{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T18:50:58Z","timestamp":1791312658878,"version":"4.3.1"},"reference-count":44,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\n BACKGROUND:<\/jats:title>\n Phase angle (PhA) is obtained through bioelectrical impedance analysis (BIA) and is a potential marker of nutritional health and cellular function. We aimed to develop an equation for estimating PhA using body composition parameters, focusing on skeletal muscle mass, body water, and fat mass.<\/jats:p>\n <\/jats:sec>\n \n MATERIALS AND METHODS:<\/jats:title>\n This cross-sectional study enrolled participants from the Iranian National Obesity Registry. Data on age, gender, body composition, and BIA measurements were collected using an InBody 770 device. Exclusion criteria included pregnancy, pacemakers, implants, or edema. The study was approved by the Ethics Committee of Mashhad University of Medical Sciences.<\/jats:p>\n <\/jats:sec>\n \n RESULTS:<\/jats:title>\n \n A total of 5980 participants (28.7% men, 71.3% women) were included. PhA showed the strongest correlations with extracellular water\/total body water (ECW\/TBW) (\n r<\/jats:italic>\n = \u22120.84,\n P<\/jats:italic>\n < 0.001), followed by intracellular water (ICW) (\n r<\/jats:italic>\n = 0.62,\n P<\/jats:italic>\n < 0.001) and skeletal muscle mass (SMM) (\n r<\/jats:italic>\n = 0.62,\n P<\/jats:italic>\n < 0.001). Linear regression models revealed a significant negative association between ECW\/TBW and PhA (\u03b2 = \u221282.81,\n P<\/jats:italic>\n < 0.001), explaining 71% of variance. Adding age (\u03b2 = 0.012,\n P<\/jats:italic>\n < 0.001) improved the model (\n R<\/jats:italic>\n \u00b2 = 0.75), and SMM (\u03b2 = 0.039,\n P<\/jats:italic>\n < 0.001) further increased explanatory power (\n R<\/jats:italic>\n \u00b2 = 0.85). Including body fat mass (BFM) (\u03b2 = 0.005,\n P<\/jats:italic>\n < 0.001) and height (\u03b2 = -0.031,\n P<\/jats:italic>\n < 0.001) led to the highest model fit (\n R<\/jats:italic>\n \u00b2 = 0.90).\n <\/jats:p>\n <\/jats:sec>\n \n CONCLUSION:<\/jats:title>\n ECW\/TBW, SMM, BFM, age, and height are significant predictors of PhA, with ECW\/TBW showing the strongest negative association.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/jehp.jehp_771_25","type":"journal-article","created":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T13:01:30Z","timestamp":1788181290000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Prediction of phase angle based on body composition: Insights from a large population-based registry"],"prefix":"10.4103","volume":"15","author":[{"given":"Ali","family":"Ebrahimi Dabagh","sequence":"first","affiliation":[{"name":"Department of Clinical Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Najmeh","family":"Seifi","sequence":"additional","affiliation":[{"name":"Department of Clinical Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mina","family":"Nosrati","sequence":"additional","affiliation":[{"name":"Department of Clinical Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shima","family":"Shishehbor","sequence":"additional","affiliation":[{"name":"Department of Nutrition Sciences, Varastegan Institute for Medical Sciences, Mashhad, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nioosha","family":"Samadi","sequence":"additional","affiliation":[{"name":"Department of Clinical Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Asadzadeh","sequence":"additional","affiliation":[{"name":"Department of Nutrition Sciences, Varastegan Institute for Medical Sciences, Mashhad, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Faezeh","family":"Sadat","sequence":"additional","affiliation":[{"name":"Department of Nutrition Sciences, Varastegan Institute for Medical Sciences, Mashhad, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahdieh","family":"Kamaljoo","sequence":"additional","affiliation":[{"name":"Department of Nutrition Sciences, Varastegan Institute for Medical Sciences, Mashhad, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gordon A.","family":"Ferns","sequence":"additional","affiliation":[{"name":"Division of Medical Education, Department of Medical Education, Brighton and Susgender Medical School, Falmer, Brighton, Susgender BN1 9PH, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Habibollah","family":"Esmaily","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Majid","family":"Ghayour-Mobarhan","sequence":"additional","affiliation":[{"name":"Department of Clinical Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran"},{"name":"International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,8]]},"reference":[{"key":"R1-20261006","doi-asserted-by":"crossref","first-page":"1939","DOI":"10.1007\/s40520-019-01413-1","article-title":"Changes