TECHNOLOGY REVIEW : NEAR INFRARED LIGHT TECHNOLOGY

1.
BACKGROUND
Body fat consists of essential fat and storage fat. Fat in the marrow of bones, in the heart,
lungs, liver, spleen, kidneys, intestines, muscles, and lipid-rich tissues throughout the
central nervous system is called essential fat, whereas fat that accumulates in adipose
tissue is called storage fat. Essential fat is necessary for normal bodily functioning.
Storage fat is located around internal organs (internal storage fat) and directly beneath the
skin (subcutaneous storage fat). Practical methods of assessing body composition such as
skinfolds, bioelectrical impedance analysis (BIA), and hydrostatic weighing are based on
the two-component (fat and fat-free mass) model of body composition (Kravitz &
Heyward, 2003). A new method for the estimation of body composition in humans called
infrared interactance which, based on the principles of light absorption, reflection and
near infrared spectroscopy. The assumption is based on the degree of infrared light
absorb and reflect related to both the composition of the tissues through which the light is
being passed and the specific wavelength being emitted by the light (Conway, Norris &
Bodwell, 1984). This method has become popular outside of the laboratory because it is
simple, fast, noninvasive, and the equipment is relatively inexpensive. However, the
amount of pressure applied to the fiber optic probe during measurement may affect the
values of optical densities, and skin color and hydration level may be potential sources of
error. To date, studies conducted with this method have produced mixed results; a high
degree of error has occurred with very lean and very obese people; and the validity of a
single-site measurement at the biceps is questionable. Numerous sources report that more
research is needed to substantiate the validity, accuracy and applicability of this method
(http://www.testsymptomsathome.com. 22/6/2004).
2.
OBJECTIVES
To assess the safety and effectiveness of the near infrared light technology
3.
METHODOLOGY
An electronic search using HTA databases, PUBMED, guidelines database, FDA site,
ECRI site general search engine GOOGLE were searched without limits using the
following keywords near infrared body composition analysis, near infrared light
technology, near infrared photospectrometry, near infrared interactance, near
spectrophotmetric device, near infrared spectrophotometer analyzer, near
spectrophotometer method, body composition analysis, body fat, either singly or in
combination. Most articles retrieved were case studies, and these were critically
appraised before analysed.
4.
TECHNICAL FEATURE
Near infrared (NIR) light technology is one the methods to measuring fat. The NIR light
technology emits near infrared light at very precise light wave frequencies (938nm and
948nm). The light rays being directed through the body will be absorbed by fat matter,
while it is reflected by the lean body matter. The measurement is taken at the mid-point
of the dominant bicep.

