CBM 94-9 BIOELECTRIC IMPEDANCE ANALYSIS IN BODY COMPOSITION MEASUREMENT January 1989 through December 1994 627 Citations Prepared by Ronald L. Gordner, M.L.S., Reference Section, National Library of Medicine Catherine Roos Selden, M.L.S., National Information Center on Health Services Research and Health Care Technology, National Library of Medicine Willis R. Foster, M.D., National Institute of Diabetes and Digestive and Kidney Diseases U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Public Health Service National Institutes of Health National Library of Medicine Reference Section 8600 Rockville Pike Bethesda, Maryland 20894 1994 National Library of Medicine Cataloging in Publication Gordner, Ronald L. Bioelectric impedance analysis in body composition measurement : January 1989 through December 1994 : 627 citations / prepared by Ronald L. Gordner, Catherine Roos Selden, Willis R. Foster. -- Bethesda, Md. (8600 Rockville Pike, Bethesda 20894) : U.S. Dept. of Health and Human Services, Public Health Service, National Institutes of Health, National Library of Medicine, Reference Section; Pittsburgh, PA : Sold by the Supt. of Docs., U.S. G.P.O., 1994. -- (Current bibliographies in medicine ; 94-9) Available from NLM at no cost though Internet FTP. Prepared in support of the Technology Assessment Conference on Bioelectric Impedance Analysis in Body Composition Measurement held at the National Institutes of Health on December 12-14, 1994. 1. Electric Impedance - bibliography 2. Body Composition - bibliography 3. Anthropometry - bibliography I. Selden, Catherine. II. Foster, Willis R. III. National Library of Medicine (U.S.). Reference Section IV. Technology Assessment Conference on Bioelectric Impedance Analysis in Body Composition Measurement (1994 : National Institutes of Health) V. Title VI. Series 02NLM: ZW 1 N272 no.94-9 SERIES NOTE Current Bibliographies in Medicine (CBM) is a continuation in part of the National Library of Medicine's Literature Search Series, which ceased in 1987 with No. 87-15. In 1989 it also subsumed the Specialized Bibliography Series. Each bibliography in the new series covers a distinct subject area of biomedicine and is intended to fulfill a current awareness function. Citations are usually derived from searching a variety of online databases. NLM databases utilized include MEDLINE, AVLINE, BIOETHICSLINE, CANCERLIT, CATLINE, HEALTH, POPLINE and TOXLINE. The only criterion for the inclusion of a particular published work is its relevance to the topic being presented; the format, ownership, or location of the material is not considered. Comments and suggestions on this series may be addressed to: Karen Patrias, Editor Current Bibliographies in Medicine Reference Section National Library of Medicine Bethesda, MD 20894 Phone: 301-496-6097 Fax: 301-402-1384 Internet: patrias@nlm.nih.gov Ordering Information: Current Bibliographies in Medicine is sold by the Superintendent of Documents, U.S. Government Printing Office, P.O. 371954, Pittsburgh, PA 15250-7954. To order the entire CBM series for calendar year 1994 (approximately 10 bibliographies), send $60.00 ($75.00 foreign) to the Superintendent of Documents citing GPO List ID: CBM94. For your convenience an order blank is given inside the back cover. Orders for individual bibliographies in the series ($8.50, $10.63 foreign) should be sent to the Superintendent of Documents citing the title, CBM number, and the GPO List ID given above. Internet Access: The Current Bibliographies in Medicine series is also available at no cost to anyone with Internet access through FTP (File Transfer Protocol). FTP to nlmpubs.nlm.nih.gov and login as anonymous. The index file in the "bibs" directory provides information on the bibliographies available. Use of funds for printing this periodical has been approved by the Director of the Office of Management and Budget through September 30, 1995. BIOELECTRIC IMPEDANCE ANALYSIS IN BODY COMPOSITION MEASUREMENT Bioelectric impedance analysis (BIA) measures the opposition of bodily tissues to the flow of a mild (less than one milliAmp) alternating electric