Accuracy of self-reported heights and weights in a predominately low-income, diverse population living in the USA

Agreement between self-reported and measured weight, height, and derived BMI by educational attainment across racial and ethnic groups of US women

OBJECTIVE

Underreporting of weight and overreporting of height is consistently shown among women, thereby reducing accuracy of estimation of body mass index-and thus obesity-in epidemiologic studies that rely on self-reported data. Additionally, misreporting has been shown to differ by socioeconomic status and race and ethnicity, which can result in differential misclassification and bias that can obfuscate associations with obesity across groups in multiethnic and socioeconomically varying populations. Therefore, we sought to assess agreement between self-reported and objectively measured weight, height, and derived body mass index (BMI) across levels of educational attainment within racial and ethnic groups in a population-based cohort of US women.

METHODS

Among self-identified White, Black, and Latina women enrolled in the Sister Study (2003-2009), we assessed mean differences in self-reported vs. objectively measured weight, height, and derived BMI. Using adjusted linear and multinomial logistic regression, we compared measurement error among participants reporting some college/vocational school or ≥college vs. ≤high school. We assessed BMI agreement using Bland-Altman plots and weighted kappa (k) statistics.

RESULTS

Among 18,638 participants (age: mean ± standard deviation = 56 ± 9.0 years), 84% identified as White, 10% Black, and 5% Latina. Approximately half (49%) attained a college education. Weight and height were generally underreported. Higher underreporting of weight among participants with ≥college vs. ≤high school was of larger magnitude among Black and Latina vs. White participants. Bland-Altman results revealed that agreement in continuous BMI was good among White participants but generally fair among Black and Latina participants. Categorical BMI agreement was consistently high with minor variation by race and ethnicity and educational attainment (weighted k range = 0.92-0.93).

CONCLUSIONS

Despite higher measurement error in weight among Black and Latina participants with ≥college education, self-reported and objectively measured BMI categories showed high agreement across groups. Results support the utility of self-reported data that reliably estimate BMI category across socioeconomic, racial, and ethnic groups in this cohort.

Prevalence of Obesity Among Electronic Cigarette and Tobacco Users in the United States: Results from the 2018 Wave of the Behavioral Risk Factor Surveillance System

Objective: Tobacco use and obesity are leading causes of preventable death in the U.S. E-cigarette use is on the rise; however, obesity prevalence among e-cigarette users is unknown. The present study characterized obesity prevalence among e-cigarette and tobacco users in a national sample of U.S. adults. Method: Data were obtained from the 2018 Behavioral Risk Factor Surveillance System. Approximately 249,726 participants provided data on e-cigarette and tobacco use, height, weight, and demographics, and were categorized as follows: Ever vaped, ever smoked; Ever vaped, never smoked; Never vaped, ever smoked; Never vaped, never smoked. Results: Obesity prevalence (BMI ≥30 kg/m2) differed significantly across groups: 33.0% (ever vaped, ever smoked); 27.7% (ever vaped, never smoked); 33.1% (never vaped, ever smoked); 32.1% (never vaped, never smoked), p < .001. Groups also differed demographically. Logistic regressions adjusted for demographics revealed subjects in the never vaped, ever smoked group were significantly more likely to have obesity relative to those in the never vaped, never smoked group (p < 0.001) with vaping status having no main effect. Secondary analyses using never smokers as the reference found current smokers were less likely to have obesity and former smokers were more likely to have obesity, p < .001. Discussion: The present study is the first to characterize U.S. obesity prevalence among e-cigarette and tobacco users. Obesity prevalence was lower in the ever vaped, never smoked group; however, this finding appears to be attributable to demographic variables. As e-cigarette use becomes more common, future research should examine the development and maintenance of obesity among users.

Home access to a weight scale in the Hispanic/Latino population attending a community-based free clinic

Background

Daily weighing has been shown to help with weight management. In primary care, the majority of virtual visits will ask patients about their weight. However, little is known about whether patients, especially those in the Hispanic/Latino population, have access to a weight scale. Our aim was to determine scale access and perceived height and weight in the Hispanic/Latino population attending a volunteer, no cost, community clinic.

