Validity of the use of bioimpedance in the assessment of body composition in children and adolescents: a systematic review
e202610081
DOI:
https://doi.org/10.67113/resp.v100i1.1736Keywords:
Bioelectrical impedance, Body composition, Child, Adolescent, Obesity, Dual-energy X-ray absorptiometry, Systematic reviewAbstract
BACKGROUND // Bioelectrical impedance analysis (BIA) is a non-invasive technique that estimates different body compartments, including fat mass, fat-free mass and total body water, and may complement traditional anthropometric measures. This review aimed to summarise the available evidence on the validity of BIA for assessing body composition in children and adolescents and to identify factors influencing its performance.
METHODS // A systematic review of diagnostic methods was conducted in accordance with the Preferred Reporting Items in Systematic Reviews and Meta-Analyses (PRISMA) recommendations. PubMed, EMBASE and the Cochrane Library were searched in February 2025 for studies published between 2010 and 2024. Validation studies in participants younger than eighteen years comparing BIA with reference methods, such as dual-energy X-ray absorptiometry (DXA), isotope dilution, air-displacement plethysmography or multicomponent models, were included. Two reviewers independently screened records and full texts and extracted relevant information. Risk of bias was assessed using QUADAS-2, and findings were narratively synthesised.
RESULTS // Fifty-six studies were included; across fifty-three studies with quantifiable sample sizes, approximately 11,100 participants were evaluated. Reported correlations ranged widely (r=0.03–0.98), being higher when population-specific equations were derived in similar cohorts and lower in obesity, young athletes, infants and clinically complex groups, particularly when generic manufacturer equations were applied. Agreement analyses frequently showed clinically relevant individual discrepancies. In overweight/obesity, BIA tended to underestimate fat mass/%body fat and to overestimate fat-free mass. Reliability was high (ICC: approximately 0.93–0.98).
CONCLUSIONS // The available evidence supports BIA as a non-invasive, reproducible and reliable tool, useful for group-level assessment, surveillance and, in particular, longitudinal monitoring of body composition in paediatric populations. It does not replace body mass index or reference methods, and its performance depends critically on the device, the equation applied and the clinical context; therefore, caution is warranted at the extremes of body composition, where population-specific equations are recommended. Nevertheless, given its feasibility and capacity to track change over time, BIA may provide complementary information on body composition and contribute to a more health- and cardiometabolic risk-oriented approach to obesity in children and adolescents when results are appropriately interpreted and communicated.
REGISTRATION // PROSPERO CRD420261305127 (https://www.crd.york.ac.uk/PROSPERO/view/CRD420261305127).
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- 2026-10-23 (2)
- 2026-10-23 (1)
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Copyright (c) 2026 Carlos MartÍn Saborido, Esther Elena García Carpintero, Lucía Pedrosa Pérez, Carlos Alberto Sánchez Piedra, Montserrat Carmona Rodríguez, David Montes Bentura, Andrés Cabrera León
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