Summary Background & aims The use of phase angle (PhA) and raw parameters of bioelectrical impedance analysis (BIA) has gained attention as alternative to conventional error-prone calculation of body ...composition in disease. This review investigates the clinical relevance and applicability of PhA and Bioelectrical Impedance Vector Analysis (BIVA) which uses the plot of resistance and reactance normalized per height. Methods A comprehensive literature search was conducted using Medline identifying studies relevant to this review until March 2011. We included studies on the use of PhA or BIVA derived from tetrapolar BIA in out- and in-patient settings or institutionalized elderly. Results Numerous studies have proven the prognostic impact of PhA regarding mortality or postoperative complications in different clinical settings. BIVA has been shown to provide information about hydration and body cell mass and therefore allows assessment of patients in whom calculation of body composition fails due to altered hydration. Reference values exist for PhA and BIVA facilitating interpretation of data. Conclusion PhA, a superior prognostic marker, should be considered as a screening tool for the identification of risk patients with impaired nutritional and functional status, BIVA is recommended for further nutritional assessment and monitoring, in particular when calculation of body composition is not feasible.
Ocean warming will continue to affect the growth, body condition and geographic distributions of marine fishes and understanding these effects is an urgent challenge for fisheries research and ...management. Determining how temperature is recorded in fish otolith carbonate, provides an additional chronological tool to investigate thermal histories, preferences and patterns of movement throughout an individual's life history. The influence of three water temperature treatments (22°C, 25°C, and 28°C) on hatchery-reared juvenile stout whiting, Sillago robusta, was tested using a controlled outdoor mesocosm system. Fish were measured for change in length and weight, and body condition was determined using bioelectrical impedance analysis. Sagittal otoliths were analysed for stable oxygen (δ18Ootolith) and carbon (δ13Cotolith) isotopes via isotope ratio mass spectrometry. Whiting kept at 22°C were significantly smaller and had diminished body condition compared to fish in 25°C and 28°C, which did not significantly differ from each other. The δ18O otolith values of stout whiting demonstrated a negative temperature-dependent fractionation relationship which was similar in slope but had a different intercept to the relationships reported for inorganic aragonite and other marine fish species. The δ13C otolith values also showed a negative relationship with water temperature, and the calculated proportion of metabolic carbon M in otoliths differed between fish reared in the coolest (22°C) and warmest (28°C) temperature treatments. Overall, the results suggest that stout whiting may have reached an upper growth threshold between 25°C and 28°C, and that growth and body condition may be optimised during warmer seasons and toward the northerly regions of their distribution. Otolith oxygen thermometry shows promise as a natural tracer of thermal life history, and species-specific fractionation equations should be utilised when possible to prevent errors in temperature reconstructions of wild-caught fish.
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•The impact of ocean warming on juvenile stout whiting (Sillago robusta) was tested using an outdoor mesocosm experiment•Fish in warmer water temperatures grew larger and developed improved body condition•Otolith oxygen isotope ratios demonstrated a negative relationship with water temperature•Species-specific otolith oxygen isotope relationships should be applied to temperature reconstructions when possible•Stout whiting may be a climate ‘winner’ along the east coast of Australia
BIA is easy, non-invasive, relatively inexpensive and can be performed in almost any subject because it is portable. Part II of these ESPEN guidelines reports results for fat-free mass (FFM), body ...fat (BF), body cell mass (BCM), total body water (TBW), extracellular water (ECW) and intracellular water (ICW) from various studies in healthy and ill subjects. The data suggests that BIA works well in healthy subjects and in patients with stable water and electrolytes balance with a validated BIA equation that is appropriate with regard to age, sex and race. Clinical use of BIA in subjects at extremes of BMI ranges or with abnormal hydration cannot be recommended for routine assessment of patients until further validation has proven for BIA algorithm to be accurate in such conditions. Multi-frequency- and segmental-BIA may have advantages over single-frequency BIA in these conditions, but further validation is necessary. Longitudinal follow-up of body composition by BIA is possible in subjects with BMI 16–34kg/m2 without abnormal hydration, but must be interpreted with caution. Further validation of BIA is necessary to understand the mechanisms for the changes observed in acute illness, altered fat/lean mass ratios, extreme heights and body shape abnormalities.
The use of bioelectrical impedance analysis (BIA) is widespread both in healthy subjects and patients, but suffers from a lack of standardized method and quality control procedures. BIA allows the ...determination of the fat-free mass (FFM) and total body water (TBW) in subjects without significant fluid and electrolyte abnormalities, when using appropriate population, age or pathology-specific BIA equations and established procedures. Published BIA equations validated against a reference method in a sufficiently large number of subjects are presented and ranked according to the standard error of the estimate.
The determination of changes in body cell mass (BCM), extra cellular (ECW) and intra cellular water (ICW) requires further research using a valid model that guarantees that ECW changes do not corrupt the ICW. The use of segmental-BIA, multifrequency BIA, or bioelectrical spectroscopy in altered hydration states also requires further research.
ESPEN guidelines for the clinical use of BIA measurements are described in a paper to appear soon in Clinical Nutrition.
