BIA health assessment -
The two contact points on a typical BIA scale are your two feet called foot-foot bioelectrical impedance analysis.
This means that when you use the device, you place each foot on a pad, and the current travels through your body between your feet. There are also hand-to-foot BIA devices, as well. Many of the newer models of BIA scales link with a smartphone app so you can track your progress over time.
The price of your BIA scale will depend on how sophisticated the product is. Some scales use more than one frequency and more advanced algorithms to provide a result.
And some offer segmental fat analysis, meaning you can get body fat measurements for each leg, arm, and belly. Some experts say that segmental fat analysis using hand-foot BIA is more accurate because hand-hand devices primarily measure the upper body, while foot-foot scales primarily measure the lower body.
Bioelectrical impedance analysis devices are considered safe for most people. However, BIA should not be used by anyone with an electronic medical implant, such as a heart pacemaker or an implantable cardioverter defibrillator ICD. Also, most device makers recommend that pregnant people not use the products.
Some studies showed that bioelectrical impedance analysis is a reasonably accurate method for estimating body fat. But these research studies generally do not test the scales you find in the store.
Experts generally agree that the accuracy of the measurement depends, in part, on the quality of the device. In addition, other factors may affect a reading when you use a BIA scale.
Some researchers also say that ethnicity can affect the accuracy of BIA measurements. Overall, studies show that this method is not very accurate although it may be able to track change over time, your results are unlikely to reflect your actual body composition.
Even if you get an accurate reading on a bioimpedance scale, the number represents an estimate of your total body fat percentage.
Bioelectrical impedance analysis does not accurately measure your total body fat. Most scales also cannot tell you where fat is located on your body. Even though many factors can affect your reading accuracy, a regular BIA scale can show you changes in your body fat over time.
The actual number may not be perfect, but you can still track changes to your body composition. Because many BIA scales offer several features for a reasonable cost and are a quick and easy way to estimate body fat percent, body fat scales that use bioelectrical impedance analysis are a worthwhile investment for consumers who are curious about their body composition.
Keep in mind that they are not likely to be very accurate but you can use them to track changes over time. Using another method of tracking your body composition can help you get a better picture of your actual measurements. It's also wise to understand that there is more to health than your body fat percentage or weight, and these scales are only a tool, not a reflection of your general wellness.
Gagnon C, Ménard J, Bourbonnais A, et al. Comparison of Foot-to-Foot and Hand-to-Foot Bioelectrical Impedance Methods in a Population with a Wide Range of Body Mass Indices.
Metab Syndr Relat Disord. Demura S, Sato S. Comparisons of accuracy of estimating percent body fat by four bioelectrical impedance devices with different frequency and induction system of electrical current. J Sports Med Phys Fitness. Bioelectrical impedance analysis BIA : A proposal for standardization of the classical method in adults.
Journal of Physics Conference Series. Androutsos O, Gerasimidis K, Karanikolou A, Reilly JJ, Edwards CA. Impact of eating and drinking on body composition measurements by bioelectrical impedance.
J Hum Nutr Diet. Blue MNM, Tinsley GM, Ryan ED, Smith-Ryan AE. Validity of body-composition methods across racial and ethnic populations. Advances in Nutrition.
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Develop and improve services. Use limited data to select content. List of Partners vendors. Thus, BIA still is an underused and underestimated tool for nutritional assessment in primary care.
This can be further explained by the fact that the costs of BIA are currently not always refundable [ 12 ] and that there are no guidelines outlining the methods for assessing malnutrition in patients with COPD [ 9 , 19 ].
BIA analysis is simply and effectively complemented by bioelectrical impedance vector analysis BIVA , which is independent of hydration status and can be used as a quality control measure for correct interpretation of BIA results [ 20 , 21 ].
BIVA is a pattern analysis of impedance measurements resistance and reactance plotted as a vector in a coordinate system [ 21 ]. Reference values adjusted for age, BMI and gender are plotted as so-called tolerance ellipses in the coordinate system.
