Reliability, biological variability, and accuracy of multi-frequency bioelectrical impedance analysis for measuring body composition components

Abstract

Introduction: Bioelectrical impedance analysis (BIA) systems are gaining popularity for use in research and fitness assessments as the technology improves and becomes more affordable and easier to use. Multifrequency BIA (MF-BIA) may improve accuracy and precision using octopolar contacts for segmental analyses.

Purpose: Evaluate reliability, biological variability, and accuracy of component measures (total body water, mass, and composition) of commercially available MF-BIA system (InBody 770, Cerritos, California, USA).

Methods: Fourteen healthy military-age adults were assessed by MF-BIA in duplicate on five laboratory visits across 3 weeks (10 measures each). Participants were evaluated at the same time of day after refraining from strenuous exercise (> 48 h), alcohol consumption (> 24 h), and caffeine, nicotine, and food (> 10 h). Systematic error (test-retest reliability) and biological variability (day-to-day reliability) were summarized by intraclass correlation coefficient (ICC) values determined for body mass (fat, fat-free, total) and body water (extracellular, intracellular, total). Body composition measurements derived from BIA on the second visit were also tested for accuracy compared to dual-energy x-ray absorptiometry (DXA).

Results: Test-retest reliability was very high for all measurements of whole-body water and mass (ICC ≥ 0.999) and high for regional body water and mass (ICC 0.973-1.000). Biological variability was observable with very minor differences between tests (same day) for total and regional body water (0.0-0.2 L) and total and regional body mass measurements (0.0-0.2 kg); while between day differences were slightly higher (0.0-0.5 L and 0.1-0.7 kg). Compared to DXA, the MF-BIA whole-body measures showed an offset in %BF (Bias -4.0 ± 2.8%; Standard error of the estimate (SEE), 2.6%), an overprediction for total body fat-free mass (Bias 2.8 ± 2.1 kg; SEE 2.2 kg) and an underprediction of total body fat mass (Bias -2.9 ± 2.0 kg; SEE 1.9 kg).

Conclusion: Under controlled conditions with fit and healthy men and women, this MF-BIA system has high methodological reliability and demonstrates stable day-to-day measurements of major body composition components. Previously reported ~3% body fat offset compared to criterion methods was again confirmed. Precision of the InBody 770 shows consistency and supports further testing of this specific device as a new military standards method and suitability across a wider range of %BF.

Keywords: BIA; BMI; DXA; FMI; body composition; body water.

Figure 1

Bland–Altman plots of agreement between percent body fat measured by MF-BIA and DXA with no correction and + 3% correction (10) to MF-BIA. Black dashed line, linear regression line of best fit; Blue solid line, bias; DXA, dual-energy x-ray absorptiometry; MF-BIA, Multi-frequency Bioelectrical Impedance Analysis; red solid lines, 95% limits of agreement.

Figure 2

Bland–Altman plots of agreement between fat mass index (FMI), fat-free mass index (FFMI), and body mass index (BMI) measured by BIA and DXA. Black dashed line, linear regression line of best fit; Blue solid line, bias; DXA, dual-energy x-ray absorptiometry; MF-BIA, Multi-frequency Bioelectrical Impedance Analysis; red solid lines, 95% limits of agreement.