what does bioelectrical impedance measure

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. By the 1990s, the market included several multi-frequency analyzers and a couple of BIS devices. D. van Marken Lichtenbelt, F. Hartgens, N. B. Vollaard, S. Ebbing and H. Kuipers, Body composition changes in bodybuilders: a method comparison, Medicine and Science in Sport and Exercise, vol. Lean tissues are highly-conductive, as they contain large quantities of water. quantities of fat mass and fat-free mass) by running a small electrical current through the body. Marini E, Buffa R, Contreras M, et al. The reliability of BIA Keywords Total Body Nutrition Services - Doylestown Health | Our Focus is You Crit Care 2016; 20:95. BIA has been compared to the four-compartment model in several studies using various populations. [12] The two-electrode, e.g., foot-to-foot or hand-to-hand measurement, is generally found to be less accurate than 4-electrode (tetra-polar technique in which the current circuit is provided by a pair of distal electrodes with impedance measured, as the voltage drop between a separate pair of proximal electrodes) methods. As mentioned previously, there are several issues with BIA measurement that may limit its use in an applied setting. Basic Life Sci. 70, pp. Methodological limitations of BIA may affect the ability of the method to accurately determine body composition. Age-related extracellular to total body water volume ratio (Ecv/TBW)--can it be used for dry weight determination in dialysis patients? Bioelectrical Impedance Analysis is a technique used for estimating body composition. Author: Cosimo Carriero, Field Applications Engineer Analog Devices. Malbrain ML, Huygh J, Dabrowski W, et al. 75, no. There are a limited amount of comparisons between BIA and the reference four-compartment model in athletic populations. Fetterplace K, Beach LJ, MacIsaac C, et al. 56. JPEN J Parenter Enteral Nutr 2017; 41:11311138. reported that he had received honoraria for advisory board meetings, lectures and travel expenses from Abbott, Amomed, Baxter, Cardinal Health, Danone-Nutricia, DIM-3, Fresenius Kabi, Lyric, Mermaid and Nestle-Novartis. How does bioelectrical impedance work? 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). BIA is likely to misrepresent changes over time, potentially missing significant changes in body composition, or suggesting changes that havent occurred. A healthy ECW/TBW ratio varies slightly between sources and device manufacturers but ranges from 0.36 to 0.40. WebConclusions Lean and fat mass calculated from BIA using published formulae produces plausible values and demonstrate good concordance between high BMI and high fat, but these differ substantially from the machine-generated values. We thank C.S. Although BIA was primarily used to determine changes in dialysis patients [2], it is a method now used to determine body composition across a range of populations, including athletes [2, 3], obese individuals [4, 5], and the general population [3]. METABOLIC SUPPORT: Edited by Paul E. Wischmeyer. R. Segal, J. Wang, B. Gutin, R. N. Pierson and T. Van Italie, Hydration and potassium content of lean body mass: effects of body fat, sex and age, American Journal of Clinical Nutrition, vol. How does muscularity assessed by bedside methods compare to computed tomography muscle area at intensive care unit admission? Similarly, hand-held instruments may only assess the body composition of the upper extremities. 23. ECW/TBW-ratio is higher among ICU nonsurvivors and correlates with a longer mechanical ventilation duration [25]. Authors P Deurenberg 1 , J A Weststrate, I Paymans, K van der Kooy. [10][11], Consumer grade devices for measuring BIA have not been found to be sufficiently accurate for single measurement use, and are better suited for use to measure changes in body composition over time for individuals. Fiaccadori E, Morabito S, Cabassi A, Regolisti G. Body cell mass evaluation in critically ill patients: killing two birds with one stone. Extracellular resistance is sensitive to tissue sodium status; implications for, 55. "Advanced body composition assessment: from body mass index to body composition profiling", "Bioelectrical impedance: effect of 3 identical meals on diurnal impedance variation and calculation of body composition", "Clinical characteristics influencing bioelectrical impedance analysis measurements", "Is bioelectrical impedance accurate for use in large epidemiological studies? Bio-electrical impedance vector analysis (BIVA) represents impedance as a vector of reactance and resistance in an x--y plot referring to reference population's tolerance ellipses (Fig. There exists a correlation between PA values and body cell mass. Sun et al., [7] validated BIA equations using the four-compartment model and reported that the equation was sufficient for use in epidemiological research studies to assess populations with normal levels of body composition. However, there was a time difference between the BIA and CT evaluation in these studies, potentially inducing bias. 199-209, 1992. 