On this basis, a statement can be made with regard to water balance normo-, hypo-, hyperhydration and body cell mass nutritional status [ 14 ]. It reflects a decade of our own practical experience of using single-frequency BIA combined with BIVA with a focus on COPD patients. BIA is a method for estimating body composition.
The principle of BIA is to determine the electric impedance of an electric current passing through the body [ 15 ]. The electrical impedance Z consists of two components, resistance R and reactance Xc.
Reactance is a measure of BCM and resistance a measure of total body water [ 15 , 22 ]. From the determined impedance a number of BIA parameters can be estimated [ 20 ]:. consists of all cells that have an effect on metabolism e. muscle, internal organs, nervous system.
increase or decrease mostly due to increased extracellular water retention or a loss of extracellular water. The strengths and limitations of different BIA methods e. single frequency, multi-frequency, segmental BIA have been extensively reviewed [ 15 , 16 , 18 , 23 — 25 ]. Our experience is based on single frequency BIA 50 kHz ; the software package we use NUTRIPLUS from Data Input GmbH includes BIVA and adapted reference values.
Detailed instructions for performing BIA measurements can be found elsewhere [ 17 , 18 ]. To give a brief description here, single frequency BIA usually involves the placing of two distal current or signal-introducing electrodes on the dorsal surfaces of the hand and foot close to the metacarpal-phalangeal and metatarsal-phalangeal joints, respectively.
The two voltage sensing electrodes are applied at the pisiform prominence of the wrist and between the medial and lateral maleoli of the ankle. The impedance analyzer delivers a constant alternating current at a fixed kHz frequency via the distal electrodes and detects the drop in voltage via the proximal electrodes.
The measured resistance and reactance are displayed by the analyzer [ 18 ]. Factors impacting BIA results [ 16 , 18 , 20 , 23 , 25 ]:.
position of the body and limbs supine position, arms abducted at least 30°, legs abducted at approximately 45°. consumption of food and beverages no beverages for at least 12 hours previously, fasted state for at least 2 hours.
medical conditions and medication that have an impact on the fluid and electrolyte balance; infection and cutaneous disease that may alter the electrical transmission between electrode and skin.
non-adherence of electrodes, use of wrong electrodes, loosening of cable clip, interchanging of electrodes. BIA parameters are largely dependent on the patient's hydration status. BIA enables the above mentioned parameters to be determined in subjects without significant fluid and electrolyte abnormalities [ 15 ].
BIVA as an integrated part of BIA measurement is a simple, quick and clinically valuable method for assessing fluid status TBW and body cell mass BCM. This method plots the direct impedance measurements resistance R and reactance Xc as a bi-variate vector in a nomogram Figure 1 [ 21 ].
Reference values adjusted for age, BMI and gender are plotted as so-called tolerance ellipses in the same coordinate system.
Three tolerance ellipses are distinguished, corresponding to the 50 th , 75 th and 95 th vector percentile of the healthy reference population [ 22 , 26 ]. Values outside of the 95 th percentile are considered abnormal.
As shown in Figure 1 , values located outside the 95 th percentile in the following four quadrants point to the following conditions [ 20 ]: a right upper quadrant e.
exsiccosis b left lower quadrant e. oedema c right lower quadrant e. malnutrition d left upper quadrant e. good training status. Interpretation of the BIVA nomogram. Age, BMI and gender adjusted reference values are plotted as so-called tolerance ellipses in the coordinate system.
Three tolerance ellipses are distinguished, corresponding to the 50 th , 75 th and 95 th vector percentile of the healthy reference population.
Values located outside the 95 th percentile in the following four quadrants point to the following conditions: a right upper quadrant e.
good training status modified with permission from Data-Input GmbH. We present below some examples of characteristic BIA findings in COPD patients with their interpretation:. From personal experience, follow-up measurements examples should be performed every 4 weeks for overweight patients and every weeks for all other cases [ 27 ].
