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      Correction of Body-Mass Index Using Body-Shape Perception and Socioeconomic Status in Adolescent Self-Report Surveys

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          Abstract

          Objectives

          To propose a simple correction of body-mass index (BMI) based on self-reported weight and height (reported BMI) using gender, body shape perception and socioeconomic status in an adolescent population.

          Methods

          341 boys and girls aged 17–18 years were randomly selected from a representative sample of 2165 French adolescents living in Paris surveyed in 2010. After an anonymous self-administered pen-and-paper questionnaire asking for height, weight, body shape perception (feeling too thin, about the right weight or too fat) and socioeconomic status, subjects were measured and weighed. BMI categories were computed according to Cole’s cut-offs. Reported BMIs were corrected using linear regressions and ROC analyses and checked with cross-validation and multiple imputations to handle missing values. Agreement between actual and corrected BMI values was estimated with Kappa indexes and Intraclass correlation coefficients (ICC).

          Results

          On average, BMIs were underreported, especially among girls. Kappa indexes between actual and reported BMI were low, especially for girls: 0.56 95%CI = [0.42–0.70] for boys and 0.45 95%CI = [0.30–0.60] for girls. The regression of reported BMI by gender and body shape perception gave the most balanced results for both genders: the Kappa and ICC obtained were 0.63 95%CI = [0.50–0.76] and 0.67, 95%CI = [0.58–0.74] for boys; 0.65 95%CI = [0.52–0.78] and 0.74, 95%CI = [0.66–0.81] for girls. The regression of reported BMI by gender and socioeconomic status led to similar corrections while the ROC analyses were inaccurate.

          Conclusions

          Using body shape perception, or socioeconomic status and gender is a promising way of correcting BMI in self-administered questionnaires, especially for girls.

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          Most cited references28

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          Prevalence of overweight among children in Europe.

          Estimates of the prevalence of childhood overweight and obesity have been made in several European countries during the last decade. The methods used and the assessment criteria differ from survey to survey. The present paper reports the prevalence data from 21 surveys in Europe using a single, internationally accepted definition of overweight in childhood, allowing direct comparisons to be made. A tendency for a higher prevalence of overweight among children in western and especially southern Europe is shown and some possible reasons for this are discussed.
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            Childhood obesity and overweight prevalence trends in England: evidence for growing socio-economic disparities

            Objective Previous data indicate a rapidly increasing prevalence of obesity and overweight among English children and an emerging socioeconomic gradient in prevalence. The main aim of this study was to update prevalence trends among school-age children and assess the changing socioeconomic gradient. Design A series of nationally representative household-based health surveys conducted between 1997 and 2007 in England. Subjects 15,271 white children (7880 boys) aged 5 to 10 years with measured height and weight. Measurements Height and weight were directly measured by trained fieldworkers. Overweight (including obesity) and obesity prevalence were calculated using the international body mass index cut-offs. Socioeconomic position (SEP) score was a composite score based on income and social class. Multiple linear regression assessed the prevalence odds with time point (1997/8, 2000/1, 2002/3, 2004/5, 2006/7) as the main exposure. Linear interaction terms of time by SEP were also tested for. Results There are signs that the overweight and obesity trend has levelled off from 2002/3 to 2006/7. The odds ratio (OR) for overweight in 2006/7 compared to 2002/3 was 0.99 (95% CI 0.88 to 1.11) and for obesity OR = 1.06 (0.86 to 1.29). The socioeconomic gradient has increased in recent years, particularly 2006/7. Compared to 1997/8, the 2006/7 age and sex-adjusted OR for overweight was 1.88 (1.52 to 2.33) in low SEP, 1.25 (1.04 to 1.50) in middle SEP, and 1.13 (0.86 to 1.48) in high SEP children. Conclusion Childhood obesity and overweight prevalence among school-age children in England has stabilised in recent years, but children from lower socio-economic strata have not benefited from this trend. There is an urgent need to reduce socio-economic disparities in childhood overweight and obesity.
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              Accuracy of adolescent self-report of height and weight in assessing overweight status: a literature review.

              To examine the accuracy of self-reported height and weight data to classify adolescent overweight status. Self-reported height and weight are commonly used with minimal consideration of accuracy. Eleven studies (4 nationally representative, 7 convenience sample or locally based). Peer-reviewed articles of studies conducted in the United States that compared self-reported and directly measured height, weight, and/or body mass index data to classify overweight among adolescents. Self-reported and directly measured height and weight. Overweight prevalence; missing data, bias, and accuracy. Studies varied in examination of bias. Sensitivity of self-reported data for classification of overweight ranged from 55% to 76% (4 of 4 studies). Overweight prevalence was -0.4% to -17.7% lower when body mass index was based on self-reported data vs directly measured data (5 of 5 studies). Females underestimated weight more than males (ranges, -4.0 to -1.0 kg vs -2.6 to 1.5 kg, respectively) (9 of 9 studies); overweight individuals underestimated weight more than nonoverweight individuals (6 of 6 studies). Missing self-reported data ranged from 0% to 23% (9 of 9 studies). There was inadequate information on bias by age and race/ethnicity. Self-reported data are valuable if the only source of data. However, self-reported data underestimate overweight prevalence and there is bias by sex and weight status. Lower sensitivities of self-reported data indicate that one-fourth to one-half of those overweight would be missed. Other potential biases in self-reported data, such as across subgroups, need further clarification. The feasibility of collecting directly measured height and weight data on a state/community level should be explored because directly measured data are more accurate.
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                Author and article information

                Contributors
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, USA )
                1932-6203
                2014
                20 May 2014
                : 9
                : 5
                : e96768
                Affiliations
                [1 ]Institut national d’études démographiques (INED), Paris, France
                [2 ]Inserm, U669, Univ Paris-Sud and Univ Paris Descartes, UMR-S0669, Paris, France
                [3 ]Institut national de prévention et d’éducation à la santé (INPES), Saint-Denis, France
                [4 ]Cermes3 - Equipe Cesames (Centre de recherche Médecine, Sciences, Santé, Santé mentale, Société, Université Paris Descartes/CNRS UMR 8211/Inserm U988/EHESS), Paris, France
                [5 ]French Monitoring Centre for Drugs and Drug Addiction - Observatoire Français des Drogues et des Toxicomanies (OFDT), Saint-Denis, France
                University of Missouri-Kansas City, United States of America
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Conceived and designed the experiments: SL FB SS. Performed the experiments: SL FB SS. Analyzed the data: SL. Contributed reagents/materials/analysis tools: SL SS NC. Wrote the paper: SL FB SS NC.

                Article
                PONE-D-13-38061
                10.1371/journal.pone.0096768
                4028195
                74defced-10b8-42a8-b70c-1e9b2a9d537e
                Copyright @ 2014

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 11 September 2013
                : 11 April 2014
                Page count
                Pages: 9
                Funding
                The study was funded by the OFDT and the INED. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Categories
                Research Article
                Biology and Life Sciences
                Nutrition
                Physiology
                Physiological Parameters
                Body Weight
                Obesity
                Medicine and Health Sciences
                Epidemiology
                Health Care
                Health Care Policy
                Child and Adolescent Health Policy
                Socioeconomic Aspects of Health
                Pediatrics
                Child Health
                Public and Occupational Health
                Behavioral and Social Aspects of Health
                Research and Analysis Methods
                Research Design
                Clinical Research Design
                Survey Research

                Uncategorized
                Uncategorized

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