Comparison of Bioelectrical Impedance Analysis, Slaughter Skinfold-Thickness Equations, and Dual-Energy X-ray Absorptiometry for Estimating Body Fat Percentage in Colombian Children and Adolescents with Excess of Adiposity

Abstract

Dual-energy X-ray absorptiometry (DXA) has been considered a reference method for measuring body fat percentage (BF%) in children and adolescents with an excess of adiposity. However, given that the DXA technique is impractical for routine field use, there is a need to investigate other methods that can accurately determine BF%. We studied the accuracy of bioelectrical impedance analysis (BIA) technology, including foot-to-foot and hand-to-foot impedance, and Slaughter skinfold-thickness equations in the measurement of BF%, compared with DXA, in a population of Latin American children and adolescents with an excess of adiposity. A total of 127 children and adolescents (11–17 years of age; 70% girls) from the HEPAFIT (Exercise Training and Hepatic Metabolism in Overweight/Obese Adolescent) study were included in the present work. BF% was measured on the same day using two BIA analysers (Seca® 206, Allers Hamburg, Germany and Model Tanita® BC-418®, TANITA Corporation, Sportlife Tokyo, Japan), skinfold measurements (Slaughter equation), and DXA (Hologic Horizon DXA System®, Quirugil, Bogotá, Columbia). Agreement between measurements was analysed using t-tests, Bland–Altman plots, and Lin’s concordance correlation coefficient (ρc). There was a significant correlation between DXA and the other BF% measurement methods (r > 0.430). According to paired t-tests, in both sexes, BF% assessed by BIA analysers or Slaughter equations differ from BF% assessed by DXA (p < 0.001). The lower and upper limits of the differences compared with DXA were 6.3–22.9, 2.2–2.8, and −3.2–21.3 (95% CI) in boys and 2.3–14.8, 2.4–20.1, and 3.9–18.3 (95% CI) in girls for Seca® mBCA, Tanita® BC 420MA, and Slaughter equations, respectively. Concordance was poor between DXA and the other methods of measuring BF% (ρc < 0.5). BIA analysers and Slaughter equations underestimated BF% measurements compared to DXA, so they are not interchangeable methods for assessing BF% in Latin American children and adolescents with excess of adiposity.

Validity of Slaughter Equations and Bioelectrical Impedance Against Dual‐Energy X‐Ray Absorptiometry in Children

“…BFP bias was approximately −0.5% in boys and approximately −4.7% in girls using the Slg‐Eq method. A similar tendency was observed by González‐Ruiz et al , who found that Slg‐Eq underestimated BFP by 9.0% in boys and 11.1% in girls. We did not find significant differences by sex using BIA, but our data seemed to show a slightly opposite tendency than González‐Ruiz et al found, in which mean bias was larger in boys (14.0%) than in girls (11.0%).…”

“…Noradilah et al included, however, a complete range of weight status (i.e., from severely thin to obesity), which might also explain the higher variability between measurements. This idea has also been reported in the recent study by González‐Ruiz et al in children and adolescents (11‐17 years) with excess adiposity. They also found that BIA and Slg‐Eq underestimated BFP compared with DXA and that the differences in Slg‐Eq against DXA could be related to the larger SKF thickness, as Slaugther et al included a sample with lower adiposity to develop their equations.…”

“…In our children (80% prepubescents and 20% pubescents), the mean sum of triceps and subscapular SKF was 52.1 ± 10.5 mm for boys and 55.2 ± 12.5 mm for girls, whereas the sum of the sample of Slaughter et al was 17.7 ± 6.9 mm for boys and 22.0 ± 5.3 mm for girls. González‐Ruiz et al obtained a sum of 37.2 ± 8.5 mm for girls, taking into account that the data shown were from postpubescents. Other studies that focused only on BIA against DXA also underestimated adiposity, which concurs with our findings.…”

“…Few studies have included the validity of both the Slg‐Eq and BIA methods against DXA for estimating body fat percentage (BFP) in a young population , with just two focused on children with overweight and obesity . To our knowledge, no longitudinal studies have compared changes over time in body composition measurements, including these three methods together.…”

Physical fitness components in relation to attention capacity in Latin American youth with overweight and obesity

“…Second, we did not measure specific cognitive outcomes that underlie executive function and physical activity. Similarly, the lack of gold‐standard measurements of adiposity (ie, Bod Pod and dual‐energy X‐ray absorptiometry) should be acknowledged as another limitation 35. A strength of the present study lies in the fact that it is the first study, to our knowledge, to assess the relationship between physical fitness and attention among Latin American youth population.…”