Skip to main content
    • Aa
    • Aa

Validation of foot-to-foot bioelectrical impedance analysis with dual-energy X-ray absorptiometry in the assessment of body composition in young children: the EarlyBird cohort

  • Joanne Hosking (a1) (a2), Brad S. Metcalf (a1), Alison N. Jeffery (a1), Linda D. Voss (a1) and Terence J. Wilkin (a1)...

Foot-to-foot bioelectrical impedance analysis (BIA) is simple and non-invasive, making it particularly suitable for use in children. There is insufficient evidence of the validity of foot-to-foot BIA compared with dual-energy X-ray absorptiometry (DEXA) as the criterion method in healthy young children. Our objective was to assess the validity of foot-to-foot BIA against DEXA in a large cohort of healthy young children. Body composition was measured by foot-to-foot BIA and DEXA in 203 children (mean age 8·9 (sd 0·3) years). Bland–Altman and simple linear regression analyses were used to determine agreement between methods. BIA overestimated fat-free mass by a mean of 2·4 % in boys and 5·7 % in girls, while fat mass was underestimated by 6·5 % in boys and 10·3 % in girls. The percentage fat recorded by BIA was, accordingly, also lower than by DEXA (boys 4·8 %; girls 12·8 %). In boys, however, there were correlations between the size of the difference between methods and the size of the measure under consideration such that in smaller boys fat-free mass was underestimated (r − 0·57; P < 0·001) while fat mass and percentage fat were overestimated (r 0·74 for fat mass; r 0·69 for percentage fat; both P < 0·001) with the reverse in bigger boys. Mean differences between techniques were greater in the girls than in the boys but in boys only, the direction of the differences was dependent upon the size of the child. Therefore, BIA may be useful for large-scale studies but is not interchangeable with DEXA and should be interpreted with caution in individuals.

Corresponding author
*Corresponding author: Dr Joanne Hosking, fax +44 1752 792471, email
Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

S Chauhan , WW Koo , M Hammami & EM Hockman (2003) Fan beam dual energy X-ray absorptiometry body composition measurements in piglets. J Am Coll Nutr 22, 408414

M de Onis & M Blossner (2003) The World Health Organization global database on child growth and malnutrition: methodology and applications. Int J Epidemiol 32, 518526

L Genton , D Hans , UG Kyle & C Pichard (2002) Dual-energy X-ray absorptiometry and body composition: differences between devices and comparison with reference methods. Nutrition 18, 6670

L Genton , VL Karsegard , S Zawadynski , UG Kyle , C Pichard , A Golay & DB Hans (2006) Comparison of body weight and composition measured by two different dual energy X-ray absorptiometry devices and three acquisition modes in obese women. Clin Nutr 25, 428437

F Goss , R Robertson , A Williams , K Sward , K Abt , M Ladewig , J Timmer & C Dixon (2003) A comparison of skinfolds and leg-to-leg bioelectrical impedance for the assessment of body composition in children. Dyn Med 2, 5

L Jartti , M Hakanen , U Paakkunainen , P Raittinen & T Ronnemaa (2000) Comparison of hand-to-leg and leg-to-leg bioelectric impedance devices in the assessment of body adiposity in prepubertal children. The STRIP study. Special Turku coronary Risk factor Intervention Project. Acta Paediatr 89, 781786

SA Jebb , TJ Cole , D Doman , PR Murgatroyd & AM Prentice (2000) Evaluation of the novel Tanita body-fat analyser to measure body composition by comparison with a four-compartment model. Br J Nutr 83, 115122

UG Kyle , I Bosaeus , AD De Lorenzo , (2004a) Bioelectrical impedance analysis – part I: review of principles and methods. Clin Nutr 23, 12261243

UG Kyle , I Bosaeus , AD De Lorenzo , (2004b) Bioelectrical impedance analysis – part II: utilization in clinical practice. Clin Nutr 23, 14301453

S Lazzer , Y Boirie , M Meyer & M Vermorel (2003) Evaluation of two foot-to-foot bioelectrical impedance analysers to assess body composition in overweight and obese adolescents. Br J Nutr 90, 987992

HC Lukaski & WA Siders (2003) Validity and accuracy of regional bioelectrical impedance devices to determine whole-body fatness. Nutrition 19, 851857

L Margulies , M Horlick , JC Thornton , J Wang , E Ioannidou & SB Heymsfield (2005) Reproducibility of pediatric whole body bone and body composition measures by dual-energy X-ray absorptiometry using the GE Lunar Prodigy. J Clin Densitom 8, 298304

J Norcross & L Van (2004) Validation of fan beam dual energy x ray absorptiometry for body composition assessment in adults aged 18–45 years. Br J Sports Med 38, 472476

L Parker , JJ Reilly , C Slater , JC Wells & Y Pitsiladis (2003) Validity of six field and laboratory methods for measurement of body composition in boys. Obes Res 11, 852858

A Pietrobelli , F Rubiano , MP St-Onge & SB Heymsfield (2004) New bioimpedance analysis system: improved phenotyping with whole-body analysis. Eur J Clin Nutr 58, 14791484

AB Sopher , JC Thornton , J Wang , RN Pierson Jr, SB Heymsfield & M Horlick (2004) Measurement of percentage of body fat in 411 children and adolescents: a comparison of dual-energy X-ray absorptiometry with a four-compartment model. Pediatrics 113, 12851290

RY Sung , P Lau , CW Yu , PK Lam & EA Nelson (2001) Measurement of body fat using leg to leg bioimpedance. Arch Dis Child 85, 263267

P Tothill & WJ Hannan (2000) Comparisons between Hologic QDR 1000W, QDR 4500A, and Lunar Expert dual-energy X-ray absorptiometry scanners used for measuring total body bone and soft tissue. Ann N Y Acad Sci 904, 6371

VJ Tyrrell , G Richards , P Hofman , GF Gillies , E Robinson & WS Cutfield (2001) Foot-to-foot bioelectrical impedance analysis: a valuable tool for the measurement of body composition in children. Int J Obes Relat Metab Disord 25, 273278

LD Voss , J Kirkby , BS Metcalf , AN Jeffery , C O'Riordan , MJ Murphy & TJ Wilkin (2003) Preventable factors in childhood that lead to insulin resistance, diabetes mellitus and the metabolic syndrome: the EarlyBird diabetes study 1. J Pediatr Endocrinol Metab 16, 12111224

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

British Journal of Nutrition
  • ISSN: 0007-1145
  • EISSN: 1475-2662
  • URL: /core/journals/british-journal-of-nutrition
Please enter your name
Please enter a valid email address
Who would you like to send this to? *



Full text views

Total number of HTML views: 0
Total number of PDF views: 18 *
Loading metrics...

Abstract views

Total abstract views: 125 *
Loading metrics...

* Views captured on Cambridge Core between September 2016 - 29th May 2017. This data will be updated every 24 hours.