The Evolution of Body Composition Measurement: From BMI to BIA
Guest writer: Rob van Berkel, Research dietitian and writer on nutrition and health
The Evolution of Body Composition Measurement: From BMI to BIA
Measuring body composition is essential for understanding health status, nutritional status, and the risk of chronic diseases. Over the years, various methods have been developed, ranging from simple anthropometric techniques to advanced technologies that provide detailed information on fat mass, fat-free mass, and body water.
Importance of Body Composition
Assessing body composition provides important insights into nutritional status and can be used as an indicator of overall health (Holmes & Racette, 2021; Jo et al., 2025). Moreover, it enables healthcare professionals to develop personalized health strategies and to monitor responses to interventions.
History of Body Composition Measurement
Today, numerous techniques exist to measure or estimate body composition with varying degrees of accuracy. However, this was not always the case. The need for more precise measurements and the availability of new technologies led to significant developments. Below is an overview of the most important discoveries and innovations, several of which were recognized with Nobel Prizes.
1830 – BMI
The Belgian mathematician, astronomer, and statistician Adolphe Quetelet (1796–1874) developed the “Quetelet Index” between 1830 and 1850, now widely known as the body mass index (BMI). He defined the index as body weight in kilograms divided by height in metres squared.
Although not originally intended for health applications, the formula was rediscovered in the 20th century by Ancel Keys, who demonstrated that BMI is a reliable indicator of fat mass and obesity at the population level. Since then, BMI has been widely used in epidemiology, clinical practice, and public health. At the individual level, however, BMI has limitations, as it does not distinguish between muscle mass and fat mass.
1895 – X-rays, CT and DXA
German physicist Wilhelm Conrad Röntgen discovered X-rays in 1895. X-rays visualize tissues of different densities: dense tissues such as bone absorb more radiation than soft tissues. While useful for skeletal imaging, this method provides limited information on overall body composition.
Computed tomography (CT), developed in 1971 by Godfrey Hounsfield and Allan Cormack, combines X-rays with computer modelling to produce detailed 3D images of bone, muscle, and the distribution of visceral versus subcutaneous fat.
Dual-energy X-ray absorptiometry (DXA), developed in the late 1980s, uses two X-ray energy levels to differentiate between bone, fat-free mass, and fat mass. DXA provides accurate, non-invasive measurements of both total and regional body composition with relatively low radiation exposure and has been widely used since 1987 to assess bone density and diagnose osteoporosis.
1896 – Radioactivity
Henri Becquerel discovered radioactivity in 1896. This discovery later formed the basis for isotope techniques used from the 1940s onward to measure components of body composition.
1915 – Underwater Weighing
Charles Spivak was the first to systematically measure human body density using underwater weighing. Based on Archimedes’ principle, body volume can be calculated from the difference between weight in air and underwater, allowing estimation of fat mass. Albert Behnke later refined these methods, laying the foundation for modern techniques such as BIA and DXA.
1920 – Skinfold Measurements
Jan Matiegka established anatomical landmarks for systematic skinfold measurements to assess subcutaneous fat. In the 1950s, Durnin and Womersley developed standardized equations to estimate body fat percentage based on measurements at four sites. Due to its simplicity, low cost, and reasonable accuracy, this method remains widely used.
1930 – Ultrasound
Karl Theodore Dussik introduced ultrasound for medical imaging. From the 1970s onward, ultrasound was applied to estimate body fat thickness at specific anatomical sites. It offers a non-invasive, inexpensive method, although measurement accuracy depends heavily on operator skill.
1951 – BIA
Dutch physiologist Johan Nyboer pioneered bioelectrical impedance analysis (BIA). Early research demonstrated that electrical conductivity is closely related to body water and tissue composition. Subsequent studies led to the development of practical BIA devices.
Later innovations included multi-frequency BIA, allowing differentiation between intracellular and extracellular water, and segmental BIA, enabling separate analysis of limbs and trunk. Since 2010, portable consumer devices have become widely available. Today, BIA is commonly used to estimate total body water, fat mass, fat-free mass, regional composition, and hydration status.
1980 – Four-Compartment Model (4C Model)
Earlier one- and two-compartment models divided the body too simplistically. The four-compartment model divides body mass into fat mass, total body water, protein, and minerals. Developed by William Lohman and later refined by others, it is considered the gold standard because it combines multiple reliable methods for each component.
1980 – MRI
Magnetic resonance imaging (MRI) evolved from nuclear magnetic resonance research by Isidor Rabi, Felix Bloch, and Edward Purcell. MRI produces highly detailed images of muscle, fat, and organs without ionizing radiation. It is safe and highly accurate but relatively expensive and less portable than alternatives such as BIA.
Conclusion
The evolution of body composition measurement illustrates the progression from simple approaches such as BMI to advanced techniques such as DXA, MRI, and BIA. Each method offers a different balance between accuracy, safety, and practicality, enabling researchers and healthcare professionals to better assess health and nutritional status.
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