Validation of two portable bioelectrical impedance analyses for the assessment of body composition in school age children

Background Bioelectrical impedance analysis (BIA) is a convenient and child-friendly method for longitudinal analysis of changes in body composition. However, most validation studies of BIA have been performed on adult Caucasians. The present cross-sectional study investigated the validity of two portable BIA devices, the Inbody 230 (BIA(8MF)) and the Tanita BC-418 (BIA(8SF)), in healthy Taiwanese children. Methods Children aged 7-12 years (72 boys and 78 girls) were recruited. Body composition was measured by the BIA(8SF) and the BIA(8MF). Dual X-ray absorptiometry (DXA) was used as the reference method. Results There were strong linear correlations in body composition measurements between the BIA(8SF) and DXA and between the BIA(8MF) and DXA. Both BIAs underestimated fat mass (FM) and percentage body fat (%BF) relative to DXA in both genders The degree of agreement in lean body mass (LBM), FM, and %BF estimates was higher between BIA(8MF) and DXA than between BIA(8SF) and DXA. The Lin's concordance correlation coefficient (rho(c)) for LBM8MF met the criteria of substantial to perfect agreement whereas the rho(c) for FM8MF met the criteria of fair to substantial agreement. Bland-Altman analysis showed a clinically acceptable agreement between LBM measures by BIA(8MF) and DXA. The limit of agreement in %BF estimation by BIA and DXA were wide and the errors were clinically important. For the estimation of ALM, BIA(8SF) and BIA(8MF) both provided poor accuracy. Conclusions For all children, LBM measures were precise and accurate using the BIA(8MF) whereas clinically significant errors occurred in FM and %BF estimates. Both BIAs underestimated FM and %BF in children. Thus, the body composition results obtained using the inbuilt equations of the BIA(8SF) and BIA(8MF) should be interpreted with caution, and high quality validation studies for specific subgroups of children are required prior to field research.