43. Bioelectrical Impedance Bodyfat Testing (BI) - Topend Sports | The Therefore, for this review, BIA will be used to denote all bioelectrical impedance assessments. [7] For example, moderate intensity exercise for 90120 minutes before BIA measurements causes nearly a 12kg overestimation of fat-free mass, i.e. Associations between nutritional energy delivery, 41. 74-78, 2005. Bioelectrical impedance The purpose of this study was to validate percentage of body fat (BF) values estimated from BIA and skinfold (SF) with those obtained from hydrodensitometry (HD). Despite studies showing promising effects of BIA on body composition, this has not been found in a large body of research. M. Evans, M. J. Saunders, M. A. Spano, S. A. Arngrimsson, R. D. Lewis and K. J. Cureton, Body-composition changes with diet and exercise in obese women: A comparison of estimates from clinical methods and a 4-component model, American Journal of Clinical Nutrition, vol. Kuchnia A, Earthman C, Teigen L, et al. Clin Nutr 2020; 39:18091817. Electrical impedance measurement on plants: a review - Home Association between multifrequency. [8] Therefore, it is recommended not to perform BIA for several hours after moderate or high intensity exercise. (2000) [11] found that leg-to-leg BIA using the manufacturer equations resulted in large errors when attempting to predict body fat, relative to the four-compartment model. Various body composition parameters are derived from thereon, using regression analyses with multiple variables obtained through reference measurements. Baldwin CE, Fetterplace K, Beach L, et al. Impact of hyperhydration on the mortality risk in critically ill patients admitted in intensive care units: comparison between bioelectrical impedance vector analysis and cumulative fluid balance recording. Effect of incorrect measures in the applied setting Bioelectrical impedance analysis (BIA) is a widely used, non-invasive field method for assessing body composition, which measures the electrical characteristics of human body either at 50 kHz (single-frequency BIA) or at several frequencies in the range 11000 kHz (multifrequency BIA and BIS = bioimpedance spectroscopy). A variety of single-frequency BIA analyzers then became commercially available, such as RJL Systems and its first commercialized impedance meter. 47. Bioelectrical impedance measurements for assessment of kidney function in critically ill patients. Bioelectrical impedance analysis. What does it measure? Nutr Clin Pract 2018; 33:217223. 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. Bioelectrical Impedance: What it Measures & Normal Levels 1040-1045, 2011. Phase angle (PA) is the tan value Tel: +31 318 434115; fax: +31 318 434116; e-mail: [emailprotected], This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. Bioelectrical impedance analysis-derived. 1017-1022, 1988. 5. 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. Get new journal Tables of Contents sent right to your email inbox, http://creativecommons.org/licenses/by-nc-nd/4.0, Bioelectric impedance analysis for body composition measurement and other potential clinical applications in critical illness, Articles in PubMed by Hanneke Pierre Franciscus Xaverius Moonen, Articles in Google Scholar by Hanneke Pierre Franciscus Xaverius Moonen, Other articles in this journal by Hanneke Pierre Franciscus Xaverius Moonen, Clinical use of peripheral perfusion parameters in septic shock, Hemodynamic monitoring in cardiogenic shock, Intracranial pressure management: moving beyond guidelines, Mechanical circulatory support in the treatment of cardiogenic shock. Early detection of muscle weakness and functional limitations in the critically ill: a retrospective evaluation of. Data is temporarily unavailable. One study using Segmental Multifrequency BIA (SMMF-BIA) found that