in the bioelectrical impedance parameters estimating appendicular skeletal muscle mass in healthy older persons","volume":"32","author":"Ko\u0142odziej","year":"2020","journal-title":"Aging Clin Exp Res"},{"key":"R2-20261006","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1007\/s11154-022-09780-3","article-title":"Bioimpedance basics and phase angle fundamentals","volume":"24","author":"Ward","year":"2023","journal-title":"Rev Endocr Metab Disord"},{"key":"R3-20261006","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1007\/s11154-022-09764-3","article-title":"Phase angle as an index of physiological status: Validating bioelectrical assessments of hydration and cell mass in health and disease","volume":"24","author":"Lukaski","year":"2023","journal-title":"Rev Endocr Metab Disord"},{"key":"R4-20261006","doi-asserted-by":"crossref","first-page":"1608","DOI":"10.3390\/ijerph20021608","article-title":"Phase angle as a potential screening tool in adults with metabolic diseases in clinical practice: A systematic review","volume":"20","author":"Praget-Bracamontes","year":"2023","journal-title":"Int J Environ Res Public Health"},{"key":"R5-20261006","doi-asserted-by":"crossref","first-page":"1851","DOI":"10.3390\/nu14091851","article-title":"Phase angle and handgrip strength as a predictor of disease-related malnutrition in admitted patients: 12-month mortality","volume":"14","author":"Fern\u00e1ndez-Jim\u00e9nez","year":"2022","journal-title":"Nutrients"},{"key":"R6-20261006","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1038\/s41430-018-0159-1","article-title":"Phase angle and mortality: A systematic review","volume":"73","author":"Garlini","year":"2019","journal-title":"Eur J Clin Nutr"},{"key":"R7-20261006","doi-asserted-by":"crossref","first-page":"2139","DOI":"10.3390\/nu15092139","article-title":"Phase angle as a prognostic indicator of survival in institutionalized psychogeriatric patients","volume":"15","author":"Barrera","year":"2023","journal-title":"Nutrients"},{"key":"R8-20261006","doi-asserted-by":"crossref","first-page":"326","DOI":"10.1016\/j.nutos.2024.10.012","article-title":"Unveiling mortality predictors: exploring phase angle as a prognostic indicator in adult and elderly patients on home enteral nutrition in Curitiba","volume":"58","author":"Vicenski","year":"2024","journal-title":"Clin Nutr Open Sci"},{"key":"R9-20261006","doi-asserted-by":"crossref","first-page":"854","DOI":"10.1016\/j.clnu.2012.05.008","article-title":"Bioelectrical phase angle and impedance vector analysis--clinical relevance and applicability of impedance parameters","volume":"31","author":"Norman","year":"2012","journal-title":"Clin Nutr"},{"key":"R10-20261006","doi-asserted-by":"crossref","first-page":"111342","DOI":"10.1016\/j.nut.2021.111342","article-title":"Annual changes in appendicular skeletal muscle mass and quality in adults over 50 y of age, assessed using bioelectrical impedance analysis","volume":"90","author":"Ko\u0142odziej","year":"2021","journal-title":"Nutrition"},{"key":"R11-20261006","doi-asserted-by":"crossref","first-page":"63","DOI":"10.12775\/JEHS.2020.10.05.005","article-title":"Bioelectrical impedance in the assessment of nutritional status","volume":"10","author":"R\u0119ba","year":"2020","journal-title":"J Educ Health Sport"},{"key":"R12-20261006","doi-asserted-by":"crossref","first-page":"3973","DOI":"10.1016\/j.clnu.2021.04.033","article-title":"Body composition assessment using bioelectrical impedance analysis (BIA) in a wide cohort of patients affected with mild to severe obesity","volume":"40","author":"Brunani","year":"2021","journal-title":"Clin Nutr"},{"key":"R13-20261006","first-page":"CC01","article-title":"Anthropometric predictors of bio-impedance analysis (BIA) phase angle in healthy adults","volume":"10","author":"Siddiqui","year":"2016","journal-title":"J Clin Diagn Res"},{"key":"R14-20261006","doi-asserted-by":"crossref","first-page":"712","DOI":"10.3945\/ajcn.115.116772","article-title":"Phase angle and its determinants in healthy subjects: Influence of body composition","volume":"103","author":"Gonzalez","year":"2016","journal-title":"Am J Clin Nutr"},{"key":"R15-20261006","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1007\/s11154-022-09774-1","article-title":"Phase angle (PhA) in overweight and obesity: Evidence of applicability from diagnosis to weight changes in obesity treatment","volume":"24","author":"Cancello","year":"2023","journal-title":"Rev Endocr Metab Disord"},{"key":"R16-20261006","doi-asserted-by":"crossref","first-page":"333","DOI":"10.4103\/jehp.jehp_514_20","article-title":"Investigating high blood pressure, type-2 diabetes, dislipidemia, and body mass index to determine the health status