Bioelectrical impedance analysis (BIA) has received significant attention as a means of studying body composition and the relationship of changes in the body's conductive and other electrical properties to changes in body water or its distribution. The application of this technology to the care of patients with nutritional and metabolic disorders is presently under investigation. In this review, a broad overview of recent literature is provided, after the background and rationale for BIA and factors affecting the accuracy of measurements are reviewed.
Get full access to this article
View all access options for this article.
References
1.
1. Nyboer J. Electrical impedance plethysmography. Springfield, IL: Charles C Thomas, 1970;3–49.
2.
2. Kushner RF, Schoeller DA.Estimation of total body water by bioelectrical impedance analysis. Am J Clin Nutr1986;44:417–24.
3.
3. Lukaski HC, Johnson PE, Bolunchuk WW, et al. Assessment of fat-free mass using bioelectrical impedance measurements of the human body. Am J Clin Nutr1985;41:810–7.
4.
4. Scanfera F, Landini S, Fracasso F.On-line bioelectrical impedance during haemodialysis: monitoring of body fluids and cell membrane status. Nephrol Dial Transplant Suppl1990;1:167–70.
5.
5. Scheltinga MR, Jacobs DO, Kimbrough TD, et al. Alterations in body fluid content can be detected by bioelectrical impedance analysis (BIA). J Surg Res1991;50:461–8.
6.
6. Scheltinga MR, Jacobs DO, Kimbrough TD, et al. Identifying body fluid distribution by measuring electrical impedance. J Trauma1992;33:665–70.
7.
7. Segal KR, Burastero S, Chun A, et al. Estimation of extracellular and total body water by multiple-frequency bioelectrical impedance measurement. Am J Clin Nutr1991;54:26–9.
8.
8. Chiolero RL, Gay LJ, Cotting J, et al. Assessment of changes in body water by bioimpedance in acutely ill surgical patients. Intensive Care Med1992;18:322–6.
9.
9. Rudis MIU, Patel RV, Zarowitz BJ.Comparison of multiple and single frequency bioelectrical impedance analysis to gold standard determination of extracellular mass and total body water [Abstract]. Crit Care Med1994;22 (Suppl):A47.
10.
10. Cornish BH, Ward LC, Thomas BJ, et al. Evaluation of multiple frequency bioelectrical impedance and Cole-Cole analysis for the assessment of body water volumes in healthy humans. Eur J Clin Nutr1996;50:159–64.
11.
11. Deurenberg P, Wolde-Gebriel Z, Shouten FJ.Validity of predicted total body water and extracellular water using multifrequency bioelectrical impedance in an Ethiopian population. Ann Nutr Metab1995;39:234–41.
12.
12. Schell B, Gross R.The reliability of bioelectrical impedance measurements in the assessment of body composition in healthy adults. Nutr Reports Intern1987;36:449–59.
13.
13. Baker LE.Principles of the impedance technique. IEEE Trans Biomed Eng1989;2:11–15.
14.
14. Maehara T, Novak I, Wyse RKH, et al. Perioperative monitoring of total body water by bioelectrical impedance in children undergoing open heart surgery. Eur J Cardio Surg1991;5:258–65.
15.
15. Kushner RF, Schoeller DA.Estimation of total body water by bioelectrical impedance analysis. Am J Clin Nutr1986;44:417–24.
16.
16. Scheltinga MR, Jacobs DO.Bioelectrical impedance analysis during health and disease: an overview and future directions. In: Bioelectrical impedance analysis: a bedside method for fluid measurement. M Scheltinga, PhD dissertation, Vrije Universiteit, VU University Press, Amsterdam, the Netherlands, 1992.
17.
17. Hoffer EC, Meador CK, Simpson DC.Correlation of whole body impedance with total body water volume. J Appl Physiol1969;27:531–4.
18.
18. Lukaski HC, Johnson PE, Bolunchuk WW, et al. Assessment of fat-free mass using bioelectrical impedance measurements of the human body. Am J Clin Nutr1985;41:810–7.
19.
19. McDougall D, Shizgal HM.Body composition measurement from whole body resistance and reactance. Surg Forum1986;37:42–4.
20.
20. Schloerb PR, Gurian JH, Lord LM, et al. Bioimpedance as a measure of total body water and body cell mass in surgical nutrition [abstract 5]. Eur Surg Res1986;18:S1.
21.
21. Houtkooper LB, Lohman TG, Going SB, et al. Validity of bioelectrical impedance for body composition assessment in children. J Appl Physiol1989;66:814–21.
22.
22. Segal KR, Gutin B, Presta E, et al. Estimation of human body composition by electrical impedance methods: a comparative study. J Appl Physiol1985;58:1565–71.
23.
23. Baumgarter RN, Chumlea WC, Roche AF.Bioelectrical impedance phase angle and body composition. Am J Clin Nutr1988;48:16–23.
24.
24. Diaz EO, Villar J, Immink M, et al. Impedance or anthropometry?Eur J Clin Nutr1989;43:129–37.
25.
25. Pasco JA, Rutishauser IHE.Body fat estimated from anthropometric and electrical impedance measurements. Hum Nutr Clin Nutr1985;39C:365–9.
26.
26. Jackson AS, Pollock ML, Graves JE, et al. Reliability and validity of bioelectrical impedance in determining body composition. J Appl Physiol1988;64:529–34.
27.
27. Kushner RF, Haas A.Estimation of total body water by bioelectrical impedance analysis compared to skinfold anthropometry. Eur J Clin Nutr1988;42:101–6.
