what does bioelectrical impedance measure

Thibault R, Makhlouf AM, Mulliez A, et al. Assessment of muscularity by BIA is recommended by the Global Leadership Initiative on Malnutrition (GLIM) [39]. Impedance is frequency sensitive; at low frequency the electric current flows preferentially through extracellular water (ECW) only while at high frequency the current can cross cell membranes and hence flows through total body water (TBW). Brain Dev 2019; 41:352358. BIA is commonly used in dialysis patients to guide fluid management by calculating dry weight goals [11,44]. However, BIA assumes static ratios, most notably a fixed hydration of tissues, which often do not apply to critically ill patients, making interpretation less straightforward. Adequate dosing of renally excreted drugs is challenging in critically ill patients because of changes in kidney function. 35. Several raw and BIA-derived body composition parameters have been validated as mortality and morbidity predictors in various patient groups and are now being researched as predictors of critical illness outcome [9,10]. Zanella PB, vila CC, de Souza CG. 13. Overhydration in ICU patients is positively correlated with adverse outcomes but current methods to assess volume status [in-bed weighing, cumulative fluid balance (CFB), central venous pressure] have their limitations. WebDirect measurement of the bodys various compartments can Other articles where bioelectrical impedance is discussed: human nutrition: Body mass, body fat, and body 1968 ). Bioelectric impedance analysis (BIA) is the most applicable bedside technique. 2. 4, pp. N. Gleichauf and D. A. Roe, The menstrual cycles effect on the reliability of bioimpedance measurements for assessing body composition., American Journal of Clinical Nutrition, vol. (1998) [18] showed that BIA was not a suitable method of body composition assessment in athletes with abnormal hydration status (e.g. This is possible simply because different bodily tissues (e.g. Does bioelectrical impedance analysis work? This method may be of benefit in a field setting, due to its convenience. However, hydration of fat-free mass has been shown to rise to over 77 % with increased levels of body fat [22]. A. Jebb, T. J. Cole, D. Doman, P. R. Murgatroyd and A. M. Prentice, Evaluation of the novel Tanita body-fat analyser to measure body composition by comparison with a four-compartment model, British Journal of Nutrition, vol. 36, no. Impact of hyperhydration on the mortality risk in critically ill patients admitted in intensive care units: comparison between bioelectrical impedance vector analysis and cumulative fluid balance recording. The tetrapolar arrangement is preferred since measurement is not confounded by the impedance of the skin-electrode interface[26], In bioelectrical impedance analysis in humans, an estimate of the phase angle can be obtained and is based on changes in resistance and reactance as alternating current passes through tissues, which causes a phase shift. You may search for similar articles that contain these same keywords or you may Several methods have been used to assess body composition in humans, each with advantages and drawbacks surrounding cost, validity, reliability, and accessibility (for more information on the methods of body composition assessment and their uses, click here). Fiaccadori E, Morabito S, Cabassi A, Regolisti G. Body cell mass evaluation in critically ill patients: killing two birds with one stone. Lopot F, Nejedl B, Novotn H, et al. The principle of BIA is that the different tissues in the body will act as conductors, semiconductors, or dielectrics (insulators). Unlike BIS, MF-BIA devices typically measure impedance at 2-6 different frequencies and are unable to determine the pure resistance values at zero and The advantage of the multiple electrode devices is that body segments may be measured simultaneously without the need to relocate electrodes. Several body composition techniques are available, based on assumptions of weight (hydrostatic weighing), water content (isotope dilution), volume (air displacement plethysmography), energy attenuation (Dual-Energy X-Ray Absorptiometry; DXA), and imaging techniques like computer tomography (CT) and MRI. 33-36, 1989. [19], In 1986, Kushner and Scholler published empirical equations using the impedance index, body weight, and gender. Please enable scripts and reload this page. For female athletes, difference in hydration status during menses may significantly alter impedance [17] and should be a consideration when assessing female athletes with BIA. Assessment of adult malnutrition and prognosis with bioelectrical impedance analysis: 10. WebBioelectrical impedance analysis (BIA) is a widely used method for estimating body composition, yet issues concerning its validity persist in the literature. Fluid distribution can also be assessed by BIA-derived ECW/TBW ratio. C. Lukaski, W. W. Bolonchuk, W. A. Siders and C. B. The increase in information obtained from BIS potentially improves predictive power. Chamney PW, Wabel P, Moissl UM, et al. Clin Nutr 2020; 39:18091817. Multiple electrodes, typically eight, may be used located on the hands and feet allowing measurement of the impedance of the individual body segments - arms, legs and torso. 