However, this is a decision that must be taken on an individual basis. Patient: female, Interpretation: With a BMI of The measurement point in the BIVA nomogram Figure 2 lies within the 50 th tolerance ellipse and thus indicates normal findings. Normal finding as illustrated in the BIVA nomogram.
The position of the measurement point in the BIVA nomogram within the 50 th tolerance ellipse range of normal values indicates a normal finding. Conclusion: All values in the table are within the normal range and the measurement point in the BIVA nomogram lies within the 50 th tolerance ellipse.
The measurement point in the BIVA nomogram Figure 3 in this patient is well below the line of normal BCM values long axis and above the line of normal TBW values short axis between the 75 th and the 95 th tolerance ellipse.
The position of the measurement point in the lower right quadrant points to malnutrition. Malnutrition in an obese COPD patient as illustrated in the BIVA nomogram. The position of the measurement point in the BIVA nomogram is below the line of normal BCM values long axis and above the line of normal TBW values short axis between the 75 th and 95 th tolerance ellipse.
The position in the lower right quadrant indicates malnutrition. The BIA parameter values listed in table 2 can be interpreted as follows: The fat mass lies above the normal range in line with the increased BMI. BCM lies within the normal range.
At first sight this does not fit in with the finding of the BIVA nomogram, which indicates malnutrition. The fact that the calculated BCM is within the range of normal values here may be explained as follows: It needs to be considered that BCM is dependent on the patient's fluid status TBW.
This means that a BCM within the normal range does not necessarily mean a normal nutritional status but may also be due to increased TBW. This indicates that BCM is actually reduced. BCM therefore only appears to lie within the range of normal values because of the increased TBW. In contrast to this somewhat complex interpretation of the calculated BIA values, the suspected diagnosis of malnutrition can be established at a glance by BIVA.
In addition, it is confirmed that the calculated BCM is too high because of the increased TBW position of the measurement point in the BIVA nomogram above the line of normal TBW values.
Conclusion: Despite the presence of obesity the patient is exhibiting malnutrition. The position of the measurement point in the BIVA nomogram in the right lower quadrant between the 75 th and the 95 th tolerance ellipse provides an indication for the suspected diagnosis of malnutrition.
The measurement point in the BIVA nomogram Figure 4 in this patient is far below the line of normal BCM values long axis and well above the line of normal TBW values short axis , far outside the 95 th tolerance ellipse.
The position of the measurement point in the lower right quadrant points to malnutrition in the form of cachexia.
Cachexia as illustrated in the BIVA nomogram. The position of the measurement point in the BIVA nomogram is far below the line of normal BCM values long axis and well above the line of normal TBW values short axis far outside the 95 th tolerance ellipse. The position in the lower right quadrant points to cachexia.
The BIA parameter values listed in table 3 can be interpreted as follows: The fat mass lies below the normal range in line with the reduced BMI.
The calculated values for BCM und TBW are reduced. It needs to be considered as regards the reduced BCM value that BCM is dependent on the patient's fluid status TBW. This means that a reduced BCM does not necessarily point to malnutrition but may also be due to a low TBW. In this example also BIVA provides a more efficient assessment of the nutritional status than the calculated BIA parameters.
Conclusion: All the values listed in the table are below the normal range and the measurement point in the BIVA nomogram is outside the 95 th tolerance ellipse in the lower right quadrant. This indicates severe malnutrition in the form of cachexia.
The assessment of the BIVA nomogram is sufficient for the suspected diagnosis of cachexia. The measurement point in the BIVA nomogram Figure 5 in this patient is above the line of normal BCM values long axis and well below the line of normal TBW values short axis on the 95 th tolerance ellipse.
The position of the measurement point in the lower left quadrant points to water retention in the form of oedema. Oedema due to right heart failure as illustrated in the BIVA nomogram. The position of the measurement point in the BIVA nomogram is above the line of normal BCM values long axis and well below the line of normal TBW values short axis on the 95 th tolerance ellipse.
The position in the lower left quadrant indicates the presence of increased water retention. The BIA parameter values listed in table 4 can be interpreted as follows: Body fat mass lies above the normal range in line with the increased BMI.