Methods

Questionnaires were issued to patients attending the community clinic and a comparator group attending a medically insured primary care practice.

Results

Only 52% of the Hispanic/Latino patients attending the community clinic had access to a scale compared with 85% of patients in the primary care office. Patients underreported weight and overreported height leading to underreporting body mass index by 0.6 ± 3.2 kg/m2.

Conclusions

Healthcare providers who care for uninsured Hispanic/Latino patients in community clinics may need to be aware that patients may not have access to a scale.

Infancy Dietary Patterns, Development, and Health: An Extensive Narrative Review

Correct dietary patterns are important for a child’s health from birth to adulthood. Understanding a child’s health as a state of entire physical, mental, and social well-being is essential. However, reaching adulthood in a complete health proper state is determined by feeding and dietary habits during preconception, pregnancy, or children infancy. Different factors, such as the mother’s lifestyle, culture, or socioeconomic status, are crucial during all these phases. In this review, we aimed to assess the long-term associations between infancy dietary patterns and health and their influence on development and growth. To reach this objective, a consensus critical review was carried out using primary sources such as scientific articles, and secondary bibliographic indexes, databases, and web pages. PubMed, SciELO, and Google Scholar were the tools used to complete this research. We found that high-income countries promote high-calorie foods and, consequently, obesity problems among children are rising. However, undernutrition is a global health issue concerning children in low- and middle-income countries; thus, parental socioeconomic status in early life is essential to children’s health and development, showing that biological, social, and environmental influences are increased risk factors for chronic diseases. This narrative review is aimed to collect evidence for early nutritional intervention and future disease prevention.

Patterns of physical activity parenting practices among parent-adolescent dyads who participated in a cross-sectional internet-based study

Background

While research exploring relationships between individual parenting practices and child physical activity (PA) exists, little is known about simultaneous use of practices. Hence, study objectives were to determine patterns of PA parenting practices and their associations with demographic, anthropometric, and PA measures in a large sample of parents and their adolescent children (12–17 years).

Methods

Dyadic survey data from Family Life, Activity, Sun, Health, and Eating (FLASHE), a cross-sectional, internet-based study, conducted in 2014 were analyzed using latent class analysis on 5 PA parenting practices – pressuring, guided choice, expectations, facilitation, and modeling. Self-report model covariates included adolescent age and parent and adolescent sex, body mass index category (based on height and weight), legitimacy of parental authority regarding PA (PA-LPA), and moderate-to-vigorous PA (MVPA).

Results

Based on 1166 parent-adolescent dyads, four latent classes were identified representing a continuum of practice use (high to low) – Complete Influencers (26%), Facilitating-Modeling Influencers (23%), Pressuring-Expecting Influencers (25%), and Indifferent Influencers (27%). Compared to dyads with parent underweight/healthy weight, dyads with parent overweight/obesity had 84% higher odds of belonging to Indifferent Influencers. Compared to dyads with adolescent underweight/healthy weight, dyads with adolescent overweight/obesity had 50 and 46% lower odds of belonging to Facilitating-Modeling and Indifferent Influencers. Odds of belonging to Pressuring-Expecting and Indifferent Influencers were less than 1% lower for every 1 min/day increase in parent MVPA and 2 and 4% lower for every 1 min/day increase in adolescent MVPA. Compared to dyads with high parental and adolescent agreement with PA-LPA, dyads with low agreement had between 3 and 21 times the odds of belonging to Facilitating-Modeling, Pressuring-Expecting, or Indifferent Influencers.

Conclusions

Findings suggest that parents utilize distinct patterns of PA practices ranging from use of many, use of some, to low use of any practice and these patterns are differentially associated with parent and adolescent PA. When planning PA interventions, a counseling or intervening approach with parents to use combinations of practices, like facilitation and modeling, to positively influence their adolescents’ and possibly their own participation in PA may prove more efficacious than parental pressuring or lack of practice use.