current. Impedance is a function of two components (vectors): the resistance of the tissues themselves and the additional opposition (reactance) due to the capacitant effect of membranes, tissue interfaces, and nonionic tissues; both components are measured in ohms. Electrodes are typically placed on a wrist and an ankle (in the tetrapolar method, on the dorsal surfaces of the right hand and foot as well as the wrist and ankle), and change in voltage between electrodes is measured. The method assumes that the body (or a segment of it) is approximately cylindrical and of uniform cross section; this allows calculation of its volume, as proportional to its length squared divided by its impedance. The proportionality constant is its specific resistivity (the mean of each tissue's characteristic specific resistivity), and this is a function of tissue composition. Body fat and bone show high resistance levels; muscle tissues show lower resistance, and body resistance is approximately that of lean muscle tissue. In effect, lean body impedance is a function of the specific resistivity of the lean tissue, together with its cross-sectional area and its length. Impedance measures vary with the frequency of the current used (typically, 50 kHz, when a single frequency is used). At low frequencies, current flows primarily through extracellular fluids, while at high frequencies it penetrates all body tissues. Applications of BIA increasingly use multiple frequency measurements, or a frequency spectrum, to show differences in body composition due to clinical and nutritional status (as well as to age, ethnicity, sex, and other variables). Many equations have been developed to estimate total body water (TBW) and fat-free mass (FFM) as a function of impedance, weight, height, gender, and age. In actual use, however, BIA calculations of an individual's body fat reported in the literature may vary by as much as 10 percent of body weight due to differences in machines and methodologies employed. Equations and their variables differ, as does the choice of a reference method. Summaries of body composition methods in use can be found in this bibliography. There is a need for a consensus of experts on the appropriate conditions of use and appropriate applications of bioelectric impedance. This bibliography was prepared in support of the Technology Assessment Conference on Bioelectric Impedance Analysis in Body Composition Measurement held at the National Institutes of Health on December 12-14, 1994. The purpose of the Conference is to compare BIA with other available techniques for determination of body composition, with a view to the assumptions, limitations, and applicability of each, and then examine in detail the rationale and instrumentation for BIA and its technique variations in current use. Variables influencing the measurement of BIA will be considered, along with the need for standardization of testing conditions. The several types of applications of BIA listed in the Table of Contents will be examined. Finally, the pressing need for additional research will be highlighted, in discussions of research issues for future attention. The bibliography represents the clinical and research literature on BIA for the five year period ending with December 1994. Journal articles are the primary type of publication covered, although citations to books, conference proceedings and papers, government publications, and dissertations have been included. Arrangement is by subject, and items may appear in more than one category. Within each category, arrangement is alphabetical by author. Citations are to English and foreign language publications. The compilers wish to thank Marlyn Schepartz, National Information Center for Health Services Research and Health Care Technology, National Library of Medicine, for editorial and production assistance. SEARCH STRATEGY A variety of online databases are usually searched in preparing bibliographies in the CBM series. To assist you in updating or otherwise manipulating the material in this search, the strategy used for the NLM's MEDLINE database is given below. Please