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McCarter DL, Morgan C, Bray L, Tume L. How is bioelectrical impedance used in neonatal intensive care? A scoping review. Eur J Pediatr 2024; 183:3053-3062. [PMID: 38656383 DOI: 10.1007/s00431-024-05558-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2024] [Revised: 03/28/2024] [Accepted: 04/04/2024] [Indexed: 04/26/2024]
Abstract
Poor growth and nutrition management in the neonatal period can have a negative impact upon both the short- and long-term outcomes for the infant. Improvements in bioelectrical impedance technology and accompanying licencing agreements now make this enhanced device available for use in infants as small as 23 weeks gestational age. An exploration of this technology and its use is now timely. The aim of the scoping review was to answer the following question: in preterm and sick term infants in the neonatal intensive care unit, how is bioelectrical impedance being utilized, in what situations, and when? The scoping review was conducted using Arksey and O'Malley's (Int J Soc Res Methodol 8(1):19-32, 2005) framework. Forty-nine papers were initially identified and 16 were included in the scoping review. Three studies were experimental designs, and 13 were observational studies. The review found that BIA was used in neonatal intensive care in three main ways, for, (1) fluid status evaluation, (2) as a measure of adequate nutrition and growth, (3) to validate the technology as an outcome measure in neonates. CONCLUSION There is a paucity of recent robust research papers which investigate the use of bioelectrical impedance in preterm neonates. Available evidence spans a range of 30 years, with technological advancement reducing the application of older studies to the modern neonatal setting. Although this technology may be helpful for decision-making around fluid management and nutrition, in preterm infants, robust evidence is needed to demonstrate the clinical benefit of bioelectrical impedance beyond that of usual care. WHAT IS KNOWN • Clinical decisions regarding neonatal nutrition and fluid management are currently based upon the interpretation of vital signs, fluid balance, weight trend, biochemical markers, and physical examination. • Bioelectrical Impedance Analysis (BIA) is a non-invasive method of assessing body composition which is now available to be used in infants as small as 23 weeks gestation. WHAT IS NEW • Bioelectrical Impedance has been used in three main ways in the NICU, for fluid status evaluation, for measuring nutrition and growth and to validate BIA as an outcome. • There is a lack of recent robust research data to support the use of the device within clinical decision making in neonatal intensive care.
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Affiliation(s)
- D L McCarter
- Neonatal Intensive Care Unit, Liverpool Women's Hospital, Crown St, Liverpool, L8 7SS, UK.
- Edge Hill University, St Helens Road, Ormskirk, L39 4QP, UK.
| | - C Morgan
- Neonatal Intensive Care Unit, Liverpool Women's Hospital, Crown St, Liverpool, L8 7SS, UK
| | - L Bray
- Edge Hill University, St Helens Road, Ormskirk, L39 4QP, UK
| | - L Tume
- Edge Hill University, St Helens Road, Ormskirk, L39 4QP, UK
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Pinheiro-Castro N, Ramos-Silva T, de Carvalho Rondó PH, Ward LC. Determination of resistance at zero and infinite frequencies in bioimpedance spectroscopy for assessment of body composition in babies. Physiol Meas 2024; 45:05NT01. [PMID: 38604189 DOI: 10.1088/1361-6579/ad3dc0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 04/11/2024] [Indexed: 04/13/2024]
Abstract
Objective. Bioimpedance spectroscopy (BIS) is a popular technique for the assessment of body composition in children and adults but has not found extensive use in babies and infants. This due primarily to technical difficulties of measurement in these groups. Although improvements in data modelling have, in part, mitigated this issue, the problem continues to yield unacceptably high rates of poor quality data. This study investigated an alternative data modelling procedure obviating issues associated with BIS measurements in babies and infants.Approach.BIS data are conventionally analysed according to the Cole model describing the impedance response of body tissues to an appliedACcurrent. This approach is susceptible to errors due to capacitive leakage errors of measurement at high frequency. The alternative is to model BIS data based on the resistance-frequency spectrum rather than the reactance-resistance Cole model thereby avoiding capacitive error impacts upon reactance measurements.Main results.The resistance-frequency approach allowed analysis of 100% of data files obtained from BIS measurements in 72 babies compared to 87% successful analyses with the Cole model. Resistance-frequency modelling error (percentage standard error of the estimate) was half that of the Cole method. Estimated resistances at zero and infinite frequency were used to predict body composition. Resistance-based prediction of fat-free mass (FFM) exhibited a 30% improvement in the two-standard deviation limits of agreement with reference FFM measured by air displacement plethysmography when compared to Cole model-based predictions.Significance.This study has demonstrated improvement in the analysis of BIS data based on the resistance frequency response rather than conventional Cole modelling. This approach is recommended for use where BIS data are compromised by high frequency capacitive leakage errors such as those obtained in babies and infants.
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Affiliation(s)
| | - Tamiris Ramos-Silva
- Nutrition Department, School of Public Health, University of São Paulo, São Paulo, Brazil
| | | | - Leigh C Ward
- School of Chemistry and Molecular Biosciences, The University of Queensland, St. Lucia, Brisbane, Australia
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Puñal SB, Nicodemus N, Saiz Del Barrio A, García-Ruiz AI. Application of bioelectrical impedance analysis to assess body composition of male and female broiler chickens from 2 different strains throughout the growth period. Poult Sci 2024; 103:103447. [PMID: 38271758 PMCID: PMC10832478 DOI: 10.1016/j.psj.2024.103447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 01/04/2024] [Accepted: 01/05/2024] [Indexed: 01/27/2024] Open
Abstract
Bioelectrical impedance analysis (BIA) was performed in males and females of 2 different broiler strains from 0 to 42 d of age to develop and validate equations to predict body composition (BC). A total of 528 birds, 132 birds per sex and strain (Ross 308 and Cobb 500) were used in the experiment. Birds were fed ad libitum following CVB recommendations with a common starter (0-14 d), grower (15-29 d), and finisher diet (30-42 d). Bioelectrical impedance analysis was measured weekly from 0 to 42 d. Birds were euthanized, frozen and ground for sample collection. Each sample was analyzed through proximate analysis for dry matter (DM), protein, fat, ash, and energy content. Water (%), protein and ash (% DM) decreased with age (77.5-67.5, 69.1-52.2, and 8.12-7.29, respectively; P < 0.0001); whereas fat (% DM) and energy (cal/g DM) increased with the age (20.7-36.4 and 5,421-6151, respectively; P < 0.0001). Males had significantly higher water (%) and protein (% DM) contents, and lower lipid (% DM) deposits than females (70.5, 55.5, and 32.6 vs. 69.6, 54.6, and 33.7, respectively; P < 0.0001). Cobb 500 had a higher fat and lower protein (% DM) and water (%) content than Ross (34.6, 54.0, and 69.7 vs. 31.7, 56.1, and 70.4, respectively; P < 0.0001). A multiple linear regression analysis was carried out to select the equation model to predict BC using the relative mean prediction error (RMPE, %) to evaluate the accuracy. The coefficients of determination (R2) to estimate water (%), protein, fat, ash (% DM) and energy content (cal/g DM) were 0.909, 0.825, 0.795, 0.493, and 0.838, respectively, and the RMPE were 1.26, 3.46, 7.73, 8.85, and 1.86%, respectively. A t test analysis was run, observing no differences in any of the parameters under study between the analyzed and estimated values. Based on these results, we can conclude that BIA can be used as a valid non-invasive technique to estimate in vivo BC in broilers.
