Abstract
The present systematic review aimed to compare the accuracy of Bioelectrical Impedance Analysis (BIA) and Bioelectrical Impedance Vector Analysis (BIVA) vs. reference methods for the assessment of body composition in athletes. Studies were identified based on a systematic search of internationally electronic databases (PubMed and Scopus) and hand searching of the reference lists of the included studies. In total, 42 studies published between 1988 and 2021 were included. The methodological quality was assessed using the Quality Assessment Tool for Observational Cohort and Cross-sectional Studies as recommended by the National Institute of Health. Twenty-three studies had an overall good rating in terms of quality, while 13 were rated as fair and 6 as poor, resulting in a low to moderate risk of bias. Fat mass was inconsistently determined using BIA vs. the reference methods, regardless of the BIA-technology. When using the foot to hand technology with predictive equations for athletes, a good agreement between BIA and the reference methods was observed for fat-free mass, total body, intra and extra cellular water. However, an underestimation in fat-free mass and body fluids was found when using generalized predictive equations. Classic and Specific BIVA represented a valid approach for assessing body fluids (Classic BIVA) and percentage of fat mass (Specific BIVA). The present systematic review suggests that BIA and BIVA can be used for assessing body composition in athletes, provided that foot-to-hand technology, predictive equations, and BIVA references for athletes are used.
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Abbreviations
- BIA:
-
Bioelectrical impedance analysis
- BIVA:
-
Bioelectrical impedance vector analysis
- BIS:
-
Bioelectrical spectroscopy analysis
- DXA:
-
Dual-energy X-ray absorptiometry
- ECW:
-
Extracellular water
- FM:
-
Fat mass
- FFM:
-
Fat free mass
- ICW:
-
Intracellular water
- LST:
-
Lean soft tissue
- R:
-
Resistance
- Xc:
-
Reactance
- TBW:
-
Total body water
- UWW:
-
Underwater weighting
- 4C:
-
Four compartment model
References
Andreoli A, Melchiorri G, Volpe SL et al (2004) Multicompartment model to assess body composition in professional water polo players. J Sports Med Phys Fit 44:38–43
Téllez MJA, Carrasco F, Romero VE et al (2019) A comparison of body composition assessment methods in climbers: which is better? PLoS ONE 14:e0224291. https://doi.org/10.1371/journal.pone.0224291
Birzniece V, Khaw C-H, Nelson AE et al (2015) A critical evaluation of bioimpedance spectroscopy analysis in estimating body composition during GH treatment: comparison with bromide dilution and dual X-ray absorptiometry. Eur J Endocrinol 172:21–28. https://doi.org/10.1530/EJE-14-0660
Boileau RA, Horswill CA (2000) Body composition in sports: measurement and applications for weight gain and loss. In: Garret WE Jr, Kinkendall DT (eds) Exercise and sport science. Lippincott Williams & Wilkins, Philadelphia, pp 319–338
Bongiovanni T, Mascherini G, Genovesi F et al (2020) Bioimpedance vector references need to be period-specific for assessing body composition and cellular health in elite soccer players: a brief report. J Funct Morphol Kinesiol. https://doi.org/10.3390/jfmk5040073
Brewer GJ, Blue MNM, Hirsch KR et al (2019) Appendicular body composition analysis: validity of bioelectrical impedance analysis compared with dual-energy X-ray absorptiometry in Division I College Athletes. J Strength Cond Res 33:2920–2925. https://doi.org/10.1519/JSC.0000000000003374
