Abstract
ObjectivesTo 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.Methods341 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).ResultsOn 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.ConclusionsUsing body shape perception, or socioeconomic status and gender is a promising way of correcting BMI in self-administered questionnaires, especially for girls.
Highlights
Obesity is responsible for numerous health complications, chronic diseases and increased risk of mortality [1], and it contributes to health inequalities because it mainly concerns poor families [2]
The aim of this study is to propose strategies that could be tested in different populations in order to compute corrected Body Mass Index (BMI) from self-administered adolescent surveys
This is consistent with the results found in the whole Paris sample
Summary
Obesity is responsible for numerous health complications, chronic diseases and increased risk of mortality [1], and it contributes to health inequalities because it mainly concerns poor families [2]. Its prevention and treatment account for a large share of health budgets in Western countries (1.5%–4.6% of the annual expenditures in France [3]). Obesity occurs very early in life and has psychological and social consequences among young people, such as discrimination [4] and bullying [5]. Monitoring the adolescent population is an important public health objective, especially because there are indications in some countries that the social gradient in childhood obesity may be increasing over time [6]. Employing technicians to measure these data is often impossible in large-scale surveys, and alternative indicators such as waist circumference and waist-to-hip ratio require a certain amount of training to be reliable
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