of people over 30 years","volume":"9","author":"Zokaei","year":"2020","journal-title":"J Educ Health Promot"},{"key":"R17-20261006","doi-asserted-by":"crossref","first-page":"1747","DOI":"10.3390\/nu11081747","article-title":"Phase angle: A possible biomarker to quantify inflammation in subjects with obesity and 25(OH) D Deficiency","volume":"11","author":"Barrea","year":"2019","journal-title":"Nutrients"},{"key":"R18-20261006","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1177\/0148607106030004309","article-title":"Phase angle from bioelectrical impedance analysis: Population reference values by age, sex, and body mass index","volume":"30","author":"Bosy-Westphal","year":"2006","journal-title":"JPEN J Parenter Enteral Nutr"},{"key":"R19-20261006","first-page":"168","article-title":"The Iranian National Obesity Registry (IRNOR): Results of the first phase","volume":"13","author":"Nosrati","year":"2023","journal-title":"J Biomed Phys Eng"},{"key":"R20-20261006","first-page":"169","article-title":"Development of the Minimum Data Set for the Iranian National Obesity Registry (IRNOR)","volume":"13","author":"Nosrati","year":"2023","journal-title":"J Biomed Phys Eng"},{"key":"R21-20261006","doi-asserted-by":"crossref","first-page":"80","DOI":"10.3390\/jcm11010080","article-title":"Relationships between Body Composition Parameters and Phase Angle as Related to Lifestyle among Young People","volume":"11","author":"Jaremk\u00f3w","year":"2021","journal-title":"J Clin Med"},{"key":"R22-20261006","doi-asserted-by":"crossref","first-page":"223","DOI":"10.4103\/jehp.jehp_358_18","article-title":"Competency in home body fat monitoring by portable devices based on bioelectrical impedance analysis: A pilot study","volume":"8","author":"Mondal","year":"2019","journal-title":"J Educ Health Promot"},{"key":"R23-20261006","doi-asserted-by":"crossref","first-page":"1491931","DOI":"10.3389\/fnut.2024.1491931","article-title":"Reliability, biological variability, and accuracy of multi-frequency bioelectrical impedance analysis for measuring body composition components","volume":"11","author":"Looney","year":"2024","journal-title":"Front Nutr"},{"key":"R24-20261006","doi-asserted-by":"crossref","first-page":"e14724","DOI":"10.1016\/j.heliyon.2023.e14724","article-title":"Phase angle and extracellular water-to-total body water ratio estimated by bioelectrical impedance analysis are associated with levels of hemoglobin and hematocrit in patients with diabetes","volume":"9","author":"Hori","year":"2023","journal-title":"Heliyon"},{"key":"R25-20261006","first-page":"633","article-title":"Phase angle and mid arm circumference as predictors of protein energy wasting in renal replacement therapy patients","volume":"36","author":"Leal","year":"2019","journal-title":"Nutr Hosp"},{"key":"R26-20261006","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1080\/01635581.2017.1299880","article-title":"Phase angle of bioelectrical impedance analysis as prognostic factor in palliative care patients at the National Cancer Institute in Mexico","volume":"69","author":"P\u00e9rez","year":"2017","journal-title":"Nutr Cancer"},{"key":"R27-20261006","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1007\/s11695-020-04869-7","article-title":"Handgrip strength and phase angle predict outcome after bariatric surgery","volume":"31","author":"Gerken","year":"2021","journal-title":"Obesity surgery."},{"key":"R28-20261006","doi-asserted-by":"crossref","first-page":"e23095","DOI":"10.1590\/s0004-2803.246102023-95","article-title":"Phase angle as a predictor of muscle mass in patients with inflammatory bowel disease","volume":"61","author":"Bongiolo","year":"2024","journal-title":"Arquivos de Gastroenterologia"},{"key":"R29-20261006","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1007\/s12603-018-1151-0","article-title":"Phase angle is a useful indicator for muscle function in older adults","volume":"23","author":"Yamada","year":"2019","journal-title":"J Nutr Health Aging"},{"key":"R30-20261006","doi-asserted-by":"crossref","first-page":"110891","DOI":"10.1016\/j.nut.2020.110891","article-title":"Impact of phase angle on postoperative prognosis in patients with gastrointestinal and hepatobiliary-pancreatic cancer","volume":"79-80","author":"Yasui-Yamada","year":"2020","journal-title":"Nutrition"},{"key":"R31-20261006","first-page":"1511","article-title":"Phase Angle (PhA) is an easy and complementary tool for assessing nutritional status in Ulcerative Colitis (UC) Patients: A Cross-Sectional Study","volume":"14","author":"Mendoza-Mart\u00ednez","year":"2024","journal-title":"Life (Basel)"},{"key":"R32-20261006","doi-asserted-by":"crossref","first-page":"112825","DOI":"10.1016\/j.physbeh.2020.112825","article-title":"Association