Buffa R, Saragat B, Cabras S et al (2013) Accuracy of specific BIVA for the assessment of body composition in the United States population. PLoS ONE 8:e58533. https://doi.org/10.1371/journal.pone.0058533
Campa F, Matias C, Gatterer H et al (2019) Classic bioelectrical impedance vector reference values for assessing body composition in male and female athletes. Int J Environ Res Public Health. https://doi.org/10.3390/ijerph16245066
Campa F, Matias CN, Marini E et al (2020) Identifying athlete body fluid changes during a competitive season with bioelectrical impedance vector analysis. Int J Sports Physiol Perform 15:361–367. https://doi.org/10.1123/ijspp.2019-0285
Campa F, Matias CN, Nunes CL et al (2021a) Specific bioelectrical impedance vector analysis identifies body fat reduction after a lifestyle intervention in former elite athletes. Biology (basel). https://doi.org/10.3390/biology10060524
Campa F, Toselli S (2018) Bioimpedance vector analysis of elite, sub-elite and low-level male volleyball players. Int J Sports Physiol Perform. https://doi.org/10.1123/ijspp.2018-0039
Campa F, Toselli S, Mazzilli M et al (2021b) Assessment of body composition in athletes: a narrative review of available methods with special reference to quantitative and qualitative bioimpedance analysis. Nutrients. https://doi.org/10.3390/nu13051620
Castizo-Olier J, Irurtia A, Jemni M et al (2018) Bioelectrical impedance vector analysis (BIVA) in sport and exercise: systematic review and future perspectives. PLoS ONE 13:e0197957. https://doi.org/10.1371/journal.pone.0197957
Civar S, Aktop A, Tercan E et al (2006) Validity of leg-to-leg bioelectrical impedance measurement in highly active women. J Strength Cond Res 20:359–365. https://doi.org/10.1519/R-15884.1
Civar S, Ozer M, Aktop A, et al (2003) Validity of leg-to-leg bioelectrical impedance measurement in higly active males. Biol Sport 20(3):209–219
Colville B, Heyward V, Sandoval W (1989) Comparison of two methods for estimating body composition of bodybuilders. J Strength Cond Res 3:5W_61
Company J, Ball S (2010) Body composition comparison: bioelectric impedance analysis with dual-energy X-ray absorptiometry in adult athletes. Meas Phys Educ Exerc Sci 14:186–201. https://doi.org/10.1080/1091367X.2010.497449
Coratella G, Campa F, Matias CN et al (2021) Generalized bioelectric impedance-based equations underestimate body fluids in athletes. Scand J Med Sci Sports. https://doi.org/10.1111/sms.14033
De Lorenzo A, Andreoli A, Matthie J, Withers P (1997) Predicting body cell mass with bioimpedance by using theoretical methods: a technological review. J Appl Physiol 82:1542–1558. https://doi.org/10.1152/jappl.1997.82.5.1542
De Lorenzo A, Bertini I, Iacopino L et al (2000) Body composition measurement in highly trained male athletes. A comparison of three methods. J Sports Med Phys Fit 40:178–183
Dellinger JR, Johnson BA, Benavides ML et al (2021) Agreement of bioelectrical resistance, reactance, and phase angle values from supine and standing bioimpedance analyzers. Physiol Meas. https://doi.org/10.1088/1361-6579/abe6fa
Deminice R, Rosa FT, Pfrimer K et al (2016) Creatine supplementation increases total body water in soccer players: a deuterium oxide dilution study. Int J Sports Med 37:149–153. https://doi.org/10.1055/s-0035-1559690
Deurenberg P, Kusters CS, Smit HE (1990) Assessment of body composition by bioelectrical impedance in children and young adults is strongly age-dependent. Eur J Clin Nutr 44:261–268
Deurenberg P, van der Kooy K, Leenen R et al (1991) Sex and age specific prediction formulas for estimating body composition from bioelectrical impedance: a cross-validation study. Int J Obes 15:17–25
