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Nutrición Hospitalaria

versión On-line ISSN 1699-5198versión impresa ISSN 0212-1611

Nutr. Hosp. vol.33 no.6 Madrid nov./dic. 2016

http://dx.doi.org/10.20960/nh.239 

TRABAJO ORIGINAL / Valoración nutricional

 

Ten-year trends (2000-2010) in bias of self-reported weight, height and body mass index in a Mediterranean adult population

Tendencia a diez años (2000-2010) en el sesgo de auto-reporte de peso, talla e índice de masa corporal en una población adulta mediterránea

 

 

Maria del Mar Bibiloni1,2, Josep Ll. Coll1, Rogelio Salas3, Jordi Pich1,2, Antoni Pons1,2 and Josep A. Tur1,2

1Research Group on Community Nutrition and Oxidative Stress. University of the Balearic Islands, and 2CIBEROBN (Fisiopatología de la Obesidad y la Nutrición), E-07122 Palma de Mallorca, Spain.
3Faculty of Public Health Nutrition. Universidad Autónoma de Nuevo León. Monterrey, Mexico

Instituto de Salud Carlos III (Projects 05/1276, 08/1259, 11/01791, 14/ 00636, Red Predimed-RETIC RD06/0045/1004, and CIBEROBN CB12/03/30038), BI Government Grants to support research groups (35/2011), and EU FEDER funds.

Correspondence

 

 


ABSTRACT

Aim: To assess trends in the biases of self-reported versus measured weight, height, and body mass index (BMI) in adults over the period 2000-2010 in a Mediterranean adult population.
Methods: The sample population consisted of young (18-35) and middle-aged (36-55) adults living in the Balearic Islands, Spain. The data represent 1,089 people during 1999-2000 and 1,081 people during 2000-2010. Weighted-based frequency estimates were used.
Results: While no differences between self-reported and measured weight, height and BMI were found in the respondents, it was seen that a decreasing percentage of the population knows their own weight and/or height. A rise in awareness was found in normal-weight men (from 95.0% to 98.9%), and also in normal-weight men and in the middle-aged obese category whose self-reported BMI was not defined as "correct" (from 41.2% to 85.7% and from 41.0% to 67.6% respectively).
Conclusions: A substantial proportion of the population does not know their own weight or height. The obtained results suggest the need to develop strategies to enhance awareness of own weight and height.

Key words: Biases. Self-reported. Body mass index. Adults. Balearic Islands.


RESUMEN

Objetivo: evaluar la tendencia del sesgo de la percepción subjetiva frente a la medida de peso, talla e índice de masa corporal (IMC) en una población adulta mediterránea durante el periodo 2000-2010.
Métodos: la población estudiada fueron adultos jóvenes (18-35 años) y de mediana edad (36-55 años) de las Islas Baleares. Los datos representan 1089 personas durante 1999-2000 y 1081 personas durante 2000-2010 en los que se registró la percepción subjetiva y la medida de peso, altura e IMC. Se utilizaron datos ponderados sobre el censo.
Resultados: si bien no se encontraron diferencias entre la percepción subjetiva y la medición de peso, altura e IMC en los encuestados, se observó que un porcentaje cada vez menor de la población conoce su propio peso y/o altura. Aumenta la propia percepción en hombres con peso normal (de 95,0% a 98,9%); la percepción subjetiva de IMC no se definió como "correcta" en estos mismos sujetos y en obesos de mediana edad (de 41,2 % a 85,7% y de 41,0% a 67,6%, respectivamente).
Conclusiones: una proporción importante de la población no conoce su propio peso o altura. Los resultados obtenidos sugieren la necesidad de desarrollar estrategias para aumentar la conciencia del propio peso y altura

Palabras clave: Sesgo. Percepción subjetiva. Índice de masa corporal. Adultos. Islas Baleares.


 

Introduction

Overweight and obesity poses one of the most serious public health challenges of the 21st century (1). Self-reported rather than measured body weight and height are usually used because interview methods are time- and cost-efficient on large population samples (2). An appropriate body self-perception can lead to healthy behaviours in weight-loss polices and eating disorders. However, many adults may be unaware of their present body weight and height (2-4), and self-reported data are usually linked with under-reporting weight and over-reporting height (5). Over reporting of height can result in a lower body mass index (BMI), and underestimation of overweight and obesity prevalence could be outlined after comparing self-reported data to measured data (6). Weight and height self-perception may be influenced by many factors: gender, socio-economic rules, mass media, lifestyles, diet and nutritional status. Furthermore, it has been reported that the influence of social desirability on self-reports has the potential to change over time as social and cultural norms towards weight and obesity change (5).