A fiber optic probe is connected to a digital analyzer that indirectly measures the tissue
composition (fat and water) at various sites on the body. This method is based on studies
that show optical densities are linearly related to subcutaneous and total body fat. The
biceps is the most often used single site for estimating body fat using the NIR method.
The NIR light penetrates the tissues and is reflected off the bone back to the detector. The
NIR data is entered into a prediction equation with the person's height, weight, frame
size, and level of activity to estimate the percent body fat.
5.
COMPETING TECHNOLOGY
Currently, there were a numerous of methods use in estimation of body fat like, Body
Mass Index, Skinfolds, hydrostatic weighing, Bioelectric impedance analysis, dualenergy X-ray absorptiometry, Magnetic Resonance Imaging
6
RESULT and DISCUSSION
6.1. Safety
There is no published article on safety of this device
6.2
Effectiveness
6.2.1 Validity of NIR interactance
Several studies have investigated the validity of NIR interactance, In Wresler, a study
substantiated the validity of NIR for predicting % BF among high school wrestlers.
Cross-validation of these equations is warranted (Oppliger, Clark & Nielsen, 2000). The
NIR method has been found to have good repeatability, with low intra- and interobserver
variability, provided readers are carefully trained. However, its offers little advantage in
reliability over conventional measures of adiposity such as waist girth or BMI, and
requires additional input of weight, height, frame size, physical activity level, age, and
gender data to calculate %BF (Schreiner et al, 1995). Another study on validity of near
infrared body analysis composition analysis in children and adolescents found that this
system offers the potential of obtaining longitudinal data in growth and development
studies. However, the significant mean differences, moderate correlations with the
criterion (r = 0.62-0.71) and inflated standard errors of estimate (SEE = 4.9-5.5% BF,
2.2-2.9 kg FFM) and total prediction errors (TE = 5.5-8.0% BF, 2.7-3.7 kg FFM) indicate
that refinement of prediction equations is needed to establish validity of the
measurement, and continued research with expanded populations is needed to further
demonstrate and evaluate the utility of this device (Cassady et al, 1993)
6.2.2 Underestimate or overestimate fat
A study found that NIR tended to underestimate higher and overestimate lower levels of
fatness (Brooke-Wavell et al, 1995). It was also found that NIR was significantly
underestimated relative body fat in self perceived overweight adults population
(Wilmore, McBride & Wilmore 1994). Similarly, McLean & Skinner (1992) reported
that FTX overestimated body fat in lean subjects with less than 8% fat and
underestimated it in subjects with greater than 30% fat. Measuring NIR at additional sites
did not improve the predicted variance. And also found a study that near infrared

instrument showed higher of lean body mass and lower percent of total body fat compare
to total body potassium (Flynn, Nolph & Krause 1995).
6.2.3 Compare with other method
Skinfolds
A study carried out by Demarini & Donnelly (1994) showed that NIR measurements
correlate well with skinfolds measurements and NIR can be measured faster than
skinfolds (5 vs 60 seconds). Thus it has been speculate that NIR could be cost-effective
for routine clinical measurement of body fat and growth in infants. However, numerous
studies showed that skinfolds is better in assessment of either subcutaneous or total body
fat than NIR especially at the extremes fat continnum (Brooke-Wavell et al, 1995;
Hortobagyi et al, 1992; McLean & Skinner, 1992). It was also found that there was a
large SEE values that allow the use seven site skinfolds but not NIR (Eaton et al, 1993).
DEXA
Comparing NIR with other body composition analysis, it was found that although the
correlation coefficients between DEXA and other methods were high, there were some
major differences (limits of agreement) between data concerning fat and lean mass. Thus
neither BIA nor NIR can be use as a single method of evaluation of body composition in
clinical obese populations (Panotopoulos et al, 2001).
BIA
Vehrs, Morrow & Butte, (1998) study indicated that NIR spectroscopy (FTX) and
Bioelectrical impedance analysis using manufacturer's equations, significantly under
predicted BF hydrostatically (UW) by 2.4 and 3.8 %BF respectively. Standard error of
estimate and total error terms provided by regression analysis of 4.6 and 5.31%BF
respectively and BIA (5.65 and 6.95%BF, respectively) were high. Dependent t-tests
revealed no significant differences in either FTX or BIA predictions of %BF using two
machines. Although FTX and BIA estimates of UW %BF were reliable, due to the
significant underestimation of UW %BF and high standard error of estimation and total
error, neither FTX nor BIA were considered valid estimates of hydrostatically determined
%BF. A study showed a large SEE values that allow the use of BIA but not NIR. It was
also found an inaccuracies of machine readings versus equation-computed %BF indicate
that BIA and NIR variables and/or constants in the equations supplied are not identical to
those used in machine-generated calculations (Eaton et al, 1993).
Underwater weighing
Another study also found that NIR significantly underpredicted %BF when using the
biceps (12.9%), chest (11.3%), abdomen (10.2%), subscapula (11.3%) and thigh (9.9%)
sites compared to the criterion %BF measured with under water weighing (Hortobagyi et
al, 1992).