Dixon CB, Deitrick RW, Pierce JR et al (2005) Evaluation of the BOD POD and leg-to-leg bioelectrical impedance analysis for estimating percent body fat in National Collegiate Athletic Association Division III collegiate wrestlers. J Strength Cond Res 19:85–91. https://doi.org/10.1519/14053.1
Domingos C, Matias CN, Cyrino ES et al (2019) The usefulness of Tanita TBF-310 for body composition assessment in Judo athletes using a four-compartment molecular model as the reference method. Rev Assoc Med Bras 65:1283–1289. https://doi.org/10.1590/1806-9282.65.10.1283
Esco M, Olson MS, Williford H et al (2011) The accuracy of hand-to-hand bioelectrical impedance analysis in predicting body composition in college-age female athletes. J Strength Cond Res 25:1040–1045
Esco MR, Snarr RL, Leatherwood MD et al (2015) Comparison of total and segmental body composition using DXA and multifrequency bioimpedance in collegiate female athletes. J Strength Cond Res 29:918–925. https://doi.org/10.1519/JSC.0000000000000732
Fornetti WC, Pivarnik JM, Foley JM, Fiechtner JJ (1999) Reliability and validity of body composition measures in female athletes. J Appl Physiol 87:1114–1122. https://doi.org/10.1152/jappl.1999.87.3.1114
Francisco R, Jesus F, Gomes T et al (2021) Validity of water compartments estimated using bioimpedance spectroscopy in athletes differing in hydration status. Scand J Med Sci Sports 31:1612–1620. https://doi.org/10.1111/sms.13966
Giorgi A, Vicini M, Pollastri L et al (2018) Bioimpedance patterns and bioelectrical impedance vector analysis (BIVA) of road cyclists. J Sports Sci. https://doi.org/10.1080/02640414.2018.1470597
Graves JE, Pollock ML, Colvin AB et al (1989) Comparison of different bioelectrical impedance analyzers in the prediction of body composition. Am J Hum Biol 1:603–611. https://doi.org/10.1002/ajhb.1310010511
Graybeal AJ, Moore ML, Cruz MR, Tinsley GM (2020) Body composition assessment in male and female bodybuilders: a 4-compartment model comparison of dual-energy X-ray absorptiometry and impedance-based devices. J Strength Cond Res 34:1676–1689. https://doi.org/10.1519/JSC.0000000000002831
Hannan WJ, Cowen SJ, Freeman CP, Wrate RM (1993) Can bioelectrical impedance improve the prediction of body fat in patients with eating disorders? Eur J Clin Nutr 47:741–746
Nunes RFH, de Bezerra ES, Orssatto LB et al (2020) Assessing body composition in rugby players: agreement between different methods and association with physical performance. J Sports Med Phys Fit 60:733–742. https://doi.org/10.23736/S0022-4707.20.10487-0
Heitmann BL (1990) Evaluation of body fat estimated from body mass index, skinfolds and impedance. A comparative study. Eur J Clin Nutr 44:831–837
Heymsfield S, Lohman T, Wang Z, Going S (2005) Human body composition, 2nd edn. Human Kinetics, Leeds
Hortobágyi T, Israel RG, Houmard JA et al (1992) Comparison of four methods to assess body composition in black and white athletes. Int J Sport Nutr 2:60–74. https://doi.org/10.1123/ijsn.2.1.60
Houtkoopr L, Mullins VA, Going SB et al (2001) Body composition profiles of elite American heptathletes. Int J Sport Nutr Exerc Metab 11:162–173. https://doi.org/10.1123/ijsnem.11.2.162
Kirkendall DT, Grogan JW, Bowers RG (1991) Field comparison of body composition techniques: hydrostatic weighing, skinfold thickness, and bioelectric impedance. J Orthop Sports Phys Ther 13:235–239. https://doi.org/10.2519/jospt.1991.13.5.235
