. 2022 Dec 7;24(3):543–562. doi: 10.1007/s11154-022-09775-0

Table 2.

Main results of the interventional studies included in the review

Authors/ year Country	Population Study design	Device	BIA protocol	Intervention	Control	Intervention effects on PhA	Intervention effects on inflammation	Conclusion
Roberts et al., 2017 [93] UK	- N = 14 (6 ♀) - Physically active individuals - Age: 31 ± 6 y Crossover RCT	SF-BIA, Impedimed DF50 (Impedimed, USA) Reliability NR	- No strenuous exercise ~ 48 h prior test - No caffeinated products ~ 48 h prior test - ~3–4 h fasting prior test - Supine	- PROHIGH: 2.9 g. kg^− 1.d^− 1 of PRO for 10 days - Resistance exercise on days 8–10 (T1-T3)	- PROMOD: 1.8 g. kg^− 1.d^− 1 of PRO for 10 days - Resistance exercise on days 8–10 (T1-T3)	- No difference in PhA change from baseline to follow-up between groups - PROHIGH had greater PhA at T3 than PROMOD (MD = + 0.18°, p = 0.012)	- No difference in TNF-α change from baseline to follow-up between groups - No difference in TNF-α between groups at follow-up	PhA values were maintained at T3 for the group with higher protein intake. The exercise protocol and diet did not influence TNF-α values
Tomeleri et al., 2018 [84] Brazil	- N = 46 ♀ - Older women - Age: 70.6 ± 5.1 y BMI: 26.9 ± 4.2 kg/m² RCT	MF-BIA, Hydra ECF/ICF 4200 (Xitron Technologies, USA) Reliability NR	- Supine position for 5 min - Euhydration confirmed by post-voiding first-morning body weights and urine color - Same technician performing pre-/post-tests	− 12 weeks of resistance training under professional supervision performed 3 times per week (45–50 min per session)(TG)	- No physical exercise of any type performed for 12 weeks (CG)	- TG had a greater PhA than CG at follow-up (MD = + 0.4°, p < 0.05) - TG had a greater PhA at follow-up than at baseline (MD = + 0.4°, p < 0.05) - CG had a decrease in PhA from baseline to follow-up (MD = − 0.2°, p < 0.05)	- TG had a lower TNF- α (MD = − 0.3, p < 0.05), IL-6 (MD = − 1.2, p < 0.05) and CRP (MD = − 2.4, p < 0.05) and a greater IL-10 (MD = + 10.3, p < 0.05) than CG at follow-up - TG had a decrease in TNF-α (MD = − 0.5, p < 0.05), IL-6 (MD = − 0.5, p < 0.05), and CRP (MD = − 0.7, p < 0.05) and an increase in IL-10 (MD = + 0.5, p < 0.05) from baseline to follow-up	12 weeks of resistance training improved PhA and inflammation
Di Renzo et al., 2019 [94] Italy	- N = 44 (10 ♀) - Head and neck squamous carcinoma (stage III) - Age: 65.48 ± 12.66 y Clinical trial	SF-BIA, BIA 101 S (Akern/RJL Systems, Italy) Reliability NR	NR	- Enteral standard nutrition for days 0–3 (ESN); 1500 kcal/d, 43% CHO, 27% PRO, 30% fat, 14 g fibre - Enteral immunonutrition for days 4–8 (EIN); 1500 kcal/d, 53% CHO, 22% PRO, 25% fat, < 3 g fibre, 9.15 MCT)	- Oral standard diet (OD) for 8 days; 2448.45 kcal/d, 50% CHO, 17% PRO, 33% fat, 32–35 g fibre	- No difference in PhA change between OD and ESN at day 3 - EIN had a greater PhA than OD at day 8 (MD = + 0.75, p = 0.045)	- No difference in leukocyte, neutrophils, lymphocytes, albumin, transferrin, and CRP change between OD and ESN at day 3 and between OD from days 0–8 - EIN trended towards a lower transferrin (MD = − 30.25, p = 0.050) and CRP (MD = − 6.64, p = 0.066) than OD at day 8, but no difference in leukocyte, neutrophils, lymphocytes and albumin change - EIN had a higher transferrin than ESN (MD = + 39.25, p < 0.05), but no difference in leukocyte, neutrophils, lymphocytes, albumin, transferrin, and CRP - ESN had higher lymphocytes at day 3 than day 0 (MD = + 0.33, p < 0.05), but no difference in leukocyte, neutrophils, albumin, transferrin, and CRP	Immunonutrition treatment improves PhA and inflammation more than an oral diet and standard enteral nutrition
Moya-Amaya et al., 2021 [88] Spain	- N = 18 (0 ♀) - Professional soccer players Clinical trial	MF-BIA, MC-780 MA (Tanita Corp., Japan) Reliability NR	- Overnight fast of ≥ 8 h - Tests performed between 8am and 10am - No moderate or intense exercise 24 h prior test - Voided bladder - Metals removed - Standing erect - Same technician performing pre-/post-tests - Performed according to manufacturer guidelines	- Players (except goalkeepers) who played > 45 min were evaluated in the morning prior to the start of and 36 h after a competitive match during the first half of the season	NA	- No difference in PhA change from prior to and 36 h after a match	- No difference in CRP and IL-6 changes from prior to and 36 h after a match	36 h of intense exercise did not affect PhA nor CRP
Barrea et al., 2022 [85] Italy	- N = 260 ♀ - Women with OW/OB - Age: 37.6 ± 14.1 y - BMI: 35.7 ± 5.4 kg/m² - OW/OB: 100% Pilot clinical trial	SF-BIA, BIA 101 (Akern Bioresearch, Italy) Reliability for intraday (R < 2%; Xc < 2.5%) and interday (R < 3.3%, Xc < 2.8%) tests assessed using same observer. Coefficient of variation of repeated measurements at 50 kHz assessed in 10 females using same observer: R = 1.4% and Xc = 1.3%.	- Same device and technician performing pre-/post-tests - Supine - Limbs slightly apart - No food, drink, or exercise 6 h prior to test - No alcohol 24 h prior to test - Voided bladder	- Very low-calorie ketogenic diet for 31 d using a commercial weight-loss program, replacement meals with a biological value of 110, a multivitamin, and saline supplements − 13% CHO (< 30 g/d), 43% PRO (1.2–1.5 g/kg IBW), 44% fat (including 10 g/d of EVOO) − 30 min of moderate physical activity 3 times per week	NA	- Participants had a greater PhA at follow-up than at baseline (MD = + 0.5°, p < 0.001)	- Participants had a lower hs-CRP at follow-up than at baseline (MD = − 1.7, p < 0.001)	31 days of a low-calorie ketogenic diet promoted a significant reduction in patient inflammation and improved PhA