note that the search strategies presented here differ from individual demand searches in that they are generally broadly formulated and irrelevant citations edited out prior to printing. SS 1 = ELECTRIC IMPEDANCE OR PLETHYSMOGRAPHY, IMPEDANCE SS 2 = (TW) ALL IMPEDANC: OR ALL BIOIMPEDANC: OR ALL IMPEDENC: OR BIA SS 3 = 1 OR 2 SS 4 = EXP E5.118 OR EXP BODY COMPOSITION OR EXP BODY FLUIDS OR EXP BODY WEIGHT SS 5 = EXP NUTRITION OR EXP NUTRITION DISORDERS OR EXP NUTRITION ASSESSMENT OR EXP NUTRITION SURVEYS SS 6 = EXP ANTHROPOMETRY OR EXP ADIPOSE TISSUE SS 7 = HIV OR HIV SEROPOSITIVITY OR EXP HIV INFECTIONS OR ACQUIRED MMUNODEFICIENCY SYNDROME SS 8 = EXP SPORTS OR EXP SPORTS MEDICINE SS 9 = EXP DIALYSIS OR EXP HEMODIALYSIS OR EXP KIDNEY DISEASES SS 10 = CRITICAL ILLNESS OR EXP LIVER DISEASES SS 11 = PHARMACOKINETICS (MH) OR PHARMACOKINETICS (SH) SS 12 = 3 AND 4 OR 3 AND 5 OR 3 AND 6 OR 3 AND 7 SS 13 = 3 AND 8 OR 3 AND 9 OR 3 AND 10 OR 3 AND 11 SS 14 = 12 OR 13 GRATEFUL MED To make online searching easier and more efficient, the Library offers GRATEFUL MED, microcomputer-based software that provides a user-friendly interface to most NLM databases. This software was specifically developed for health professionals and features multiple choice menus and "fill in the blank" screens for easy search preparation. GRATEFUL MED runs on an IBM PC (or IBM-compatible) with DOS 2.0 or a Macintosh, and requires a Hayes (or Hayes-compatible) modem. It may be purchased from the National Technical Information Service in Springfield, Virginia, for $29.95 (plus $3.00 per order for shipping). For your convenience, an order blank has been enclosed at the back of this bibliography. SAMPLE CITATIONS Citations in this bibliographic series are formatted according to the rules established for Index Medicus*. Sample journal and monograph citations appear below. For journal articles written in a foreign language, the English translation of the title is placed in brackets; for monographs, the title is given in the original language. In both cases the language of publication is shown by a three letter abbreviation appearing at the end of the citation. Note also that a colon (:) may appear within an author's name or article title. The NLM computer system automatically inserts this symbol in the place of a diacritical mark. Journal Article: Authors Article Title Chumlea WC, Guo SS. Bioelectrical impedance and body composition: present status and future directions. Nutr Rev 1994 Apr;52(4):123-31. Abbreviated Journal Date Volume Issue Pages Title Monograph: Authors/Editors Title Lohman TG. Advances in body composition assessment. Champaign (IL): Human Kinetics Books; 1992. 150 p. Place of Publisher Date Total No. Publication of Pages _________________________________ *For details of the formats used for references, see the following publication: Patrias, Karen. National Library of Medicine recommended formats for bibliographic citation. Bethesda (MD): The Library; 1991 Apr. Available from: NTIS, Springfield, VA; PB91-182030. TABLE OF CONTENTS Techniques Instrumentation Methodology - Comparison of Techniques - Variables Affecting Measurement Evaluation -- General Studies Applications: General Usage Obesity, Adiposity Surveys, Epidemiologic Use Performance, Exercise, Energy Balance Evaluations, Clinical and Endocrinologic Military and Space Body Water and Cell Mass: Clinical Analysis Overview and Evaluation Malnutrition, Wasting, AIDS, Cancer Critical Illness and Liver Failure Kidney Failure, Dialysis Diabetes Cystic Fibrosis Pharmacokinetics Research Issues Frequency Spectra, Multiple Frequency Imaging, Impedance Tomography Modeling Segmental Impedance Books and Dissertations TECHNIQUES Instrumentation Andersen RE. Accuracy of bioelectric impedance for body composition assessment in obese women before and after a weight reduction program [dissertation]. Philadelphia: Temple University; 1993. 