BIA body shape analysis -
Total body water TBW is estimated, and this estimation is used to calculate fat-free mass. Fat mass is then calculated as the difference between fat-free mass and body mass. Several methods have been used to assess body composition in humans, each with advantages and drawbacks surrounding cost, validity, reliability , and accessibility.
It is unclear how many frequencies would be needed for a BIA device to be considered a BIS device, however, the principles behind how the devices work are the same. Therefore, for this review, BIA will be used to denote all bioelectrical impedance assessments.
Hand-held BIA Different types of BIA analysers are available, such as hand-held and leg-to-leg devices. Hand-held BIA machines assess the conductance of a small alternating current through the upper body and use built-in software to calculate body composition after it has been calibrated with the following variables: weight, height, age, and gender [6].
This method may be of benefit in a field setting, due to its convenience. Leg-to-Leg BIA Similar to hand-held methods, leg-to-leg BIA involves an individual standing on scales with four electrodes situated at each footplate, with a low-level current passed through the lower body.
The path of the electrical current may differ between this method and the hand-held method, and could potentially influence body composition results; though this issue is discussed later in the article. Hand-to-Foot BIA Hand-to-foot BIA uses electrodes in a mounted footplate, as well as electrodes in hand grips, to determine whole-body measurements.
As hand-held and leg-to-leg methods may not account for the resistance of the lower- or upper body, respectively, it is logical to assume that hand-to-foot measurements may better reflect whole-body composition than the alternatives.
Estimates of body composition using BIA are facilitated using empirically validated equations, which consider variables including gender, race, height, weight, and age.
Consequently, it is important the correct equation is used for the population measured to ensure that any results are valid. It is also important to understand the reference assessment method used to validate these equations.
For example, many BIA equations are validated against assessment methods such as hydrostatic weighing and Dual-energy X-ray Absorptiometry DEXA. From the results of this assessment method, the manufacturer constructs an equation using the individual variables mentioned previously to determine what the body fat would be.
These equations will have an error rate when compared to the hydrostatic weighing method, and thus, this error is multiplied by the original error of the reference method to provide a body composition assessment that may be somewhat distant from the actual values reported using a four-compartment model.
The validity the agreement between the true value and a measurement value of body composition is key to determining the precision of BIA measurement, and its suitability for clinical use. The criterion method for determining body composition is the four-compartment model 1] fat mass, 2] total body water, 3] bone mineral mass, and 4] residual mass , and should be used when assessing the validity of BIA measurements.
BIA has been compared to the four-compartment model in several studies using various populations. Sun et al. It is important to note that this analysis utilised DEXA as the reference method, which may also lead to further error, as eluded to earlier in this review read my article on the use of DEXA scanning for body composition assessment HERE.
The validity of BIA for one-off measures of body composition Despite studies showing promising effects of BIA on body composition , this has not been found in a large body of research. BIA has been shown to underestimate fat mass and overestimate fat-free mass by 1.
This finding is supported by other research on bodybuilders, showing that BIA underestimated fat mass, and overestimated fat-free mass when compared to the four-compartment model [10].
Research conducted by Jebb et al. The authors subsequently developed a novel prediction equation to estimate fat mass from the same Tanita bioimpedance analyser, with the four-compartment method as a reference. However, later research found that this equation also failed to outperform the Tanita manufacturer equation, and resulted in wide limits of agreement [12].
Potentially of greater concern to practitioners considering the use of BIA to determine body composition in the applied setting, are the individual error rates of BIA, rather than data on group means. The study mentioned previously on obese subjects [9] reported that in 12 of the 50 participants, BIA underestimated fat mass by 5 kg or more.
This is supported by the findings of Van Marken Lichtenbelt et al. This suggests that BIA may provide data that is not sufficiently accurate for the determination of individual body composition.
The validity of using BIA to measure changes over time A further consideration for the use of BIA is the validity of its use in measuring changes in fat mass and fat-free mass over time, as this may indicate the efficacy of a nutritional or training intervention looking to manipulate body composition.
To revisit the study by Ritz et al. Fat mass was underestimated by 1. Individual error rates were greater than at baseline, with BIA underestimating fat mass by 7. A further study on obese populations [13] showed individual disagreement in body fat measurement between BIA and the four-compartment model was high.
Individual measures of body fat ranged from There are a limited amount of comparisons between BIA and the reference four-compartment model in athletic populations. There is disagreement amongst the limited research available, with only one study suggesting that BIA is suitable for assessing body composition in athletes [15], whereas other research suggests that body fat estimates are much higher in athletes when using the BIA method [16].
The discrepancies between the studies may be due to various issues including differences in methodology, equations, and athletic population. There are currently no BIA equations for athletes that have been derived from the criterion four-compartment method fat mass, total body water, bone mineral mass, residual mass.
This makes the application of BIA in this population difficult, as athletes are likely to possess substantially different quantities of fat and fat-free mass when compared to the general population or diseased populations that current equations are based on.