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Affiliation(s)
- Samuel Benítez Puñal
- Trouw Nutrition R&D Poultry Research Centre, Casarrubios del Monte, 45950, Spain; Departamento de Producción Agraria, E.T.S.I. Agronómica, Alimentaria y de Biosistemas, Universidad Politécnica de Madrid, Madrid, 28040, Spain
| | - Nuria Nicodemus
- Departamento de Producción Agraria, E.T.S.I. Agronómica, Alimentaria y de Biosistemas, Universidad Politécnica de Madrid, Madrid, 28040, Spain
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Jerome ML, Valcarce V, Lach L, Itriago E, Salas AA. Infant body composition: A comprehensive overview of assessment techniques, nutrition factors, and health outcomes. Nutr Clin Pract 2023; 38 Suppl 2:S7-S27. [PMID: 37721459 PMCID: PMC10513728 DOI: 10.1002/ncp.11059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 07/08/2023] [Accepted: 07/16/2023] [Indexed: 09/19/2023] Open
Abstract
Body composition assessment is a valuable tool for clinical assessment and research that has implications for long-term health. Unlike traditional measurements such as anthropometrics or body mass index, body composition assessments provide more accurate measures of body fatness and lean mass. Moreover, depending on the technique, they can offer insight into regional body composition, bone mineral density, and brown adipose tissue. Various methods of body composition assessment exist, including air displacement plethysmography, dual-energy x-ray absorptiometry, bioelectrical impedance, magnetic resonance imaging, D3 creatine, ultrasound, and skinfold thickness, each with its own strengths and limitations. In infants, several feeding practices and nutrition factors are associated with body composition outcomes, such as breast milk vs formula feeding, protein intake, breast milk composition, and postdischarge formulas for preterm infants. Longitudinal studies suggest that body composition in infancy predicts later body composition, obesity, and other cardiometabolic outcomes in childhood, making it a useful early marker of cardiometabolic health in both term and preterm infants. Emerging evidence also suggests that body composition during infancy predicts neurodevelopmental outcomes, particularly in preterm infants at high risk of neurodevelopmental impairment. The purpose of this narrative review is to provide clinicians and researchers with a comprehensive overview of body composition assessment techniques, summarize the links between specific nutrition practices and body composition in infancy, and describe the neurodevelopmental and cardiometabolic outcomes associated with body composition patterns in term and preterm infants.
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Affiliation(s)
| | | | - Laura Lach
- Medical University of South Carolina, Charleston, SC
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Lyons-Reid J, Ward LC, Derraik JGB, Thway-Tint M, Monnard CR, Ramos Nieves JM, Albert BB, Kenealy T, Godfrey KM, Chan SY, Cutfield WS. Prediction of fat-free mass in young children using bioelectrical impedance spectroscopy. Eur J Clin Nutr 2023:10.1038/s41430-023-01317-4. [PMID: 37524804 DOI: 10.1038/s41430-023-01317-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Revised: 07/17/2023] [Accepted: 07/19/2023] [Indexed: 08/02/2023]
Abstract
BACKGROUND Bioimpedance devices are practical for measuring body composition in preschool children, but their application is limited by the lack of validated equations. OBJECTIVES To develop and validate fat-free mass (FFM) bioimpedance prediction equations among New Zealand 3.5-year olds, with dual-energy X-ray absorptiometry (DXA) as the reference method. METHODS Bioelectrical impedance spectroscopy (SFB7, ImpediMed) and DXA (iDXA, GE Lunar) measurements were conducted on 65 children. An equation incorporating weight, sex, ethnicity, and impedance was developed and validated. Performance was compared with published equations and mixture theory prediction. RESULTS The equation developed in ~70% (n = 45) of the population (FFM [kg] = 1.39 + 0.30 weight [kg] + 0.39 length2/resistance at 50 kHz [cm2/Ω] + 0.30 sex [M = 1/F = 0] + 0.28 ethnicity [1 = Asian/0 = non-Asian]) explained 88% of the variance in FFM and predicted FFM with a root mean squared error of 0.39 kg (3.4% of mean FFM). When internally validated (n = 20), bias was small (40 g, 0.3% of mean FFM), with limits of agreement (LOA) ±7.6% of mean FFM (95% LOA: -0.82, 0.90 kg). Published equations evaluated had similar LOA, but with marked bias (>12.5% of mean FFM) when validated in our cohort, likely due to DXA differences. Of mixture theory methods assessed, the SFB7 inbuilt equation with personalized body geometry values performed best. However, bias and LOA were larger than with the empirical equations (-0.43 kg [95% LOA: -1.65, 0.79], p < 0.001). CONCLUSIONS We developed and validated a bioimpedance equation that can accurately predict FFM. Further external validation of the equation is required.
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Affiliation(s)
- Jaz Lyons-Reid
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Leigh C Ward
- School of Chemistry and Molecular Biosciences, University of Queensland, Brisbane, QLD, Australia
| | - José G B Derraik
- Liggins Institute, University of Auckland, Auckland, New Zealand
- Department of Paediatrics: Child and Youth Health, University of Auckland, Auckland, New Zealand
- Environmental-Occupational Health Sciences and Non-communicable Diseases Research Group, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Mya Thway-Tint
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
- Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Cathriona R Monnard
- Nestlé Institute of Health Sciences, Nestlé Research, Société des Produits Nestlé S.A., Lausanne, Switzerland
| | - J Manuel Ramos Nieves
- Nestlé Institute of Health Sciences, Nestlé Research, Société des Produits Nestlé S.A., Lausanne, Switzerland
| | | | - Timothy Kenealy
- Liggins Institute, University of Auckland, Auckland, New Zealand
- Department of Medicine and Department of General Practice and Primary Health Care, University of Auckland, Auckland, New Zealand
| | - Keith M Godfrey
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Shiao-Yng Chan
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
- Department of Obstetrics & Gynaecology, National University of Singapore, Singapore, Singapore
| | - Wayne S Cutfield
- Liggins Institute, University of Auckland, Auckland, New Zealand.
- A Better Start - National Science Challenge, University of Auckland, Auckland, New Zealand.
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Yumani DFJ, de Jongh D, Ket JCF, Lafeber HN, van Weissenbruch MM. Body composition in preterm infants: a systematic review on measurement methods. Pediatr Res 2023; 93:1120-1140. [PMID: 35995939 DOI: 10.1038/s41390-022-02262-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 06/20/2022] [Accepted: 07/24/2022] [Indexed: 11/08/2022]
Abstract
BACKGROUND There are several methods to measure body composition in preterm infants. Yet, there is no agreement on which method should be preferred. METHODS PubMed, Embase.com, Wiley/Cochrane Library, and Google Scholar were searched for studies that reported on the predictive value or validity of body composition measurements in preterms, up to 6 months corrected age. RESULTS Nineteen out of 1884 identified studies were included. Predictive equations based on weight and length indices, body area circumferences, skinfold thickness, bioelectrical impedance, and ultrasound did not show agreement with body composition measured with air displacement plethysmography (ADP), dual-energy x-ray absorptiometry (DXA), magnetic resonance imaging (MRI), or isotope dilution. ADP agreed well with fat mass density measured by isotope dilution (bias -0.002 g/ml, limits of agreement ±0.012 g/ml, n = 14). Fat mass percentage measured with ADP did not agree well with fat mass percentage measured by isotope dilution (limits of agreement up to ±5.8%) and the bias between measurements was up to 2.2%. DXA, MRI, and isotope dilution were not compared to another reference method in preterms. CONCLUSIONS DXA, ADP, and isotope dilution methods are considered trustworthy validated techniques. Nevertheless, this review showed that these methods may not yield comparable results. IMPACT Based on validation studies that were conducted in a limited number of study subjects, weight and length indices, body area circumferences, skinfold thickness, bioelectrical impedance, and ultrasound seem to be a poor representation of body composition in preterm infants. DXA, ADP, and isotope dilution methods are considered trustworthy and validated techniques. Nevertheless, these methods may not yield comparable results.
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Affiliation(s)
- Dana F J Yumani
- Department of Pediatrics, VU University Medical Center, Amsterdam UMC, Amsterdam, The Netherlands.
| | - Dide de Jongh
- Faculty of Science, VU University, Amsterdam, The Netherlands
- Faculty of Medical Ethics and Internal Medicine, Erasmus MC, Rotterdam, The Netherlands
| | | | - Harrie N Lafeber
- Department of Pediatrics, VU University Medical Center, Amsterdam UMC, Amsterdam, The Netherlands
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Body composition measurement for the preterm neonate: using a clinical utility framework to translate research tools into clinical care. J Perinatol 2022; 42:1550-1555. [PMID: 36203085 PMCID: PMC9617782 DOI: 10.1038/s41372-022-01529-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Revised: 09/23/2022] [Accepted: 09/26/2022] [Indexed: 11/08/2022]
Abstract
Body composition analysis to distinguish between fat mass and fat-free mass is an established research approach to assess nutritional status. Within neonatal medicine, preterm infant body composition is linked with later health outcomes including neurodevelopment and cardiometabolic health. Mounting evidence establishing fat-free mass as an indicator of nutritional status, coupled with the availability of testing approaches that are feasible to use in preterm infants, have enhanced interest in measuring body composition in the neonatal intensive care unit (NICU) setting. In this paper, we use the concept of clinical utility-the added value of a new methodology over current standard care-as a framework for assessing several existing body composition methodologies with potential for clinical application to preterm neonates. We also use this framework to identify remaining knowledge gaps and prioritize efforts to advance our understanding of clinically-oriented body composition testing in the NICU.