176 p. Deurenberg P, van der Kooy K, Leenen R. Differences in body impedance when measured with different instruments [letter]. Eur J Clin Nutr 1989 Dec;43(12):885-6. Johnson HL, Virk SP, Mayclin P, Barbieri T. Predicting total body water and extracellular fluid volumes from bioelectrical measurements of the human body. J Am Coll Nutr 1992 Oct;11(5):539-47. Pallas-Areny R, Webster JG. AC instrumentation amplifier for bioimpedance measurements. IEEE Trans Biomed Eng 1993 Aug;40(8):830-3. Pallas-Areny R, Webster JG. Bioelectric impedance measurements using synchronous sampling. IEEE Trans Biomed Eng 1993 Aug;40(8):824-9. Paulson K, Breckon W, Pidcock M. A hybrid phantom for electrical impedance tomography. Clin Phys Physiol Meas 1992;13 Suppl A:155-9. Riu PJ, Rosell J, Lozano A, Pallas-Areny R. A broadband system for multifrequency static imaging in electrical impedance tomography. Clin Phys Physiol Meas 1992;13 Suppl A:61-5. Smye SW, Sutcliffe J, Pitt E. A comparison of four commercial systems used to measure whole-body electrical impedance. Physiol Meas 1993 Nov;14(4):473-8. Vehrs PR, George JD, Payne C, Peugnet J, Bryce GR, Fellingham GW, Fisher AG. Reliability of four methods of body composition assessment. Med Exerc Nutr Health 1994 Jan-Feb;3(1):2-8. Victor OJ, Astrup A, Garby L, Heitmann BL. [Bioimpedance analysis in determining body composition. Testing of a new simple apparatus]. Ugeskr Laeger 1989 Jul 24;151(30):1937-9. (Dan). Wu YT, Nielsen DH, Cassady SL, Cook JS, Janz KF, Hansen JR. Cross-validation of bioelectrical impedance analysis of body composition in children and adolescents. Phys Ther 1993 May;73(5):320-8. Methodology - Comparison of Techniques Albu J, Smolowitz J, Lichtman S, Heymsfield SB, Wang J, Pierson RN Jr, Pi-Sunyer FX. Composition of weight loss in severely obese women:a new look at old methods. Metabolism 1992 Oct;41(10):1068-74. Armellini F, Zamboni M, Rigo L, Bergamo-Andreis IA, Robbi R, Vicentini R, De Marchi M, Formentini G, Bosello O. [Value of echography in the measurement of changes in the total and visceral adipose mass]. Minerva Endocrinol 1991 Jan-Mar;16(1):21-5. (Ita). Baumgartner RN, Heymsfield SB, Lichtman S, Wang J, Pierson RN Jr. Body composition in elderly people:effect of criterion estimates on predictive equations. Am J Clin Nutr 1991 Jun;53(6):1345-53. Blanchard J, Conrad KA, Harrison GG. Comparison of methods for estimating body composition in young and elderly women. J Gerontol 1990 Jul;45(4): B119-24. Borrelli R, Diaz EO. [Statistical techniques for developing equations for impedance measurement]. Minerva Endocrinol 1990 Oct-Dec;15(4):239-43. (Ita). Brambilla P, Manzoni P, Salvatoni A, Battistini N, Simone P, Braggini M, Chiumello G. Body composition and fat distribution using dual-enerfy xray absorptiometry DEXA in obese children comparison with deuterium dilution D20 anthropometry and (BIA) [abstract]. Pediatr Res 1993;33(5 Suppl):S80. Brodie DA, Eston RG. Body fat estimations by electrical impedance and infra-red interactance. Int J Sports Med 1992 May;13(4):319-25. Broekhoff C, Voorrips LE, Weijenberg MP, Witvoet GA, van Staveren WA, Deurenberg P. Relative validity of different methods to assess body composition in apparently healthy elderly women. Ann Nutr Metab 1992;36(3):148-56. Campos AC, Chen M, Meguid MM. Comparisons of body composition derived from anthropometric and bioelectrical impedance methods. J Am Coll Nutr 1989 Dec;8(6):484-9. Carroll JF, Garzerella L, Ishida Y, Pollock ML, Graves JE, Leggett SH. Comparison of ultrasound with bioelectrical impedance and anthropometry for the prediction of body density in women [abstract]. Med Sci Sports Exerc 1991;23(4 Suppl):S90. Chumlea WC, Baumgartner RN. Bioelectric impedance methods for the estimation of body composition. Can J Sport Sci 1990 Sep;15(3):172-9. Chumlea WC, Guo SS. Bioelectrical impedance and body composition: present status and future directions. Nutr Rev 1994 Apr;52(4):123-31. Clark RR, Kuta JM, Sullivan JC. Cross-validation of methods to predict body fat in African-American and Caucasian collegiate football players. Res Q Exerc Sport 1994 Mar;65(1):21-30. Clark RR, Kuta JM, Sullivan JC, Bedford WM, Penner JD, Studesville EA. A comparison of methods to predict minimal weight in high school wrestlers. Med Sci Sports Exerc 1993 Jan;25(1):151-8. Colville BC, Heyward VH, Sandoval WM. Comparison of two methods for estimating body composition of bodybuilders. J Appl Sport Sci Res 1989 Aug-Sep;3(3):57-61. Colvin LA. Total and subcutaneous adipose tissue in children as measured by magnetic resonance imaging, hydrostatic weighing, skinfold calipers, bioelectrical impedance and near infrared interactance (body composition) [dissertation]. Hattiesburg (MS): University of Southern Mississippi; 1993. 