Authors/ year
Country

Population
Study design

Device

BIA protocol

Intervention

Control

Intervention effects on PhA

Intervention effects on inflammation

Conclusion

Roberts et al., 2017 [93]

- N = 14 (6 ♀)

- Physically active individuals

- Age: 31 ± 6 y

Crossover RCT

SF-BIA, Impedimed DF50 (Impedimed, USA)

Reliability NR

- No

strenuous exercise ~ 48 h prior test

- No caffeinated

products ~ 48 h prior test

- ~3–4 h fasting prior test

- Supine

- PROHIGH: 2.9 g. kg^− 1.d^− 1 of PRO for 10 days

- Resistance exercise on days 8–10 (T1-T3)

- PROMOD: 1.8 g. kg^− 1.d^− 1 of PRO for 10 days

- Resistance exercise on days 8–10 (T1-T3)

- No difference in PhA change from baseline to follow-up between groups

- PROHIGH had greater PhA at T3 than PROMOD (MD = + 0.18°, p = 0.012)

- No difference in TNF-α change from baseline to follow-up between groups

- No difference in TNF-α between groups at follow-up

PhA values were maintained at T3 for the group with higher protein intake. The exercise protocol and diet did not influence TNF-α values

Tomeleri et al., 2018 [84]

Brazil

- N = 46 ♀

- Older women

- Age: 70.6 ± 5.1 y

BMI: 26.9 ± 4.2 kg/m²

RCT

MF-BIA, Hydra ECF/ICF 4200 (Xitron Technologies, USA)

Reliability NR

- Supine position for 5 min

- Euhydration confirmed by post-voiding first-morning body weights and urine color

- Same technician performing pre-/post-tests

− 12 weeks of resistance training under professional supervision performed 3 times per week (45–50 min per session)(TG)

- No physical exercise of any type performed for 12 weeks (CG)

- TG had a greater PhA than CG at follow-up (MD = + 0.4°, p < 0.05)

- TG had a greater PhA at follow-up than at baseline (MD = + 0.4°, p < 0.05)

- CG had a decrease in PhA from baseline to follow-up (MD = − 0.2°, p < 0.05)

- TG had a lower TNF- α (MD = − 0.3, p < 0.05), IL-6 (MD = − 1.2, p < 0.05) and CRP (MD = − 2.4, p < 0.05) and a greater IL-10 (MD = + 10.3, p < 0.05) than CG at follow-up

- TG had a decrease in TNF-α (MD = − 0.5, p < 0.05), IL-6 (MD = − 0.5, p < 0.05), and CRP (MD = − 0.7, p < 0.05) and an increase in IL-10 (MD = + 0.5, p < 0.05) from baseline to follow-up

12 weeks of resistance training improved PhA and inflammation

Di Renzo et al., 2019 [94]