Kotler DP, Burastero S, Wang J, Pierson RN Jr (1996) Prediction of body cell mass, fat-free mass, and total body water with bioelectrical impedance analysis: effects of race, sex, and disease. Am J Clin Nutr 64:489S-497S. https://doi.org/10.1093/ajcn/64.3.489S
Krzykała M, Konarski JM, Malina RM et al (2016) Fatness of female field hockey players: comparison of estimates with different methods. Homo 67:245–257. https://doi.org/10.1016/j.jchb.2016.03.003
Kushner R, Schoeller DA, Fjeld CR, Danford L (1992) Is the Impedance index (ht2/R) significant in predicting total body water? Am J Clin Nutr 56:835–839. https://doi.org/10.1093/ajcn/56.5.835
Kushner RF, Schoeller DA (1986) Estimation of total body water by bioelectrical impedance analysis. Am J Clin Nutr 44:417–424. https://doi.org/10.1093/ajcn/44.3.417
Kyle UG, Bosaeus I, De Lorenzo AD et al (2004a) Bioelectrical impedance analysis–part I: review of principles and methods. Clin Nutr 23:1226–1243. https://doi.org/10.1016/j.clnu.2004.06.004
Kyle UG, Bosaeus I, De Lorenzo AD et al (2004b) Bioelectrical impedance analysis-part II: utilization in clinical practice. Clin Nutr 23:1430–1453. https://doi.org/10.1016/j.clnu.2004.09.012
Lee L-C, Hsu P-S, Hsieh K-C et al (2021) Standing 8-electrode bioelectrical impedance analysis as an alternative method to estimate visceral fat area and body fat mass in athletes. Int J Gen Med 14:539–548. https://doi.org/10.2147/IJGM.S281418
Loenneke JP, Wilson JM, Wray ME et al (2012) The estimation of the fat free mass index in athletes. Asian J Sports Med 3:200–203. https://doi.org/10.5812/asjsm.34691
Loenneke JP, Wray ME, Wilson JM et al (2013) Accuracy of field methods in assessing body fat in collegiate baseball players. Res Sports Med 21:286–291. https://doi.org/10.1080/15438627.2013.792087
Lohman TG (1992) Advances in body composition assessment. Cad Saude Publica 9:S116–S117
Lukaski H, Bolonchuk W (1987) Theory and validation of the tetrapolar bioelectrical impedance method to assess human body composition. In vivo body composition studies; proceedings of an international symposium held at Brookhaven National Laboratory, New York on September 28-October 1, 1986, and sponsored by: United States Department Energy, Brookhaven National Laboratory, Associated Universities, Inc. / edited by K.J. Ellis, S. Yasumura and W.D. Morgan. The Institute of Physical Sciences in Medicine, London
Lukaski H, Raymond-Pope CJ (2021) New frontiers of body composition in sport. Int J Sports Med. https://doi.org/10.1055/a-1373-5881
Lukaski HC, Bolonchuk WW (1988) Estimation of body fluid volumes using tetrapolar bioelectrical impedance measurements. Aviat Space Environ Med 59:1163–1169
Lukaski HC, Bolonchuk WW, Hall CB, Siders WA (1986) Validation of tetrapolar bioelectrical impedance method to assess human body composition. J Appl Physiol 60:1327–1332. https://doi.org/10.1152/jappl.1986.60.4.1327
Lukaski HC, Bolonchuk WW, Siders WA, Hall CB (1990) Body composition assessment of athletes using bioelectrical impedance measurements. J Sports Med Phys Fit 30:434–440
Lukaski HC, Johnson PE, Bolonchuk WW, Lykken GI (1985) Assessment of fat-free mass using bioelectrical impedance measurements of the human body. Am J Clin Nutr 41:810–817. https://doi.org/10.1093/ajcn/41.4.810
Lukaski HC, Piccoli A (2012) Bioelectrical impedance vector analysis for assessment of hydration in physiological states and clinical conditions. In: Preedy V (ed) Handbook of anthropometry. Springer, London, pp 287–305
Marini E, Campa F, Buffa R et al (2020) Phase angle and bioelectrical impedance vector analysis in the evaluation of body composition in athletes. Clin Nutr 39:447–454. https://doi.org/10.1016/j.clnu.2019.02.016