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Lyons-Reid J, Ward LC, Derraik JGB, Tint MT, Monnard CR, Ramos Nieves JM, Albert BB, Kenealy T, Godfrey KM, Chan SY, Cutfield WS. Prediction of fat-free mass in a multi-ethnic cohort of infants using bioelectrical impedance: Validation against the PEA POD. Front Nutr 2022; 9:980790. [PMID: 36313113 PMCID: PMC9606768 DOI: 10.3389/fnut.2022.980790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 09/12/2022] [Indexed: 11/22/2022] Open
Abstract
Background Bioelectrical impedance analysis (BIA) is widely used to measure body composition but has not been adequately evaluated in infancy. Prior studies have largely been of poor quality, and few included healthy term-born offspring, so it is unclear if BIA can accurately predict body composition at this age. Aim This study evaluated impedance technology to predict fat-free mass (FFM) among a large multi-ethnic cohort of infants from the United Kingdom, Singapore, and New Zealand at ages 6 weeks and 6 months (n = 292 and 212, respectively). Materials and methods Using air displacement plethysmography (PEA POD) as the reference, two impedance approaches were evaluated: (1) empirical prediction equations; (2) Cole modeling and mixture theory prediction. Sex-specific equations were developed among ∼70% of the cohort. Equations were validated in the remaining ∼30% and in an independent University of Queensland cohort. Mixture theory estimates of FFM were validated using the entire cohort at both ages. Results Sex-specific equations based on weight and length explained 75-81% of FFM variance at 6 weeks but only 48-57% at 6 months. At both ages, the margin of error for these equations was 5-6% of mean FFM, as assessed by the root mean squared errors (RMSE). The stepwise addition of clinically-relevant covariates (i.e., gestational age, birthweight SDS, subscapular skinfold thickness, abdominal circumference) improved model accuracy (i.e., lowered RMSE). However, improvements in model accuracy were not consistently observed when impedance parameters (as the impedance index) were incorporated instead of length. The bioimpedance equations had mean absolute percentage errors (MAPE) < 5% when validated. Limits of agreement analyses showed that biases were low (< 100 g) and limits of agreement were narrower for bioimpedance-based than anthropometry-based equations, with no clear benefit following the addition of clinically-relevant variables. Estimates of FFM from BIS mixture theory prediction were inaccurate (MAPE 11-12%). Conclusion The addition of the impedance index improved the accuracy of empirical FFM predictions. However, improvements were modest, so the benefits of using bioimpedance in the field remain unclear and require further investigation. Mixture theory prediction of FFM from BIS is inaccurate in infancy and cannot be recommended.
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Affiliation(s)
- Jaz Lyons-Reid
- Liggins Institute, The University of Auckland, Auckland, New Zealand
| | - Leigh C. Ward
- School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, QLD, Australia
| | - José G. B. Derraik
- Liggins Institute, The University of Auckland, Auckland, New Zealand
- Department of Paediatrics: Child and Youth Health, School of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
- Environmental-Occupational Health Sciences and Non-communicable Diseases Research Group, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
| | - Mya-Thway Tint
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore
- Human Potential Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Cathriona R. Monnard
- Nestlé Institute of Health Sciences, Nestlé Research, Société des Produits Nestlé S.A., Lausanne, Switzerland
| | - Jose M. Ramos Nieves
- Nestlé Institute of Health Sciences, Nestlé Research, Société des Produits Nestlé S.A., Lausanne, Switzerland
| | | | - Timothy Kenealy
- Liggins Institute, The University of Auckland, Auckland, New Zealand
- Department of Medicine and Department of General Practice and Primary Health Care, The University of Auckland, Auckland, New Zealand
| | - Keith M. Godfrey
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, United Kingdom
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Shiao-Yng Chan
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore
- Department of Obstetrics and Gynecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Wayne S. Cutfield
- Liggins Institute, The University of Auckland, Auckland, New Zealand
- A Better Start–National Science Challenge, The University of Auckland, Auckland, New Zealand
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Orsso CE, Gonzalez MC, Maisch MJ, Haqq AM, Prado CM. Using bioelectrical impedance analysis in children and adolescents: Pressing issues. Eur J Clin Nutr 2022; 76:659-665. [PMID: 34620999 DOI: 10.1038/s41430-021-01018-w] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 09/06/2021] [Accepted: 09/21/2021] [Indexed: 11/08/2022]
Abstract
Single- and multifrequency bioelectrical impedance analysis (BIA) has gained popularity as a tool to assess body composition and health status of children and adolescents, but many questions and misconceptions remain. This review addresses pressing issues researchers and health care providers may encounter when using BIA in the young population. The importance of choosing population-specific and device-specific equations to estimate body composition as well as the use of BIA in longitudinal analyses are discussed. When specific equations are not available, raw bioimpedance values (i.e., resistance, reactance, and impedance) can be used to compute bioimpedance parameters, such as phase angle, impedance ratio, and bioelectrical impedance vector analysis. As interpreting these parameters is challenging, suggestions are provided on the use of reference data, cut-off points, and adjustment factors. Furthermore, unsolved technical and analytical issues are listed. Based on existing issues and potential for future development, a greater interaction between industry and academic researchers to improve the validity of BIA measurements among children and adolescents across their developmental stages is encouraged.
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Affiliation(s)
- Camila E Orsso
- Human Nutrition Research Unit, Department of Agricultural, Food and Nutritional Science, University of Alberta, 4-002 Li Ka Shing Centre for Health Innovation, Edmonton, AB, T6G 2E1, Canada.
| | - Maria Cristina Gonzalez
- Postgraduate Program in Health and Behavior, Catholic University of Pelotas, R. Gonçalves Chaves 377, Pelotas, RS, 96010280, Brazil
- Pennington Biomedical Research Center, LSU System, 6400 Perkins Road, Baton Rouge, LA, 70808, USA
| | | | - Andrea M Haqq
- Department of Pediatrics & Department of Agricultural, Food and Nutritional Science, University of Alberta, 1C4 Walter C. Mackenzie Health Sciences Center, Edmonton, AB, T6G 2B7, Canada
| | - Carla M Prado
- Human Nutrition Research Unit, Department of Agricultural, Food and Nutritional Science, University of Alberta, 4-002 Li Ka Shing Centre for Health Innovation, Edmonton, AB, T6G 2E1, Canada
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Ward LC, Wells JCK, Lyons-Reid J, Tint MT. Individualized body geometry correction factor (K B) for use when predicting body composition from bioimpedance spectroscopy. Physiol Meas 2022; 43. [PMID: 35294931 DOI: 10.1088/1361-6579/ac5e83] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Accepted: 03/16/2022] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Prediction of body composition from bioimpedance spectroscopy (BIS) measurements using mixture theory-based biophysical modelling invokes a factor (KB) to account for differing body geometry (or proportions) between individuals. To date, a single constant value is commonly used. The aim of this study was to investigate variation in KB across individuals and to develop a procedure for estimating an individualized KBvalue. APPROACH Publicly available body dimension data, primarily from the garment industry, were used to calculate KBvalues for individuals of varying body sizes across the life-span. The 3-D surface relationship between weight, height and KB, was determined and used to create look-up tables to enable estimation of KBin individuals based on height and weight. The utility of the proposed method was assessed by comparing body composition predictions from BIS using either a constant KBvalue or the individualized value. RESULTS Computed KB values were well fitted to height and weight by a 3-D surface (R2 = 0.988). Body composition was predicted more accurately compared to reference methods when using individualized KBthan a constant value in infants and children but improvement in prediction was less in adults particularly those with high body mass index. SIGNIFICANCE Prediction of body composition from BIS and mixture theory is improved by using an individualized body proportion factor in those of small body habitus, e.g. children. Improvement is small in adults or non-existent in those of large body size. Further improvements may be possible by incorporating a factor to account for trunk size, i.e., waist circumference.
