Association of Bioelectrical Impedance Vector Analysis (BIVA) with Body Composition in Lebanese Adolescents

Abstract

Background: Accurate assessment of body composition during adolescence is essential for understanding growth, nutritional status, and associated health risks. Conventional methods such as body mass index (BMI) are limited in their ability to distinguish between fat mass and fat-free mass, while reference techniques such as deuterium dilution, although accurate, are not always feasible in field settings. Bioelectrical impedance vector analysis (BIVA) has emerged as a promising alternative that utilizes raw impedance measurements to assess body composition without relying on predictive equations. However, its validity in adolescent populations, particularly in the Middle Eastern context, remains insufficiently explored. Objectives: This study aimed to evaluate the efficacy of BIVA in assessing body composition among Lebanese adolescents using the deuterium dilution method as the reference standard. Methods: This cross-sectional study was conducted among 150 Lebanese adolescents aged 15–18 years recruited as part of the Nutrition and Health in Arab Adolescents (NaHAR) project. Anthropometric measurements and bioelectrical impedance analysis were performed under standardized conditions, and BIVA parameters were derived using both classic and specific approaches. Total body water was assessed using the deuterium dilution technique, and fat-free mass and fat mass were subsequently calculated. Statistical analyses included correlation analysis, group comparisons using median splits, and multivariate vector comparisons using Hoteling’s T2 test. The results demonstrated that BIVA parameters were significantly associated with body composition indicators. Classic BIVA showed stronger relationships with total body water and fat-free mass, whereas specific BIVA was more closely associated with fat mass and adiposity-related indicators. In males, both classic and specific BIVA significantly differentiated between body composition groups, with clear vector displacement observed in both fat-free mass and fat mass percentage groups. In contrast, no significant vector separation was observed in females, indicating reduced discriminatory ability in this subgroup. In conclusion, BIVA provides a valid and informative approach for assessing body composition in adolescents when evaluated against a reference method. The findings highlight the complementary roles of classic and specific BIVA and underscore the importance of sex-specific interpretation. BIVA may serve as a practical, non-invasive tool for body composition assessment, particularly in male adolescents and in settings where access to advanced techniques is limited.