Although the need to assess hydration is well recognized, laboratory tests and clinical impressions are impractical and lack sensitivity, respectively, to be clinically meaningful. Different ...approaches use bioelectrical impedance measurements to overcome some of these limitations and aid in the classification of hydration status. One indirect approach utilizes single or multiple frequency bioimpedance in regression equations and theoretical models, respectively, with anthropometric measurements to predict fluid volumes (bioelectrical impedance spectroscopy-BIS) and estimate fluid overload based on the deviation of calculated to reference extracellular fluid volume. Alternatively, bioimpedance vector analysis (BIVA) uses direct phase-sensitive measurements of resistance and reactance, measured at 50 kHz, normalized for standing height, then plotted on a bivariate graph, resulting in a vector with length related to fluid content, and direction with phase angle that indexes hydration status. Comparison with healthy population norms enables BIVA to classify (normal, under-, and over-) and rank (change relative to pre-treatment) hydration independent of body weight. Each approach has wide-ranging uses in evaluation and management of clinical groups with over-hydration with an evolving emphasis on prognosis. This review discusses the advantages and limitations of BIS and BIVA for hydration assessment with comments on future applications.
Body mass, body mass index (BMI), and body composition components are essential for health and longevity. Considering the influence of demographic factors on body composition, there is a need for ...tailored reference values based on age-, sex-, and geography. We aimed to construct a comprehensive reference material on body composition in healthy Norwegian adults.
In this cross-sectional study, we estimated age- and sex-specific reference values for body-, fat-, and muscle mass variables using multi-frequency bioelectrial impedance analysis (such as body fat percentage, skeletal muscle mass and visceral fat area) in 22,191 healthy adults aged 20–99 years participating in the Trøndelag Health Study 4 (HUNT4). We calculated the fat mass and skeletal muscle mass index as the total fat and muscle mass relative to height squared and used general linear models to explore the associations between physical activity (PA), BMI, and age.
With a BMI (kg/m2) of 25.4 (SD 5.1) and 26.0 (4.5) for women and men, respectively, the youngest age group (20–39 yrs) had a lower BMI compared to their counterparts aged 40–59 years (26.3 4.5 and 27.5 3.8) and ≥ 60 years (25.7 4.1 and 26.5 3.4), respectively. Those aged 20–39 years also had the lowest values for the different body fat variables measured. Fat mass index (kg/m2) was 8.41 (4.00) and 5.81 (3.29) for women and men aged 20–39 years, respectively, compared to 9.25 (3.21) and 6.86 (2.46) for those aged ≥60 years. The oldest age group had the lowest values for the various muscle mass variables; women and men aged 60+ years had a skeletal muscle mass index (kg/m2) of 8.91 (0.85) and 10.96 (1.00), respectively. Corresponding values for those aged 20–39 years were 9.33 (0.97) and 11.49 (1.15). For all age groups and both sexes, regular physical activity was associated with lower levels of fat mass, whereas the association between muscle mass and PAwas less conclusive. When using body fat percentage as an obesity measure, we observed a much higher obesity prevalence (41.2%) in the study population compared to BMI (17.3%).
Our study offers a comprehensive reference for body composition among healthy adults in Norway, aiding the identification of abnormal fat and muscle mass values across age groups. We also highlight that BMI often misclassifies individuals with adiposity levels in the overweight or obese category as lean. Therefore, incorporating body composition when defining obesity could enable early intervention to prevent cardiometabolic diseases.
An adequate nutritional status in patients with cystic fibrosis correlates with higher survival and better pulmonary function. Body mass index (BMI) is an anthropometric indicator with independent ...association with pulmonary function, and it can hide alterations of nutritional status in cystic fibrosis.
To determine the relationship of lung function with BMI and body composition parameters in children with cystic fibrosis in a Hight Complexity institution between 2015 and 2018.
It was an observational study with analytical, cross-sectional, and retrospective scope, including 33 patients between 5 and 17 years old. Spearman's test was applied to evaluate correlation of FEV1 (forced expiratory volume in first second) with BMI and five body composition parameters by bioelectrical impedance using InbodyS10 equipment. Statistical significance was considered with p < 0.05.
Positive correlation was obtained between FEV1 and appendicular skeletal muscle mass between lung function and percentage of fat-free mass (p = 0.006) and phase angle (p = 0.001). Percent fat mass had a negative correlation with FEV1 (p = 0.007). BMI and fat free mass index did not correlate with lung function (p = 0.085).
Appendicular skeletal muscle mass correlated better than BMI with lung function in children with cystic fibrosis. It is recommended to perform anthropometric follow-up by BMI complemented with body composition study in children with cystic fibrosis. Analyses with larger populations are required to standardize its use.
Bioelectrical impedance analysis (BIA) is widely considered a body composition technique suitable for routine application. However, its utility in sick or malnourished children is complicated by ...variability in hydration. A BIA variant termed vector analysis (BIVA) aims to resolve this, by differentiating hydration from cell mass. However, the model was only partially supported by children's data. To improve accuracy, further adjustment for body shape variability has been proposed, known as specific BIVA (BIVAspecific).
We re-analysed body composition data from 281 children and adolescents (46% male) aged 4–20 years of European ancestry. Measurements included anthropometry, conventional BIA, BIVA outcomes adjusted either for height (BIVAconventional), or for height and body cross-sectional area (BIVAspecific), and fat-free mass (FFM) and fat mass (FM) by the criterion 4-component model. Graphic analysis and regression analysis were used to evaluate different BIA models for predicting FFM and FM.
Age was strongly correlated with BIVAconventional parameters, but weakly with BIVAspecific parameters. FFM correlated more strongly with BIVAconventional than with BIVAspecific parameters, whereas the opposite pattern was found for FM. In multiple regression analyses, the best prediction models combined conventional BIA with BIVAspecific parameters, explaining 97.0% and 89.8% of the variance in FFM and FM respectively. These models could be further improved by incorporating body weight.
The prediction of body composition can be improved by combining two different theoretical models, each of which appears to provide different information about the two components FFM and FM. Further work should test the utility of this approach in pediatric patients.
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