Validity and reliability of bioelectrical impedance analysis to estimate body fat percentage against air displacement plethysmography and dual-energy X-ray absorptiometry

AbstractAir displacement plethysmography (ADP) and dual‐energy X‐ray absorptiometry (DXA) are well‐regarded methods for predicting body fat percentage (BF%). Bioelectrical impedance analysis (BIA) also predicts BF% and has distinct advantages in research settings.AimTo assess the validity of BIA against ADP and DXA to measure BF%, and to test the reliability of each method.MethodsAdults (n = 166) with a wide range of body mass index (19–38 kg/m2) were tested twice during a 5‐day period. ADP was conducted in a BodPod (Life Measurement Inc, Concord, CA, USA); DXA measurements on a QDR Discovery A (Hologic) and BIA measurements used the InBody 230 (Biospace Ltd., Seoul, Korea). Agreement between measurements was analysed using t‐tests, effect size, linear regression models and method of triads (estimating true value).ResultsBIA showed excellent relative agreement to the estimated true value (ρ = 0.97 (0.96, 0.98)) and to ADP (R2 = 0.88) and DXA (R2 = 0.92), but wide limits of agreement (−4.25 to 8.37%). BIA underestimated BF% by 2%, across all values. DXA showed excellent relative agreement to the estimated true value (ρ = 0.97 (0.96, 0.98)) and with ADP (R2 = 0.92), good absolute agreement but wide limits of agreement (−6.13 to 6.91%) and under‐ and overestimation at high and low BF% levels, respectively. All methods showed excellent reliability with repeat measurements differing by less than 0.2% with very small 95% CIs.ConclusionsBIA may be a valid method in research and population samples. All three methods showed excellent reliability.