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Affiliation(s)
- Leigh C Ward
- School of Chemistry and Molecular Biosciences, University of Queensland, Brisbane, QLD 4072, Brisbane, 4072, AUSTRALIA
| | - Jonathan C K Wells
- Childhood Nutrition Research Centre, University College London, Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London WC1N 1EH, London, London, WC1N1EH, UNITED KINGDOM OF GREAT BRITAIN AND NORTHERN IRELAND
| | - Jaz Lyons-Reid
- The University of Auckland Liggins Institute, University of Auckland, 85 Park Road,, Grafton, Auckland, Auckland, Auckland, 1023, NEW ZEALAND
| | - Mya Thway Tint
- Agency for Science , Technology and Research (A*STAR), Singapore Institute for Clinical Sciences, #20-10 Fusionopolis Way,, Connexis, North Tower,, Singapore, 138632, SINGAPORE
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Yamaguchi T, Ogawa E, Ueno A. Short-Time Impedance Spectroscopy Using a Mode-Switching Nonsinusoidal Oscillator: Applicability to Biological Tissues and Continuous Measurement. SENSORS (BASEL, SWITZERLAND) 2021; 21:6951. [PMID: 34770258 PMCID: PMC8587290 DOI: 10.3390/s21216951] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Revised: 10/13/2021] [Accepted: 10/18/2021] [Indexed: 01/04/2023]
Abstract
Herein, we propose an impedance spectroscopy method using a mode-switching nonsinusoidal oscillator and apply this method for measuring the impedance of biological tissues and continuous impedance measurement. To obtain impedance spectra over a wide frequency range, we fabricated a novel nonsinusoidal oscillator incorporating binary counters and analog switches. This oscillator could periodically switch oscillation frequency through the mode switching of the feedback resistor. From the oscillation waveform at each oscillation frequency of this circuit (oscillator), we determined the impedance spectrum of a measured object using the discrete-time Fourier transform. Subsequently, we obtained the broad impedance spectrum of the measured object by merging odd-order harmonic spectral components up to the 19th order for each oscillation frequency. From the measured spectrum, the resistive and capacitive components of the circuit simulating bioimpedance were estimated with high accuracy. Moreover, the proposed method was used to measure the impedance of porcine myocardium; changes in the impedance spectrum of the myocardial tissue due to coagulation could be measured. Furthermore, rapid variations in the resistance value of a CdS photocell could be continuously measured using the proposed method.
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Affiliation(s)
- Tomiharu Yamaguchi
- Department of Electrical and Electronic Engineering, Tokyo Denki University, Tokyo 120-8551, Japan;
| | - Emiyu Ogawa
- School of Allied Health Science, Kitasato University, Kanagawa 252-0373, Japan;
| | - Akinori Ueno
- Department of Electrical and Electronic Engineering, Tokyo Denki University, Tokyo 120-8551, Japan;
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Woodward AJ, Wallen MP, Ryan J, Ward LC, Coombes JS, Macdonald GA. Evaluation of techniques used to assess skeletal muscle quantity in patients with cirrhosis. Clin Nutr ESPEN 2021; 44:287-296. [PMID: 34330481 DOI: 10.1016/j.clnesp.2021.05.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Accepted: 05/26/2021] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Loss of skeletal muscle mass is a well-recognised complication of cirrhosis. Bedside methods to assess skeletal muscle mass including anthropometrics and bioelectrical impedance analysis (BIA) are negatively impacted by fluid overload in advanced cirrhosis and thus there is a need to identify alternatives. There is a paucity of data on the accuracy of commonly used radiological methods such as dual X-ray absorptiometry (DXA) to assess appendicular lean mass (ALM), and computed tomography (CT) skeletal muscle area in patients with cirrhosis. The aim of this study was to evaluate the relationships and agreement of several skeletal muscle mass estimation methods compared to a reference model in patients with cirrhosis. PATIENTS AND METHODS A cross-sectional, single centre study was performed by prospectively recruiting patients with cirrhosis referred to the Queensland Liver Transplant Service. Patients underwent assessment of skeletal muscle mass using bedside techniques (mid-upper arm muscle circumference (MUAMC), bioelectrical impedance spectroscopy (BIS), ultrasound muscle thickness (USMT)) and radiological methods (DXA ALM, CT skeletal muscle area). These were compared to a reference measurement of body cell mass derived from a multi-compartment model using isotope dilution tests and DXA. RESULTS Forty-two patients (age 56 years, interquartile range 48-60, 86% male) were recruited. Bedside skeletal muscle mass estimation techniques were strongly correlated to the body cell mass reference, with BIS estimation having the strongest correlation coefficients (r = 0.78-0.79; P < 0.01). A novel technique measuring USMT offered no advantage over traditional bedside techniques. Of the radiological methods, DXA ALM had the strongest correlation coefficient (r = 0.781; P < 0.01). Weaker correlation coefficients were observed in patients with ascites, except when using the MUAMC. Bland-Altman analysis of BIS body composition estimates demonstrated significant systematic biases and large limits of agreement compared to reference values. CONCLUSION These results confirm the difficulties in assessing skeletal muscle mass in patients with cirrhosis, particularly in those with ascites. DXA ALM and BIS measurements provided the best correlation to body cell mass. We suggest DXA ALM for estimation of skeletal muscle mass in patients with cirrhosis as there are established thresholds for skeletal muscle mass depletion, and an accurate assessment of bone mass and density can also be provided. The use of USMT over other bedside skeletal muscle mass estimates was not supported by our results. Further studies evaluating novel bedside skeletal muscle mass estimation techniques in cirrhosis patients are required.
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Affiliation(s)
- Aidan J Woodward
- School of Medicine, The University of Queensland, Brisbane, Queensland, Australia; Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, Queensland, Australia; Translational Research Institute, Brisbane, Australia.
| | - Matthew P Wallen
- Centre for Research on Exercise, Physical Activity and Health (CRExPAH), School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - John Ryan
- Department of Radiology, Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - Leigh C Ward
- School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Jeff S Coombes
- Centre for Research on Exercise, Physical Activity and Health (CRExPAH), School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Graeme A Macdonald
- School of Medicine, The University of Queensland, Brisbane, Queensland, Australia; Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, Queensland, Australia; Translational Research Institute, Brisbane, Australia
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Ward LC. Attenuated Total Reflection Fourier Transform Infrared (ATR FT-IR) Spectroscopy for the Quantitative Analysis of Deuterium in Plasma: Application to Total Body Water Determination in Humans and Other Animals. APPLIED SPECTROSCOPY 2021; 75:698-705. [PMID: 33635101 DOI: 10.1177/00037028211002532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Conventional methods for measuring the concentration of deuterium in body fluids are by either isotope ratio mass spectrometry or Fourier transform infrared transmission (FT-IR) spectroscopy. The latter method is often preferred as it is less expensive and time consuming; however, having a lower sensitivity means a larger sample volume is required. This study investigated an alternative FT-IR spectroscopic method, attenuated total reflection Fourier transform infrared spectroscopy (ATR FT-IR), which has the potential to provide shorter analysis times while requiring smaller sample volumes. Deuterium was assayed using ATR FT-IR in plasma in the concentration range 0.5 to 2.5 mg mL-1, typical of those observed in tracer dilution measurements of total body water. Minimal sample preparation was required and analysis time was substantially decreased compared to transmission FT-IR. Samples were analyzed with high precision (coefficient of variation (CV) < 0.5%). Precision of assay was maintained when assaying plasma volumes of only 10 µL. The application of the method to the determination of total body water in humans and animals (horses) was demonstrated. A rapid and simple method for the measurement of deuterium in plasma is described that only requires very small sample volumes, rendering the method suitable for use in pediatrics where blood sampling is required to be kept to a minimum.
