Skip to main content
Top
Published in: BMC Medical Research Methodology 1/2017

Open Access 01-12-2017 | Research article

Validity of self-reported weight and height: a cross-sectional study among Malaysian adolescents

Authors: C. C. Kee, K. H. Lim, M. G. Sumarni, C. H. Teh, Y. Y. Chan, M. I. Nuur Hafizah, Y. K. Cheah, E. O. Tee, Y. Ahmad Faudzi, M. Amal Nasir

Published in: BMC Medical Research Methodology | Issue 1/2017

Login to get access

Abstract

Background

Self-reported weight and height are commonly used in lieu of direct measurements of weight and height in large epidemiological surveys due to inevitable constraints such as budget and human resource. However, the validity of self-reported weight and height, particularly among adolescents, needs to be verified as misreporting could lead to misclassification of body mass index and therefore overestimation or underestimation of the burden of BMI-related diseases. The objective of this study was to determine the validity of self-reported weight and height among Malaysian secondary school children.

Methods

Both self-reported and directly measured weight and height of a subgroup of 663 apparently healthy schoolchildren from the Malaysian Adolescent Health Risk Behaviour (MyAHRB) survey 2013/2014 were analysed. Respondents were required to report their current body weight and height via a self-administrative questionnaire before they were measured by investigators. The validity of self-reported against directly measured weight and height was examined using intraclass correlation coefficient (ICC), the Bland-Altman plot and weighted Kappa statistics.

Results

There was very good intraclass correlation between self-reported and directly measured weight [r = 0.96, 95% confidence interval (CI): 0.93, 0.97] and height (r = 0.94, 95% CI: 0.90, 0.96). In addition the Bland-Altman plots indicated that the mean difference between self-reported and direct measurement was relatively small. The mean difference (self-reported minus direct measurements) was, for boys: weight, −2.1 kg; height, −1.6 cm; BMI, −0.44 kg/m2 and girls: weight, −1.2 kg; height, −0.9 cm; BMI, −0.3 kg/m2. However, 95% limits of agreement were wide which indicated substantial discrepancies between self-reported and direct measurements method at the individual level. Nonetheless, the weighted Kappa statistics demonstrated a substantial agreement between BMI status categorised based on self-reported weight and height and the direct measurements (kappa = 0.76, 95% CI: 0.67, 0.84).