impedance, reactance and PhA showed more predictive power for mortality than the SAPS, APACHE-II and SOFA severity scoring systems. As such, the following areas of research are needed to expand current knowledge on this topic: To conclude, it is likely that BIA is not a suitable body composition assessment method for athletic populations. WebFactors affecting bioelectrical impedance measurements in humans Eur J Clin Nutr. 46. (1988) [23] reported an underestimation of fat-free mass when assessing changes in body composition following weight loss. E. Chouinard, D. A. Schoeller, A. C. Watras, R. Randall Clark, R. N. Close and A. C. Buchholz, Bioelectrical Impedance vs. Four-compartment Model to Assess Body Fat Change in Overweight Adults, Obesity, vol. Scharfetter, T. Schlager, R. Stollberger, R. Felsberger, H. Hutten and H. Hinghofer-Szalkav, Assessing abdominal fatness with local bioimpedance analysis: basics and experimental findings, International Journal of Obesity and Related Metabolic Disorders, vol. Moonen HPFX, van Zanten FJL, Driessen L, et al. Kim D, Sun JS, Lee YH, et al. bioelectrical impedance Martinoli R, Mohamed EI, Maiolo C, et al. What does bioelectrical impedance spectroscopy (BIS) measure? BIA-derived muscle mass appears a promising biomarker for sarcopenia, correlating well with CT-analysis. However, it still requires extrapolation based on population references. The correlation with DXA can be as high as 99% when measuring fat-free mass, if strict guidelines are adhered to. Assessed by Bioelectrical Impedance Spectroscopy 40. Hand-to-Foot BIA PhA measured at 50 kHz is most frequently used, and most reference data are available for this frequency, as this is the frequency at which both resistance and maximum reactance are best measured [7,8]. the resistance of the electrical current [Z]) of the current and then estimate body composition hence the name bioelectrical impedance. Hui D, Dev R, Pimental L, et al. This review discusses the potential clinical applications of BIA and explores caveats and solutions to its use in the intensive care setting. quantities of fat mass and fat-free mass) by running a small electrical current through the body. In addition, eating and strenuous exercise 2-4 hours prior to assessment have also previously been shown to decrease impedance; ultimately affecting the accuracy of the measurement [19]. WebThe measurement is an indication of resistance by fat tissue to an electrical current, a reliable test for measuring a persons body fat to lean muscle ratio. Bioimpedance spectroscopy (BIS) applies a more extensive frequency range than MF-BIA. In renal replacement therapy patients, a PhA cut-off of 4.6 has been shown to predict malnutrition, defined by protein--energy wasting [36,37]. 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. Bioelectrical impedance is the measure of impedance of the body. 434-440, 1990. [9], BIA is considered reasonably accurate for measuring groups, of limited accuracy for tracking body composition in an individual over a period of time, but is not considered sufficiently accurate for recording of single measurements of individuals. The measured phase angle therefore depends on several biological factors. Cunningham, or Katch--McArdle). A practical guide to bioelectrical impedance - Nutrition Journal 50. WebAdvantages - The test accurately measures what % of your body weight is made up of fat, bone , muscle and water. H.P.F.X.M. Bioelectrical impedance analysis (BIA) is a simple, inexpensive, quick and non-invasive technique for measuring body composition. Buter H, Veenstra JA, Koopmans M, Boerma CE. Safety and results of bioelectrical impedance analysis in patients with cardiac implantable electronic devices. 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 use of multiple frequencies or BIS in specific BIA devices has been shown to have high correlation with DXA when measuring body fat percentage. Conversely, reactance increases proportionally to cell numbers and their integrity, because of membrane capacitance. 30, pp. Bioelectrical impedance methods are often classified by the number of frequencies used for analysis, with BIA often referring to single-frequency devices, whereas multiple-frequency devices are referred to as Bioelectrical Spectroscopy (BIS) as it uses a spectra of frequencies [5]. 