In the first decade of the 21st century, diet and traditional food patterns in the Balearic Islands, an archipelago located off the Mediterranean eastern coast of Spain, have been affected by the socio-cultural changes seen in the rest of Spain and Europe, the development of a tourism-based economy, and a high population growth mainly due to an influx of people from overseas (6), and then the introduction of new dietary, lifestyle and socio-cultural habits (7).

The aim of this study was to assess trends in the biases of self-reported versus measured weight, height, and body mass index (BMI) in adults over the 2000-2010 period in a Mediterranean adult population.

 

Method

The sample population included in this analysis were young (18-35) and middle-aged (36-55) adults living in the Balearic Islands. The data represent 1,089 people during the 1999-2000 period and 1,081 people during the 2009-2010 period. Samples sizes were considered sufficient to detect risk factors with 95% confidence and a precision rate of 3.0%. Weighted data based on the results of the 2001 and 2011 Balearic Islands census were used.

ETHICS

Both studies were conducted according to the guidelines laid down in the Declaration of Helsinki, and all procedures were approved by the Balearic Islands Ethics Committee. Written informed consent was obtained from all subjects.

ANTHROPOMETRIC MEASUREMENTS

Body weight was determined to the nearest 100 g using a digital scale (Tefal sc9210, Tefal, Rumilly, France). The subjects were weighed in bare feet and light clothes. Height was determined using a mobile anthropometer (Kawe 44444, Kirchner & Wilhelm GmbH + Co. KG, Asperg, Germany) to the nearest millimetre, with the subject's head in the Frankfurt plane. Height and weight measures were used to calculate BMI (kg/m2). BMI was classified as normal-weight (18.5 < 25.0), overweight (25.0 < 30.0) and obese (≥ 30.0). Data from the underweight category were not included.

Self-reported weight and height was defined as "correct" if the absolute difference between self-reported minus measured weight and height was lower than 2.0 kg and 2.0 cm, respectively. Self-reported BMI was defined as "correct" if the absolute difference between reported minus measured BMI was lower than 1.40 kg/m2.

STATISTICS

Analyses were performed with SPSS version 21.0 (Chicago, IL, USA). Significant differences in prevalence were calculated by means of χ2. Mean differences in self- reported and measured weight, height and BMI were tested by unpaired Students' t test. The level of significance for acceptance was p < 0.05.

 

Results

While no differences between self-reported and measured weight, height and BMI were found during the 2000-2010 period in the respondents, it was seen that a decreasing percentage of the population knows their own weight and/or height (Table I). Overall, results showed a rise in awareness in the normal-weight category (from 96.1% to 98.7%), specifically among men (Table II). When subjects whose self-reported BMI was not defined as "correct" were analysed, a rise in awareness was also found in normal-weight men (from 41.2% to 85.7%). Moreover, increased awareness was shown in obese subjects, particularly middle-aged adults, who demonstrated a rising perception of their weight and/or height (from 41.0% to 67.6%).

 

 

 

Discussion

Despite no differences between self-reported and measured data being found over the 2000-2010 period, our results revealed a decreasing percentage of respondents self-reporting data. Nevertheless, amongst those responding, a rise in awareness was found in normal-weight men, and also in normal-weight men and middle-aged obese subjects whose self-reported BMI was not defined as "correct".

In the USA and Canada, the biases between mean self-reported and measured weight increased 0.2 and 0.3 kg over the 1976-1980 and 2003-2004 periods, respectively (8). Moreover, in the USA, the prevalence of weight/height discrimination grew from 7.3% in 1995-1996 to 12% in 2004-2006 affecting the entire normal-weight population apart from the elderly (9). No differences were shown by the overweight and obese population in this analysis (9). In Europe around 30% of the population misclassifies their current weight (10). A decreasing trend for people who misperceived their current weight over the 1995-2008 period was found in Denmark (11).