405-411, 2007. S. Sun, C. W. Chumlea, S. B. Heymsfield , H. C. Lukaski, D. Schoeller, K. Friedl, R. J. Kuczmarski, K. M. Flegal, C. L. Johnson and V. S. Hubbard, Development of bioelectrical impedance analysis prediction equations for body composition with the use of a multicomponent model for use in epidemiologic surveys, American Journal of Clinical Nutrition, vol. Yang SF, Tseng CM, Liu IF, et al. Keyword Highlighting Methodological limitations of BIA may affect the ability of the method to accurately determine body composition. Kyle UG, Bosaeus I, De Lorenzo AD, et al. This can have wide-ranging implications, from assessing the efficacy of previous dietary and training interventions to making decisions on the correct interventions moving forward. However, these methods can also lead to error, as hydrostatic weighing has been shown to lead to individual error rates of 6 % [6]. It is important to note that this analysis utilised DEXA as the reference method, which may also lead to further error, as eluded to earlier in this review (read my article on the use of DEXA scanning for body composition assessment HERE). Clin Nutr 2004; 23:14301453. 417-424, 1986. 21. da Silva TK, Berbigier MC, Rubin BA, et al. As hand-held and leg-to-leg methods may not account for the resistance of the lower- or upper body, respectively, it is logical to assume that hand-to-foot measurements may better reflect whole-body composition than the alternatives. Bioelectrical impedance vector analysis in critically ill patients: a prospective, clinician-blinded investigation. A. Weststrate and J. G. A. J. Hautvast, Changes in fat-free mass during weight loss measured by bioelectrical impedance and by densitometry, American Journal of Clinical Nutrition, vol. 57. The phase angle (PhA) shows the relationship between reactance and resistance (Fig. He has previously supported athletes in a variety of sports including canoeing, boxing, cricket, rugby league, Olympic weightlifting and strongwoman. Acta Diabetol 2003; 40: (Suppl 1): S203S206. Indices of extracellular (noncontractile) and cellular (contractile) compartments in skeletal muscle tissues were determined using the Cole-Cole plot from S Having said that, the development of an equation for athletic populations that are validated against the gold-standard four-compartment model may improve the validity of the measure. BIA determines body composition by running small electrical currents through the body. It is important that these equations are validated using a total-body, water-based, four-compartment method, in an attempt to minimise the measurement error that is found when equations are based on the two-compartment model; such as hydrostatic weighing. Accuracy. Diminished cell count, membrane integrity and altered hydration status in critical illness can lead to changes in reactance and resistance, thereby decreasing PhA compared with healthy individuals [11,12]. 7 minutes read. Crit Care 2016; 20:95. [21] In 1992, Kushner proposed the use of multiple frequencies to increase the accuracy of BIA devices to measure the human body as 5 different cylinders (right arm, left arm, torso, right leg, left leg) instead of one. 24. 12. The correlation with DXA can be as high as 99% when measuring fat-free mass, if strict guidelines are adhered to. 1040-1045, 2011. Bioelectrical Impedance Analysis (BIA) is able to make an estimation of body composition (e.g. Basso F, Berdin G, Virz GM, et al. Body composition describes the relative contribution of fat, muscle, bone and water to an individual's body volume. Malbrain ML, Huygh J, Dabrowski W, et al. WebFactors affecting bioelectrical impedance measurements in humans Eur J Clin Nutr. WebOther instruments measure impedance from hand to hand and allow (with a build-in software program in which weight, height, age and sex has to be entered) the reading of body fat When an electrical current is sent through the body, tissues present varying resistance levels. Inclusion fees for patients in nutrition trials were paid to the local ICU research foundation. 42. Bioelectrical impedance spectroscopy to estimate fluid balance in critically ill patients. BIA has been compared to the four-compartment model in several studies using various populations. Meyer P, Makhlouf AM, Mondouagne Engkolo LP, et al. However, BIA did correctly identify patients with low CT-MM [31]. 