The reliability of BIA The reliability of BIA the reproducibility of the observed value when the measurement is repeated is also important to determine single-measurement precision, as well as the ability to track changes over time.
A plethora of research has indicated the importance — and potentially the inability — of standardising BIA measures to sufficiently account for various confounders. The mean coefficient of variation for within-day, intra-individual measurements, has ranged from 0.
Standard measurement conditions may vary depending on the machine type e. hand-to-hand, leg-to-leg, supine vs. standing, etc. Other factors which may impact the BIA measurement and should therefore also be standardised are [16]:. The standardisation of hydration status is clearly of importance for BIA, as the method is reliant on estimations of total body water to ascertain fat-free mass.
For female athletes, difference in hydration status during menses may significantly alter impedance [17] and should be a consideration when assessing female athletes with BIA.
Saunders et al. hyperhydrated or hypohydrated , indicating that even small changes in fluid balance that occur with endurance training may be interpreted as a change in body fat content.
In addition, eating and strenuous exercise hours prior to assessment have also previously been shown to decrease impedance; ultimately affecting the accuracy of the measurement [19]. The need to standardise eating, exercise, and both acute and chronic hydration changes are clearly important to provide valid body composition estimations.
As mentioned previously, there are several issues with BIA measurement that may limit its use in an applied setting. Methodological limitations of BIA may affect the ability of the method to accurately determine body composition. The primary issues with BIA are:.
Sensor Placement One such limitation is the placement of the sensors, and their ability to give readings of total body composition. As electrical current follows the path of least resistance, some scales may send current through the lower body only, missing the upper body entirely.
Similarly, hand-held instruments may only assess the body composition of the upper extremities. As females typically have a higher proportion of adipose tissue in the gluteal-femoral region [20], it is possible that this would not be represented using hand-held BIA devices.
Hand-to-foot BIA devices, however, may allow for greater accuracy, as the current is sent from the upper body to the lower body, and is less likely to be influenced by the distribution of body fat. Hydration and Glycogen Levels Regardless, all devices are still subject to the same limitations that other BIA devices are.
Deurenberg et al. They speculated that changes in glycogen stores, and the loss of water bound to glycogen molecules, may affect BIA estimates of fat-free mass.
In athletic populations, where varying glycogen stores are likely throughout a training week, it is likely that this will lead to some variation in the detection of change in fat-free mass in athletes as glycogen is likely to be affected by both diet, as well as the intensity, duration, and modality of previous training sessions — even with protocol standardisation.
In order for an electric current to flow through your body, your body must have two or more contact points. It is therefore understandable that the contact points of a Hand-held BIA are your hands, and your body composition is calculated by measuring the resistance of the current through your upper body.
The same is true for the other two methods. Of these three methods, the hand-foot BIA is the most accurate one, measuring your limbs and torso separately, as body fat scales with this BIA technology are the most expensive. Leg-to-Leg BIA is the most common body fat scale technology on the market today.
When you stand with your feet on the body fat scale, your feet act as contact points , allowing tiny electrical currents to flow through your lower body, creating a current loop.
The data from your lower body is used as the basis to calculate your body composition after it has been calibrated with the following variables: weight, height, age, and gender. Some studies have shown that bioelectrical impedance analysis is a fairly accurate way to estimate body fat.
That's why it has become the measurement technique used in most body fat scales. Of course, the accuracy of the measurement does not depend entirely on the technique itself, but also on many other factors:. But despite the imperfections, body fat scales can still help you track the trends of your body data over a period of time in a simple, convenient way.
This is a very worthwhile investment for people who are on a weight loss programme or want to keep an eye on their health status, as most body fat scales are relatively inexpensive. Many of the body fat scales on the market today are quite feature-rich and come with apps that can interact with your phone.
Some body fat scales can even monitor your heart rate in addition to measuring body composition. This new large screen body fat scale from the lepulse brand is one that has a good overall rating.
Powered with cutting-edge bioimpedance analysis, it can deliver 15 compositions of your body. Conductivity is higher through fat free mass which includes muscle, bone and water than through fat mass which contains very little water.
Different body components have varying levels of impedance in response to different frequencies of the electrical current. Output is commonly provided in the form of an impedance value expressed in the unit Ohms, Ω; approximate range between Ω - Ω.
Interpretation of the impedance value varies by BIA instrument type. For single frequency BIA, the impedance value is interpreted as resistance R. For multi-frequency BIA and bioelectrical impedance spectroscopy, two values are provided, one for resistance R , and one for reactance Xc.
The impedance value is related to the volume of a conductor the overall body size and the square of the length of the conductor a distance which is a function of the height of the participant. BIA is used to assess the dimensions shown in Table 1, depending upon the type of instrumentation used.
The types of BIA instrument are described in more detail in the section below. Table 1 Anthropometric dimensions which can be assessed according to BIA instrument type. Bioelectrical impedance analysis BIA instruments use contact electrodes that send the electrical signal through the body.