The determined TBW is increased and the calculated BCM lies in the upper range of normal. These findings are consistent with the position of the measurement point above the line of normal BCM values and below the line of normal TBW values in the lower left quadrant.
With the derived normal BIA value for BCM it needs once again to be taken into account here that BCM is dependent on the patient's fluid status TBW. This means that a BCM within the normal range does not necessarily indicate an actually normal BCM or normal nutritional status but may also appear normal due to an increased TBW.
In addition to the increased TBW, ECM is also markedly increased, indicating oedema. The suspicion of oedema is established at a glance with BIVA.
BIVA confirms simply and rapidly the calculated BIA values BCM and TBW. The suspicion of oedema was confirmed on physical examination of the legs. Conclusion: The values listed in the table for TBW and ECM are outside the normal range and the measurement point in the BIVA nomogram is on the 95 th tolerance ellipse in the lower left quadrant, indicating oedema.
The determined BCM is in the upper range of normal and the measurement point in the BIVA nomogram is above the line of normal BCM values. The position of the measurement point in the nomogram provides an indication for the suspected diagnosis of oedema.
For the general differential diagnosis of underweight we present a female patient with anorexia: female, The measurement point in the BIVA nomogram Figure 6 lies almost on the line of normal BCM values long axis and far above the line of normal TBW values short axis outside the 95 th tolerance ellipse.
The position of the measurement point in the upper right quadrant points to the presence of anorexia. Anorexia as illustrated in the BIVA nomogram.
The position of the measurement point in the BIVA nomogram is almost on the line of normal BCM values long axis and far above the line of normal TBW values short axis outside the 95 th tolerance ellipse.
The position in the upper right quadrant points to the presence of anorexia. The BIA parameter values listed in table 5 can be interpreted as follows: Body fat mass is reduced in line with the low BMI.
TBW is markedly reduced and BCM also is decreased. With the reduced BCM it needs to be kept in mind here that BCM is dependent on the patient's fluid status TBW.
This means that a lower BCM may also appear reduced due to a lower TBW. This indicates that BCM is normal and that the calculated value was too low only because of the low TBW. BIVA confirms the suspicion raised by the BIA values that the calculated BCM was too low because of the reduced TBW.
Again, the suspected diagnosis of anorexia can be established more efficiently and more reliably by BIVA. Conclusion: The patient exhibits a markedly reduced BMI, decreased body water and a normal BCM in the form of anorexia. The position of the measurement point in the nomogram in the upper right quadrant outside the 95 th tolerance ellipse provides an indication for the suspected diagnosis of anorexia.
Bioelectrical impedance analysis BIA , particularly in combination with bioelectrical impedance vector analysis BIVA , provides a viable opportunity for evaluating body composition in humans. As the examples suggest the interpretation of BIA results is often complex and a suspected diagnosis can be established more efficiently and more reliably by integrating BIVA into the patient assessment process.
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Bioimpedance analysis BIA is a valuable tool for measuring your Orange Peels Uses BIA health assessment measurement of body uealth in relation to lean body mass. It BIA health assessment an important part BIA health assessment hhealth comprehensive yealth and nutrition assessment. A normal balance of body hewlth to lean body mass is associated with good health and longevity. Excess fat in relation to lean body mass, a condition known as altered body composition, can greatly increase your risk of cardiovascular disease, diabetes, and more. BIA enables early detection of an improper balance in your body composition, which allows for earlier intervention and prevention. BIA also provides the measurement of fluid and body mass that can be a critical assessment tool for your current state of health. Bioelectrical Impedance Radiant complexion BIA can estimate body composition e. fat mass and fat-free mass via a small electrical current. Assessmdnt Charlie Beestone Heakth updated: September 25th, 16 min read. Bioelectrical Impedance Analysis BIA is able to make an estimation of body composition e. quantities of fat mass and fat-free mass by running a small electrical current through the body. This is possible simply because different bodily tissues e. muscle, fat, bone, etc.
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