Bioelectrical impedance vector analysis in obese and overweight children

INTRODUCTION: BMI is the most commonly used indicator to evaluate overweight and obesity, but it cannot distinguish changes in body composition. Over recent years, it has been demonstrated that bioelectrical impedance analysis (BIA) is a more accurate method for analyzing body composition. Bioelectrical impedance vector analysis (BIVA) has revealed its effectiveness as an indicator of nutritional status and hydration. OBJECTIVE: To assess the usefulness of bioimpedance analysis on the study of body composition in a group of children with overweight and obesity. MATERIALS AND METHODS: Cross-sectional observational study. The anthropometric parameters of 167 (79 were older than 12 years) overweight and obese children were recorded. Their body composition was analyzed using BIA and BIVA, and was classified based on different criteria. Concordance was analyzed (intraclass correlation coefficient, Bland-Altman analysis and weighted Kappa coefficient). The BIVA of the subgroups was compared using the Mahalanobis distance and Hotelling’s T(2). Statistical significance was considered for p<0.05. RESULTS: The BMI revealed that the majority of the assessed subjects were obese, although 12% had a normal percentage of fat mass (%FM). The classification by Z-BMI and Z-%FM significantly discriminate between subjects with different levels of adiposity. In children over the age of 12, the classification of fat mass index also discriminates significantly between obesity and non-obesity. As anticipated, in the tolerance ellipses, most of the individual vectors were situated in the left lower quadrant. CONCLUSIONS: BIVA reflects differences in the bioelectric patterns of children who are classified as being overweight or obese (BMI) and who have different levels of %FM and FMI. BIVA permits a fast and easy monitoring of the evolution of the nutritional state and changes associated with body composition, and it identifies those children whose body compartments may be precisely estimated using traditional BIA methods.