These electrodes are either patch types similar to ECG electrodes or stainless steel plates. BIA instruments can be broadly classified into three types: single-frequency BIA SF-BIA ; multi-frequency BIA MF-BIA ; bioelectrical impedance spectroscopy BIS.
Some BIA systems are incorporated into digital electronic scales, simultaneously measuring impedance and body weight with a force sensor. SF-BIA frequency of 50 kHz also known as tetrapolar impedance is the most commonly used BIA instrument, based on 4 contact electrodes 2 injecting and 2 sensing electrodes.
The impedance is then used together with other anthropometric data, age and gender to predict body composition variables using empirical linear regression equations. SF-BIA is unable to distinguish the distribution of total body water into its intracellular and extracellular components.
MF-BIA frequencies up to kHz allows differentiation of intracellular and extracellular components of total body water. It relies on the principle that the body's impedance is dependent on the frequency of the alternating current applied. Total body water is distributed between the intracellular and extracellular components, separated by cell membranes.
Cell membranes act as capacitors that insulate the intracellular water ICW at low frequencies so that predominantly extracellular water ECW is measured. At higher frequencies, the membranes are permeable to the current, so that ICW and ECW are both determined.
MF-BIA like SF-BIA also uses regression models to evaluate FFM, TBW, ICW and ECW. ViScan is a tetrapolar impedance method. The abdominal body composition values total abdominal adiposity and visceral fat are derived from extrapolation of impedance measures at 6. It consists of a wireless measurement belt and an infrared beam projected over the waist at the umbilical sagittal plane.
It detects the waist circumference using two infrared sensors on either side of the base unit. BIS uses a series of frequencies and it is based on the Cole—Cole plot and Hanai models which characterise the measurement segment with parallel circuits for ECW and ICW, and accounts for a capacitive effect introduced by the non-conducting membrane that separates the ICW and ECW.
BIS firstly determines the electrical resistance of ECW and ICW, and then calculates the volumes of these respective components. By differentiating between extracellular water and intracellular water spaces, BIS can provide an estimate of body cell mass.
The multi-segmental approach which is based on 8 contact electrodes 2 on each hand and foot assumes that the body is made up of a group of cylinders left and right arms, the left and right legs, and the total body are measured and provides body composition values for the trunk and limbs as well as the whole body.
Multi-segmental BIA SEG-BIA is available in both single-frequency and multi-frequency body composition monitors. Figure 1 Electrodes placement on hand and foot. Source: MRC Epidemiology Unit. Figure 3 BIA using the hand to foot 8-electrode body composition monitor.
Figure 4 Estimating abdominal fat using ViScan. A selection of published BIA equations for predicting FFM, FM, TBW, and ECW, which include description of BIA instruments, the criterion used to validate the equations and standard error of the estimates was published by Kyle et al.
When deriving fat mass from those equations, the absolute error of estimates at individual level will vary, but the ranking of individuals i. relative validity will be relatively stable regardless of the equation used.
If, in the analysis, the investigators are only interested in determining ranking of body composition traits rather than absolute values, an alternative approach, which avoids the need for population specific validation equations can be used, as described by Vanltalie et al , Tyrrell et al.
This method involves correcting lean and fat masses kg for height cm by deriving the following indices. Total body water then requires adjustment for the hydration of lean tissue H LT to calculate lean mass.
The adjustment for H LT assumes a constant level of hydration between individuals. Based on this theoretical approach, individuals of the same sex can be ranked according to this simple BIA index.
Considerations relating to the use of BIA in specific populations are described in Table 3. Estimates of body composition values are dependent on the validity of the BIA equation used for the population. Refer to section: Practical considerations for objective anthropometry.
About About the DAPA Measurement Toolkit What's New Other resources Toolkit Team Contact. Introduction Validity Reliability Error and bias Feasibility Data processing Statistical assessment of reliability and validity Harmonisation.
Introduction Subjective methods Objective methods Harmonisation Videos Dietary assessment decision matrix. Introduction Subjective methods Objective methods Harmonisation Videos Physical activity assessment decision matrix.
Introduction Subjective methods Objective methods Anthropometric indices Harmonisation Videos Anthropometry decision matrix. Anthropometry Domain. Bioelectric impedance analysis.
What is assessed? How is the measurement conducted? When is this method used? How are estimates of body composition derived? Populations Further considerations Resources required Instrument library References. Impedance comprises both resistance and reactance: The resistance R reflects the opposition of the tissue to the flow of electrons.
It is related to the amount of water present in tissues. The reactance Xc by contrast reflects the capacitive losses caused by cell membranes. Single-frequency BIA SF-BIA SF-BIA frequency of 50 kHz also known as tetrapolar impedance is the most commonly used BIA instrument, based on 4 contact electrodes 2 injecting and 2 sensing electrodes.
Multi-frequency BIA MF-BIA MF-BIA frequencies up to kHz allows differentiation of intracellular and extracellular components of total body water.