50. M Azcue 1 ,, M Neuman , P Pencharz 64, pp. [9], BIA is considered reasonably accurate for measuring groups, of limited accuracy for tracking body composition in an individual over a period of time, but is not considered sufficiently accurate for recording of single measurements of individuals. ECW/TBW-ratio is higher among ICU nonsurvivors and correlates with a longer mechanical ventilation duration [25]. Marked BIVA-OH on the first 5 days after ICU admission was shown in ICU and 60-day nonsurvivors [19,23,24]. 5-12, 1999. Denneman N, Hessels L, Broens B, et al. 490-497, 2004. ", "Bioelectrical impedance analysis: population reference values for phase angle by age and sex", "Reliability of body fat measurement: Skinfold, bioelectrical impedance analysis and infrared", "Clinical detection of sarcopenic obesity by bioelectrical impedance analysis", The International Society for Electrical Bioimpedance, Bioimpedance Analysis Electronic Media Review, https://en.wikipedia.org/w/index.php?title=Bioelectrical_impedance_analysis&oldid=1151830472, Short description is different from Wikidata, All articles with vague or ambiguous time, Articles with unsourced statements from April 2023, Articles with unsourced statements from September 2019, Creative Commons Attribution-ShareAlike License 4.0, This page was last edited on 26 April 2023, at 14:22. They tend to under-read body fat percentage by approximately 5kg (7kg LoA) on average, despite showing a linear correlation with MRI-based measurements of 0.75 and 0.81 for females and males, respectively. 1-6, 2014. A prospective study among 60 ventilated ICU patients found that a cumulative energy-deficit during ICU stay was independently associated with loss of BIS-FFM between inclusion and ICU discharge, as well as with ICU-acquired weakness [40]. Barbosa-Silva MC, Barros AJ, Wang J, et al. 56. In the 2-electrode (bipolar) configuration a small current on the order of 1-10 A is passed between two electrodes, and the voltage is measured between the same whereas in the tetrapolar arrangement resistance is measured between as separate pair of proximally located electrodes. However, a recent pilot-study comparing CT-MM at ICU admission and BIS-FFM adjusted for overhydration, using an algorithm developed for dialysis patients, found significant correlations and good agreements between the two techniques [32]. In the 1980s, Lukaski, Segal, and other researchers discovered that the use of a single frequency (50kHz) in BIA assumed the human body to be a single cylinder, which created many technical limitations in BIA. You may be trying to access this site from a secured browser on the server. Dehesa-Lpez E, Martnez-Felix JI, Ruiz-Ramos A, Atilano-Carsi X. Discordance between bioelectrical impedance vector analysis and the new ESPEN definition of malnutrition for the diagnosis of hospital malnutrition. Bioelectrical impedance can supply a robust and useful field measure of body composition, so long as the machine-generated Lambell KJ, Earthman CP, Tierney AC, et al. The equation (the squared value of height divided by impedance measurements of the right half of the body) showed a correlation coefficient of 0.92 with total body water. Crit Care 2015; 19:290. Bioelectrical impedance is the measure of impedance of the body. 42, pp. reported that he had received honoraria for advisory board meetings, lectures and travel expenses from Abbott, Amomed, Baxter, Cardinal Health, Danone-Nutricia, DIM-3, Fresenius Kabi, Lyric, Mermaid and Nestle-Novartis. WebBioelectrical impedance analysis (BIA) has been proposed for measuring fat-free mass, total body water, percent fat, body cell mass, intracellular water, and extracellular water: a 81, pp. Furthermore, rapid wasting of muscle mass is a major clinical conundrum, as it is a strong independent predictor for morbidity, mortality, physical functioning and quality of life. However, BIA assumes static ratios, most notably a fixed hydration We showed increased SMMF-BIA-OH, and ECW/TBW ratio were associated with mortality in COVID-19 [20]. Davenport A. First commercially available in the mid-1980s [1], bioelectrical Impedance Analysis (BIA) is an inexpensive and portable piece of body composition testing equipment. Bioelectrical impedance measurements for assessment of kidney function in critically ill patients. 5, pp. J. Saunders, J. E. Blevins and C. E. Broeder, Effects of hydration changes on bioelectrical impedance in endurance trained individuals, Medicine and Science in Sport and Exercise, vol. Association between multifrequency. Hand-to-foot BIA devices, however, may allow for greater accuracy, as the current is sent from the upper body to the lower body, and is less likely to be influenced by the distribution of body fat. However, the cut-off values for the predictive value of PhA vary across these studies. It is unclear how many frequencies would be needed for a BIA device to be considered a BIS device, however, the principles behind how the devices work are the same. To revisit the study by Ritz et al. 4, pp. The assumption that the hydration fraction of skeletal muscle remains at 73 % is based on the chemical analysis of six cadavers as part of the Brussels Cadaver Analysis Study [21]. 