6.2.4 Others
Near infrared interactance and compared to result from deuterium oxide dilution (r=0.94),
skinfold (r=0.90), and ultrasound (r=0.89) measurement, it was concluded that this

method is safe, noninvasive, rapid, easy to use, and may prove useful to predict
percentage body fat, especially in the obese (Conway,Norris & Bodwell, 1984).
5.
CONCLUSION
There is evidence to conclude that NIR is underestimate higher and overestimate lower
lever of fatness. It also evidence to conclude that other existing methods showed more
accuracy estimation of body fat.

REFENRENCES
Brooke-Wavell K, Jones PR, Norgan NG, Hardman AE. (1995) Evaluation of near infrared interactance for assessment of subcutaneous and total body fat. Eur J Clin Nutr.49(1),
Jan, pp 57-65.
Cassady SL, Nielsen DH, Janz KF, Wu YT, Cook JS, Hansen JR. (1993) Validity of near
infrared body composition analysis in children and adolescents. Med Sci Sports Exerc.
25(10), Oct, pp 1185-91.
Conway JM, Norris KH, Bodwell CE (1984) A New approach for the estimation of body
composition: infrared interactance. Am J Clin Nutr 40(6), Dec, pp 1123-30
Demarini S, Donnelly MM. (1994) Near-infrared interactance (NIR): a new non-invasive
technique to estimate subcutaneous body fat in newborns. Neonatal Intensive Care.7(5),
Sep-Oct, pp 28-30.
Eaton AW, Israel RG, O'Brien KF, Hortobagyi T, McCammon MR. (1993) Comparison
of four methods to assess body composition in women. Eur J Clin Nutr. 47(5), May, pp
353-60.
Flynn MA, Nolph GB, Krause G. (1995) Comparison of body composition measured by
total body potassium and infrared interactance. J Am Coll Nutr.14(6), Dec, pp 652-5
Hortobagyi T, Israel RG, Houmard JA, McCammon MR, O'Brien KF. (1992)
Comparison of body composition assessment by hydrodensitometry, skinfolds, and
multiple site near-infrared spectrophotometry. Eur J Clin Nutr. 46(3), Mar, pp 205-11.
Kravitz L & Heyward VH Getting a Grip on Body Composition
fitness.com/body fat-analysis.html

http://www.new-

McLean KP, Skinner JS. (1992) Validity of Futrex-5000 for body composition
determination. Med Sci Sports Exerc. 24(2), Feb, pp 253-8.
Oppliger RA, Clark RR, Nielsen DH. (2000) New equations improve NIR prediction of
body fat among high school wrestlers. J Orthop Sports Phys Ther. 30(9), Sep, pp 536-43.
Panotopoulos G, Ruiz JC, Guy-Grand B, Basdevant A. (2001) Dual x-ray absorptiometry,
bioelectrical impedance, and near infrared interactance in obese women. Med Sci Sports
Exerc.;33(4), Apr, pp 665-70.
Schreiner PJ, Pitkaniemi J, Pekkanen J, Salomaa VV.(1995) Reliability of near-infrared
interactance body fat assessment relative to standard anthropometric techniques. J Clin
Epidemiol.,48(11), Nov, pp 1361-7.

Smith DB, Johnson GO, Stout JR, Housh TJ, Housh DJ, Evetovich TK. (1997) Validity
of near-infrared interactance for estimating relative body fat in female high school
gymnasts. Int J Sports Med.18(7), Oct, pp 531-7.
Vehrs P, Morrow JR Jr, Butte N. (1998) Reliability and concurrent validity of Futrex and
bioelectrical impedance. Int J Sports Med. 19(8), Nov, pp 560-6.
Wilmore KM, McBride PJ, Wilmore JH. (1994) Comparison of bioelectric impedance
and near-infrared interactance for body composition assessment in a population of selfperceived overweight adults. Int J Obes Relat Metab Disord.18(6), Jun, pp 375-81.