Bioelectrical impedance spectroscopy BIS BIS uses a series of frequencies and it is based on the Cole—Cole plot and Hanai models which characterise the measurement segment with parallel circuits for ECW and ICW, and accounts for a capacitive effect introduced by the non-conducting membrane that separates the ICW and ECW.
Multi-segmental approach The multi-segmental approach which is based on 8 contact electrodes 2 on each hand and foot assumes that the body is made up of a group of cylinders left and right arms, the left and right legs, and the total body are measured and provides body composition values for the trunk and limbs as well as the whole body.
Manufacturers guidelines provide calibration values cut offs. BIA can be performed standing or supine, via hand to foot or arm-leg or foot to foot or leg-leg impedance depending on device.
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Impedance is frequency sensitive; at low frequency the electric current flows preferentially through extracellular water ECW only while at high frequency the current can cross cell membranes and hence flows through total body water TBW. In bioimpedance spectroscopy devices BIS resistance at zero and infinite frequency can be estimated and, at least theoretically, should provide the optimal predictors of ECW and TBW and hence body fat-free mass respectively.
In practice, the improvement in accuracy is marginal. The use of multiple frequencies or BIS in specific BIA devices has been shown to have high correlation with DXA when measuring body fat percentage.
The electrical properties of tissues have been described since These properties were further described for a wider range of frequencies on a larger range of tissues, including those that were damaged or undergoing change after death.
InThomasset conducted the original studies using electrical impedance measurements as an index of total body water TBWusing two subcutaneously inserted needles. InHoffer concluded that a whole-body impedance measurement could predict total body water. The equation the squared value of height divided by impedance measurements of the right half of the body showed a correlation coefficient of 0.
This equation, Hoffer proved, is known as the impedance index used in BIA. InNyober validated the use of whole body electrical impedance to assess body composition.
By the s the foundations of BIA were established, including those that underpinned the relationships between the impedance and the body water content of the body.
A variety of single-frequency BIA analyzers then became commercially available, such as RJL Systems and its first commercialized impedance meter.
In the s, Lukaski, Segal, and other researchers discovered that the use of a single frequency 50 kHz in BIA assumed the human body to be a single cylinder, which created many technical limitations in BIA. The use of a single frequency was inaccurate for populations that did not have the standard body type.
To improve the accuracy of BIA, researchers created empirical equations using empirical data gender, age, ethnicity to predict a user's body composition. InLukaski published empirical equations using the impedance index, body weight, and reactance. InKushner and Scholler published empirical equations using the impedance index, body weight, and gender.
However, empirical equations were only useful in predicting the average population's body composition and was inaccurate for medical purposes for populations with diseases.
The use of multiple frequencies would also distinguish intracellular and extracellular water. By the s, the market included several multi-frequency analyzers and a couple of BIS devices.
The use of BIA as a bedside method has increased because the equipment is portable and safe, the procedure is simple and noninvasive, and the results are reproducible and rapidly obtained. More recently, segmental BIA has been developed to overcome inconsistencies between resistance R and the body mass of the trunk.
Inan eight-polar stand-on BIA device, InBodythat did not utilize empirical equations was created and was found to "offer accurate estimates of TBW and ECW in women without the need of population-specific formulas.
InAURA Devices brought the fitness tracker AURA Band with built-in BIA. In BIA became available for Apple Watch users with the accessory AURA Strap with built-in sensors. The impedance of cellular tissue can be modeled as a resistor representing the extracellular path in parallel with a resistor and capacitor in series representing the intracellular path, the resistance that of intracellular fluid and the capacitor the cell membrane.
This results in a change in impedance versus the frequency used in the measurement. Whole body impedance measurement is generally measured from the wrist to the ipsilateral ankle and uses either two rarely or four overwhelmingly electrodes. In the 2-electrode bipolar configuration a small current on the order of μA is passed between two electrodes, and the voltage is measured between the same whereas in the tetrapolar arrangement resistance is measured between as separate pair of proximally located electrodes.
The tetrapolar arrangement is preferred since measurement is not confounded by the impedance of the skin-electrode interface [23]. In bioelectrical impedance analysis in humans, an estimate of the phase angle can be obtained and is based on changes in resistance and reactance as alternating current passes through tissues, which causes a phase shift.
A phase angle therefore exists for all frequencies of measurement although conventionally in BIA it is phase angle at a measurement frequency of 50 kHz that is considered. The measured phase angle therefore depends on several biological factors. Phase angle is greater in men than women, and decreases with increasing age.
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Download as PDF Printable version. Method for estimating body composition. Clinical Nutrition. doi : PMID S2CID Journal of Investigative Medicine. PMC Retrieved 14 February Retrieved 11 January Journal of Applied Physiology.
The American Journal of Clinical Nutrition. percentage of body fat varied by 8. Nutrition Journal. Nutrition in Clinical Practice. In general, bioelectrical impedance technology may be acceptable for determining body composition of groups and for monitoring changes in body composition within individuals over time.
Use of the technology to make single measurements in individual patients, however, is not recommended. Clinical Physiology and Functional Imaging. ISSN X. Int J Exerc Sci. Obesity Facts. One of the eight authors of this study is employed by body composition monitor manufacturer Omron, who financed the study.