Matias CN, Campa F, Santos DA et al (2021) Fat-free mass bioelectrical impedance analysis predictive equation for athletes using a 4-compartment model. Int J Sports Med 42:27–32. https://doi.org/10.1055/a-1179-6236
Matias CN, Júdice PB, Santos DA et al (2016a) Suitability of bioelectrical based methods to assess water compartments in recreational and elite athletes. J Am Coll Nutr 35:413–421. https://doi.org/10.1080/07315724.2015.1058198
Matias CN, Santos DA, Júdice PB et al (2016b) Estimation of total body water and extracellular water with bioimpedance in athletes: a need for athlete-specific prediction models. Clin Nutr 35:468–474. https://doi.org/10.1016/j.clnu.2015.03.013
Micheli ML, Pagani L, Marella M et al (2014) Bioimpedance and impedance vector patterns as predictors of league level in male soccer players. Int J Sports Physiol Perform 9:532–539. https://doi.org/10.1123/ijspp.2013-0119
Moissl UM, Wabel P, Chamney PW et al (2006) Body fluid volume determination via body composition spectroscopy in health and disease. Physiol Meas 27:921–933. https://doi.org/10.1088/0967-3334/27/9/012
Morgenstern BZ, Mahoney DW, Warady BA (2002) Estimating total body water in children on the basis of height and weight: a reevaluation of the formulas of Mellits and Cheek. J Am Soc Nephrol 13:1884–1888. https://doi.org/10.1097/01.asn.0000019920.30041.95
NIH (2014) Quality assessment tool for observational cohort and cross- sectional studies. National Institution of Health: U. S Department of Health and Human Services
Oppliger RA, Nielsen D, Hoegh J, Vance C (1991) Bioelectrical impedance prediction of fat free mass for high school wrestlers validated. Med Sci Sports Exerc 23:S73
Page MJ, McKenzie JE, Bossuyt PM et al (2021) The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 372:n71. https://doi.org/10.1136/bmj.n71
Piccoli A, Rossi B, Pillon L, Bucciante G (1994) A new method for monitoring body fluid variation by bioimpedance analysis: the RXc graph. Kidney Int 46:534–539
Pichard C, Kyle UG, Gremion G et al (1997) Body composition by X-ray absorptiometry and bioelectrical impedance in female runners. Med Sci Sports Exerc 29:1527–1534. https://doi.org/10.1097/00005768-199711000-00021
Raymond CJ, Dengel DR, Bosch TA (2018) Total and segmental body composition examination in collegiate football players using multifrequency bioelectrical impedance analysis and dual X-ray absorptiometry. J Strength Cond Res 32:772–782. https://doi.org/10.1519/JSC.0000000000002320
Santos DA, Silva AM, Matias CN et al (2010) Accuracy of DXA in estimating body composition changes in elite athletes using a four compartment model as the reference method. Nutr Metab (lond) 7:22. https://doi.org/10.1186/1743-7075-7-22
Sardinha LB, Correia IR, Magalhães JP et al (2020) Development and validation of BIA prediction equations of upper and lower limb lean soft tissue in athletes. Eur J Clin Nutr 74:1646–1652. https://doi.org/10.1038/s41430-020-0666-8
Schoeller DA, Luke A (2000) Bioelectrical impedance analysis prediction equations differ between African Americans and Caucasians, but it is not clear why. Ann N Y Acad Sci 904:225–226. https://doi.org/10.1111/j.1749-6632.2000.tb06456.x
Segal KR, Van Loan M, Fitzgerald PI et al (1988) Lean body mass estimation by bioelectrical impedance analysis: a four-site cross-validation study. Am J Clin Nutr 47:7–14. https://doi.org/10.1093/ajcn/47.1.7