Conclusion

Our results show that the self-reported weight and height were consistent with direct measurements and therefore can be used in assessing the nutritional status of Malaysian school children from the age of 13 to 17 years old in epidemiological studies and for surveillance purposes when direct measurements are not feasible, but not for assessing nutritional status at the individual level.
Literature
1.
go back to reference Brener ND, Kann L, Shanklin S, Kinchen S, Eaton DK, Hawkins J, et al. Methodology of the Youth Risk Behavior Surveillance System--2013. MMWR Recomm Rep 2013. 62(RR-1):1–20. Brener ND, Kann L, Shanklin S, Kinchen S, Eaton DK, Hawkins J, et al. Methodology of the Youth Risk Behavior Surveillance System--2013. MMWR Recomm Rep 2013. 62(RR-1):1–20.
3.
go back to reference Himes JH. Challenges of accurately measuring and using BMI and other indicators of obesity in children. Pediatrics. 2009;124(Suppl 1):S3–22.CrossRefPubMed Himes JH. Challenges of accurately measuring and using BMI and other indicators of obesity in children. Pediatrics. 2009;124(Suppl 1):S3–22.CrossRefPubMed
4.
go back to reference Ohlmer R, Jacobi C, Fittig E. Diagnosing underweight in adolescent girls: should we rely on self-reported height and weight? Eat Behav. 2012;13(1):1–4.CrossRefPubMed Ohlmer R, Jacobi C, Fittig E. Diagnosing underweight in adolescent girls: should we rely on self-reported height and weight? Eat Behav. 2012;13(1):1–4.CrossRefPubMed
5.
go back to reference De Vriendt T, Huybrechts I, Ottevaere C, Van Trimpont I, De Henauw S. Validity of self-reported weight and height of adolescents, its impact on classification into BMI-categories and the association with weighing behaviour. Int J Environ Res Public Health. 2009;6(10):2696–711.CrossRefPubMedPubMedCentral De Vriendt T, Huybrechts I, Ottevaere C, Van Trimpont I, De Henauw S. Validity of self-reported weight and height of adolescents, its impact on classification into BMI-categories and the association with weighing behaviour. Int J Environ Res Public Health. 2009;6(10):2696–711.CrossRefPubMedPubMedCentral
6.
go back to reference Perez A, Gabriel K, Nehme EK, Mandell DJ, Hoelscher DM. Measuring the bias, precision, accuracy, and validity of self-reported height and weight in assessing overweight and obesity status among adolescents using a surveillance system. Int J Behav Nutr Phys Act. 2015;12 Suppl 1:S2.CrossRefPubMed Perez A, Gabriel K, Nehme EK, Mandell DJ, Hoelscher DM. Measuring the bias, precision, accuracy, and validity of self-reported height and weight in assessing overweight and obesity status among adolescents using a surveillance system. Int J Behav Nutr Phys Act. 2015;12 Suppl 1:S2.CrossRefPubMed
7.
go back to reference Yoshitake N, Okuda M, Sasaki S, Kunitsugu I, Hobara T. Validity of self-reported body mass index of Japanese children and adolescents. Pediatr Int. 2012;54(3):397–401.CrossRefPubMed Yoshitake N, Okuda M, Sasaki S, Kunitsugu I, Hobara T. Validity of self-reported body mass index of Japanese children and adolescents. Pediatr Int. 2012;54(3):397–401.CrossRefPubMed
8.
go back to reference Ekstrom S, Kull I, Nilsson S, Bergstrom A. Web-based self-reported height, weight, and body mass index among Swedish adolescents: a validation study. J Med Internet Res. 2015;17(3):e73.CrossRefPubMedPubMedCentral Ekstrom S, Kull I, Nilsson S, Bergstrom A. Web-based self-reported height, weight, and body mass index among Swedish adolescents: a validation study. J Med Internet Res. 2015;17(3):e73.CrossRefPubMedPubMedCentral
9.
go back to reference Zhou X, Dibley MJ, Cheng Y, Ouyang X, Yan H. Validity of self-reported weight, height and resultant body mass index in Chinese adolescents and factors associated with errors in self-reports. BMC Public Health. 2010;10:190.CrossRefPubMedPubMedCentral Zhou X, Dibley MJ, Cheng Y, Ouyang X, Yan H. Validity of self-reported weight, height and resultant body mass index in Chinese adolescents and factors associated with errors in self-reports. BMC Public Health. 2010;10:190.CrossRefPubMedPubMedCentral
10.
go back to reference Gwet KL: Handbook of inter-rater reliability: The definitive guide to measuring the extent of agreement among raters: Advanced Analytics,LLC; 2014. Gwet KL: Handbook of inter-rater reliability: The definitive guide to measuring the extent of agreement among raters: Advanced Analytics,LLC; 2014.
11.
