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Effectiveness of Family-Based Behavior Change Interventions on Obesity-Related Behavior Change in Children: A Realist Synthesis
Open AccessArticle

Is BMI a Valid Indicator of Overweight and Obesity for Adolescents?

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Department of Health Psychology and Research Methodology, Faculty of Medicine, P.J. Safarik University in Kosice, 040 01 Kosice, Slovakia
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Graduate School Kosice Institute for Society & Health, P.J. Safarik University in Kosice, 040 01 Kosice, Slovakia
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Department of Community & Occupational Medicine, University Medical Center Groningen, University of Groningen, 9713AV Groningen, The Netherlands
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Institute of Mathematics, Faculty of Natural Sciences, P.J. Safarik University in Kosice, 040 01 Kosice, Slovakia
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Department of Natural Sciences in Kinanthropology, Faculty of Physical Culture, Palacky University in Olomouc, 771 11 Olomouc, Czech Republic
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Olomouc University Social Health Institute, Palacky University in Olomouc, 771 11 Olomouc, Czech Republic
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Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2020, 17(13), 4815; https://doi.org/10.3390/ijerph17134815
Received: 4 May 2020 / Revised: 29 June 2020 / Accepted: 1 July 2020 / Published: 4 July 2020
(This article belongs to the Special Issue Obesity Prevention and Intervention in Children and Adolescents)
Background: Overweight and obesity are mostly monitored via the Body Mass Index (BMI), based on self-reported or measured height and weight. Previous studies have shown that BMI as a measure of obesity can introduce important misclassification problems. The aim of this study was to assess the validity of overweight and obesity classification based on self-reported and on measured height and weight versus the proportion of body fat as the criterion. Methods: We used data on 782 adolescents (mean age = 13.5, 55.8% boys) from the Health Behaviour in School-Aged Children (HBSC) study conducted in 2018 in Slovakia. We obtained self-reported (height and weight) and objective measures (height, weight) and the proportion of fat (as the criterion measure) measured via bioimpedance body composition analysis (BIA) with an InBody 230 from the adolescents. Results: Both measured and self-reported BMI indicated overweight and obesity with relatively low sensitivity (66–82%), but high specificity (90–92%). The superior accuracy of measured BMI in comparison to self-reported BMI was confirmed by the area under the curve (AUC) based on the receiver operating characteristics (ROC) curves (AUC measured/self-reported: 0.94/0.89; p < 0.001). The misclassification of overweight and obesity was significantly higher when using self-reported BMI than when using measured BMI. Conclusion: Both self-reported and measured BMI as indicators of overweight and obesity underestimate the prevalence of adolescents with overweight and obesity. View Full-Text
Keywords: adolescents; overweight; obesity; body mass index; body fat proportion adolescents; overweight; obesity; body mass index; body fat proportion
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Karchynskaya, V.; Kopcakova, J.; Klein, D.; Gába, A.; Madarasova-Geckova, A.; van Dijk, J.P.; de Winter, A.F.; Reijneveld, S.A. Is BMI a Valid Indicator of Overweight and Obesity for Adolescents? Int. J. Environ. Res. Public Health 2020, 17, 4815.

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