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Affiliation(s)
- Leigh C Ward
- School of Chemistry and Molecular Biosciences, 1974The University of Queensland, St. Lucia, Australia
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14
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Lyons-Reid J, Derraik JGB, Ward LC, Tint MT, 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. [PMID: 33565254 DOI: 10.1111/cob.12441] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 01/12/2021] [Accepted: 01/13/2021] [Indexed: 01/10/2023]
Abstract
Bioelectrical impedance analysis (BIA) is an easy to use, portable tool, but the accuracy of the technique in infants and young children (<24 months) remains unclear. A systematic literature review was conducted to identify studies that have developed and validated BIA equations in this age group. MEDLINE, Scopus, EMBASE, and CENTRAL were searched for relevant literature published up until June 30, 2020, using terms related to bioelectrical impedance, body composition, and paediatrics. Two reviewers independently screened studies for eligibility, resulting in 15 studies that had developed and/or validated equations. Forty-six equations were developed and 34 validations were conducted. Most equations were developed in young infants (≤6 months), whereas only seven were developed among older infants and children (6-24 months). Most studies were identified as having a high risk of bias, and only a few included predominantly healthy children born at term. Using the best available evidence, BIA appears to predict body composition at least as well as other body composition tools; however, among younger infants BIA may provide little benefit over anthropometry-based prediction equations. Currently, none of the available equations can be recommended for use in research or in clinical practice.
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Affiliation(s)
- Jaz Lyons-Reid
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - José G B Derraik
- Liggins Institute, University of Auckland, Auckland, New Zealand
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
- Endocrinology Department, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
- NCD Centre of Excellence, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Leigh C Ward
- Liggins Institute, University of Auckland, Auckland, New Zealand
- School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Australia
| | - Mya-Thway Tint
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Timothy Kenealy
- Liggins Institute, University of Auckland, Auckland, New Zealand
- Department of Medicine and Department of General Practice and Primary Health Care, University of Auckland, Auckland, New Zealand
| | - Wayne S Cutfield
- Liggins Institute, University of Auckland, Auckland, New Zealand
- Endocrinology Department, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
- A Better Start-National Science Challenge, University of Auckland, Auckland, New Zealand
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15
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Lyons-Reid J, Ward LC, Tint MT, Kenealy T, Godfrey KM, Chan SY, Cutfield WS. The influence of body position on bioelectrical impedance spectroscopy measurements in young children. Sci Rep 2021; 11:10346. [PMID: 33990622 PMCID: PMC8121940 DOI: 10.1038/s41598-021-89568-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 04/16/2021] [Indexed: 12/11/2022] Open
Abstract
Bioelectrical impedance techniques are easy to use and portable tools for assessing body composition. While measurements vary according to standing vs supine position in adults, and fasting and bladder voiding have been proposed as additional important influences, these have not been assessed in young children. Therefore, the influence of position, fasting, and voiding on bioimpedance measurements was examined in children. Bioimpedance measurements (ImpediMed SFB7) were made in 50 children (3.38 years). Measurements were made when supine and twice when standing (immediately on standing and after four minutes). Impedance and body composition were compared between positions, and the effect of fasting and voiding was assessed. Impedance varied between positions, but body composition parameters other than fat mass (total body water, intra- and extra-cellular water, fat-free mass) differed by less than 5%. There were no differences according to time of last meal or void. Equations were developed to allow standing measurements of fat mass to be combined with supine measurements. In early childhood, it can be difficult to meet requirements for fasting, voiding, and lying supine prior to measurement. This study provides evidence to enable standing and supine bioimpedance measurements to be combined in cohorts of young children.
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Affiliation(s)
- Jaz Lyons-Reid
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Leigh C Ward
- Liggins Institute, University of Auckland, Auckland, New Zealand.,School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Australia
| | - Mya-Thway Tint
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore.,Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Timothy Kenealy
- Liggins Institute, University of Auckland, Auckland, New Zealand.,Department of Medicine and Department of General Practice and Primary Health Care, University of Auckland, Auckland, New Zealand
| | - Keith M Godfrey
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.,NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Shiao-Yng Chan
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore.,Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Wayne S Cutfield
- Liggins Institute, University of Auckland, Auckland, New Zealand. .,A Better Start - National Science Challenge, University of Auckland, Auckland, New Zealand.
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Muller TL, Ward LC, Plush KJ, Pluske JR, D'Souza DN, Bryden WL, van Barneveld RJ. Use of bioelectrical impedance spectroscopy to provide a measure of body composition in sows. Animal 2020; 15:100156. [PMID: 33573950 DOI: 10.1016/j.animal.2020.100156] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 11/24/2020] [Accepted: 11/26/2020] [Indexed: 12/31/2022] Open
Abstract
The ability to accurately estimate fat mass and fat-free mass (FFM) has the potential to improve the way in which sow body condition can be managed in a breeding herd. Bioelectrical impedance spectroscopy (BIS) has been evaluated as a practical technique for assessment of body composition in several livestock species, but similar work is lacking in sows. Bioelectrical impedance uses population-specific algorithms that require values for the apparent resistivities of body fluids and body proportion factors. This study comprised three major aims: (i) to derive apparent resistivity coefficients for extracellular water (ECW) and intracellular water (ICW) required for validation of BIS predictions of total body water (TBW) in live sows against standard reference tracer dilution methods; (ii) to develop predictions of TBW to body composition prediction algorithms, namely FFM, by developing a body geometry correction factor (Kb) and (iii) to compare the BIS predictions of FFM against existing impedance predictors and published prediction equations for use in sows, based on physical measurements of back-fat depth and BW (P2-based predictors). Whole body impedance measurements and the determination of TBW by deuterium dilution and ECW by bromide dilution were performed on 40 Large White x Landrace sows. Mean apparent resistivity coefficients of body fluids were 431.1 Ω.cm for ECW and 1827.8 Ω.cm for ICW. Using these coefficients, TBW and ECW were over-estimated by 6.5 and 3.3%, respectively, compared to measured reference values, although these differences were not statistically different (P > 0.05). Mean Kb was 1.09 ± 0.14. Fat-free mass predictions were 194.9 kg, which equates to 60.9% of total sow weight, and 183.0 kg for BIS and the deuterium dilution method, respectively. Mean differences between the predicted and measured FFM values ranged from -8.2 to 32.7%, but were not statistically different (P > 0.05). Method validation (leave-one-out procedure) revealed that mean differences between predicted and measured values were not statistically significant (P > 0.05). Of the impedance-based predictors, equivalence testing revealed that BIS displayed the lowest test bias of 11.9 kg (8.2%), although the P2-based prediction equations exhibited the lowest bias and percentage equivalence, with narrow limits of agreement. Results indicate although differences between mean predicted and measured values were not significantly different, relatively wide limits of agreement suggest BIS as an impractical option for assessing body composition in individual sows compared to the use of existing prediction equations based on BW and back fat.
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Affiliation(s)
- T L Muller
- SunPork Group, Eagleview Place, Eagle Farm, Queensland, Australia; Agricultural Sciences, College of Science, Health, Engineering and Education, Murdoch University, Murdoch, Western Australia, Australia.
| | - L C Ward
- School of Chemistry and Molecular Biosciences, The University of Queensland, St Lucia, Queensland, Australia
| | - K J Plush
- SunPork Group, Eagleview Place, Eagle Farm, Queensland, Australia
| | - J R Pluske
- Agricultural Sciences, College of Science, Health, Engineering and Education, Murdoch University, Murdoch, Western Australia, Australia
| | - D N D'Souza
- SunPork Group, Eagleview Place, Eagle Farm, Queensland, Australia
| | - W L Bryden
- School of Agriculture and Food Sciences, The University of Queensland, Gatton Campus, Gatton, Queensland, Australia
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Utility of published skinfold thickness equations for prediction of body composition in very young New Zealand children. Br J Nutr 2020; 124:349-360. [PMID: 32248845 DOI: 10.1017/s0007114520001221] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Measurement of body composition is increasingly important in research and clinical settings but is difficult in very young children. Bioelectrical impedance analysis (BIA) and air displacement plethysmography (ADP) are well-established but require specialist equipment so are not always feasible. Our aim was to determine if anthropometry and skinfold thickness measurements can be used as a substitute for BIA or ADP for assessing body composition in very young New Zealand children. We used three multi-ethnic cohorts: 217 children at a mean age of 24·2 months with skinfold and BIA measurements; seventy-nine infants at a mean age of 20·9 weeks and seventy-three infants at a mean age of 16·2 weeks, both with skinfold and ADP measurements. We used Bland-Altman plots to compare fat and fat-free mass calculated using all potentially relevant equations with measurements using BIA or ADP. We also calculated the proportion of children in the same tertile for measured fat or fat-free mass and tertiles (i) calculated using each equation, (ii) each absolute skinfold, and (iii) sum of skinfold thicknesses. We found that even for the best equation for each cohort, the 95 % limits of agreement with standard measures were wide (25-200 % of the mean) and the proportion of children whose standard measures fell in the same tertile as the skinfold estimates was ≤69 %. We conclude that none of the available published skinfold thickness equations provides good prediction of body composition in multi-ethnic cohorts of very young New Zealand children with different birth history and growth patterns.
