All Title Author
Keywords Abstract

Using Correction Equations Based on Measured Height and Weight Weakens Associations between Obesity Based on Self-Reports and Chronic Diseases

DOI: 10.1155/2013/890762

Full-Text   Cite this paper   Add to My Lib


Objective. Researchers have established a preponderance of height overestimation among men and weight underestimation among women in self-reported anthropometric data, which skews obesity prevalence data and obscures obesity-chronic disease relationships. The objective of this study was to reevaluate associations between obesity and chronic diseases using body mass index (BMI) correction equations derived from measured data. Methods. Measured height and weight (MHW) data were collected on a subsample of the 17,126 Atlantic Canadians who participated in the 2007-2008 Canadian Community Health Survey (CCHS). To obtain corrected BMI estimates for the 17,126 adults, correction equations were developed in the MHW subsample and multiple regression procedures were used to model BMI. To test obesity-chronic disease relationships, logistic regression models were utilized. Results. The correction procedure eliminated statistically significant relations ( ) between obesity and chronic bronchitis and obesity and stroke. Also, correction attenuated many relationships between adiposity and chronic disease. For example, among obese adults, there was a 13%, 12%, and 7% reduction in the adjusted odds ratios for asthma, urinary incontinence, and cardiovascular disease, respectively. Conclusion. Further research is needed to fully understand how the usage of self-reported data alters our understanding of the relationships between overweight or obesity and chronic diseases. 1. Introduction With over one billion people overweight (body mass index (BMI) 25.0–29.9?kg/m2) and 500 million obese (BMI ≥ 30.0?kg/m2), the World Health Organization (WHO) considers obesity to be a global epidemic [1, 2]. Obesity is listed as a risk factor for cardiovascular disease (CVD, that is, hypertension, stroke, congestive heart failure, and coronary artery disease), type 2 diabetes, several types of cancer (i.e., colorectal, kidney, breast, endometrial, ovarian, and pancreatic), asthma, gallbladder disease, osteoarthritis, and chronic back pain [3]. Besides the heavy toll on morbidity and mortality rates exacted especially by severe obesity [4, 5], excess body fat also reportedly has a substantial economic burden on society. In Canada, the direct medical cost of overweight and obesity was $6.0 billion in 2006 [6]. While research has shown that obesity is associated with a number of chronic health conditions [1, 7], the relationships, though still significant, may be weaker than once thought [8–12]. Most studies investigating the link between obesity and adverse health outcomes use


[1]  World Health Organization. Obesity and overweight, c2012,
[2]  World Health Organization. Controlling the global obesity epidemic. c2012,
[3]  D. P. Guh, W. Zhang, N. Bansback, Z. Amarsi, C. L. Birmingham, and A. H. Anis, “The incidence of co-morbidities related to obesity and overweight: a systematic review and meta-analysis,” BMC Public Health, vol. 9, article 88, 2009.
[4]  H. Jia and E. I. Lubetkin, “Trends in quality-adjusted life-years lost contributed by smoking and obesity,” American Journal of Preventive Medicine, vol. 38, no. 2, pp. 138–144, 2010.
[5]  H. M. Orpana, J. M. Berthelot, M. S. Kaplan, D. H. Feeny, B. McFarland, and N. A. Ross, “BMI and mortality: results from a national longitudinal study of Canadian adults,” Obesity, vol. 18, no. 1, pp. 214–218, 2010.
[6]  A. H. Anis, W. Zhang, N. Bansback, D. P. Guh, Z. Amarsi, and C. L. Birmingham, “Obesity and overweight in Canada: an updated cost-of-illness study,” Obesity Reviews, vol. 11, no. 1, pp. 31–40, 2010.
[7]  Public Health Agency of Canada and the Canadian Institute for Health Information. Obesity in Canada, The Agency and Institute, Ottawa, Canada, 2011.
[8]  S. Connor Gorber, M. Shields, M. S. Tremblay, and I. McDowell, “The feasibility of establishing correction factors to adjust self-reported estimates of obesity,” Health Reports, vol. 19, no. 3, pp. 71–82, 2008.
[9]  A. Chiolero, I. Peytremann-Bridevaux, and F. Paccaud, “Associations between obesity and health conditions may be overestimated if self-reported body mass index is used,” Obesity Reviews, vol. 8, no. 4, pp. 373–374, 2007.
[10]  M. Shields, S. Connor Gorber, and M. S. Tremblay, “Effects of measurement on obesity and morbidity,” Health Reports, vol. 19, no. 2, pp. 77–84, 2008.
[11]  M. Yannakoulia, D. B. Panagiotakos, C. Pitsavos, and C. Stefanadis, “Correlates of BMI misreporting among apparently healthy individuals: the ATTICA study,” Obesity, vol. 14, no. 5, pp. 894–901, 2006.
[12]  M. Shields, S. Connor Gorber, and M. S. Tremblay, “Estimates of obesity based on self-report versus direct measures,” Health Reports, vol. 19, no. 2, pp. 61–76, 2008.
[13]  M. Shields, S. Connor Gorber, I. Janssen, and M. S. Tremblay, “Bias in self-reported estimates of obesity in Canadian health surveys: an update on correction equations for adults,” Health Reports, vol. 22, no. 3, pp. 1–11, 2011.
[14]  Statistics Canada. Canadian Community Health Survey (CCHS): 2007 Microdata files user guide. c2008,
[15]  Statistics Canada. Canadian Community Health Survey (CCHS)-Annual component: User guide 2008 microdata files. c2009,
[16]  Health Canada. Canadian guidelines for body weight classification in adults: Quick reference tool for professionals. c2008,
[17]  C. L. Murray, G. W. Walsh, and S. Connor Gorber, “A comparison between Atlantic Canadian and National correction equations to improve the accuracy of self-reported obesity estimates in Atlantic Canada,” Journal of Obesity, vol. 2012, Article ID 492410, 7 pages, 2012.
[18]  M. Lalonde, A New Perspective on the Health of Canadians, Minister of Supply and Services, Ottawa, Canada, 1974.
[19]  US Surgeon General, Healthy People: The Surgeon General’s Report on Health Promotion and Disease Prevention, US Department of Health, Education and Welfare/Public Health Service, Washington, DC, USA, 1979.
[20]  K. Hayward and R. Colman, Population and Public Health Branch, Atlantic Regional Office, Health Canada. The Tides of Change: Addressing Inequity and Chronic Disease in Atlantic Canada, Health Canada, Halifax, Canada, 2003.
[21]  Public Health Agency of Canada, Tracking Heart Disease and Stroke in Canada, Public Health Agency of Canada, Ottawa, Canada, 2009.
[22]  D. Yach and R. Beaglehole, “Globalization of risks for chronic diseases demands global solutions,” Perspectives on Global Development and Technology, vol. 3, no. 1-2, pp. 213–233, 2004.
[23]  A. A. Santillan and C. A. Camargo, “Body mass index and asthma among Mexican adults: the effect of using self-reported vs measured weight and height,” International Journal of Obesity, vol. 27, no. 11, pp. 1430–1433, 2003.
[24]  P. M. Dubbert, T. Carithers, A. E. Sumner et al., “Obesity, physical inactivity, and risk for cardiovascular disease,” American Journal of the Medical Sciences, vol. 324, no. 3, pp. 116–126, 2002.


comments powered by Disqus