Accuracy of the body adiposity index and body adiposity index FELS compared with air displacement plethysmography

Issue: Vol. 5 No 3

Published by Journal of Fitness Research, 08/12/2016. Volume 5.3

Tags: Body Composition , Body Fat Percentage , Health Risk , Body Adiposity , Prediction Equations

Download PDF Version »

  1. Justin R. Brown (Corresponding Author)
    Department of Exercise and Sport Science, University of Utah, Salt Lake City, Utah
  2. Laura M. Young
    Department of Exercise and Sport Science, University of Utah, Salt Lake City, Utah
  3. Trever J. Ball
    Department of Exercise and Sport Science, University of Utah, Salt Lake City, Utah
  4. Andrew T. Del Pozzi
    School of Kinesiology, Ball State University, Muncie, IN


The Body Adiposity Index (BAI) estimates a person’s percent body fat using hip circumference and height. A slight variation of the BAI from the FELS longitudinal study (BAIFELS) has more recently proposed to estimate percent body fat better than the BAI.

Purpose: Assess criterion validity of the BAI and BAIFELS with air displacement plethysmography (ADP).

Methods: Percent body fat was estimated for 1636 volunteer healthy adults (881M; 755F, age: 36.9 ±10.5 yrs; BMI: 25.4 ± 4.6 kg/m2) using ADP and BAI and BAIFELS. Differences in percent body fat between ADP, BAI, and BAIFELS were tested using an repeated measure ANOVA with post hoc analyses. Agreement between methods was tested using Bland-Altman plots.

Results: Differences in percent body fat between each method were statistically significant (p<.05).Percent body fat assessed by ADP correlated moderately with BAI (r=0.534, p<0.001), BAIFELS (r=0.526, p<0.001),and BMI (r=0.476, p<0.001).BAI and BAIFELS underestimated percent body fat compared to ADP on average 2.1% and 1.1% respectively. BAI equations overestimated percent body fat for lean persons and overestimated percent body fat for overweight or obese persons.Agreement between BAI, BAIFELS was poor with wide limits of agreement.

Conclusion: BAI and BAIFELS are easier and less expensive alternatives to estimate percent body fat in humans compared to ADP. However, health risk due to body fat will be better estimated using either ADP or waist circumference and waist-to-hip ration in addition to an BAI.BAI would be most suitable where resources for estimating percent body fat are most limited.

Download PDF Version »

Related Articles

Also In This Issue

« Back to Articles

Article Title

Accuracy of the body adiposity index and body adiposity index FELS compared with air displacement plethysmography

Journal Title

Journal of Fitness Research Volume 5.3

Online Publication Date


Author Names

Justin R. Brown (Corresponding Author)
Laura M. Young
Trever J. Ball
Andrew T. Del Pozzi

1.Garn, S.M., Leonard, W.R. & Hawthorne, V.M. (1986).  Three limitations of the body mass index. Am J Clin Nutr, 44(6), 996-997.

2.Prentice, A.M. & Jebb, S.A. (2001).  Beyond body mass index. Obes Rev, 2(3), 141-147.

3.Esco, M.R., Williford, H.N. & Russell, A.R. (2011).  Cross-validation of BMI-based equations for predicting percent body fat in female collegiate athletes. JEPonline 14(3), 43-52.

4.Park, Y.W., Zhu, S., Palaniappan, L., Heshka, S., Carnethon, M.R. &

Heymsfield, S.B. (2003).  The metabolic syndrome: prevalence and associated risk factor findings in the US population from the Third National Health and Nutrition Examination Survey, 1988-1994. Arch Intern Med, 163(4), 427-436.

5.Song, Y.M., Sung, J., Smith, G.D. & Ebrahim, S. (2004).  Body mass index and ischemic and hemorrhagic stroke a prospective study in korean men. Stroke, 35(4), 831-836.

6.Wilson, P.W., D\'Agostino, R.B., Sullivan, L., Parise, H. & Kannel, W.B. (2002).  Overweight and obesity as determinants of cardiovascular risk: the Framingham experience. Arch Internal Med, 162(16), 1867-1872.

7.Adamson, J., Ebrahim, S., Dieppe, P. & Hunt, K. (2006).  Prevalence and risk factors for joint pain among men and women in the West of Scotland Twenty-07 study. Ann Rheum Dis, 65(4), 520-524.

8.Flegal, K.M., Graubard, B.I., Williamson, D.F. & Gail, M.H. (2005).  Excess deaths associated with underweight, overweight, and obesity.  JAMA, 293(15),1861-1867.

9.Fontaine, K.R., Redden, D.T., Wang, C., Westfall, A.O. & Allison, D.B. (2003). Years of life lost due to obesity.  JAMA, 289, 187-193.

