The Role of Body Adiposity Index in Determining Body Fat Percentage in Colombian Adults with Overweight or Obesity

Robinson Ramírez-Vélez, Jorge Enrique Correa-Bautista, Katherine González-Ruíz, Alejandra Tordecilla-Sanders, Antonio García-Hermoso, Jacqueline Schmidt-RioValle, Emilio González-Jiménez, Robinson Ramírez-Vélez, Jorge Enrique Correa-Bautista, Katherine González-Ruíz, Alejandra Tordecilla-Sanders, Antonio García-Hermoso, Jacqueline Schmidt-RioValle, Emilio González-Jiménez

Abstract

The aim of this study is to investigate the accuracy of body adiposity index (BAI) as a convenient tool for assessing body fat percentage (BF%) in a sample of adults with overweight/obesity using bioelectrical impedance analysis (BIA). The study population was composed of 96 volunteers (60% female, mean age 40.6 ± 7.5 years old). Anthropometric characteristics (body mass index, height, waist-to-height ratio, hip and waist circumference), socioeconomic status, and diet were assessed, and BF% was measured by BIA-BF% and by BAI-BF%. Pearson's correlation coefficient was used to evaluate the correlation between BAI-BF% and BF% assessed by BIA-BF%, while controlling for potential confounders. The concordance between the BF% measured by both methods was obtained with a paired sample t-test, Lin's concordance correlation coefficient, and Bland-Altman plot analysis. Overall, the correlation between BF% obtained by BIA-BF% and estimated by BAI-BF% was r = 0.885, p < 0.001, after adjusting for potential confounders (age, socioeconomic status, and diet). Lin's concordance correlation coefficient was moderate in both sexes. In the men, the paired t-test showed a significant mean difference in BF% between the methods (-5.6 (95%CI -6.4 to -4.8); p < 0.001). In the women, these differences were (-3.6 (95%CI -4.7 to -2.5); p < 0.001). Overall, the bias of the BAI-BF% was -4.8 ± 3.2 BF%; p < 0.001), indicating that the BAI-BF% method significantly underestimated the BF% in comparison with the reference method. In adults with overweight/obesity, the BAI presents low agreement with BF% measured by BIA-BF%; therefore, we conclude that BIA-BF% is not accurate in either sex when body fat percentage levels are low or high. Further studies are necessary to confirm our findings in different ethnic groups.

Trial registration: ClinicalTrials.gov NCT02715063.

Keywords: adults; body composition; obesity; prediction; validity.

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Bland-Altman plots with mean bias (central line) and 95% limits of agreement for comparing BAI-BF% and BIA-BF% among women (A), and men (C). Panels (B,D) represent residual values for Bland-Altman linear regression. The central line represents the systematic bias between BAI-BF% and BIA-BF%; the outer lines represent 95% limits. Solid lines represent the regression line and dashed lines indicate ± 1.96 SD. SD: standard deviation.

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