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18
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Lyons-Reid J, Ward LC, Kenealy T, Cutfield W. Bioelectrical Impedance Analysis-An Easy Tool for Quantifying Body Composition in Infancy? Nutrients 2020; 12:E920. [PMID: 32230758 PMCID: PMC7230643 DOI: 10.3390/nu12040920] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 03/20/2020] [Accepted: 03/25/2020] [Indexed: 12/26/2022] Open
Abstract
There has been increasing interest in understanding body composition in early life and factors that may influence its evolution. While several technologies exist to measure body composition in infancy, the equipment is typically large, and thus not readily portable, is expensive, and requires a qualified operator. Bioelectrical impedance analysis shows promise as an inexpensive, portable, and easy to use tool. Despite the technique being widely used to assess body composition for over 35 years, it has been seldom used in infancy. This may be related to the evolving nature of the fat-free mass compartment during this period. Nonetheless, a number of factors have been identified that may influence bioelectrical impedance measurements, which, when controlled for, may result in more accurate measurements. Despite this, questions remain in infants regarding the optimal size and placement of electrodes, the standardization of normal hydration, and the influence of body position on the distribution of water throughout the body. The technology requires further evaluation before being considered as a suitable tool to assess body composition in infancy.
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Affiliation(s)
- Jaz Lyons-Reid
- Liggins Institute, The University of Auckland, Auckland 1023, New Zealand;
| | - Leigh C. Ward
- School of Chemistry and Molecular Biosciences, The University of Queensland, St. Lucia, Brisbane, QLD 4072, Australia;
| | - Timothy Kenealy
- Department of Medicine and Department of General Practice and Primary Health Care, The University of Auckland, Auckland 1023, New Zealand;
| | - Wayne Cutfield
- Liggins Insitute and A Better Start – National Science Challenge, The University of Auckland, Auckland 1023, New Zealand
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Does maternal smoking in pregnancy explain the differences in the body composition trajectory between breastfed and formula-fed infants? Br J Nutr 2020; 123:402-409. [PMID: 31699167 DOI: 10.1017/s0007114519002848] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Growth patterns are known to differ between breastfed and formula-fed infants, but little is known about the relative impact of maternal smoking in pregnancy v. feeding mode on growth trajectory in infancy. We conducted a secondary analysis of a trial, the Tolerance of Infant Goat Milk Formula and Growth Assessment trial involving 290 healthy infants, to examine whether smoking in pregnancy modified the association between feeding mode and body composition of infants. Fat mass (FM) and fat-free mass (FFM) were estimated at 1, 2, 3, 4, 6 and 12 months of age using bioimpedance spectroscopy. Formula-fed infants (n 190) had a higher mean FFM at 4 months (mean difference (MD) 160 g, 95 % CI 50·4, 269·5 g, P < 0·05)) and 6 months (MD 179 g, 95 % CI 41·5, 316·9 g, P < 0·05) compared with the breastfed infants (n 100). Sub-group analysis of breastfed v. formula-fed infants by maternal smoking status in pregnancy showed that there were no differences in the FM and FFM between the breastfed and formula-fed infants whose mothers did not smoke in pregnancy. Formula-fed infants whose mothers smoked in pregnancy were smaller at birth and had a lower FM% and higher FFM% at 1 month compared with infants of non-smoking mothers regardless of feeding mode, but the differences were not significant at other time points. Adequately powered prospective studies with an appropriate design are warranted to better understand the relative impact of maternal smoking, feeding practice and the growth trajectory of infants.
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Nagel E, Hickey M, Teigen L, Kuchnia A, Curran K, Soumekh L, Earthman C, Demerath E, Ramel S. Clinical Application of Body Composition Methods in Premature Infants. JPEN J Parenter Enteral Nutr 2020; 44:785-795. [DOI: 10.1002/jpen.1803] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 01/08/2020] [Accepted: 01/15/2020] [Indexed: 01/25/2023]
Affiliation(s)
- Emily Nagel
- Department of Food Science and NutritionUniversity of Minnesota‐Twin Cities Minneapolis MN USA
| | - Marie Hickey
- Department of PediatricsUniversity of Minnesota‐Twin Cities Minneapolis MN USA
| | - Levi Teigen
- Department of GastroenterologyUniversity of Minnesota‐Twin Cities Minneapolis MN USA
| | - Adam Kuchnia
- Department of Nutritional SciencesUniversity of Wisconsin‐Madison Madison WI USA
| | - Kent Curran
- Department of PediatricsAlbany Medical Center Albany NY USA
| | - Lisa Soumekh
- School of MedicineUniversity of Minnesota‐Twin Cities Minneapolis MN USA
| | | | - Ellen Demerath
- School of Public HealthUniversity of Minnesota‐Twin Cities Minneapolis MN USA
| | - Sara Ramel
- Department of PediatricsUniversity of Minnesota‐Twin Cities Minneapolis MN USA
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Development of a Segmental Bioelectrical Impedance Spectroscopy Device for Body Composition Measurement. SENSORS 2019; 19:s19224825. [PMID: 31698709 PMCID: PMC6891272 DOI: 10.3390/s19224825] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 10/30/2019] [Accepted: 11/01/2019] [Indexed: 12/18/2022]
Abstract
Whole-body bioelectrical impedance analysis for measuring body composition has been well-explored but may not be sensitive enough to changes in the trunk compared to changes in the limbs. Measuring individual body segments can address this issue. A segmental bioelectrical impedance spectroscopy device (SBISD) was designed for body composition measurement and a prototype was implemented. Compensation was performed to adjust the measured values to correct for a phase difference at high frequencies and to counteract the hook effect when measuring the human body. The SBISD was used to measure five subjects and was compared against three existing analyzers. For most segmental measurements, the SBISD was within 10% of the R0 and R∞ values determined with a Bodystat Multiscan 5000 and an Impedimed SFB7. The impedance values from the third reference device, a Seca 514, differed significantly due to its eight-electrode measuring technique, meaning impedance measurements could not be compared directly.
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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. [PMID: 31438871 PMCID: PMC6704501 DOI: 10.1186/s12882-019-1511-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Accepted: 08/02/2019] [Indexed: 11/25/2022] Open
Abstract
Background Oedema, characterized by accumulation of extracellular water (ECW), is one of the major clinical manifestations in children suffering from nephrotic syndrome (NS). The lack of a simple, inexpensive and harmless method for assessing ECW may be solved by the use of the bioelectrical impedance analysis (BIA) technique. The aims of this study were to examine whether phase angle (PA), bioelectrical impedance vector analysis (BIVA) and the impedance ratio (IR) reflect change in disease status in children with NS. Methods Eight children (age range: 2–10 years) with active NS (ANS group) were enrolled. In five of these (ANS* subgroup), impedance was also measured at remission (NSR group). Thirty-eight healthy children (age range: 2–10 years) were included as healthy controls (HC group). Whole-body impedance was measured with a bioimpedance spectroscopy device (Xitron 4200) with surface electrodes placed on the wrist and ankle. Results Values of PA, BIVA and IR were found to be significantly lower (p-value range < 0.001 to < 0.01) in the ANS patients compared to the HC and NSR groups. No significant differences were observed between the NSR and HC groups. Conclusion The studied parameters can be used to assess change in disease status in NS patients. Data were consistent with NS being associated with expansion of ECW. Electronic supplementary material The online version of this article (10.1186/s12882-019-1511-y) contains supplementary material, which is available to authorized users.