136 p. Danford L, Schoeller DA, Kushner RF. Measurement of body composiion in children by bioelectrical impedance analysis compared to deuterium dilution [abstract]. FASEB J 1990;4(4):A936. Danford LC, Schoeller DA, Kushner RF. Comparison of two bioelectrical impedance analysis models for total body water measurement in children. Ann Hum Biol 1992 Nov-Dec;19(6):603-7. Davies PS, Joughin C. Assessment of body composition in the Prader-Willi syndrome using bioelectrical impedance. Am J Med Genet 1992 Sep 1;44(1):75-8. de Waart FG, Li R, Deurenberg P. Comparison of body composition assessments by bioelectrical impedance and by anthropometry in premenopausal Chinese women. Br J Nutr 1993 May;69(3):657-64. DeLozier MG, Gutin B, Wang J, Basch CE, Contento I, Shea S, Irigoyen M, Zybert P, Rips J, Pierson R. Validity of anthropometry and bioimpedance with 4 to 8 year olds. Pediatr Exerc Sci 1991 Aug;3(3):238-49. Deurenberg P. Methods for determining fat mass and fat distribution. Acta Paediatr Suppl 1992 Sep;383:53-7; discussion 58. Deurenberg P, van der Kooy K. Bioelectrical impedance or anthropometry? [letter]. Eur J Clin Nutr 1989 Jul;43(7):503-4. Comment on: Eur J Clin Nutr 1989 Feb;43(2):129-37. Deurenberg P, van der Kooy K, Hautvast JG. The assessment of the body composition in the elderly by densitometry, anthropometry and bioelectrical impedance. Basic Life Sci 1990;55:391-3. Deurenberg P, Westerterp KR, Velthuis-Te Wierik EJ. Between-laboratory comparison of densitometry and bio-electrical impedance measurements. Br J Nutr 1994 Mar;71(3):309-16. Diaz EO, Villar J, Immink M, Gonzales T. Bioimpedance or anthropometry? Eur J Clin Nutr 1989 Feb;43(2):129-37. Comment in: Eur J Clin Nutr 1989 Jul;43(7):503-4. Dolgener FA, Hensley LD, Becker TE, Marsh JJ. A comparison of bioelectric impedance and hydrodensitometry in lean males. J Appl Sport Sci Res 1992 Aug-Sep;6(3):147-51. Eaton AW, Israel RG, O'Brien KF, Hortobagyi T, McCammon MR. Comparison of four methods to assess body composition in women. Eur J Clin Nutr 1993 May;47(5):353-60. Elia M, Parkinson SA, Diaz E. Evaluation of near infra-red interactance as a method for predicting body composition. Eur J Clin Nutr 1990 Feb;44(2): 113-21. Estimating body fat in lean and obese women. Nutr Rev 1992 Mar;50(3):80-1. Fearon KC, Richardson RA, Hannan J, Cowan S, Watson W, Shenkin A, Garden OJ. Bioelectrical impedance analysis in the measurement of the body composition of surgical patients. Br J Surg 1992 May;79(5):421-3. Fowler PA, Fuller MF, Glasbey CA, Foster MA, Cameron GG, McNeill G, Maughan RJ. Total and subcutaneous adipose tissue in women: the measurement of distribution and accurate prediction of quantity by using magnetic resonance imaging. Am J Clin Nutr 1991 Jul;54(1):18-25. Franssila-Kallunki A. Comparison of near-infrared light spectroscopy, bioelectrical impedance and tritiated water techniques for the measurement of fat-free mass in humans. Scand J Clin Lab Invest 1992 Dec;52(8):879-85. Franssila-Kallunki A, Ekstrand A, Rissanen A, Blomqvist AC, Saarinen H, Groop L. Comparison of four different methods for the measurement of body composition in man [abstract]. Acta Endocrino Suppl 1990;122(3):15. Fulcher GR, Farrer M, Walker M, Rodham D, Clayton B, Alberti KM. A comparison of measurements of lean body mass derived by bioelectrical impedance, skinfold thickness and total body potassium. A study in obese and non-obese normal subjects. Scand J Clin Lab Invest 1991 May;51(3):245-53. Fuller NJ. Comparison of abilities of various interpretations of bio-electrical impedance to predict reference method body composition assessment. Clin Nutr 1993;12(4):236-42. Fuller NJ, Elia