ORIGINAL RESEARCH article
Front. Nutr.
Sec. Nutritional Epidemiology
This article is part of the Research TopicBioimpedance Analysis: Lifelong Health, Disease, and Sport ApplicationsView all 21 articles
Establishing Percentiles for Phase Angle, Skeletal Muscle Mass Index, and Muscle-to-Fat Ratio in Brazilian Adolescents: A Bioelectrical Impedance Analysis Study with 59,000 Participants
Provisionally accepted
Fernando Guimarães Teixeira1
Flávio Andrade Amaral Motta2,3
Alberto Sá Filho1
Iransé Oliveira-Silva1Patrícia Sardinha Leonardo4
Rodrigo Alvaro Brandão Lopes-Martins2,5,6*- 1Universidade Evangelica de Goias, Anápolis, Brazil
- 2Hospital do Cancer de Muriae, Muriaé, Brazil
- 3Centro Universitario UNIFAMINAS, Muriaé, Brazil
- 4Afya Centro Universitário Itaperuna, Itaperuna, Brazil
- 5Afya Centro Universitário Itaperuna, Itaperuna, Brasil, Brazil
- 6Universidade Brasil, São Paulo, Brazil
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Word count: 208 Background: Adolescence is a period of rapid and nonlinear changes in body composition, influenced by sex, age, and environmental factors. In Brazil, the absence of large-scale, population-specific reference values for bioelectrical impedance analysis (BIA) limits its clinical and public health applications. Objective: To establish normative percentiles and Gaussian distribution curves for key body composition parameters in Brazilian adolescents aged 10–19 years, stratified by sex and age group. Methods: This cross-sectional study analyzed 59,000 standardized BIA examinations from a nationally distributed adolescent sample. Parameters included body fat percentage, fat-free mass, muscle mass, total body water, phase angle (PhA), and muscle-to-fat ratio (MFR). Percentile curves were generated using LMS modeling, and sex-and age-related differences were assessed. Results: Distinct sex-specific trajectories were observed. Males exhibited progressive increases in lean mass, muscle mass, and PhA, while females showed higher body fat and lower MFR. BMI failed to differentiate between adipose and lean mass in many cases. Low PhA and MFR were associated with less favorable metabolic profiles, independent of BMI. Conclusion: We provide the first large-scale, Brazil-specific multi-frequency BIA reference percentiles (P5–P95) for adolescents, offering practical tools for diagnosis, nutritional surveillance, and risk stratification in Brazil..
Keywords: adolescents, Body Composition, BIA, Reference Values, phase angle, bioelectrical impedance analysis
Received: 14 Aug 2025; Accepted: 17 Nov 2025.
Copyright: © 2025 Teixeira, Motta, Sá Filho, Oliveira-Silva, Leonardo and Lopes-Martins. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Rodrigo Alvaro Brandão Lopes-Martins, ralopesmartins@gmail.com
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