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Bioimpedance Resistance Indices and Cell Membrane Capacitance Used to Assess Disease Status and Cell Membrane Integrity in Children with Nephrotic Syndrome. ScientificWorldJournal 2019; 2019:4274856. [PMID: 31210755 PMCID: PMC6532278 DOI: 10.1155/2019/4274856] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Accepted: 04/17/2019] [Indexed: 11/17/2022] Open
Abstract
Background Accumulation of extracellular water (ECW) is a major clinical manifestation of nephrotic syndrome (NS) in children. Bioimpedance spectroscopy (BIS) is a simple, noninvasive technique that reflects body water volumes. BIS can further measure cell membrane capacitance (CM), which may be altered in NS. The aims of the study were to explore how BIS measurements could reflect disease status in NS, while avoiding prediction equations which are often only validated in adult populations. Methods The study involved 8 children (2-10 years) with active NS (ANS group), 5 of which were also studied at NS remission (NSR group), as well as 38 healthy children of similar age (HC group). BIS measurements determined resistances RINF, RE, and RI (reflecting total body water, extracellular water, and intracellular water) and CM. Also resistance indices based on height (H) were considered, RI = H2/R. Results It was found that RE and RINF were significantly lower in the ANS group than in both NSR and HC groups (p < 0.001). Corresponding resistance indices were significantly higher in the ANS group than in the NSR (p < 0.01) and the HC (p < 0.05) groups, in accordance with elevated water volumes in NS patients. Indices of intracellular water were not significantly different between groups. CM was significantly lower in the ANS group than in NSR and HC groups (p < 0.05). Conclusion BIS could distinguish children with active NS from well-treated and healthy children. Studies with more children are warranted.
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McClunan K, Nel DG, Dhansay MA, van Niekerk E. Effect of Nutritional Intake on the Body Composition of HIV-Exposed and HIV-Unexposed Preterm and Low Birth Weight Infants. Breastfeed Med 2019; 14:144-153. [PMID: 30715911 DOI: 10.1089/bfm.2018.0113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Human breast milk (HBM) is considered inadequate in meeting protein requirements, especially for very low birth weight (VLBW) infants, which could affect body composition. OBJECTIVES The primary objective was to determine the effect of HBM on body composition of HIV-exposed and unexposed preterm VLBW and extremely low birth weight infants. The secondary objectives were to ascertain the effect breast milk fortification and days nil per os (NPO) have on body composition. MATERIALS AND METHODS A descriptive cross-sectional study was conducted. Preterm infants with a birth weight of ≤1,200 g were included. Infant nutritional intakes and body composition measurements were recorded during the 28-day follow-up period. RESULTS One hundred ten of 113 preterm infants received HBM and 91 infants received fortified HBM. HIV-exposed and unexposed infants receiving fortified HBM displayed differences in fat mass percentage (FM%) (0.88% versus 1.36%, p = 0.01; 0.97% versus 1.49%, p = 0.03) and fat-free mass percentage (FFM%) (98.98% versus 98.68%, p = 0.03; 99.02% versus 98.49%, p = 0.02) on days 21 and 28, respectively. Infants kept NPO displayed differences in FM% on days 7, 21, and 28 (0.9% versus 1.3%, p = 0.03; 0.99% versus 1.4%, p = 0.02; and 0.9% versus 1.6%, p = 0.0004) as well as differences in FFM% (99.1% versus 98.4%; p = 0.0005) on day 28 of life. CONCLUSION There were no significant differences in the body composition of infants who received HBM versus fortified HBM. However, significant differences in body composition were reported between HIV exposure groups for infants who received fortified HBM. Infants who were kept NPO were generally smaller, shorter, and had lower FM% and more FFM%.
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Affiliation(s)
- Klara McClunan
- 1 Division of Human Nutrition, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Daniel Gerhardus Nel
- 2 Department of Mathematical Sciences, Stellenbosch University, Cape Town, South Africa.,3 Department of Statistics and Actuarial Sciences, Stellenbosch University, Cape Town, South Africa
| | - Muhammad Ali Dhansay
- 4 Burden of Diseases Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Evette van Niekerk
- 1 Division of Human Nutrition, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
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Strydom K, Van Niekerk E, Dhansay MA. Factors affecting body composition in preterm infants: Assessment techniques and nutritional interventions. Pediatr Neonatol 2019; 60:121-128. [PMID: 29239827 DOI: 10.1016/j.pedneo.2017.10.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Revised: 07/26/2017] [Accepted: 10/20/2017] [Indexed: 11/19/2022] Open
Abstract
Limited research has been conducted that elucidates the growth and body composition of preterm infants. It is known that these infants do not necessarily achieve extra-utero growth rates and body composition similar to those of their term counterparts. Preterm infants, who have difficulty in achieving these growth rates, could suffer from growth failure. These infants display an increased intra-abdominal adiposity and abnormal body composition when they achieve catch-up growth. These factors affect the quality of weight gain, as these infants are not only shorter and lighter than term infants, they also have more fat mass (FM) and less fat-free mass (FFM), resulting in a higher total fat percentage. This could cause metabolic syndrome and cardiovascular problems to develop later in a preterm infant's life. The methods used to determine body composition in preterm infants should be simple, quick, non-invasive and inexpensive. Available literature was reviewed and the Dauncey anthropometric model, which includes skinfold thickness at two primary sites and nine body dimensions, is considered in this review the best method to accurately determine body composition in preterm infants, especially in resource-poor countries. It is imperative to accurately assess the quality of growth and body composition of this fragile population in order to determine whether currently prescribed nutritional interventions are beneficial to the overall nutritional status and quality of life-in the short- and long-term-of the preterm infant, and to enable timely implementation of appropriate interventions, if required.
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Affiliation(s)
- K Strydom
- Division of Human Nutrition, Faculty of Medicine and Health Sciences, Stellenbosch University and Tygerberg Academic Hospital, Cape Town, South Africa.
| | - E Van Niekerk
- Division of Human Nutrition, Faculty of Medicine and Health Sciences, Stellenbosch University and Tygerberg Academic Hospital, Cape Town, South Africa
| | - M A Dhansay
- South African Medical Research Council, Burden of Disease Research Unit, Cape Town, South Africa; Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
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Measuring body composition in the preterm infant: Evidence base and practicalities. Clin Nutr 2019; 38:2521-2530. [PMID: 30737045 DOI: 10.1016/j.clnu.2018.12.033] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Revised: 12/08/2018] [Accepted: 12/28/2018] [Indexed: 12/15/2022]
Abstract
Preterm birth and body composition have demonstrable effects on growth and later health outcomes. Preterm infants reach term equivalent age with a lower proportion of lean mass and higher body fat percentage than their term equivalent counterparts. Weight and length do not give an accurate assessment of body composition. Tracking body composition rather than just weight is a fundamental part of improving nutritional outcomes. This is important given the ongoing controversies regarding the nutritional needs of preterm infants, as well as establishing suitable targets for their growth. In this review we describe current methodologies used in the measurement of body composition of the preterm infant and the review the recent published evidence for their accuracy and utility. Current measurement techniques employed include air displacement plethysmography, bioelectrical impedance analysis, isotope dilution techniques, MRI and a combination of manual measurements including skinfold thickness, body mass index and mid upper arm/mid-thigh circumference. These measures allow for the estimation of fat mass, fat-free mass and regional assessment of adiposity. Some methods, such as dual-energy X-ray absorptiometry and air displacement plethysmography do allow for comparison of change in body composition over time in cohorts of preterm infants that may be studied over a longer period of time and into adult life. However, none of the currently described methods give an accurate and practically achievable method of obtaining body composition measures in preterm infants in day to day routine clinical practise, although this remains a key priority when decisions are being made about how best to feed.
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Reid J, Makrides M, McPhee AJ, Stark MJ, Miller J, Collins CT. The Effect of Increasing the Protein Content of Human Milk Fortifier to 1.8 g/100 mL on Growth in Preterm Infants: A Randomised Controlled Trial. Nutrients 2018; 10:nu10050634. [PMID: 29772833 PMCID: PMC5986513 DOI: 10.3390/nu10050634] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 05/11/2018] [Accepted: 05/15/2018] [Indexed: 11/16/2022] Open
Abstract
The aim of this study was to assess the effect of feeding high protein human milk fortifier (HMF) on growth in preterm infants. In this single-centre randomised trial, 60 infants born 28–32 weeks’ gestation were randomised to receive a higher protein HMF providing 1.8 g protein (n = 31) or standard HMF providing 1 g protein per 100 mL expressed breast milk (EBM) (n = 29). The primary outcome was rate of weight gain. Baseline characteristics were similar between groups. There was no difference between high and standard HMF groups for weight gain (mean difference (MD) −14 g/week; 95% CI −32, 4; p = 0.12), length gain (MD −0.01 cm/week; 95% CI −0.06, 0.03; p = 0.45) or head circumference gain (MD 0.007 cm/week; 95% CI −0.05, 0.06; p = 0.79), despite achieving a 0.7 g/kg/day increase in protein intake in the high protein group. Infants in the high protein group had a higher proportion of lean body mass at trial entry; however, there was no group by time effect on lean mass gains over the study. Increasing HMF protein content to 1.8 g per 100 mL EBM does not improve growth in preterm infants born 28–32 weeks’ gestation.