115-122, 2000. Similarly, hand-held instruments may only assess the body composition of the upper extremities. 77, pp. This finding is supported by other research on bodybuilders, showing that BIA underestimated fat mass, and overestimated fat-free mass when compared to the four-compartment model [10]. From the results of this assessment method, the manufacturer constructs an equation using the individual variables mentioned previously to determine what the body fat would be. Low standardized. 46. Standard measurement conditions may vary depending on the machine type (e.g. 2). Indeed, two studies found that low BIA/BIS-PhA corresponded to low CT- muscle mass (CT-MM) and muscle density in the critically ill [31,32]. Safety of bioelectrical impedance analysis in patients equipped with implantable cardioverter defibrillators. Electrolyte-rich body water is highly conductive; therefore, muscles, having a higher water content, will encounter less resistance than relatively anhydrous tissues, such as fat. 16. There are currently too many uncertainties and discrepancies regarding the interpretation of BIA measurements in critical illness to justify large therapeutic consequences, emphasizing the need for further evaluation of the use and interpretation of bioelectric impedance in the ICU setting. 48. The current is administered usually at the hands and feet and it Fluid balance and. WebBioelectrical Impedence measure of body composition. About usContact usJoin our teamPrivacy policyTerms of useTerms and conditionsDisclaimer, 2023 Science for Sport | Catapult Sports, https://www.ncbi.nlm.nih.gov/pubmed/16215137, https://www.ncbi.nlm.nih.gov/pubmed/4468420, https://www.ncbi.nlm.nih.gov/pubmed/24755478, https://www.ncbi.nlm.nih.gov/pubmed/11319654, https://www.ncbi.nlm.nih.gov/pubmed/23299872, https://www.ncbi.nlm.nih.gov/pubmed/8695593, https://www.ncbi.nlm.nih.gov/pubmed/12540391, https://www.ncbi.nlm.nih.gov/pubmed/15640463, https://www.sciencedirect.com/science/article/pii/S0168822707000332, https://www.ncbi.nlm.nih.gov/pubmed/15076792, https://www.ncbi.nlm.nih.gov/pubmed/10743490, https://www.ncbi.nlm.nih.gov/pubmed/17228035, https://www.ncbi.nlm.nih.gov/pubmed/10393132, https://www.ncbi.nlm.nih.gov/pubmed/15181388, http://europepmc.org/abstract/med/15064592, https://www.ncbi.nlm.nih.gov/pubmed/1578098, https://www.ncbi.nlm.nih.gov/pubmed/2816797, https://www.ncbi.nlm.nih.gov/pubmed/9624647, https://www.ncbi.nlm.nih.gov/pubmed/8379501, https://www.researchgate.net/publication/16706298_Gross_Tissue_Weights_in_the_Human_Body_by_Cadaver_Dissection, https://www.sciencedirect.com/science/article/pii/002196818290056X, https://www.ncbi.nlm.nih.gov/pubmed/2912008, https://www.ncbi.nlm.nih.gov/pubmed/2079851, https://www.ncbi.nlm.nih.gov/pubmed/20647951, https://www.ncbi.nlm.nih.gov/pubmed/8780358, https://www.ncbi.nlm.nih.gov/pubmed/16837369, https://www.ncbi.nlm.nih.gov/pubmed/3529918, Types of Bioelectrical Impedance Analysis, The Bioelectrical Impedance Analysis Equations, Validity and Reliability of Bioelectrical Impedance Analysis, Issues with Bioelectrical Impedance Analysis, Effect of incorrect measures in the applied setting, A BIA equation for use in athletic populations, The validity of BIA vs. the four-compartment model for athletes with more extreme body composition (e.g. WebLevels of Accuracy How does BIA technology work? Deurenberg, J. hand-to-hand, leg-to-leg, supine vs. standing, etc.). 56, pp. Moonen HPFX, van Zanten FJL, Driessen L, et al. [7] For example, moderate intensity exercise for 90120 minutes before BIA measurements causes nearly a 12kg overestimation of fat-free mass, i.e. A phase angle therefore exists for all frequencies of measurement although conventionally in BIA it is phase angle at a measurement frequency of 50 kHz that is considered. 