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A Literature Review

Bettylou Sherry, PhD, RD; Maria Elena Jefferds, PhD; Laurence M. Grummer-Strawn, PhD

Arch Pediatr Adolesc Med. 2007;161(12):1154-1161.

Objective  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.

Data Sources  Eleven studies (4 nationally representative, 7 convenience sample or locally based).

Study Selection  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.

Main Exposures  Self-reported and directly measured height and weight.

Main Outcome Measures  Overweight prevalence; missing data, bias, and accuracy.

Results  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.

Conclusions  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.

Author Affiliations: Maternal Child Nutrition Branch, Division of Nutrition and Physical Activity, Centers for Disease Control and Prevention, Atlanta, Georgia.

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