Objective . Bioimpedance devices are commonly used to assess health parameters and track changes in body composition. However, the cross-sectional agreement between different devices has not been conclusively established. Thus, the objective of this investigation was to examine the agreement between raw bioelectrical variables (resistance, reactance, and phase angle at the 50 kHz frequency) obtained from three bioimpedance analyzers. Approach . Healthy male ( n = 76, mean ± SD; 33.8 ± 14.5 years; 83.9 ± 15.1 kg; 179.4 ± 6.9 cm) and female ( n = 103, mean ± SD; 33.4 ± 15.9 years; 65.6 ± 12.1 kg; 164.9 ± 6.4 cm) participants completed assessments using three bioimpedance devices: supine bioimpedance spectroscopy (BIS), supine single-frequency bioelectrical impedance analysis (SFBIA), and standing multi-frequency bioelectrical impedance analysis (MFBIA). Differences in raw bioelectrical variables between the devices were quantified via one-way analysis of variance for the total sample and for each sex. Equivalence testing was used to determine equivalence between methods. Main results . Significant differences in all bioelectrical variables were observed between the three devices when examining the total sample and males only. The devices appeared to exhibit slightly better agreement when analyzing female participants only. Equivalence testing using the total sample as well as males and females separately revealed that resistance and phase angle were equivalent between the supine devices (BIS, SFBIA), but not with the standing analyzer (MFBIA). Significance . The present study demonstrated disagreement between different bioimpedance analyzers for quantifying raw bioelectrical variables, with the poorest agreement between devices that employed different body positions during testing. These results suggest that researchers and clinicians should employ device-specific reference values to classify participants based on raw bioelectrical variables, such as phase angle. If reference values are needed but are unavailable for a particular bioimpedance analyzer, the set of reference values produced using the most similar analyzer and reference population should be selected.
The purpose of this investigation was to expand upon the limited existing research examining the test–retest reliability, cross-sectional validity and longitudinal validity of a sample of bioelectrical impedance analysis (BIA) devices as compared with a laboratory four-compartment (4C) model. Seventy-three healthy participants aged 19–50 years were assessed by each of fifteen BIA devices, with resulting body fat percentage estimates compared with a 4C model utilising air displacement plethysmography, dual-energy X-ray absorptiometry and bioimpedance spectroscopy. A subset of thirty-seven participants returned for a second visit 12–16 weeks later and were included in an analysis of longitudinal validity. The sample of devices included fourteen consumer-grade and one research-grade model in a variety of configurations: hand-to-hand, foot-to-foot and bilateral hand-to-foot (octapolar). BIA devices demonstrated high reliability, with precision error ranging from 0·0 to 0·49 %. Cross-sectional validity varied, with constant error relative to the 4C model ranging from −3·5 (sd 4·1) % to 11·7 (sd 4·7) %, standard error of the estimate values of 3·1–7·5 % and Lin’s concordance correlation coefficients (CCC) of 0·48–0·94. For longitudinal validity, constant error ranged from −0·4 (sd 2·1) % to 1·3 (sd 2·7) %, with standard error of the estimate values of 1·7–2·6 % and Lin’s CCC of 0·37–0·78. While performance varied widely across the sample investigated, select models of BIA devices (particularly octapolar and select foot-to-foot devices) may hold potential utility for the tracking of body composition over time, particularly in contexts in which the purchase or use of a research-grade device is infeasible.
Intermittent fasting (IF) is a dietary strategy that involves alternating periods of abstention from calorie consumption with periods of ad libitum food intake. There is significant interest in the body of literature describing longitudinal adaptations to IF. Less attention has been given to the acute physiological responses that occur during the fasting durations that are commonly employed by IF practitioners. Thus, the purpose of this review was to examine the physiological responses – including alterations in substrate metabolism, systemic hormones, and autophagy – that occur throughout an acute fast. Literature searches were performed to locate relevant research describing physiological responses to acute fasting and short-term starvation. A single fast demonstrated the ability to alter glucose and lipid metabolism within the initial 24 hours, but variations in protein metabolism appeared to be minimal within this time frame. The ability of an acute fast to elicit significant increases in autophagy is still unknown. The information summarized in this review can be used to help contextualize existing research and better inform development of future IF interventions.