1988 Dec;42(12):1017-22. PhA inherently reflects BCM. 6. WebIn electrical engineering, impedance is the opposition to alternating current presented by the combined effect of resistance and reactance in a circuit. In 1996, an eight-polar stand-on BIA device, InBody, that did not utilize empirical equations was created and was found to "offer accurate estimates of TBW and ECW in women without the need of population-specific formulas. (2003) [8] stated that BIA is a suitable alternative for estimating body fat percentages when subjects are within a normal body fat range, however, there is a tendency for BIA to overestimate body fat in lean subjects and underestimate body fat in obese individuals. Saunders et al. Affiliation 1 Department of Human Nutrition, Agricultural University, Wageningen, The Netherlands. On ICU days 1 and 3, BIS-OH (>1l) associated significantly with hospital mortality in 140 ICU patients with 23 nonsurvivors. Despite being popular in many commercial gyms and within epidemiological research on group body composition, BIA does not appear to provide valid single- or repeated-measures of body composition for athletes. muscle, fat, bone, etc.) BIA defines the water volumes using impedance and body height, upon which other body composition parameters are based. Bioelectric impedance is a method to measure the resistance of body tissues to the flow of a small electrical signal, and from Identifying critically ill patients with low muscle mass: agreement between bioelectrical impedance analysis and computed tomography. Abstract: Bioelectrical impedance analysis (BIA) has been proposed for measuring fat-free mass, total body water, percent fat, body cell mass, intracellular water, and extracellular water: a veritable laboratory in a box. In the ICU, real-time knowledge of body composition is advantageous to the individualization and optimization of fluid balances, nutrition regimes and medication dosing. Although they are validated against standard methods (usually MRI and DXA), the exact equations used by BIA software are rarely released by manufacturers, impairing judgment of applicability [48]. [3][4], Dehydration is a recognized factor affecting BIA measurements as it causes an increase in the body's electrical resistance, so has been measured to cause a 5kg underestimation of fat-free mass i.e. There are currently no BIA equations for athletes that have been derived from the criterion four-compartment method (fat mass, total body water, bone mineral mass, residual mass). 903-907, 1989. The validity (the agreement between the true value and a measurement value) of body composition is key to determining the precision of BIA measurement, and its suitability for clinical use. More ICU-free and ventilator-free days were observed among patients with normal hydration status on day 3 (OH <1 to 1 l) [30]. Total body water (TBW) is estimated, and this estimation is used to calculate fat-free mass. 58. Without considered interpretation of this result, coaches may question an athletes commitment and professionalism if they believe that their body fat has increased drastically over time. There is disagreement amongst the limited research available, with only one study suggesting that BIA is suitable for assessing body composition in athletes [15], whereas other research suggests that body fat estimates are much higher in athletes when using the BIA method [16]. Experience with BIA-guided fluid management in the ICU is limited. The, Overview of the relationship between several frequently used derived, 1. Many of the early research studies showed that BIA was quite variable and it was not regarded by many as providing an accurate measure of body composition. Furthermore, increased muscle mass in ICU patients should not be interpreted as muscle mass of good quality, as intramuscular edema will be classified as muscle mass by both BIA and CT analysis. Park KH, Shin JH, Hwang JH, Kim SH. Fat mass was underestimated by 1.6 kg, whereas fat-free mass was overestimated by 1.8 kg. (2007) [9], BIA was unable to accurately assess changes in body composition when compared to the four-compartment model. Electrical impedance measurement (complex resistance in the presence of alternating current) is a useful tool for the investigation of the structural characteristics of solid materials and biological tissues, the changes of the latter reflect the physiological state of the tissue itself (Hayden et al. For more information, please refer to our Privacy Policy. This review discusses the potential clinical applications of BIA and explores caveats and solutions to its use in the intensive care setting. Armed with that information, the machine is able to calculate the impedance (i.e. [14][15] It is important to recognize that correlation is NOT a measure of accuracy or method agreement, BIA methods typically exhibit 2 standard deviation (2SD) limits of agreement with reference methods (e.g., DXA, MRI or 4C model) of around 10%. The mean coefficient of variation for within-day, intra-individual measurements, has ranged from 0.3 % to 2.8 %, with daily or weekly variability ranging from 0.9 % to 3.6 %, respectively [2, 17]. Razzera EL, Marcadenti A, Rovedder SW, et al. Individual measures of body fat ranged from -3.6 % to 4.8 % of the four-compartment value, highlighting the potential for significant discrepancies when measuring individual body composition over time. There are currently too many uncertainties and discrepancies regarding interpretation of bioimpedance in critical illness, to justify therapeutic consequences. In practice, the improvement in accuracy is marginal. 