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Affiliation(s)
- Jessica Reid
- Healthy Mothers, Babies and Children, South Australian Health and Medical Research Institute, Adelaide, SA 5006, Australia.
| | - Maria Makrides
- Healthy Mothers, Babies and Children, South Australian Health and Medical Research Institute, Adelaide, SA 5006, Australia.
- Adelaide Medical School, Discipline of Paediatrics, The University of Adelaide, Adelaide, SA 5006, Australia.
| | - Andrew J McPhee
- Healthy Mothers, Babies and Children, South Australian Health and Medical Research Institute, Adelaide, SA 5006, Australia.
- Neonatal Medicine, Women's and Children's Hospital, Adelaide, SA 5006, Australia.
| | - Michael J Stark
- Neonatal Medicine, Women's and Children's Hospital, Adelaide, SA 5006, Australia.
- The Robinson Research Institute, The University of Adelaide, Adelaide, SA 5006, Australia.
| | - Jacqueline Miller
- Healthy Mothers, Babies and Children, South Australian Health and Medical Research Institute, Adelaide, SA 5006, Australia.
- Nutrition and Dietetics, Flinders University, Adelaide, SA 5006, Australia.
| | - Carmel T Collins
- Healthy Mothers, Babies and Children, South Australian Health and Medical Research Institute, Adelaide, SA 5006, Australia.
- Adelaide Medical School, Discipline of Paediatrics, The University of Adelaide, Adelaide, SA 5006, Australia.
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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; 41:460-479. [DOI: 10.1080/03091902.2017.1333165] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Affiliation(s)
- Steven Brantlov
- Department of Procurement & Clinical Engineering, Aarhus University Hospital, Aarhus, Denmark
| | - Lars Jødal
- Department of Nuclear Medicine, Aalborg University Hospital, Aalborg, Denmark
| | - Aksel Lange
- Department of Paediatrics, Aarhus University Hospital, Aarhus, Denmark
| | - Søren Rittig
- Department of Paediatrics, Aarhus University Hospital, Aarhus, Denmark
| | - Leigh C. Ward
- School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Australia
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Determinants of body composition in breastfed infants using bioimpedance spectroscopy and ultrasound skinfolds-methods comparison. Pediatr Res 2017; 81:423-433. [PMID: 27828939 DOI: 10.1038/pr.2016.235] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Accepted: 08/30/2016] [Indexed: 11/08/2022]
Abstract
BACKGROUND Accurate, noninvasive, and inexpensive methods are required to measure infant body composition. Ultrasound (US) and bioimpedance spectroscopy (BIS) have been validated in adults and introduced in pediatric populations. The aim of this study was to evaluate the performance of both methods in determining percentage fat mass (%FM) in breastfed infants. METHODS %FM of 2, 5, 9, and 12 mo-old healthy, breastfed term infants (n = 58) was calculated using BIS-derived total body water equations and skinfold equations then compared with reference models. Skinfolds were measured with US at two and four sites (biceps, suprailiac and/or triceps, and subscapular). RESULTS %FM differed widely within and between methods, with the degree of variation affected by infant age/sex. Not a single method/equation was consistent with the distributions of appropriate reference values for all age/sex groups. Moderate number of matches with references values (13-24 out of 36) was seen for both types of equations. High number of matches (25-36) was seen for US skinfold-based equations. %FM values calculated from US and BIS were not significantly different (P = 0.35). CONCLUSION Both BIS and US are practical for predicting %FM in infants. BIS calculations are highly dependent upon an appropriate set of validated age-matched equations.
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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 2016; 41:22-35. [DOI: 10.1080/03091902.2016.1209590] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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Klein DR, Vale MM, Silva LP, Santos JPA, Branco T, Fernandes MO. Bioimpedance as a Non-Invasive Method to Evaluate Eggs and Poultry. BRAZILIAN JOURNAL OF POULTRY SCIENCE 2016. [DOI: 10.1590/1806-9061-2015-0087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Affiliation(s)
- DR Klein
- Federal University of Santa Maria, Brazil
| | - MM Vale
- Federal University of Paraná, Brazil
| | - LP Silva
- Federal University of Santa Maria, Brazil
| | - JPA Santos
- Federal University of Santa Maria, Brazil
| | - T Branco
- Federal University of Santa Maria, Brazil
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Abstract
The aims of this study were to develop and validate a prediction equation of fat-free mass (FFM) based on bioelectrical impedance analysis (BIA) and anthropometry using air-displacement plethysmography (ADP) as a reference in Asian neonates and to test the applicability of the prediction equations in an independent Western cohort. A total of 173 neonates at birth and 140 at two weeks of age were included. Multiple linear regression analysis was performed to develop the prediction equations in a two-third randomly selected subset and validated on the remaining one-third subset at each time point and in an independent Queensland cohort. FFM measured by ADP was the dependent variable, and anthropometric measures, sex and impedance quotient (L2/R50) were independent variables in the model. Accuracy of prediction equations was assessed using intra-class correlation and Bland-Altman analyses. L2/R50 was the significant predictor of FFM at week two but not at birth. Compared with the model using weight, sex and length, including L2/R50 slightly improved the prediction with a bias of 0·01 kg with 2 sd limits of agreement (LOA) (0·18, -0·20). Prediction explained 88·9 % of variation but not beyond that of anthropometry. Applying these equations to the Queensland cohort provided similar performance at the appropriate age. However, when the Queensland equations were applied to our cohort, the bias increased slightly but with similar LOA. BIA appears to have limited use in predicting FFM in the first few weeks of life compared with simple anthropometry in Asian populations. There is a need for population- and age-appropriate FFM prediction equations.
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Ward LC, White KJ, van der Aa Kuhle K, Cawdell-Smith J, Bryden WL. Body composition assessment in horses using bioimpedance spectroscopy1. J Anim Sci 2016; 94:533-41. [DOI: 10.2527/jas.2015-9837] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
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Buendia R, Seoane F, Lindecrantz K, Bosaeus I, Gil-Pita R, Johannsson G, Ellegård L, Ward LC. Estimation of body fluids with bioimpedance spectroscopy: state of the art methods and proposal of novel methods. Physiol Meas 2015; 36:2171-87. [DOI: 10.1088/0967-3334/36/10/2171] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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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. [DOI: 10.1038/ejcn.2015.86] [Citation(s) in RCA: 95] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Revised: 02/13/2015] [Accepted: 03/16/2015] [Indexed: 01/10/2023]
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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. [PMID: 26034992 DOI: 10.1088/0967-3334/36/7/1529] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Body composition is commonly predicted from bioelectrical impedance spectroscopy using mixture theory algorithms. Mixture theory algorithms require the input of values for the resistivities of intra-and extracellular water of body tissues. Various derivations of these algorithms have been published, individually requiring resistivity values specific for each algorithm. This study determined apparent resistivity values in 85 healthy males and 66 healthy females for each of the four published mixture theory algorithms. The resistivity coefficients determined here are compared to published values and the inter-individual (biological) variation discussed with particular reference to consequential error in prediction of body fluid volumes. In addition, the relationships between the four algorithmic approaches are derived and methods for the inter-conversion of coefficients between algorithms presented.
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Affiliation(s)
- L C Ward
- School Chemistry and Molecular Biosciences, The University of Queensland, Australia
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Fosbøl MØ, Zerahn B. Contemporary methods of body composition measurement. Clin Physiol Funct Imaging 2014; 35:81-97. [DOI: 10.1111/cpf.12152] [Citation(s) in RCA: 107] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2013] [Accepted: 03/18/2014] [Indexed: 12/29/2022]
Affiliation(s)
- Marie Ø. Fosbøl
- Department of Clinical Physiology and Nuclear Medicine; Center of Functional and Diagnostic Imaging and Research; University of Copenhagen; Hvidovre Hospital; Hvidovre Denmark
| | - Bo Zerahn
- Department of Clinical Physiology and Nuclear Medicine; University of Copenhagen; Herlev Hospital; Herlev Denmark
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