October Journal of Exercise Physiology Online. ISSN Impedance measurement in clinical medicine. Significance of curves obtained]. Lyon Medical in French.
Nontraumatic electrical detection of total body water and density in man. Proceeding of the 6th International Conference of Electrical Bioimpedance. Journal of the American College of Nutrition. European Journal of Clinical Nutrition. American Journal of Clinical Nutrition. Retrieved 3 April Tsao C, Lin K, Lai J, Lan C September Journal of the Physical Therapy Association of the Republic of China.
Máttar JA November Brazilian Group for Bioimpedance Study".
: BIA body shape analysis| Bioelectrical Impedance Analysis (BIA) | Boey more cars get onto the freeway, the longer it takes for BIA body shape analysis to Herbal alternative therapies through bldy path, creating resistance. The Premier line of our Sgape body composition analyzers for analysusfitness BIA body shape analysis, and wellness applications. Lescale F4 Pro Large Display Smart Body Fat Scale. InBody devices are used by leading professionals around the world to give their clients results they can trust and track. Essential cookies. For the general differential diagnosis of underweight we present a female patient with anorexia: female, Bioelectrical impedance analysis BIA is a method used to measure the components of the bodyincluding muscle mass, body fat, and total body water. |
| Bioelectrical impedance analysis | We use BIA body shape analysis to offer useful features and BIA body shape analysis performance to improve your experience. Set analysls the GDPR Cookie Consent plugin, this cookie is used Nitric oxide and antioxidant properties store the shale consent for cookies in anaysis category "Performance". How BIA Works BIA simply involves two electrodes being placed on your right hand and your right foot. Table 4 Oedema due to right heart failure Full size table. The fact that the calculated BCM is within the range of normal values here may be explained as follows: It needs to be considered that BCM is dependent on the patient's fluid status TBW. See Our Editorial Process. Interpretation: With a BMI of |
| Bioelectrical Impedance Analysis (BIA) | Soeters shaep E. Cardiovascular health Our Analywis. You may have seen body fat scales on store BIA body shape analysis or online that use bioelectrical impedance analysis. relative validity will be relatively stable regardless of the equation used. By clicking on "Download E-Book "I agree to the Terms and Conditions. |
| InBody Canada - Award winning BIA body composition analyzers | BIA uses these differences in resistance to the flow of electrical current through the body to estimate body composition [2]. Tinsley, G. Article PubMed Google Scholar Creutzberg EC, Wouters EF, Mostert R, Weling-Scheepers CA, Schols AM: Efficacy of nutritional supplementation therapy in depleted patients with chronic obstructive pulmonary disease. Williford, S. BIA is a method for estimating body composition. |
BIA body shape analysis -
Normal finding as illustrated in the BIVA nomogram. The position of the measurement point in the BIVA nomogram within the 50 th tolerance ellipse range of normal values indicates a normal finding. Conclusion: All values in the table are within the normal range and the measurement point in the BIVA nomogram lies within the 50 th tolerance ellipse.
The measurement point in the BIVA nomogram Figure 3 in this patient is well below the line of normal BCM values long axis and above the line of normal TBW values short axis between the 75 th and the 95 th tolerance ellipse.
The position of the measurement point in the lower right quadrant points to malnutrition. Malnutrition in an obese COPD patient as illustrated in the BIVA nomogram.
The position of the measurement point in the BIVA nomogram is below the line of normal BCM values long axis and above the line of normal TBW values short axis between the 75 th and 95 th tolerance ellipse.
The position in the lower right quadrant indicates malnutrition. The BIA parameter values listed in table 2 can be interpreted as follows: The fat mass lies above the normal range in line with the increased BMI.
BCM lies within the normal range. At first sight this does not fit in with the finding of the BIVA nomogram, which indicates malnutrition. The fact that the calculated BCM is within the range of normal values here may be explained as follows: It needs to be considered that BCM is dependent on the patient's fluid status TBW.
This means that a BCM within the normal range does not necessarily mean a normal nutritional status but may also be due to increased TBW. This indicates that BCM is actually reduced.
BCM therefore only appears to lie within the range of normal values because of the increased TBW. In contrast to this somewhat complex interpretation of the calculated BIA values, the suspected diagnosis of malnutrition can be established at a glance by BIVA. In addition, it is confirmed that the calculated BCM is too high because of the increased TBW position of the measurement point in the BIVA nomogram above the line of normal TBW values.
Conclusion: Despite the presence of obesity the patient is exhibiting malnutrition. The position of the measurement point in the BIVA nomogram in the right lower quadrant between the 75 th and the 95 th tolerance ellipse provides an indication for the suspected diagnosis of malnutrition.
The measurement point in the BIVA nomogram Figure 4 in this patient is far below the line of normal BCM values long axis and well above the line of normal TBW values short axis , far outside the 95 th tolerance ellipse.