6, pp. For example, many BIA equations are validated against assessment methods such as hydrostatic weighing and Dual-energy X-ray Absorptiometry (DEXA). Jansen AK, Gattermann T, da Silva FJ, et al. One main drawback of BIA is the incorporation of reference population values, for all but the raw parameters, which might not apply to the individual patient or population. [2], Although the instruments are straightforward to use, careful attention to the method of use (as described by the manufacturer) should be given. - The test can be administered repeatedly without adverse effects. In 89 ICU patients, a PhA less than less than 5.5 showed an accuracy of 79% in identifying patients at high nutrition risk (NUTRIC score 5) [19]. The measured phase angle therefore depends on several biological factors. The electrical properties of tissues have been described since 1872. Bioelectrical impedance analysis (BIA) is a widely used, non-invasive field method for assessing body composition, which measures the electrical characteristics of human body either at 50 kHz (single-frequency BIA) or at several frequencies in the range 11000 kHz (multifrequency BIA and BIS = bioimpedance spectroscopy). WebImpedance methods can measure both total body water and extracellular fluid (ECF) in humans on the basis of the electrical properties of individual tissues. It is familiar in the consumer market as a simple instrument for estimating body fat. Bioelectrical impedance analysis-derived. 885-892, 1998. Looijaard WGPM, Stapel SN, Dekker IM, et al. Clin Nutr ESPEN 2017; 18:4448. BIA-derived muscle mass appears a promising biomarker for sarcopenia, correlating well with CT-analysis. Another group calculated SMM, ASMM and total muscle mass based on raw SF-BIA measurements, using three different equations, and found that although the BIA and CT measurements correlated significantly, the agreement was low, with increasing overestimation of muscle mass by BIA at higher CT-MM. 9, pp. The primary issues with BIA are: Sensor Placement Age-related extracellular to total body water volume ratio (Ecv/TBW)--can it be used for dry weight determination in dialysis patients? all have varying amounts of water content, and, as a result, they all differ in terms of electrical conductivity. A healthy ECW/TBW ratio varies slightly between sources and device manufacturers but ranges from 0.36 to 0.40. However, there are several promising areas of research, concerning some of the most urgent clinical problems in intensive care, emphasizing the need to evaluate further the use and interpretation of bioimpedance in the intensive care setting. 199-209, 1992. A study comparing the accuracy of BIVA, versus the definition according to ESPEN in hospitalized patients, in predicting malnutrition, found that BIVA might be the superior method [38]. Phase angle is greater in men than women, and decreases with increasing age.[27]. The heterogeneity of the ICU populations studied might in part explain these discrepancies. Similarly, athletes often take interest in their body fat percentages, and a false score indicating so-called negative changes in body fat may impact the confidence and compliance of an athlete. Beaudart C, Bruyre O, Geerinck A, et al. 58, no. 67, pp. quantities of fat mass and fat-free mass) by running a small electrical current through the body. Similarly, the landmark Phase Angle Project showed that a combined multivariable score improved the discriminative power in predicting mortality, compared with PhA alone [22]. 49, pp. Learn As mentioned previously, there are several issues with BIA measurement that may limit its use in an applied setting. Consequently, it is important that the correct equation is used for the population measured to ensure that any results are valid. Research conducted by Jebb et al. 70, pp. (1988) [23] reported an underestimation of fat-free mass when assessing changes in body composition following weight loss. What is BIS? A correlation is repeatedly found between raw impedance parameters, fluid ratios, overhydration, and adverse outcome of critical illness. Logically, increased ECW is associated with a lower BCM/FFM-ratio. Nitisha Dubey April 29, 2020. Protein targets are usually set to measured actual weight or calculated FFM. an overestimation of body fat. Berbigier MC, Pasinato VF, Rubin BA, et al. The criterion method for determining body composition is the four-compartment model (1] fat mass, 2] total body water, 3] bone mineral mass, and 4] residual mass), and should be used when assessing the validity of BIA measurements.

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