57. A prospective, clinician-blinded study was conducted to assess the feasibility and validity of BIVA as a measure of hydration in critically ill patients. Armed with that information, the machine is able to calculate the impedance (i.e. Therefore, BIA might be clinically useful to identify sarcopenic patients at risk for adverse outcome. 59. 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. 33. Use of bioelectrical impedance analysis for the assessment of nutritional status in critically ill patients. You may be trying to access this site from a secured browser on the server. They speculated that changes in glycogen stores, and the loss of water bound to glycogen molecules, may affect BIA estimates of fat-free mass. Garlini LM, Alves FD, Kochi A, et al. Thus, a large PhA is consistent with a large body cell mass (BCM) relative to ECW, as seen in healthy individuals, whereas ICU patients tend to have a lower PhA. Some error has occurred while processing your request. [21] In 1992, Kushner proposed the use of multiple frequencies to increase the accuracy of BIA devices to measure the human body as 5 different cylinders (right arm, left arm, torso, right leg, left leg) instead of one. 9. [17], In 1983, Nyober validated the use of whole body electrical impedance to assess body composition.[18]. By the early 2020s smartwatches like the Samsung Galaxy Watch 4 contained built in BIAs. Barbosa-Silva MC, Barros AJ, Wang J, et al. WebBioelectrical impedance analysis (BIA) is a widely used method for estimating body composition, yet issues concerning its validity persist in the literature. Unlike BIS, MF-BIA devices typically measure impedance at 2-6 different frequencies and are unable to determine the pure resistance values at zero and Body composition A study comparing sepsis patients with other critically ill patients found that PhA was negatively correlated with the APACHE-II score only in the nonsepsis group [21]. Bioelectrical impedance Several other caveats impair routine use of BIA in the ICU, such as use of inexact input parameters, the lack of ICU reference and cut-off values, and the possible bias introduced by a rapidly changing clinical status. 7 minutes read. 5-12, 1999. Crit Care Med 2019; 47:e984e992. In CRRT ICU patients, a cut-off for SMMF-BIA ECW/TBW-ratio of 0.413 predicted 28-day mortality, with 71.4% sensitivity and 70.6% specificity [27]. Diminished cell count, membrane integrity and altered hydration status in critical illness can lead to changes in reactance and resistance, thereby decreasing PhA compared with healthy individuals [11,12]. PA depends on cell membrane integrity and on body cell mass. Deurenberg, J. A.R.H.V.Z. What is Bioelectric Impedance Analysis and How - Home - Remi Cederholm T, Jensen GL, Correia MITD, et al. Davenport A. Anaesthesiol Intensive Ther 2014; 46:381391. The Theory and Fundamentals of Bioimpedance Analysis in Clinical Several raw and BIA-derived body composition parameters have been validated as mortality and morbidity predictors in various patient groups and are now being researched as predictors of critical illness outcome [9,10]. Phase angle is greater in men than women, and decreases with increasing age.[27]. The validity of BIA for one-off measures of body composition Superiority of BIS to the SF-BIA and MF-BIA techniques has not been proven in nonhealthy populations [13,4]. Bioelectrical impedance is a test that looks at body composition. Seoane F, Abtahi S, Abtahi F, et al. The use of bio-electrical impedance analysis (BIA) to guide fluid management, resuscitation and deresuscitation in critically ill patients: a bench-to-bedside review. muscle, fat, bone, etc.) BCM is the metabolically active part of FFM, in contrast to bone and ECW. All rights reserved. Bioelectrical Impedance Analysis (BIA) is able to make an estimation of body composition (e.g. Bioelectrical impedance vector analysis in critically ill patients: a prospective, clinician-blinded investigation. 67, pp. FFM is closely related to energy expenditure, and some BIA devices offer options to estimate basal metabolic rate (BMR), using FFM-based equations (e.g. High-frequency currents will go through cells. A. Bergsma-Kadijk, B. Baumeister and P. Deurenberg, Measurement of body fat in young and elderly women: comparison between a four-compartment model and widely used reference methods., British Journal of Nutrition, vol. Moonen, Hanneke Pierre Franciscus Xaveriusa; Van Zanten, Arthur Raymond Huberta,b, aDepartment of Intensive Care Medicine, Gelderse Vallei Hospital, Ede, bDivision of Human Nutrition and Health, Wageningen University & Research, Wageningen, The Netherlands, Correspondence to Arthur Raymond Hubert Van Zanten, MD, PhD, Department of Intensive Care, Gelderse Vallei Hospital, Willy Brandtlaan 10, 6716 RP Ede, The Netherlands. 