Underestimation of obesity prevalence in Switzerland: comparison of two methods for correction of self-report.
Underestimation of obesity prevalence in Switzerland: comparison of two methods for correction of self-report.
复制标题
瑞士肥胖患病率的低估：两种自我报告校正方法的比较。
作者：
D. Faeh;J. Braun;Matthias Bopp
背景/目的
使用自我报告的研究可能会低估肥胖患病率，因为参与者往往高估自己的身高，低估自己的体重，从而严重低估自己的身体质量指数（BMI）。为了找到调整这种错误估计的方法，我们通过比较推导出的肥胖患病率与基于测量的身高和体重的肥胖患病率，测试了两种自我报告的校正方法。
方法
我们使用了6项基于自我报告BMI的研究（1980-2007，n = 46589）和5项基于测量BMI的研究（1977-2004，n = 20130）的个体数据。所有研究都是基于人口的样本，在瑞士进行。我们仅限于35至74岁的男性和女性。肥胖定义为BMI ≥ 30 kg/m2。对于校正方法一，我们使用较低的BMI截止值29.2 kg/m2（男女）来定义肥胖;对于方法二，我们使用来自另一个人群的方程来调整体重和身高（关于年龄和性别）。结果是年龄标准化的。采用考虑随机效应的逻辑回归模型测量差异。
结果
身高和体重的调整（方法二）基本上接近BMI分布的基础上未经调整的自我报告的BMI分布的基础上测量。在2002/2003年度，采用方法二得出的肥胖患病率（男性和女性分别为16.3%和13.0%）与采用方法一得出的肥胖患病率（13.8%和11.0%）相比，更接近于测量的肥胖患病率（16.4%和13.9%）。
结论
自我报告的体重和身高的方程校正提供了按性别和年龄的真实的（测量的）BMI分布的近似值，并且优于使用通用下限临界水平来校正自我报告。然而，为了适当调整自我报告，应根据相同个体的测量和自我报告的身高和体重制定瑞士特有的方程。
BACKGROUND/OBJECTIVE
Studies using self-report may underestimate obesity prevalence because participants tend to overestimate their height, underestimate their weight and thus seriously underestimate their Body Mass Index (BMI). In order to find ways to adjust for this misestimation, we tested two correction methods for self-report by comparing the derived obesity prevalence rates with those based on measured height and weight.
METHODS
We used individual data from six studies based on self-reported BMI (1980-2007, n = 46589) and from five studies based on measured BMI (1977-2004, n = 20130). All studies were population-based samples and carried out in Switzerland. We limited to men and women aged 35 to 74 years. Obesity was defined as BMI > or =30 kg/m2. For correction method one, we used a lower BMI cutoff of 29.2 kg/m2 (for both sexes) for the definition of obesity; for method two, we adjusted weight and height (respecting age and sex) using equations that were derived from another population. Results were age-standardised. Differences were measured with a logistic regression model considering random effects.
RESULTS
Adjustment of height and weight (method two) substantially approximated the BMI distribution based on unadjusted self-report to the BMI distribution based on measurement. In 2002/2003, obesity prevalence obtained with method two (men and women respectively: 16.3% and 13.0%) tended to be more similar to measured obesity prevalence (16.4% and 13.9%) than obesity prevalence obtained with method one (13.8% and 11.0%).
CONCLUSION
Equation adjustment of self-reported weight and height provides an approximation of the real (measured) BMI distribution by sex and age and has advantages over the use of a universal lower cutoff level to adjust for self-report. However, to appropriately adjust for self-report, a Swiss-specific equation should be developed based on measured and self-reported heights and weights of the same individuals.