28.
28. Campos AC, Chen M, Meguid MM.Comparisons of body composition derived from anthropometric and bioelectrical methods. J Am Coll Nutr1989;8:484–9.
29.
29. Segal KR, Gutin B, Presta E, et al. Estimation of human body composition by electrical impedance methods: a comparative study. J Appl Physiol1985;58:1565–71.
30.
30. Schroeder D, Christi PM, Hill GL.Bioelectrical impedance analysis for body composition: clinical evaluation in general surgical patients. JPEN1990;14:129–33.
31.
31. Brown BH, Karatzas T, Nakielny R, et al. Determination of upper arm muscle and fat areas using electrical impedance measurements. Clin Phys Physiol Meas1988;9:47–55.
32.
32. Svendsen OL, Haarbo J, Heitmann BL, et al. Measurement of body fat in elderly subjects by dual-energy x-ray absorptiometry, bioelectrical impedance analysis and antrhopometry. Am J Clin Nutr1991;53:1117–23.
33.
33. Gran MI, Khaled MA.Cross-validation of fat-free mass estimated from body density against bioelectrical resistance: effects of obesity and gender. Obes Res1995;3:531–9.
34.
34. Fuller NJ, Sawyer MB, Laskey MA, et al. Prediction of body composition in elderly men over 75 years of age. Ann Hum Biol1996;23:127–47.
35.
35. Roubenoff R. Applications of bioelectrical impedance analysis for body composition to epidemiologic studies. Am J Clin Nutr1996;64:459s-62s.
36.
36. Nelson ME, Fiatarone MA, Layne JE, et al. Analysis of body-composition techniques and models for detecting changes in soft tissue with strength training. Am J Clin Nutr1996;63:678–86.
37.
37. Eckerson JM, Stout JR, Housh TJ, et al. Validity of bioelectrical impedance equations for estimating percent fat in males. Med Sci Sports Exercise1996;28:523–30.
38.
38. Segal KR.Use of bioelectrical impedance analysis measurements as an evaluation for participating in sports. Am J Clin Nutr1996;64:469s-71s.
39.
39. Hodgdon JA, Friedl KE, Beckett MR, et al. Use of bioelectrical impedance analysis measurements as predictors of physical performance. Am J Clin Nutr1996;64:463s-8s.
40.
40. Jacobs DO.Use of bioelectrical impedance analysis measurements in the clinical management of critical illness. Am J Clin Nutr1996;64 (suppl):4985–5025.
41.
41. Kotler DP, Burastero S, Wang J, et al. 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 Nutr1996;64:489s-97s.
42.
42. Pencharz PB, Azcue M.Use of bioelectrical impedance analysis measurements in the clinical management of malnutrition. Am J Clin Nutr1996;64:485s-8s.
43.
43. Bosaeus I, Johannsson G, Rosen T, et al. Comparison of methods to estimate body fat in growth hormone deficient adults. Clin Endocrinol1996;44:395–402.
44.
44. Stall S, Ginsberg NS, Lynn RI, et al. Bioelectrical impedance analysis and dual energy x-ray absorptiometry to monitor nutritional status. Perit Dial Int1995;15 (5 Suppl):S59–62.
45.
45. Chertow GM, Lowrie EG, Wilmore DW, et al. Nutritional assessment with bioelectrical impedance analysis in maintenance hemodilaysis patients. J Am Soc Nephrol1995;6:75–81.
46.
46. Sluys TE, van der Ende ME, Swart GR, et al. Body composition in patients with acquired immunodeficiency syndrome: a validation of bioelectric impedance analysis. JPEN1993;17:404–6.
47.
47. Schloerb PR, Foster J, Delcore R, et al. Bioelectrical impedance in the clinical evaluation of liver disease. Am J Clin Nutr1996;64:510s-4s.
48.
48. Chiolero RL, Gay LJ, Cotting J, et al. Assessment of changes in body water by bioimpedance in acutely ill surgical patients. Intensive Care Med1992;18:322–6.
49.
49. Roos AN, Westendorp RGJ, Frolich M, et al. Weight changes in critically ill patients evaluated by fluid balances and impedance measurements. Crit Care Med1993;21:871–7.
51. Meguid MM, Lukaski HC, Tripp MD, et al. Rapid bedside method to assess changes in postoperative fluid status with bioelectrical impedance analysis. Surgery1992;112:502–8.
52.
52. Schroeder D, Christie PM, Hill GL.Bioelectrical impedance analysis for body composition: clinical evaluation in general surgical patients. JPEN1990;14:129–33.
53.
53. Fearson KCH, Richardson RA, Hannan J, et al. Bioelectrical impedance analysis in the measurement of the body composition of surgical patients. Br J Surg1992;79:421–3.
54.
54. Chertow GM, Jacobs D, Lazarus JM, et al. Phase angle predicts survival in hemodialysis patients. J Renal Nutr 1997 (in press).
55.
55. Maggiore Q, Nigrelli S, Ciccarelli C, et al. Nutritional and prognostic correlates of bioimpedance indexes in hemodialysis patients. Kidney Int1996;50:2103–8.
56.
56. Mattar JA.Application of total body bioimpedance to the critically ill patient. New Horiz1996;4:493–503.
57.
57. Zarowitz BJ.Bioelectrical impedance analysis measurements for drug pharmacokinetics. Am J Clin Nutr1996;64:519s-23s.
