Original ResearchComparison of body composition with bioelectric impedance (BIA) and dual energy X-ray absorptiometry (DEXA) among Singapore Chinese
Introduction
There is a strong connection between body fat percentage (%BF), obesity, and ethnicity as %BF differs according to ethnicity and also within ethnic groups.1 Therefore, due to inter- and intra-ethnic variations in the pattern of fat distribution, results of various body measurement techniques on a particular ethnic group cannot be compared universally.
Measurement of body composition has evolved from a single unit of weight measurement to multi-compartment models that include water, protein, mineral and fat.2 Previously, underwater weighing was considered as the gold standard in measurement of body composition but this method had many technical problems.3 Measurements of skinfolds are relatively easy but this technique does not accurately measure the changes in fat free mass (FFM) and may underestimate the loss of FFM due to weight loss.4 Currently, dual energy X-ray absorptiometry (DEXA) has been considered as the ‘gold standard’ and as an armamentarium in soft tissue particularly fat mass and lean muscle mass measurements. However, this technique is expensive and not widely accessible. Thus, it is not a simple and cost effective method. Bioelectric impedance (BIA) has been proven to be one of the most practical methods to estimate body composition among different groups due to its ready accessibility, low cost, quick assessment procedures, and its high validity (r = 0.88–0.94, p < 0.05) against DEXA as the reference method.5
There are few studies on body composition that have been conducted on Singapore Chinese adults.6 But to date none of the studies have investigated the agreement of BIA with DEXA in measuring %BF among Singapore Chinese adults. The purpose of the present study was to evaluate the agreement of BIA with DEXA in the estimation of %BF among healthy Singapore Chinese adults.
Section snippets
Methods
Hundred Singapore Chinese adults [63 healthy males (age: 25.2 ± 0.5 yrs; weight: 69.7 ± 1.9 kg) and 37 females (age: 22.9 ± 0.4 yrs; weight: 51.6 ± 0.8 kg)] from the college population of Nanyang Technological University, Singapore were selected to participate in the study. The Physical Education and Sport Science Academic Group's ethical committee approved the investigation. All the participants were given verbal and written explanations about the experimental procedures before signing a declaration of
Results
The %BFBIA (20.1 ± 0.6%) obtained in the total cohort was significantly higher (p < 0.001) than %BFDEXA (18.8 ± 0.7%) with mean difference or bias of 1.3% (95% CI: 1.98 to −0.60). According to gender, there was higher bias among males (2.2%; 95% CI: 1.36 to 3.06) than females (−0.3%; 95% CI: −1.31 to 0.74) (Table 1).
Discussion
BIA overestimated the measurement of %BF as compared to the measurement by DEXA among total cohort, specifically among males. These results are comparable with Sun et al.’s5 study on 591 healthy participants in which BIA overestimated the %BF by 3.03% among males with %BF lower than 15%. Similarly, the %BF of more than 80% of male cohort [%BF; mean (M) = 13.2%] in the present study was below 20% and studies have indicated that the BIA generally overestimated the %BF measurement among population
Conclusion
This study has shown a good level of agreement between BIA and DEXA in estimating the %BF among Singapore Chinese adults. On gender basis and total cohort basis, small bias was detected in %BF measurement through these methods. Therefore, BIA can be suitably employed to measure the %BF among Singapore Chinese adults on a group basis. However, this technique may not be precise enough to measure %BF on an individual basis or in clinical practices in Singapore Chinese adults due to wider limits of
Practical implication
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In addition to its accuracy and its high validity against DEXA (0.87; p < 0.001), BIA method may be the most practical method to measure body composition among a cohort of Singapore Chinese adults since it is readily accessible, easy to use, inexpensive, convenient, and requires minimal time for measurements.
Acknowledgement
The author would like to acknowledge the participants from National Institute of Education, Nanyang Technological University, Singapore. There was no grant/financial support provided for this study.
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