Multivitamin/mineral (MVM) supplements are one of the most popular dietary supplement categories. The purpose of this analysis was to determine if a novel liposomal delivery mechanism improves mineral absorption from an MVM product. In a randomized crossover trial, 25 healthy participants (12 females, 13 males) completed two testing sessions in which blood samples were collected at baseline and 2, 4, and 6 h following the ingestion of either a liposomal MVM or a nutrient-matched standard MVM. Analysis of MVM products indicated an elemental iron content of 9.4 and 10.1 mg (~50% U.S. FDA Daily Value) and an elemental magnesium content of 22.0 and 23.3 mg (~5% U.S. FDA Daily Value) in the liposomal and standard MVM products, respectively. Blood samples were analyzed for concentrations of iron and magnesium using colorimetric assays. Changes in mineral concentrations were analyzed using linear mixed models, and pharmacokinetic parameters were compared between conditions. For iron, statistically significant condition × time interactions were observed for percent change from baseline (p = 0.002), rank of percent change from baseline (p = 0.01), and raw concentrations (p = 0.02). Follow-up testing indicated that the liposomal condition exhibited larger changes from baseline than the standard MVM condition at 4 (p = 0.0001; +14.3 ± 18.5% vs. −6.0 ± 13.1%) and 6 h (p = 0.0002; +1.0 ± 20.9% vs. −21.0 ± 15.3%) following MVM ingestion. These changes were further supported by a 50% greater mean incremental area under the curve in the liposomal condition (33.2 ± 30.9 vs. 19.8 ± 19.8 mcg/dL × 6 h; p = 0.02, Cohen’s d effect size = 0.52). In contrast, no differential effects for magnesium absorption were observed. In conclusion, iron absorption from an MVM product is enhanced by a liposomal delivery mechanism.
21 January 2025 in Journal of Clinical Epidemiology
We aimed to determine whether the existing risk of bias assessment tools addressed constructs other than risk of bias or internal validity and whether they used numerical scores to express quality, which is discouraged and may be a misleading approach. We searched Ovid MEDLINE and Embase to identify quality appraisal tools across all disciplines in human health research. Tools designed specifically to evaluate reporting quality were excluded. Potentially eligible tools were screened by independent pairs of reviewers. We categorized tools according to conceptual constructs and evaluated their scoring methods. We included 230 tools published from 1995 to 2023. Access to the tool was limited to a peer-reviewed journal article in 63% of the sample. Most tools (76%) provided signaling questions, whereas 39% produced an overall judgment across multiple domains. Most tools (93%) addressed concepts other than risk of bias, such as the appropriateness of statistical analysis (65%), reporting quality (64%), indirectness (41%), imprecision (38%), and ethical considerations and funding (22%). Numerical scoring was used in 25% of tools. Currently available study quality assessment tools were not explicit about the constructs addressed by their items or signaling questions and addressed multiple constructs in addition to risk of bias. Many tools used numerical scoring systems, which can be misleading. Limitations of the existing tools make the process of rating the certainty of evidence more difficult. Many tools have been made to assess how well a scientific study was designed, conducted, and written. We searched for these tools to better understand the types of questions they ask and the types of studies to which they apply. We found 230 tools published between 1995 and 2023. One in every four tools used a numerical scoring system. This approach is not recommended because it does not distinguish well between different ways quality can be assessed. Tools assessed quality in a number of different ways, with the most common ways being risk of bias (how a study is designed and run to reduce biased results; 98%), statistical analysis (how the data were analyzed; 65%), and reporting quality (whether important details were included in the article; 64%). People who make tools in the future should carefully consider the aspects of quality that they want the tool to address and distinguish between questions of study design, conduct, analysis, ethics, and reporting.