While no biases between self-reported and measured BMI were found in the USA over the 1976-2004 period, stable awareness in the normal-weight population and decreased awareness in the overweight and obese population (from 75.3% to 66% and from 79.5 to 53.4%, respectively) were described for the 1998-2007 period (12). In Canada rising biases between self-reported and measured BMI were observed over the 1986-2005 period, from -0.8 to -1.1 (12). In an Irish study, Shiely et al. (5) described rising biases between self-reported and measured BMI during 1998-2007 with an increased tendency to underestimate BMI when self-reporting. In addition, they concluded that there was underestimation of self-reported BMI when compared with measured BMI among the overweight and obese population. In Spain, contrary to our results, while the prevalence of overweight (≥ 25 kg/m2) increased, the frequency of misperceived overweight remained stable at around 35% in men and 20.8% in women (13).

 

Conclusions

Despite finding a rising awareness of self-weight and height among those who did respond, particularly in normal-weight male and middle-aged obese subjects, a substantial proportion of the population does not know their own weight or height. These results suggest the need to develop strategies to enhance awareness about own weight and height.

 

References

1. World Health Organization. 2014. Avalaible at: http://www.who.int/mediacentre/factsheets/fs311/en/index.html. Accessed 26 June 2016.         [ Links ]

2. Kuczmarski MF, Kuczmarski RJ, Najjar M. Effects of age on validity of self-reported height, weight, and body mass index: Findings from the third National Health and Nutrition Examination Survey, 1988-1994. J Am Diet Assoc 2001;101:28-34.         [ Links ]

3. Alvarez-Torices JC, Franch-Nadal, J. Alvarez-Guisasola F, Hernandez-Mejia R, Cueto-espinar A. Self-reported height and weight and prevalence of obesity: study in a Spanish population. Int J Obes 1993;17:663-7.         [ Links ]

4. Connor Gorber S, Tremblay M, Moher D, Gorber B. A comparison of direct vs. self-report measures for assessing height, weight and body mass index: a systematic review. Obes Rev 2007;8:307-26.         [ Links ]

5. Shiely F, Perry IJ, Lutomski J, Harrington J, Kelleher CC, McGee H, Hayes K. Temporal trends in misclassification patterns of measured and self-report based body mass index categories - findings from three population surveys in Ireland. BMC Public Health 2010;10:560.         [ Links ]

6. Bibiloni MM, Salas R, Coll JL, Pons A, Tur JA. Ten-year trends in compliance with the current Spanish nutritional objectives in Balearic Islands adult population (2000-2010). Nutrition 2014;30:800-6.         [ Links ]

7. Llull R, Bibiloni MM, Pons A, Tur JA. Food consumption patterns of Balearic Islands' adolescents depending on their origin. J Immigr Minor Health 2015;17:358-66.         [ Links ]

8. Connor Gorber S, Tremblay MS. The bias in self-reported obesity from 1976 to 2005: a Canada-US comparison. Obesity (Silver Spring) 2010;2:354-61.         [ Links ]

9. Andreyeva T, Puhl RM, Brownell KD. Changes in perceived weight discrimination among Americans, 1995-1996 Through 2004-2006. Obesity 2008;16:1129-34.         [ Links ]

10. Mikolajczyk RT, Maxwell AE, El Ansari W, Stock C, Petkeviciene J, Guillen-Grima F. Relationship between perceived body weight and body mass index based on self reported height and weight among university students: a cross sectional survey in seven European countries. BMC Public Health 2010;10:40.         [ Links ]

11. Matthiessen J, Biltoft-Jensen A, Fagt S, Knudsen VK, Tetens I, Groth MV. Misperception of body weight among overweight Danish adults: trends from 1995 to 2008. Public Health Nutr 2014;17:1439-46.         [ Links ]

12. Stomel M, Osier N. Temporal changes in bias of body mass index scores based on self-reported height and weight. Int J Obs (Lond) 2013;3:461-7.         [ Links ]

13. Salcedo V, Gutierrez Fisac JL, Guallar-Castillón P, Rodríguez Artalejo F. Trends in overweight and misperceived overweight in Spain from 1987 to 2007. Int J Obes (Lond) 2010;12:1759-65.         [ Links ]

 

 

Correspondence:
Josep A. Tur.
Research Group on Community Nutrition and Oxidative Stress.
Universitat de les Illes Balears & CIBEROBN.
Guillem Colom Bldg, Campus.
07122 Palma de Mallorca, Spain
e-mail: pep.tur@uib.es

Received: 27/06/2016
Accepted: 18/09/2016