33-36, 1989. 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. The principle of BIA is that the different tissues in the body will act as conductors, semiconductors, or dielectrics (insulators). Bioelectric impedance analysis (BIA) is the most applicable bedside technique. It is familiar in the consumer market as a simple instrument for estimating body fat. Reactance, resistance, impedance and PhA, are often referred to as raw BIA parameters, that is, not reliant upon empirical modeling. Clin Nutr 2004; 23:14301453. Bioelectrical Impedance Analysis (BIA) is able to make an estimation of body composition (e.g. BIA[1] actually determines the electrical impedance, or opposition to the flow of an electric current through body tissues which can then be used to estimate total body water (TBW), which can be used to estimate fat-free body mass and, by difference with body weight, body fat. Bioelectrical Impedance Analysis in Monitoring of the Clinical Status and Diagnosis of Diseases. WebBioimpedance spectroscopy (BIS) is the only noninvasive, low-cost technology that can accurately measure a patients total body water, extracellular and intracellular fluid volumes in a clinical setting. Bioelectrical Impedance J Crit Care 2017; 40:103107. Although they are validated against standard methods (usually MRI and DXA), the exact equations used by BIA software are rarely released by manufacturers, impairing judgment of applicability [48]. 649-657, 1996. One main drawback of BIA is the incorporation of reference population values, for all but the raw parameters, which might not apply to the individual patient or population. 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]. Multifrequency BIA devices (MF-BIA), therefore, provide a more direct portrayal of water compartments, making them more reliable in case of altered hydration status or electrolyte imbalances. A PhA greater than 6 is assumed normal in health, although PhA varies with sex (men) and age (because of loss of fat-free mass; FFM), and should ideally be related to a reference population, or converted to standardized PhA (SPhA) before comparing across populations [5,6]. N. Gleichauf and D. A. Roe, The menstrual cycles effect on the reliability of bioimpedance measurements for assessing body composition., American Journal of Clinical Nutrition, vol. This can have wide-ranging implications, from assessing the efficacy of previous dietary and training interventions to making decisions on the correct interventions moving forward. Estimating resting energy expenditure by different methods as compared with indirect calorimetry for patients with pulmonary hypertension. Hall, Body composition assessment of athletes using bioelectrical impedance measurements, Journal of Sports Medicine and Physical Fitness, pp. 53. [2], Although the instruments are straightforward to use, careful attention to the method of use (as described by the manufacturer) should be given. 15, no. 4, pp. Bioelectrical Impedance 2. It reports information about the amount of muscle, bone and fat using a weak electrical current. 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). BIA is commonly used in dialysis patients to guide fluid management by calculating dry weight goals [11,44]. Most equations to estimate glomerular filtration rate are based on serum creatinine measurement. Contrastingly, experience with BIA-guided fluid management is still limited and suggested methods of reducing bias in BIA-measurements in the critically ill require validation. 443-446, 2004. 3. 13. WebBioelectrical impedance analysis (BIA) is a noninvasive method based on the electrical current conductance properties of tissues. Buccholz, C. Bartok and D. A. Schoeller, The Validity of Bioelectrical Impedance Models in Clinical Populations, Nutrition in Clinical Practice, vol. 81, pp. Chamney PW, Wabel P, Moissl UM, et al. Whole body impedance measurement is generally measured from the wrist to the ipsilateral ankle and uses either two (rarely) or four (overwhelmingly) electrodes. Resting energy expenditure prediction using bioelectrical impedance analysis in patients with severe motor and intellectual disabilities.

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