Data from Digital Health Devices Informs Ideal Cardiovascular Health

Ideal cardiovascular health is associated with a decrease in adverse cardiovascular events. The My Research Legacy study examined ideal cardiovascular health using the Life's Simple 7 survey and data from digital health devices. We hypothesized that digital devices provide a more objective view of overall cardiovascular health status than self-reported measures. Therefore, we analyzed weight and activity data recorded by digital devices to recalculate the Life's Simple 7 Health Score. All study participants (n = 1561) answered the survey, while a subgroup (n = 390) provided data from digital devices. Individuals with digital devices had a lower body mass index (BMI) and higher weekly minutes of vigorous exercise than participants without digital devices (p < 0.01). Baseline Health Scores were higher in individuals with digital devices compared to those without (7.0 ± 1.6 vs. 6.6 ± 1.6, p < 0.01). Data from digital devices reveal both increases and decreases in measured vs. self-reported BMI (p < 0.04) and weekly minutes of moderate and vigorous exercise activity (p < 0.01). Using these data, a significant difference was found between the recalculated and the self-reported Life's Simple 7 Health Score (p < 0.05). These findings suggest that incorporation of digital health devices should be considered as part of a precision medicinal approach to assessing ideal cardiovascular health.

A cross-sectional analysis of physical activity and weight misreporting in diverse populations: The Seattle Obesity Study III

BACKGROUND

In-person assessments of physical activity (PA) and body weight can be burdensome for participants and cost prohibitive for researchers. This study examined self-reported PA and weight accuracy and identified patterns of misreporting in a diverse sample.

METHODS

King, Pierce and Yakima county residents, aged 21-59 years (n = 728), self-reported their moderate-to-vigorous PA (MVPA) and weight, in kilograms. Self-reports were compared with minutes of bout-level MVPA, from 3 days of accelerometer data, and measured weights. Regression models examined characteristics associated with underreporting and overreporting of MVPA and weight, the potential bias introduced using each measure and the relation between perceived and measured PA and weight.

RESULTS

MVPA underreporting was higher among males and college educated participants; however, there was no differential MVPA overreporting. Weight underreporting was higher among males, those age 40-49 years and persons with obesity. Weight overreporting was higher among Hispanic participants and those reporting stress, unhappiness and fair or poor health. The estimated PA-obesity relation was similar using measured and self-reported PA but not self-reported weight. Perceived PA and weight predicted measured values.

CONCLUSION

Self-reported PA and weight may be useful should objective measurement be infeasible; however, though population-specific adjustment for differential reporting should be considered.

Associations between maternal and paternal feeding styles of infants in a racially diverse US birth cohort

BACKGROUND

Maternal feeding style has been associated with childhood obesity and has been the target of numerous interventions, but few studies included fathers.

OBJECTIVES

We assessed correlations and associations between maternal and paternal feeding style.

METHODS

We examined 202 mothers, fathers, and infants in Nurture, a racially diverse US cohort (2013-2017). Mothers and fathers completed the Infant Feeding Style Questionnaire when infants were 6 and 12 months. We examined unadjusted correlations using Spearman's Rho and adjusted associations using linear regressions.

RESULTS

All feeding styles were significantly correlated. After adjustment, maternal feeding style was associated with paternal feeding style at 6 and 12 months for responsive (ß 0.31; CI 0.18, 0.45; P ≤ 0.0001 and ß 0.67; CI 0.50, 0.84; P ≤ 0.0001), restrictive (ß 0.24; CI 0.09, 0.38; P = 0.001 and ß 0.44; CI 0.29, 0.59; P ≤ 0.0001), pressuring (ß 0.46; CI 0.34, 0.58; P ≤ 0.0001 and ß 0.51; CI 0.38, 065; P ≤ 0.0001), indulgent (ß 0.36; CI 0.20, 0.52; P ≤ 0.0001 and ß 0.57; CI 0.40, 0.73; P ≤ 0.0001), and laissez-faire (ß 0.39; CI 0.24, 0.55; P ≤ 0.0001 and ß 0.55; CI 0.37, 0.72; P ≤ 0.0001).

CONCLUSIONS

Maternal and paternal feeding styles were correlated. Associations held after adjustment, suggesting that mothers and fathers are in relative agreement in their reporting.