go back to reference Roth C, Pekrun A, Bartz M, Jarry H, Eber S, Lakomek M, et al. Short stature and failure of pubertal development in thalassaemia major: evidence for hypothalamic neurosecretory dysfunction of growth hormone secretion and defective pituitary gonadotropin secretion. Eur J Pediatr. 1997;156(10):777–83. Roth C, Pekrun A, Bartz M, Jarry H, Eber S, Lakomek M, et al. Short stature and failure of pubertal development in thalassaemia major: evidence for hypothalamic neurosecretory dysfunction of growth hormone secretion and defective pituitary gonadotropin secretion. Eur J Pediatr. 1997;156(10):777–83.
12.
go back to reference Fine RN. Etiology and treatment of growth retardation in children with chronic kidney disease and end-stage renal disease: a historical perspective. Pediatr Nephrol. 2010;25(4):725–32.CrossRefPubMed Fine RN. Etiology and treatment of growth retardation in children with chronic kidney disease and end-stage renal disease: a historical perspective. Pediatr Nephrol. 2010;25(4):725–32.CrossRefPubMed
15.
go back to reference de Onis M, Onyango AW, Borghi E, Siyam A, Nishida C, Siekmann J. Development of a WHO growth reference for school-aged children and adolescents. Bull World Health Organ. 2007;85(9):660–7.CrossRefPubMedPubMedCentral de Onis M, Onyango AW, Borghi E, Siyam A, Nishida C, Siekmann J. Development of a WHO growth reference for school-aged children and adolescents. Bull World Health Organ. 2007;85(9):660–7.CrossRefPubMedPubMedCentral
16.
go back to reference Lin CJ, DeRoo LA, Jacobs SR, Sandler DP. Accuracy and reliability of self-reported weight and height in the Sister Study. Public Health Nutr. 2012;15(6):989–99.CrossRefPubMed Lin CJ, DeRoo LA, Jacobs SR, Sandler DP. Accuracy and reliability of self-reported weight and height in the Sister Study. Public Health Nutr. 2012;15(6):989–99.CrossRefPubMed
17.
go back to reference Zaki R, Bulgiba A, Ismail R, Ismail NA. Statistical Methods Used to Test for Agreement of Medical Instruments Measuring Continuous Variables in Method Comparison Studies: A Systematic Review. PLoS One. 2012;7(5):e37908.CrossRefPubMedPubMedCentral Zaki R, Bulgiba A, Ismail R, Ismail NA. Statistical Methods Used to Test for Agreement of Medical Instruments Measuring Continuous Variables in Method Comparison Studies: A Systematic Review. PLoS One. 2012;7(5):e37908.CrossRefPubMedPubMedCentral
18.
go back to reference Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet. 1986;1(8476):307–10.CrossRefPubMed Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet. 1986;1(8476):307–10.CrossRefPubMed
19.
go back to reference Jakobsson U, Westergren A. Statistical methods for assessing agreement for ordinal data. Scand J Caring Sci. 2005;19(4):427–31.CrossRefPubMed Jakobsson U, Westergren A. Statistical methods for assessing agreement for ordinal data. Scand J Caring Sci. 2005;19(4):427–31.CrossRefPubMed
20.
go back to reference Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977;33(1):159–74.CrossRefPubMed Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977;33(1):159–74.CrossRefPubMed
21.
go back to reference Bae J, Joung H, Kim JY, Kwon KN, Kim Y, Park SW. Validity of self-reported height, weight, and body mass index of the Korea Youth Risk Behavior Web-based Survey questionnaire. J Prev Med Public Health. 2010;43(5):396–402.CrossRefPubMed Bae J, Joung H, Kim JY, Kwon KN, Kim Y, Park SW. Validity of self-reported height, weight, and body mass index of the Korea Youth Risk Behavior Web-based Survey questionnaire. J Prev Med Public Health. 2010;43(5):396–402.CrossRefPubMed
22.
go back to reference Tokmakidis SP, Christodoulos AD, Mantzouranis NI. Validity of self-reported anthropometric values used to assess body mass index and estimate obesity in Greek school children. J Adolesc Health. 2007;40(4):305–10.CrossRefPubMed Tokmakidis SP, Christodoulos AD, Mantzouranis NI. Validity of self-reported anthropometric values used to assess body mass index and estimate obesity in Greek school children. J Adolesc Health. 2007;40(4):305–10.CrossRefPubMed
23.
go back to reference Fonseca H, Silva AM, Matos MG, Esteves I, Costa P, Guerra A, et al. Validity of BMI based on self-reported weight and height in adolescents. Acta Paediatr. 2010;99(1):83–8. Fonseca H, Silva AM, Matos MG, Esteves I, Costa P, Guerra A, et al. Validity of BMI based on self-reported weight and height in adolescents. Acta Paediatr. 2010;99(1):83–8.
24.