M. Potential use of bioelectrical impedance of the `whole body' and of body segments for the assessment of body composition: comparison with densitometry and anthropometry. Eur J Clin Nutr 1989 Nov;43(11):779-91. Fuller NJ, Jebb SA, Laskey MA, Coward WA, Elia M. Four-component model for the assessment of body composition in humans: comparison with alternative methods, and evaluation of the density and hydration of fat-free mass. Clin Sci (Colch) 1992 Jun;82(6):687-93. Garzarella L. Predicting body composition of healthy females by B mode ultrasound: comparison with anthropometry and bioelectrical impedance [master's thesis on microfiche]. Eugene (OR): University of Oregon, College of Human Development and Performance, Microform Publications; 1992. 2 microfiche. Gomez I, Leon-Sanz M, Valero MA, Martinez G, Hawkins F. [Comparative study of impedance- based predictive models of body composition]. Nutr Hosp 1993 May-Jun;8(5):295-300. (Spa). Gray DS, Bray GA, Bauer M, Kaplan K, Gemayel N, Wood R, Greenway F, Kirk S. Skinfold thickness measurements in obese subjects. Am J Clin Nutr 1990 Apr;51(4):571-7. Comment in: Am J Clin Nutr 1990 Sep;52(3):578. Greaves KA, Harrison JA, Baranowski T, Puhl J. Inter-observer reliability for bioelectrical impedance analysis and anthropometric measurements [abstract]. Med Sci Sports Exerc 1990;22(2 Suppl):S109. Gregory JW, Greene SA, Jung RT, Scrimgeour CM, Rennie MJ. Changes in body composition and energy expenditure after six weeks' growth hormone treatment. Arch Dis Child 1991 May;66(5):598-602. Comment in: Arch Dis Child 1991 Oct;66(10):1261. Gregory JW, Greene SA, Scrimgeour CM, Rennie MJ. Body water measurement in growth disorders: a comparison of bioelectrical impedance and skinfold thickness techniques with isotope dilution. Arch Dis Child 1991 Feb;66(2):220-2. Hammond J, Rona RJ, Chinn S. Estimation in community surveys of total body fat of children using bioelectrical impedance or skinfold thickness measurements. Eur J Clin Nutr 1994 Mar;48(3):164-71. Hannan WJ, Cowen SJ, Freeman CP, Wrate RM, Barton J. Evaluation of dual-energy X-ray absorptiometry for the assessment of body composition in anorexic females. Basic Life Sci 1993;60:169-72. Hansen NJ, Lohman TG, Going SB, Hall MC, Pamenter RW, Bare LA, Boyden TW, Houtkooper LB. Prediction of body composition in premenopausal females from dual-energy X-ray absorptiometry. J Appl Physiol 1993 Oct;75(4):1637-41. Heitmann BL. Evaluation of body fat estimated from body mass index, skinfolds and impedance. A comparative study. Eur J Clin Nutr 1990 Nov; 44(11):831-7. Heitmann BL. Prediction of body water and fat in adult Danes from measurement of electrical impedance. A validation study. Int J Obes 1990 Sep;14(9):789-802. Heitmann BL, Sorensen SS, Isaksson B. [The use of the impedance measurement technic for calculating body fat mass. A validity study]. Ugeskr Laeger 1989 Oct 2;151(40):2588-91. (Dan). Heymsfield SB, Matthews D. Body composition: research and clinical advances--1993 A.S.P.E.N. research workshop. JPEN J Parenter Enteral Nutr 1994 Mar-Apr;18(2):91-103. Heymsfield SB, Waki M. Body composition in humans: advances in the development of multicompartment chemical models. Nutr Rev 1991 Apr;49(4):97-108. Heymsfield SB, Wang J, Aulet M, Kehayias J, Lichtman S, Kamen Y, Dilmanian FA, Lindsay R, Pierson RN Jr. Dual photon absorptiometry: validation of mineral and fat measurements. Basic Life Sci 1990;55:327-37. Heymsfield SB, Wang J, Kehayias J, Heshka S, Lichtman S, Pierson RN Jr. Chemical determination of human body density in vivo: relevance to hydrodensitometry. Am J Clin Nutr 1989 Dec;50(6):1282-9. Heymsfield SB, Wang J, Lichtman S, Kamen Y, Kehayias J, Pierson RN Jr. Body composition in elderly subjects: a critical appraisal of clinical methodology. Am J Clin Nutr 1989 Nov;50(5 Suppl):1167-75; discussion 1231-5. Heymsfield SB, Wang Z, Baumgartner RN, Dilmanian FA, Ma R, Yasumura S. Body composition and aging: a study by in vivo neutron activation analysis. J Nutr 1993 Feb;123(2 Suppl):432-7. Heyward VH, Cook KL, Hicks VL, Jenkins KA, Quatrochi JA, Wilson WL. Predictive accuracy