The position of the measurement point in the lower right quadrant points to malnutrition in the form of cachexia. Cachexia as illustrated in the BIVA nomogram. The position of the measurement point in the BIVA nomogram is far below the line of normal BCM values long axis and well above the line of normal TBW values short axis far outside the 95 th tolerance ellipse.
The position in the lower right quadrant points to cachexia. The BIA parameter values listed in table 3 can be interpreted as follows: The fat mass lies below the normal range in line with the reduced BMI.
The calculated values for BCM und TBW are reduced. It needs to be considered as regards the reduced BCM value that BCM is dependent on the patient's fluid status TBW. This means that a reduced BCM does not necessarily point to malnutrition but may also be due to a low TBW.
In this example also BIVA provides a more efficient assessment of the nutritional status than the calculated BIA parameters. Conclusion: All the values listed in the table are below the normal range and the measurement point in the BIVA nomogram is outside the 95 th tolerance ellipse in the lower right quadrant.
This indicates severe malnutrition in the form of cachexia. The assessment of the BIVA nomogram is sufficient for the suspected diagnosis of cachexia. The measurement point in the BIVA nomogram Figure 5 in this patient is above the line of normal BCM values long axis and well below the line of normal TBW values short axis on the 95 th tolerance ellipse.
The position of the measurement point in the lower left quadrant points to water retention in the form of oedema. Oedema due to right heart failure as illustrated in the BIVA nomogram.
The position of the measurement point in the BIVA nomogram is above the line of normal BCM values long axis and well below the line of normal TBW values short axis on the 95 th tolerance ellipse.
The position in the lower left quadrant indicates the presence of increased water retention. The BIA parameter values listed in table 4 can be interpreted as follows: Body fat mass lies above the normal range in line with the increased BMI. The determined TBW is increased and the calculated BCM lies in the upper range of normal.
These findings are consistent with the position of the measurement point above the line of normal BCM values and below the line of normal TBW values in the lower left quadrant. With the derived normal BIA value for BCM it needs once again to be taken into account here that BCM is dependent on the patient's fluid status TBW.
This means that a BCM within the normal range does not necessarily indicate an actually normal BCM or normal nutritional status but may also appear normal due to an increased TBW. In addition to the increased TBW, ECM is also markedly increased, indicating oedema.
The suspicion of oedema is established at a glance with BIVA. BIVA confirms simply and rapidly the calculated BIA values BCM and TBW. The suspicion of oedema was confirmed on physical examination of the legs. Conclusion: The values listed in the table for TBW and ECM are outside the normal range and the measurement point in the BIVA nomogram is on the 95 th tolerance ellipse in the lower left quadrant, indicating oedema.
The determined BCM is in the upper range of normal and the measurement point in the BIVA nomogram is above the line of normal BCM values. The position of the measurement point in the nomogram provides an indication for the suspected diagnosis of oedema.
For the general differential diagnosis of underweight we present a female patient with anorexia: female, The measurement point in the BIVA nomogram Figure 6 lies almost on the line of normal BCM values long axis and far above the line of normal TBW values short axis outside the 95 th tolerance ellipse.
The position of the measurement point in the upper right quadrant points to the presence of anorexia. Anorexia as illustrated in the BIVA nomogram.
The position of the measurement point in the BIVA nomogram is almost on the line of normal BCM values long axis and far above the line of normal TBW values short axis outside the 95 th tolerance ellipse.
The position in the upper right quadrant points to the presence of anorexia. The BIA parameter values listed in table 5 can be interpreted as follows: Body fat mass is reduced in line with the low BMI.
TBW is markedly reduced and BCM also is decreased. With the reduced BCM it needs to be kept in mind here that BCM is dependent on the patient's fluid status TBW. This means that a lower BCM may also appear reduced due to a lower TBW. This indicates that BCM is normal and that the calculated value was too low only because of the low TBW.
BIVA confirms the suspicion raised by the BIA values that the calculated BCM was too low because of the reduced TBW. Again, the suspected diagnosis of anorexia can be established more efficiently and more reliably by BIVA. Conclusion: The patient exhibits a markedly reduced BMI, decreased body water and a normal BCM in the form of anorexia.
The position of the measurement point in the nomogram in the upper right quadrant outside the 95 th tolerance ellipse provides an indication for the suspected diagnosis of anorexia.
Bioelectrical impedance analysis BIA , particularly in combination with bioelectrical impedance vector analysis BIVA , provides a viable opportunity for evaluating body composition in humans.
As the examples suggest the interpretation of BIA results is often complex and a suspected diagnosis can be established more efficiently and more reliably by integrating BIVA into the patient assessment process. Engelen MP, Schols AM, Baken WC, Wesseling GJ, Wouters EF: Nutritional depletion in relation to respiratory and peripheral skeletal muscle function in out-patients with COPD.
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King DA, Cordova F, Scharf SM: Nutritional aspects of chronic obstructive pulmonary disease. Proc Am Thorac Soc. Article PubMed PubMed Central Google Scholar. Shoup R, Dalsky G, Warner S, Davies M, Connors M, Khan M, Khan F, ZuWallack R: Body composition and health-related quality of life in patients with obstructive airways disease.