10.Bergman, R.N., Stefanovski, D., Buchanan, T.A., Sumner, A.E., Reynolds, J.C., Sebring, N.G., Xiang, A.H., & Watanabe, R.M. (2012).  A better index of body adiposity. Obesity, 19(5), 1083-1089.

11.Lemacks, J.L., Liu, P.Y., Shin, H., Ralston, P.A., & Ilich, J.Z. (2012).

Validation of body adiposity index as a measure of obesity in overweight and obese postmenopausal white women and its comparison with body mass index. Menopause, 19(11), 1277-1279.

12.López, A.A., Cespedes, M.L., Vicente, T., Tomas, M., Bennasar-Veny, M., Tauler, P. & Aguilo, A. (2012).  Body Adiposity Index Utilization in a Spanish Mediterranean Population: Comparison with the Body Mass Index. PloS one, 7(4), e35281.

13.Godoy-Matos, A.F., Moreira, R.O., Valerio, C.M., Mory, P.B. & Moises, R.S. (2011).  A new method for body fat evaluation, body adiposity index, is useful in women with familial partial lipodystrophy. Obesity, 20, 440-443.

14.Belarmino, G., Horie, L.M., Sala, P.C., Torrinhas, R.S., Heymsfield, S.B. & Waitzberg, D.L. (2015).   Body adiposity index performance in estimating body fat in a sample of severely obese Brazilian patients. Nutr J, 14(1), 130.

15.Johnson, W., Chumlea, W.C., Czerwinski, S.A. & Demerath, E.W. (2012).

Concordance of the recently published body adiposity index with measured body fat percent in European-American adults. Obesity, 20, 900-903.

16.Lam, B.C.C., Lim, S.C., Wong, M.T.K., Shum, E., Ho, C.Y., Bosco, J.I.E. & Koh, G.C.H. (2013).  A method comparison study to validate a novel parameter of obesity, the body adiposity index, in chinese subjects. Obesity, 21(12), E634-E639.

17.Zhang, Z.Q., Liu, Y.H., Xu, Y., Dai, X.W., Ling, W.H., Su, Y.X. & Chen, Y.M. (2014).  The validity of the body adiposity index in predicting percentage body fat and cardiovascular risk factors among Chinese. Clin Endocrinol, 81(3), 356-362.

18.Carpio-Rivera, E., Hernández-Elizondo, J., Salicetti-Fonseca, A., Solera-Herrera, A. & Moncada-Jiménez, J. (2016).  Predictive validity of the body adiposity index in costa rican students. Am J Hum Biol, 28(3), 394-397.

19.McCrory, M.A., Molé, P.A., Gomez, T.D., Dewey, K.G. & Bernauer, E.M. (1998).  Body composition by air-displacement plethysmography by using predicted and measured thoracic gas volumes. J Appl Physiol, 84(4), 1475-1479.

20.Siri, WE. (1961).  Body composition from fluid spaces and density: analysis of methods. Techniques for measuring body composition 61, 223-44.

21.Dobbelsteyn, C.J., Joffres, M.R., MacLean, D.R. & Flowerdew, G. A. (2001). Comparative evaluation of waist circumference, waist-to-hip ratio and body mass index as indicators of cardiovascular risk factors. The Canadian Heart Health Surveys. Int J Obes Relat Metab Disord, 25(5), 652-661.

22.Bland, J.M. & Altman, D.G. (1999).  Measuring agreement in method comparison studies. Stat Methods Med Res, 8(2), 135-160.

23.Cerqueira, M., Amorim, P., Magalhães, F., Castro, E., Franco, F., Franceschini, S. & Doimo, L. (2013).  Validity of body adiposity index in predicting body fat in a sample of brazilian women. Obesity, 21(12), E696-E699.

24.Elisha, B., Rabasa-Lhoret, R., Messier, V., Abdulnour, J. & Karelis, A.D. (2013).  Relationship between the body adiposity index and cardiometabolic risk factors in obese postmenopausal women. Eur J Nutr, 52(1), 145-151.

25.Esco, M.R. (2013).  The accuracy of the Body Adiposity Index for predicting body fat percentage in collegiate female athletes. J Strength Cond Res, 27(6), 1679-1683.

26.Kuhn, P.C., Vieira Filho, J.P.B., Franco, L., Dal Fabbro, A., Franco, L.J. & Moises, R.S. (2013).  Evaluation of body adiposity index (BAI) to estimate percent body fat in an indigenous population. Clinical Nutrition, 33(2), 287-290.

27.Miazgowski, T., Safranow, K., Major-Goluch, A. & Krzyanowska-Swiniarska,

B. (2012).  Validation of a new index of body adiposity (BAI) to assess body fat in normal weight premenopausal Caucasian women. e-SPEN Journal, 7(3), e115-e118.