of three field methods for estimating relative body fatness of nonobese and obese women. Int J Sport Nutr 1992 Mar;2(1):75-86. Hoover LW, Boote EJ, Hillard AE, Thomas TR, Firman JD, Hewett JE, Gay JW. Abdominal fat assessment in postmenopausal women receiving hormone replacement therapy. Basic Life Sci 1993;60:215-8. Hortobagyi T, Israel RG, Houmard JA, O'Brien KF, Johns RA, Wells JM. Comparison of four methods to assess body composition in black and white athletes. Int J Sport Nutr 1992 Mar;2(1):60-74. Houtkooper LB, Going SB, Lohman TG, Roche AF, Van Loan M. Bioelectrical impedance estimation of fat-free body mass in children and youth: a cross-validation study. J Appl Physiol 1992 Jan;72(1):366-73. Israel RG, Eaton AW, O'Brien KF, Hortobagyi T, Mccammon MR. Comparison of four methods to assess body composition in women [abstract]. Med Sci Sports Exerc 1992;24(5):S188. Jebb SA, Elia M. Techniques for the measurement of body composition: a practical guide. Int J Obes Relat Metab Disord 1993 Nov;17(11):611-21. Jebb SA, Murgatroyd PR, Goldberg GR, Prentice AM, Coward WA. In vivo measurement of changes in body composition: description of methods and their validation against 12-d continuous whole-body calorimetry. Am J Clin Nutr 1993 Oct;58(4):455-62. Kaminsky LA, Whaley MH. Differences in estimates of percent body fat using bioelectrical impedance. J Sports Med Phys Fitness 1993 Jun;33(2):172-7. Kehayias JJ, Heymsfield SB, LoMonte AF, Wang J, Pierson RN Jr. In vivo determination of body fat by measuring total body carbon. Am J Clin Nutr 1991 Jun;53(6):1339-44. Keim NL, Barbieri TF, Van Loan M. Comparison of conductivity, impedance and density methods for body composition assessment of obese women. Basic Life Sci 1990;55:227-9. Kirkendall DT, Grogan JW, Bowers RG. Field comparison of body composition techniques: hydrostatic weighing, skinfold thickness, and bioelectric impedance. J Orthop Sports Phys Ther 1991 May;13(5):235-9. Komiya S. [Methods for the assessment of human body composition: skinfold thickness and bioelectrical impedance measurements]. Ann Physiol Anthropol 1991 Jan;10(1):3-17. (Jpn). Kreitzman SN, Coxon A. The use of electrical impedance and infra-red interactance to determine non water lean component of fat free mass. Basic Life Sci 1990;55:433-5. Kushner R. Nutritional assessment: body composition measurement in nutrition support [abstract]. J Am Coll Nutr 1993;12(5):583. Kushner RF, Kunigk A, Alspaugh M, Andronis PT, Leitch CA, Schoeller DA. Validation of bioelectrical-impedance analysis as a measurement of change in body composition in obesity. Am J Clin Nutr 1990 Aug;52(2):219-23. Comment in: Am J Clin Nutr 1991 Jan;53(1):178-9 and Am J Clin Nutr 1991 Jan;53(1): 179-81. Lands LC, Gordon C, Bar-Or O, Blimkie CJ, Hanning RM, Jones NL, Moss LA, Webber CE, Wilson WM, Heigenhauser GJ. Comparison of three techniques for body composition analysis in cystic fibrosis. J Appl Physiol 1993 Jul;75(1):162-6. Lindsay R, Himmelstein S, Herrington BS, Cosman F. Body composition studies in premenopausal healthy women. Basic Life Sci 1990;55:95-9. Little KD, Sinning WE, Wilmore JH, Pollock ML, Graves JE, Lohman TG. Bioelectrical impedance and anthropometric estimates of body composition in middle-age adults [abstract]. Med Sci Sports Exerc 1989;21(2 Suppl):S38. Maki KC, Briones ER, Langbein WE, Inman-Felton A, Nemchausky BA, Burton J, Welch M. A comparison between bioelectrical impedance and near infrared interactance for assessing body composition in persons with spinal cord injury [abstract]. J Am Coll Nutr 1993;12(5):616. Mandolfo S, Imbasciati E. [Comparison and repeatability among bioelectric impedance anthropometry and kinetic modelling]. G Ital Nefrol 1993;10(2):111-5. (Ita). Maughan RJ. An evaluation of a bioelectrical impedance analyser for the estimation of body fat content. Br J Sports Med 1993 Mar;27(1):63-6. Mazariegos M, Kral JG, Wang J, Waki M, Heymsfield SB, Pierson RN Jr, Thornton JC, Yasumura S. Body composition and surgical treatment of obesity. Effects of weight loss on fluid distribution. 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