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The BIA compendium. de ]3. Bosy-Westphal A, Danielzik S, Dörhöfer RP, Piccoli A, Müller MJ: Patterns of bioelectrical impedance vector distribution by body mass index and age: implications for body-composition analysis.
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Creutzberg EC, Wouters EF, Mostert R, Weling-Scheepers CA, Schols AM: Efficacy of nutritional supplementation therapy in depleted patients with chronic obstructive pulmonary disease. Download references. Nutritional Consulting Practice, Emil-Schüller-Straße, Koblenz, , Germany.
Pneumology Practice, Emil-Schüller-Straße, Koblenz, , Germany. KG, Binger Straße, Ingelheim, , Germany. Department of Pulmonary Disease, III. Medical Clinic, Johannes Gutenberg-University, Langenbeckstraße, Mainz, , Germany. You can also search for this author in PubMed Google Scholar.
Correspondence to Thomas Glaab. The authors declare that they have no competing interests. TG and MMG were employees of Boehringer Ingelheim at the time of manuscript submission.
AWK and TG conceived of the review, drafted and coordinated the manuscript. MMG and AK critically discussed and helped to draft the manuscript.
All authors read and approved the final manuscript. The contents of this original manuscript have not been previously presented or submitted elsewhere. Open Access This article is published under license to BioMed Central Ltd. Reprints and permissions. Walter-Kroker, A. et al. A practical guide to bioelectrical impedance analysis using the example of chronic obstructive pulmonary disease.
Nutr J 10 , 35 Download citation. Received : 08 November Accepted : 21 April Published : 21 April Anyone you share the following link with will be able to read this content:. Sorry, a shareable link is not currently available for this article.
In other words, the technical limitations of BIA could be overcome by measuring the different body segments at different frequencies. By doing so, the impedance in the limbs and torso were measured separately, yielding highly accurate results without using empirical data based on factors like age, gender, ethnicity, athleticism, and body shape.
Thus, the InBody DSM-MFBIA body composition analyzer is a precision medical device. Many BIA products today provide segmental measures of muscle and fat mass, but most of these products are still unable to take segmental impedance measurements, particularly in the torso. The InBody measure each segment separately and shows the impedance values of all five cylinders of the body at each frequency in the Impedance Section of the InBody Result Sheet.
InBody uses multiple currents at varying frequencies to provide precise body water analysis. When measuring impedance with electrodes, contact resistance occurs. InBody accounts for contact resistance with strategically placed electrodes to ensure that measurements are accurate and reproducible.
InBody measures your impedance independently, so your results are not affected by your age, gender, ethnicity, athleticism, or body shape. BIA Tech Problem The ability to distinguish between extracellular and total body water is important to identify fluid imbalances related to acute inflammation or edema.
Many BIA devices use only one frequency at 50 kHz to measure impedance. As a result, patients with increased extracellular water may be misidentified as being healthy. InBody uses a combination of low and high frequencies to determine extracellular, intracellular, and total body water.
The use of multiple frequencies allows InBody devices to achieve a high level of precision. Medical practitioners can use InBody for measurements of body composition and fluid status. Total body water TBW is stored throughout the body and can be separated into 2 compartments:. Early BIA devices used a single 50 kHz frequency to calculate TBW.
Therefore, ICW was estimated proportionally based on the ECW. This estimation was used to determine TBW, lean mass, and fat mass. The estimation of intracellular water was based on the assumption that the ratio of ICW to ECW in healthy adults is about However, individuals with body compositions that differ from conventionally healthy adults, such as elderly, obese or chronic disease patients, often have a higher ratio of ECW.
Thus, in these patient populations, relying on the ICW:ECW ratio could result in significant error. InBody uses multiple frequencies ranging from 1 kHz to 1 MHz to provide precision body water analysis.
Electrical currents interact differently with the cells at different frequencies, which allows the InBody to quantify the different fluid compartments. Low frequencies are better suited for measuring ECW, while high frequencies can pass through cell membranes to measure ICW and therefore TBW.
An accurate measure of TBW and the ability to analyze ICW versus ECW allows for a deeper analysis of individual body composition. Compartmental water measures can be used to properly quantify and identify changes in fluid balance to reflect nutritional status and fitness progress.
If the starting measurement position changes, the length of the measured cylinder also changes. This directly impacts impedance and introduces error.
When the human body comes in contact with an electrode, resistance occurs. To accurately measure the resistance in the human body, it is important to control the measurement location.
These designs can cause measurements to start in the palm, which has a high impedance and can cause inaccuracies, or lead to inconsistent measurement starting points, reducing the reliability of results.
The anatomical design of the hand electrode creates a simple holding position that is easy to reproduce. Utilizing the anatomical characteristics of the human body, when an InBody user grasps the hand grip, current flows from the palm electrode and the electrical energy, or voltage, is initiated at the thumb electrode.