28.Nickerson, B.S., Esco, M.R., Bicard, S.C., Russell, A.R., Williford, H.N. & Schaefer, G. (2015).  Validity of the body adiposity index in adults with Down syndrome. Res Dev Disabil, 38, 92-96.

29.Ramírez, R. & González, K. (2015).  Body adiposity index in Colombian elite athletes: A comparison between the body mass index and other measures. Revista Colombiana de Cardiología, 22(1), 22-26.

30.Vinknes, K.J., Elshorbagy, A.K., Drevon, C.A., Gjesdal, C.G., Tell, G.S., Nygård, O. & Refsum, H. (2013).  Evaluation of the body adiposity index in a Caucasian population: the Hordaland health study. Am J Epidemiol, 177(6), 586-592.

31.Schulze, M.B., Thorand, B., Fritsche, A., Häring, H.U., Schick, F., Zierer, A. & Stefan, N. (2012).  Body adiposity index, body fat content and incidence of type 2 diabetes. Diabetologia, 55,1660-1667.

32.Geliebter, A., Atalayer, D., Flancbaum, L., & Gibson, C.D. (2013). Comparison of body adiposity index (BAI) and BMI with estimations of% body fat in clinically severe obese women. Obesity, 21(3), 493-498.

33.Silva, M.I.B., Vale, B.S., Lemos, C., Torres, M.R. & Bregman, R. (2013).

Body adiposity index assess body fat with high accuracy in nondialyzed chronic kidney disease patients. Obesity, 21(3), 546-552.

34.Aleman-Mateo, H., Huerta, R.H., Esparza-Romero, J., Mendez, R.O., Urquidez, R. & Valencia, M.E. (2007).  Body composition by the four-compartment model: validity of the Bod Pod for assessing body fat in Mexican elderly.  Eur J Clin Nutr, 61(7), 830-836.

35.Ballard, T.P., Fafara, L. & Vukovich, M.D. (2004).  Comparison of Bod Pod and DXA in female collegiate athletes.  Med Sci Sports Exerc, 36(4), 731-735.

36.Nuñez, C., Kovera, A.J., Pietrobelli, A., Heshka, S., Horlick, M., Kehayias, J.J., Wang, Z. & Heymsfield, S.B. (1999).  Body composition in children and adults by air displacement plethysmography.  Eur J Clin Nutr, 53, 382-387.

37.McCrory, M.A., Gomez, T.D., Bernauer, E.M. & Molé, P.A. (1995). Evaluation of a new air displacement plethysmograph for measuring human body composition. Med Sci Sports Exerc, 27(12), 1686-1691.

38.Noreen, E.E. & Lemon, P.W. (2006).  Reliability of air displacement plethysmography in a large, heterogeneous sample. Med Sci Sports Exerc, 38(8), 1505.

39.Heiss, C.J., Gara, N., Novotny, D., Heberle, H., Morgan, L., Stufflebeam, J., & Fairfield, M. (2009). Effect of a 1 liter fluid load on body composition measured by air displacement plethysmography and bioelectrical impedance. Journal of Exercise Physiology, 12(2), 1-8.

40. Vukovich, M. D., & Peeters, B. M. (2003). Reliability of air-displacement plethysmography in detecting body composition changes after water ingestion and after creatine supplementation. J. Exerc. Physiol. Online, 6, 115-122.

41.Martin, B.J., Verma, S., Charbonneau, F., Lonn, E.M. & Anderson, T.J. (2013).  The relationship between anthropometric indexes of adiposity and vascular function in the FATE cohort. Obesity, 21(2), 266-273.

42.Freedman, D.S., Thornton, J.C., Pi-Sunyer, F.X., Heymsfield, S.B., Wang, J., Pierson, R.N., Blanck, H.M. & Gallagher, D. (2012).  The body adiposity index (hip circumference÷ height1.5) is not a more accurate measure of adiposity than is BMI, waist circumference, or hip circumference. Obesity, 20(12), 2438-2444.

43.Gadelha, A.B., Myers, J., Moreira, S., Dutra, M.T., Safons, M.P. & Lima, R.M. (2016).  Comparison of adiposity indices and cut-off values in the prediction of metabolic syndrom in postmenopausal women. Diabetes & Metabolic Syndrome: Clinical Research & Reviews.

44.Bennasar-Veny, M., Lopez-Gonzalez, A.A., Tauler, P., Cespedes, M.L.,

Vicente-Herrero, T., Yañez, A., Tomas-Salva, M. & Aguilo, A. Body adiposity index and cardiovascular health risk factors in Caucasians: a comparison with the body mass index and others. PLoS One, 8(5), e63999.

No citations available


Blog comments powered by Disqus