go back to reference Brettschneider AK, Rosario AS, Ellert U. Validity and predictors of BMI derived from self-reported height and weight among 11- to 17-year-old German adolescents from the KiGGS study. BMC Res Notes. 2011;4:414.CrossRefPubMedPubMedCentral Brettschneider AK, Rosario AS, Ellert U. Validity and predictors of BMI derived from self-reported height and weight among 11- to 17-year-old German adolescents from the KiGGS study. BMC Res Notes. 2011;4:414.CrossRefPubMedPubMedCentral
25.
go back to reference Jayawardene W, Lohrmann D, YoussefAgha A. Discrepant body mass index: behaviors associated with height and weight misreporting among US adolescents from the National Youth Physical Activity and Nutrition Study. Child Obes. 2014;10(3):225–33.CrossRefPubMed Jayawardene W, Lohrmann D, YoussefAgha A. Discrepant body mass index: behaviors associated with height and weight misreporting among US adolescents from the National Youth Physical Activity and Nutrition Study. Child Obes. 2014;10(3):225–33.CrossRefPubMed
26.
go back to reference Sherry B, Jefferds ME, Grummer-Strawn LM. Accuracy of adolescent self-report of height and weight in assessing overweight status: a literature review. Arch Pediatr Adolesc Med. 2007;161(12):1154–61.CrossRefPubMed Sherry B, Jefferds ME, Grummer-Strawn LM. Accuracy of adolescent self-report of height and weight in assessing overweight status: a literature review. Arch Pediatr Adolesc Med. 2007;161(12):1154–61.CrossRefPubMed
27.
go back to reference Clarke P, Sastry N, Duffy D, Ailshire J. Accuracy of self-reported versus measured weight over adolescence and young adulthood: Findings from the national longitudinal study of adolescent health, 1996–2008. Am J Epidemiol. 2014;180(2):153–9.CrossRefPubMedPubMedCentral Clarke P, Sastry N, Duffy D, Ailshire J. Accuracy of self-reported versus measured weight over adolescence and young adulthood: Findings from the national longitudinal study of adolescent health, 1996–2008. Am J Epidemiol. 2014;180(2):153–9.CrossRefPubMedPubMedCentral
28.
go back to reference Aasvee K, Rasmussen M, Kelly C, Kurvinen E, Giacchi MV, Ahluwalia N. Validity of self-reported height and weight for estimating prevalence of overweight among Estonian adolescents: the Health Behaviour in School-aged Children study. BMC Research Notes. 2015;8(1):606.CrossRefPubMedPubMedCentral Aasvee K, Rasmussen M, Kelly C, Kurvinen E, Giacchi MV, Ahluwalia N. Validity of self-reported height and weight for estimating prevalence of overweight among Estonian adolescents: the Health Behaviour in School-aged Children study. BMC Research Notes. 2015;8(1):606.CrossRefPubMedPubMedCentral
29.
go back to reference Hogan MJ, Strasburger VC. Body image, eating disorders, and the media. Adolesc Med State Art Rev. 2008;19(3):521–46. x-xiPubMed Hogan MJ, Strasburger VC. Body image, eating disorders, and the media. Adolesc Med State Art Rev. 2008;19(3):521–46. x-xiPubMed
30.
go back to reference Carey RN, Donaghue N, Broderick P. Body image concern among Australian adolescent girls: the role of body comparisons with models and peers. Body Image. 2014;11(1):81–4.CrossRefPubMed Carey RN, Donaghue N, Broderick P. Body image concern among Australian adolescent girls: the role of body comparisons with models and peers. Body Image. 2014;11(1):81–4.CrossRefPubMed
31.
go back to reference Hanneman SK. Design, analysis, and interpretation of method-comparison studies. AACN Adv Crit Care. 2008;19(2):223–34.PubMedPubMedCentral Hanneman SK. Design, analysis, and interpretation of method-comparison studies. AACN Adv Crit Care. 2008;19(2):223–34.PubMedPubMedCentral
32.
go back to reference Rasmussen M, Holstein BE, Melkevik O, Damsgaard MT. Validity of self-reported height and weight among adolescents: the importance of reporting capability. BMC Med Res Methodol. 2013;13:85.CrossRefPubMedPubMedCentral Rasmussen M, Holstein BE, Melkevik O, Damsgaard MT. Validity of self-reported height and weight among adolescents: the importance of reporting capability. BMC Med Res Methodol. 2013;13:85.CrossRefPubMedPubMedCentral
Metadata
Title
Validity of self-reported weight and height: a cross-sectional study among Malaysian adolescents
Authors
C. C. Kee
K. H. Lim
M. G. Sumarni
C. H. Teh
Y. Y. Chan
M. I. Nuur Hafizah
Y. K. Cheah
E. O. Tee
Y. Ahmad Faudzi
M. Amal Nasir
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Medical Research Methodology / Issue 1/2017
Electronic ISSN: 1471-2288
DOI
https://doi.org/10.1186/s12874-017-0362-0

Other articles of this Issue 1/2017

BMC Medical Research Methodology 1/2017 Go to the issue