between phase angle and isolated and grouped physical fitness indicators in adolescents","volume":"217","author":"Martins","year":"2020","journal-title":"Physiol Behav"},{"key":"R33-20261006","doi-asserted-by":"crossref","first-page":"113400","DOI":"10.1016\/j.physbeh.2021.113400","article-title":"Phase angle cutoff value as a marker of the health status and functional capacity in breast cancer survivors","volume":"235","author":"Martins","year":"2021","journal-title":"Physiol Behav"},{"key":"R34-20261006","doi-asserted-by":"crossref","first-page":"99","DOI":"10.4067\/s0717-75182019000200099","article-title":"Asociaci\u00f3n del \u00e1ngulo de fase con par\u00e1metros de evaluaci\u00f3n del estado nutricional en pacientes en hemodi\u00e1lisis","volume":"46","author":"Duarte","year":"2019","journal-title":"Revista chilena de nutrici\u00f3n"},{"key":"R35-20261006","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1016\/j.clnu.2012.09.003","article-title":"Phase angle from BIA as a prognostic and nutritional status tool for children and adolescents undergoing hematopoietic stem cell transplantation","volume":"32","author":"Farias","year":"2013","journal-title":"Clin Nutr"},{"key":"R36-20261006","doi-asserted-by":"crossref","first-page":"1245","DOI":"10.1016\/j.clnu.2014.12.020","article-title":"Bioelectrical impedance phase angle relates to function, disease severity and prognosis in stable chronic obstructive pulmonary disease","volume":"34","author":"Maddocks","year":"2015","journal-title":"Clin Nutr"},{"key":"R37-20261006","doi-asserted-by":"crossref","first-page":"2065","DOI":"10.3390\/nu12072065","article-title":"Phase angle: Could be an easy tool to detect low-grade systemic inflammation in adults affected by prader-willi syndrome?","volume":"12","author":"Barrea","year":"2020","journal-title":"Nutrients"},{"key":"R38-20261006","doi-asserted-by":"crossref","first-page":"113104","DOI":"10.1016\/j.physbeh.2020.113104","article-title":"Phase angle associated with different indicators of health-related physical fitness in adults with obesity","volume":"225","author":"Streb","year":"2020","journal-title":"Physiol Behav"},{"key":"R39-20261006","first-page":"771","article-title":"Nutritional assessment of hospitalized HIV-infected patients by the phase angle z-score measurement","volume":"27","author":"Araujo","year":"2012","journal-title":"Nutr Hosp"},{"key":"R40-20261006","doi-asserted-by":"crossref","first-page":"314","DOI":"10.1053\/j.jrn.2010.01.008","article-title":"The phase angle and mass body cell as markers of nutritional status in hemodialysis patients","volume":"20","author":"Oliveira","year":"2010","journal-title":"J Ren Nutr"},{"key":"R41-20261006","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1016\/j.nutos.2023.07.004","article-title":"The relationship between phase angle measurements and cardiovascular risk factor in adults: Insights from an epidemiologic cohort study","volume":"51","author":"Raji","year":"2023","journal-title":"Clin Nutr Open Sci"},{"key":"R42-20261006","doi-asserted-by":"crossref","first-page":"924199","DOI":"10.3389\/fendo.2022.924199","article-title":"Reference data of phase angle using bioelectrical impedance analysis in overweight and obese Chinese","volume":"13","author":"Fu","year":"2022","journal-title":"Front Endocrinol (Lausanne)"},{"key":"R43-20261006","doi-asserted-by":"crossref","first-page":"107","DOI":"10.3390\/jfmk8030107","article-title":"A bioelectrical impedance analysis in adult subjects: The Relationship between Phase Angle and Body Cell Mass","volume":"8","author":"Cimmino","year":"2023","journal-title":"J Funct Morphol Kinesiol"},{"key":"R44-20261006","doi-asserted-by":"crossref","first-page":"1124565","DOI":"10.3389\/fendo.2023.1124565","article-title":"Association between serum uric acid and phase angle in patients with type 2 diabetes mellitus: A cross-sectional study","volume":"14","author":"Hu","year":"2023","journal-title":"Front Endocrinol (Lausanne)"}],"container-title":["Journal of Education and Health Promotion"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/jehp.jehp_771_25","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T18:00:45Z","timestamp":1791309645000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/jehp.jehp_771_25"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8]]},"references-count":44,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.4103\/jehp.jehp_771_25","relation":{},"ISSN":["2277-9531","2319-6440"],"issn-type":[{"value":"2277-9531","type":"print"},{"value":"2319-6440","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8]]},"assertion":[{"value":"2025-04-25","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-07-12","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}