were used to compare the degree of association among the BIA measures with muscle performance for each age group, controlling for sex, age, and body weight.

RESULTS

TBW, ICW, and PhA were associated with muscle performance at the lower and upper limbs in all age groups (p < 0.05), with the exception of PhA with handgrip strength in adults and older adults and TBW with lower limb total force in the older adults. In youth, the highest associations observed were PhA with lower limb muscle power (r = 0.45, CI:0.35-0.54, p < 0.05) and with handgrip strength (r = 0.42, CI:0.32-0.52, p < 0.05). In adults and older adults, the major associations observed were those of ICW with lower limb muscle power (adults, r = 0.53, CI:0.43-0.61, p < 0.05; older adults, r = 0.52, CI = 0.33-0.67, p < 0.05). ECW had significantly lower associations (p < 0.05) with both lower limb force and power in adults and older adults compared to youth. In the older adults, ECW was negatively associated with lower limb total force (r = -0.24; p < 0.05).

CONCLUSIONS

BIA derived hydration parameters may be useful markers of muscle performance in all age groups. In particular, the ICW compartment was a better predictor of muscle performance in adults and older adults compared to youth. In youth, PhA had stronger associations with muscle performance than those of ICW. Thus, phase angle appears to be a useful marker of muscle performance, particularly in youth.

Association between Hydration Status and Body Composition in Healthy Adolescents from Spain

At present, obesity and overweight are major public health concerns. Their classical determinants do not sufficiently explain the current situation and it is urgent to investigate other possible causes. In recent years, it has been suggested that water intake could have important implications for weight management. Thus, the aim of this study was to examine the effect of hydration status on body weight and composition in healthy adolescents from Spain. The study involved 372 subjects, aged 12-18 years. Water intake was assessed through the validated "hydration status questionnaire adolescent young". Anthropometric measurements were performed according to the recommendations of the International Standards for Anthropometric Assessment (ISAK) and body composition was estimated by bioelectrical impedance analysis. Water intake normalized by body weight was positively correlated with body water content (boys (B): r = 0.316, p = 0.000; girls (G): r = 0.245, p = 0.000) and inversely with body mass index (BMI) (B: r = -0.515, p = 0.000; G: r = -0.385, p =0.000) and fat body mass (B: r = -0.306, p = 0.000; G: r = -0.250, p = 0.001). Moreover, according to BMI, overweight/obese individuals consumed less water than normal weight ones. In conclusion, higher water balance and intake seems to be related with a healthier body composition. In conclusion, higher water balance and intake is associated with a healthier body composition.

Accuracy of Bioelectrical Impedance Analysis in Estimated Longitudinal Fat-Free Mass Changes in Male Army Cadets

Introduction

Bioelectrical impedance analysis (BIA) is a practical and rapid method for making a longitudinal analysis of changes in body composition. However, most BIA validation studies have been performed in a clinical population and only at one moment, or point in time (cross-sectional study). The aim of this study is to investigate the accuracy of predictive equations based on BIA with regard to the changes in fat-free mass (FFM) in Brazilian male army cadets after 7 mo of military training. The values used were determined using dual-energy X-ray absorptiometry (DXA) as a reference method.

Materials and Methods

The study included 310 male Brazilian Army cadets (aged 17-24 yr). FFM was measured using eight general predictive BIA equations, with one equation specifically applied to this population sample, and the values were compared with results obtained using DXA. The student's t-test, adjusted coefficient of determination (R2), standard error of estimation (SEE), Lin's approach, and the Bland-Altman test were used to determine the accuracy of the predictive BIA equations used to estimate FFM in this population and between the two moments (pre- and post-moment).

Results

The FFM measured using the nine predictive BIA equations, and determined using DXA at the post-moment, showed a significant increase when compared with the pre-moment (p < 0.05). All nine predictive BIA equations were able to detect FFM changes in the army cadets between the two moments in a very similar way to the reference method (DXA). However, only the one BIA equation specific to this population showed no significant differences in the FFM estimation between DXA at pre- and post-moment of military routine. All predictive BIA equations showed large limits of agreement using the Bland-Altman approach.

Conclusion

The eight general predictive BIA equations used in this study were not found to be valid for analyzing the FFM changes in the Brazilian male army cadets, after a period of approximately 7 mo of military training. Although the BIA equation specific to this population is dependent on the amount of FFM, it appears to be a good alternative to DXA for assessing FFM in Brazilian male army cadets.

Effect of 12-Week Swimming Training on Body Composition in Young Women

Background: Systematic physical activity can permanently prevent disadvantageous developments in the human body. This is very important especially for women, for whom the maintenance of a lean body in good shape is sometimes a primary consideration. However, in most cases, this activity is taken randomly and does not produce the desired effects such as reducing body fat. The purpose of the study was to evaluate changes in female body composition induced by 12 weeks of swimming training compared to sedentary controls. Methods: Training sessions occurred three times per week (60 min/session). Height, body mass, and waist/hip circumference and waist/hips ratio (WHR) were measured. Body cell mass (BCM), total body water (TBW), extracellular (ECW) and intracellular water (ICW), fat mass (FM), lean mass (FFM), and muscle mass (MM) were measured using bioelectrical impedance (pre/post). Results: Training elicited decreases in hip circumference and increase in WHR. No changes were recorded in BCM, TBW, ECW, ICW, FM, FFM, and MM. Controls experienced decreases in values of BCM, ICW, and MM and increases in ECW. Conclusion: The applied swimming training did not significantly affect the body composition parameters. Inactivity also triggered a tendency toward unhealthy movement of water from the intracellular to extracellular space.

