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ABSTRACT: Despite the increasing use of tetrapolar whole-body bioelectric impedance (BI) analysis in the assessment of body composition, its usefulness in estimating fat-free mass (FFM) has
not been evaluated in comparison with conventional skinfold anthropometry in children. We therefore compared 1) the intraobserver and interobserver reproducibility of BI and skinfold
measurements and the derived FFM estimates, and 2) the predictability of FFM as calculated from measurements of total body potassium (TBK) using 40K spectrometry by equations based on either
BI or skinfold measurements in 112 healthy children, adolescents, and young adults aged 3.9 to 19.3 y. A best-fitting equation to predict TBK-derived FFM from BI and other potential
independent predictors was developed and cross validated in two randomly selected subgroups of the study population by stepwise multiple regression analysis. Although the technical error
associated with BI measurements was much smaller than that of skinfold measurements, the reproducibility of BI-derived FFM estimates (intraobserver coefficient of variation [CV], 0.39%;
inter-observer CV, 1.23%) was only slightly better than that of FFM estimates obtained by use of weight and two skinfold measurements (0.62% and 1.39%, respectively). The cross validation
procedure yielded the following best-fitting prediction equation: FFM = 0.65. (height2/impedance) + 0.68-age + 0.15 (R2 = 0.975, root mean square error = 1.98 kg, CV = 5.8%, 95% limits of
agreement = −11.1% to + 12.4%). Conventional anthropometry, using published equations to estimate FFM from skinfolds, slightly overestimated TBK-derived FFM, but predicted FFM with precision
similar to the best-fitting equation involving BI. Previously published FFM equations incorporating BI predicted TBK-derived FFM with variable predictive precision and accuracy. We conclude
that BI analysis provides an alternative technique to assess FFM in children. At least within the range of normal body composition, its predictive power is similar to that of established
skinfold techniques.
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