When current and voltage overlap, impedance can be measured. By separating current and voltage into the hand and foot electrodes, the point of overlap can be controlled to isolate the five cylinders of the body limbs and torso and consistently start at the same location on the wrists and ankles for reproducible results.
With this design, the point of measure stays the same even when the user changes the holding position of the hand electrode or the contact points on the hands and feet.
Traditional BIA views the human body as one cylinder. However, the torso of the body needs to be measured separately because its short length and large cross-sectional area mean that even a small measurement mistake can lead to substantial error.
Direct segmental measurement bioelectrical impedance analysis regards the human body as five cylinders: left arm, right arm, torso, left leg, and right leg.
InBody independently measures each cylinder to provide accurate measurements for the entire body. Traditional BIA systems viewed the human body as a single cylinder, using whole-body impedance to determine total body water.
One of the biggest problems with the single cylinder method is the lack of a separate torso measurement. The torso has the shortest length and highest cross-sectional area, which results in a very low impedance typically ohms. Therefore, small errors in torso impedance have significant impact on body composition results.
With whole-body impedance measurement, the torso impedance is not observed separately and thus, changes in torso impedance cannot be quantified.
Because of the large amount of lean mass in the torso, small variability in impedance measures can have a drastic effect on how the results are interpreted. Differences and percentages may vary based on the individual.
Some BIA devices avoid the torso measurement entirely. For example, with many BIA scales, only the impedance of your legs and a small part of your torso are measured. Similarly, with handheld BIA devices, only the impedance of your arms and a small portion of your torso are measured.
With this design, the rest of the body must be estimated. In many bioimpedance technologies today , empirical equations are incorporated to compensate for technological flaws, including the lack of torso impedance due to whole-body impedance measurement , single frequency measurements which are unable to differentiate between water compartments , and lack of reproducibility from electrode placement or positioning.
InBody measures body composition without relying on empirical assumptions based on age, gender, ethnicity, or body shape, producing accurate and precise results that are validated to gold standard methods.
Put simply, InBody provides individualized feedback for better tracking of progress to help you achieve your goals. These equations help compensate for the lack of torso impedance measurement and ability to differentiate between body water compartments by plugging in empirical data based on factors, such as age, gender, and ethnicity.
For example, these equations may take into consideration that muscle mass generally decreases with age and that males tend to have more muscle mass than females. This expectation is then reflected in the results. Therefore, the problem with relying heavily on empirical estimations is that your results are predetermined, regardless of your actual body composition.
Testing on the InBody will give a user the same body composition measurements whether that user tests as a male or female because the InBody does not use empirical estimations based on factors of age, gender, ethnicity, athleticism, or body shape in its measurements.
In other words, direct measures of your impedance and water distribution are used to determine your individualized results. Because of its technology, InBody has been found to be one of the most accurate BIA devices on the market.
In fact, it has been found to have a high correlation of 0. InBody devices are used by leading professionals around the world to give their clients results they can trust and track. Disclaimer: Please be aware that your actual monthly payment liability is subject to change based on the amount financed, which is at the financer's discretion and that the amount shown here is merely an estimate and does not include applicable federal and sales tax.
Hit enter to search or ESC to close. Close Search. InBody Technology. Menu What is BIA? The History of BIA Technology The Evolution of BIA through InBody. What is Bioelectrical Impedance Analysis BIA? Resistance When an electrical current is sent through your body, components such as body water, fat, muscle, and bone present varying levels of resistance.
Reactance In addition to the resistance described above, the human body presents another type of resistance, called reactance. The body is composed of trillions of cells, each of which is protected by a cell membrane that separates the inside of the cell intracellular from the outside extracellular environment.
Impedance: The combination of resistance and reactance Impedance is the vector sum of resistance and reactance.
The History of BIA Technology. Source: Hoffer, E. Correlation of whole-body impedance with total body water volume. Journal of Applied Physiology, 27 4 , and the Impedance Index.
Image Credit: RJL Systems. Sample empirical estimation equation Source: Schoeller, D. Determination of body fluids by the impedance technique. IEEE Engineering in Medicine and Biology Magazine, 8 1 , Sample empirical estimation equation Source: Lukaski, H.
Estimation of body fluid volumes using tetrapolar bioelectrical measurements. Aviation Space and Environmental Medicine, 59 12 , Cha creates the InBody Body Composition Analyzer.
In today's increasingly Ayurvedic energy supplements world, almost everyone has a body fat scale at home. And bioimpedance analysis is the measurement technology used by most shapr fat qnalysis today. BIA body shape analysis how much BIA body shape analysis you bodh about bioimpedance technology? In this article, we will learn the concept of bioimpedance analysis and how it measures body composition, analyse its accuracy and credibility, and help you gain insight into understanding and using body fat scales. BIA determines body composition by measuring the rate at which a painless, low-level electric current passes through the body. Firstly, it assumes that the body consists of a series of cylinders of uniform shape, length and cross-sectional area with constant electrical conductivity.
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