Fluid distribution and cell integrity indicators evaluated by bioelectrical impedance in university athletes: comparison between team sports and individual sports

OBJECTIVE

To compare indicators of fluid distribution and cellular integrity in university athletes through a cross-sectional study of 167 university athletes (18-35 years) who competed in team sports and individual sports.

APPROACH

Bioimpedance was used to estimate total body water (TBW), intracellular water (ICW), extracellular water (ECW), ECW/ICW ratio, impedance (Z), reactance (Xc), resistance (R), phase angle, body cell mass (BCM) and ECW/BCM ratio at a frequency of 50 kHz. X-ray absorptiometry was used to determine lean soft tissue mass and body fat. As covariables, sex, age, time of practice and type of modality were obtained by questionnaire.

MAIN RESULTS

Individual male athletes presented higher values of ECW/ICW ratio (means difference MD  =  0.006, p   =  0.020) and ECW/BCM ratio (MD  =  0.006, p   =  0.017) than team sports male athletes. Values of Z (MD  =  24.988, p   =  0.009), Xc (MD  =  3.327, p   =  0.008) and R (MD  =  24.755, p   =  0.09) were higher in male athletes practicing team sports than individual sports. Female team sports athletes presented higher values of Z (MD  =  32.029, p   =  0.015) and R (MD  =  31.987, p   =  0.015) than individual female athletes. It was concluded that ECW/ICW and ECW/BCM ratios were higher in male athletes who practiced individual sports. For the Z, R, and Xc values, the athletes in team sports presented higher values. The female athletes who practiced team sports presented higher values of Z and R than did individual female athletes.

SIGNIFICANCE

ECW/ICW and ECW/BCM ratios were higher in male athletes who practiced individual sports. For the Z, R, and Xc values, the athletes in team sports presented higher values. The female athletes who practiced team sports presented higher values of Z and R than did individual female athletes.

Evidence based survey of the distribution volume of ethanol: Comparison of empirically determined values with anthropometric measures

The Widmark equation is commonly used when blood alcohol calculations are required in forensic and legal medicine, such as in road-traffic cases and alcohol-related deaths. An important biological variable in this connection is the volume of distribution (V_d) of ethanol, which is commonly referred to as the rho-factor. Although a person's V_d can be determined empirically through controlled drinking experiments, this approach is not very practical in reality. For this reason, a number of anthropometric equations have been developed that utilize sex, age, height and weight to estimate the person's total body water (TBW) and hence V_d of ethanol. To date, there are not any studies that compare V_d derived from anthropometric data with robust values measured empirically. From the literature we compiled information about the V_d of ethanol from drinking studies with 173 Caucasian males and 63 Caucasian females from Western Europe. These empirically derived values of V_d were then compared with estimates derived from various anthropometric equations. In males the Watson, Watson and Batt regression equation involving age, height and weight gave the most accurate results (bias was 0.00L/kg) and 95% range ±0.13L/kg. The equation derived by Forrest, which took into consideration a person's body mass index (BMI), gave the best estimates of V_d for females; mean bias -0.01L/kg and range ±0.15L/kg.

Bioimpedance parameters in adolescent athletes in relation to bone maturity and biochemical zinc indices

Phase angle (PA) is derived from resistance and reactance determined by bioimpedance analysis (BIA) and it appears to relate to cellular stability and integrity. Interpretation of PA values could be complemented by bioelectrical impedance vector analysis (BIVA), which relates to body hydration and structure. Body composition, age, sex, and nutrients are known to stabilize cell membranes, such as zinc, have been related to PA although information is scarce in adolescent athletes. The aim of the present study was to assess the association of body composition, skeletal maturity and zinc biochemical indices with phase angle and bioelectrical impedance parameters, in forty male adolescent soccer athletes (13.4±0.6years). BIA was performed with a single-frequency tetrapolar analyzer. PA and BIVA were determined using resistance and reactance BIA data. Plasma and erythrocyte zinc concentrations were measured using inductively coupled plasma-optical emission spectrometry. Body composition was determined by dual-energy X-ray absorptiometry, and bone age by hand X-ray measurements. PA was higher in adolescents classified by bone age as "Early" (6.8±0.9°) compared to "Late" (5.7±0.5°) (p<0.05). PA correlated with bone age (r=0.562), BMI (r=0.382), fat-free mass (r=0.468), and erythrocyte zinc (r=0.379) (p<0.05). BIVA confidence ellipses were sensitive to skeletal maturity status. Phase angle was higher in adolescents with erythrocyte zinc concentration above the median (>0.66μmol.g hemoglobin^-1) compared to those below the median. Multiple linear regression analysis showed that bone age (B=0.254, p=0.001) and erythrocyte zinc concentration (B=1.168, p=0.047) were significantly related to PA in this group, and accounted for 34% of its variability. Our results indicate that bone age and zinc erythrocyte contribute to PA values in the young male soccer athletes and that BIVA is influenced by skeletal maturity status in this group.