Body composition analysis by leg-to-leg bioelectrical impedance and dual-energy X-ray absorptiometry in non-obese and obese individuals

Aim: The aim of this study is to compare total weight, % body fat (% BF), fat mass (FM) and fat‐free mass (FFM) measured by bioelectrical impedance analysis (BIA) and dual‐energy X–ray absorptiometry (DXA). Methods: This cross‐sectional study included 159 women (mean age: 49.1 ± 10.0 years) and 124 men (mean age: 51.4 ± 8.0 years) subdivided according to sex and body mass index (BMI): BMI < 30 kg/m² (66 women and 50 men); BMI 30–35 kg/m² (53 women and 44 men) and BMI ≥ 35 kg/m² (40 women and 30 men). Bioelectrical impedance was performed in the fasting state on a Tanita TBF‐215 leg‐to‐leg analyser (Tanita, Tokyo, Japan). Whole‐body DXA scans were performed on a Hologic QDR 4500 A bone densitometer (Hologic, Bedford, MA, USA). Total weight, % BF, FM and FFM were tested for intermethod differences. Linear regression and correlation analysis was performed. Limits of agreement and Bland–Altman plots were built. Results: DXA‐derived body composition parameters were not significantly different from BIA estimates and were highly correlated (e.g. for FFM, r = 0.82–0.95). In lean individuals, BIA tended to produce lower values for FM and % BF and higher ones for FFM in comparison with DXA. This trend was reversed at BMI > 35 kg/m². The correlations decreased with increasing BMI. The limits of agreement were much better in men than in women and increased with increasing BMI in both sexes. Conclusions: Compared with DXA, the leg‐to‐leg Tanita TBF‐215 analyser accurately assessed body composition in a heterogeneous group of both sexes. In the very obese women (BMI > 35 kg/m²), BIA measurements should be viewed with caution.