Italy

- N = 44 (10 ♀)

- Head and neck squamous carcinoma (stage III)

- Age: 65.48 ± 12.66 y

Clinical trial

SF-BIA, BIA 101 S (Akern/RJL Systems, Italy)

Reliability NR

- Enteral standard nutrition for days 0–3 (ESN); 1500 kcal/d, 43% CHO, 27% PRO, 30% fat, 14 g fibre

- Enteral immunonutrition for days 4–8 (EIN); 1500 kcal/d, 53% CHO, 22% PRO, 25% fat, < 3 g fibre, 9.15 MCT)

- Oral standard diet (OD) for 8 days; 2448.45 kcal/d, 50% CHO, 17% PRO, 33% fat, 32–35 g fibre

- No difference in PhA change between OD and ESN at day 3

- EIN had a greater PhA than OD at day 8 (MD = + 0.75, p = 0.045)

- No difference in leukocyte, neutrophils, lymphocytes, albumin, transferrin, and CRP change between OD and ESN at day 3 and between OD from days 0–8

- EIN trended towards a lower transferrin (MD = − 30.25, p = 0.050) and CRP (MD = − 6.64, p = 0.066) than OD at day 8, but no difference in leukocyte, neutrophils, lymphocytes and albumin change

- EIN had a higher transferrin than ESN (MD = + 39.25, p < 0.05), but no difference in leukocyte, neutrophils, lymphocytes, albumin, transferrin, and CRP

- ESN had higher lymphocytes at day 3 than day 0 (MD = + 0.33, p < 0.05), but no difference in leukocyte, neutrophils, albumin, transferrin, and CRP

Immunonutrition treatment improves PhA and inflammation more than an oral diet and standard enteral nutrition

Moya-Amaya et al., 2021 [88]

Spain

- N = 18 (0 ♀)

- Professional soccer players

Clinical trial

MF-BIA, MC-780 MA (Tanita Corp., Japan)

Reliability NR

- Overnight fast of ≥ 8 h

- Tests performed between 8am and 10am

- No moderate or intense exercise 24 h prior test

- Voided bladder

- Metals removed

- Standing erect

- Same technician performing pre-/post-tests

- Performed according to manufacturer guidelines

- Players (except goalkeepers) who played > 45 min were evaluated in the morning prior to the start of and 36 h after a competitive match during the first half of the season

- No difference in PhA change from prior to and 36 h after a match

- No difference in CRP and IL-6 changes from prior to and 36 h after a match

36 h of intense exercise did not affect PhA nor CRP

Barrea et al., 2022 [85]

Italy

- N = 260 ♀

- Women with OW/OB

- Age: 37.6 ± 14.1 y

- BMI: 35.7 ± 5.4 kg/m²

- OW/OB: 100%

Pilot clinical trial

SF-BIA, BIA 101 (Akern Bioresearch, Italy)

Reliability for intraday (R < 2%; Xc < 2.5%) and interday (R < 3.3%, Xc < 2.8%) tests assessed using same observer.

Coefficient of variation of repeated measurements at 50 kHz assessed in 10 females using same observer: R = 1.4% and Xc = 1.3%.

- Same device and technician performing pre-/post-tests

- Supine

- Limbs slightly apart

- No food, drink, or exercise 6 h prior to test

- No alcohol 24 h prior to test

- Voided bladder

- Very low-calorie ketogenic diet for 31 d using a commercial weight-loss program, replacement meals with a biological value of 110, a multivitamin, and saline supplements

− 13% CHO (< 30 g/d), 43% PRO (1.2–1.5 g/kg IBW), 44% fat (including 10 g/d of EVOO)

− 30 min of moderate physical activity 3 times per week

- Participants had a greater PhA at follow-up than at baseline (MD = + 0.5°, p < 0.001)

- Participants had a lower hs-CRP at follow-up than at baseline (MD = − 1.7, p < 0.001)

31 days of a low-calorie ketogenic diet promoted a significant reduction in patient inflammation and improved PhA

Abbreviations: ♀, female; BIA, bioelectrical impedance analysis; BMI, body mass index; CHO, carbohydrates; CG, control group; CRP, C-reactive protein; EIN, enteral immunonutrition; ESN, enteral standard nutrition; EVOO, extra virgin olive oil; hs-CRP, high-sensitivity CRP; IBW, ideal body weight; IL-10, interleukin-10; IL-6, interleukin-6; MCT, medium chain triglycerides; MD, mean/median difference; MF-BIA, multi-frequency BIA; N, sample size; NR, not reported; OD, oral diet; PhA, phase angle; PRO, protein; R, resistance; RCT, randomized controlled trial; SF-BIA, single-frequency BIA; TG, training group; TNF-α, tumor necrosis factor-α; Xc, reactance;