Sergi G, Bussolotto M, Perini P et al (1994) Accuracy of bioelectrical impedance analysis in estimation of extracellular space in healthy subjects and in fluid retention states. Ann Nutr Metab 38:158–165. https://doi.org/10.1159/000177806
Shiose K, Kondo E, Takae R et al (2020) Validity of bioimpedance spectroscopy in the assessment of total body water and body composition in wrestlers and untrained subjects. Int J Environ Res Public Health. https://doi.org/10.3390/ijerph17249433
Silva AM, Matias CN, Nunes CL et al (2019) Lack of agreement of in vivo raw bioimpedance measurements obtained from two single and multi-frequency bioelectrical impedance devices. Eur J Clin Nutr 73:1077–1083. https://doi.org/10.1038/s41430-018-0355-z
Silva AM, Nunes CL, Matias CN et al (2020) Usefulness of raw bioelectrical impedance parameters in tracking fluid shifts in judo athletes. Eur J Sport Sci 20:734–743. https://doi.org/10.1080/17461391.2019.1668481
Stagi S, Irurtia A, Rafel JR et al (2021) Segmental body composition estimated by specific BIVA and dual-energy X-ray absorptiometry. Clin Nutr 40:1621–1627. https://doi.org/10.1016/j.clnu.2021.02.043
Stahn A, Terblanche E, Gunga H-C (2012) Use of bioelectrical impedance: general principles and overview. In: Preedy VR (ed) Handbook of anthropometry: physical measures of human form in health and disease. Springer, New York, pp 49–90
Stolarczyk LM, Heyward VH, Hicks VL, Baumgartner RN (1994) Predictive accuracy of bioelectrical impedance in estimating body composition of Native American women. Am J Clin Nutr 59:964–970. https://doi.org/10.1093/ajcn/59.5.964
Stratton MT, Smith RW, Harty PS et al (2021) Longitudinal agreement of four bioimpedance analyzers for detecting changes in raw bioimpedance during purposeful weight gain with resistance training. Eur J Clin Nutr 75:1060–1068. https://doi.org/10.1038/s41430-020-00811-3
Sun SS, Chumlea WC, Heymsfield SB et al (2003) Development of bioelectrical impedance analysis prediction equations for body composition with the use of a multicomponent model for use in epidemiologic surveys. Am J Clin Nutr 77:331–340. https://doi.org/10.1093/ajcn/77.2.331
Svantesson U, Zander M, Klingberg S, Slinde F (2008) Body composition in male elite athletes, comparison of bioelectrical impedance spectroscopy with dual energy X-ray absorptiometry. J Negat Results Biomed 7:1. https://doi.org/10.1186/1477-5751-7-1
Syed-Abdul MM, Soni DS, Barnes JT, Wagganer JD (2021) Comparative analysis of BIA, IBC and DXA for determining body fat in American Football players. J Sports Med Phys Fitness 61:687–692. https://doi.org/10.23736/S0022-4707.21.11278-2
Van Loan M, Mayclin P (1987) Bioelectrical impedance analysis: is it a reliable estimator of lean body mass and total body water? Hum Biol 69:299–309
Wang Z, Pi-Sunyer FX, Kotler DP, Wielopolski L, Withers RT, Pierson Jr RN, Heymsfield SB (2002) Multicomponent methods: evaluation of new and traditional soft tissue mineral models by in vivo neutron activation analysis. Am J clin Nutr 76(5):968–974
Williams CA, Bale P (1998) Bias and limits of agreement between hydrodensitometry, bioelectrical impedance and skinfold calipers measures of percentage body fat. Eur J Appl Physiol Occup Physiol 77:271–277. https://doi.org/10.1007/s004210050332
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Campa, F., Gobbo, L.A., Stagi, S. et al. Bioelectrical impedance analysis versus reference methods in the assessment of body composition in athletes. Eur J Appl Physiol 122, 561–589 (2022). https://doi.org/10.1007/s00421-021-04879-y
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DOI: https://doi.org/10.1007/s00421-021-04879-y