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The prevalence and validity of high, biologically implausible values of weight, height, and BMI among 8.8 million children
Author(s) -
Freedman David S.,
Lawman Hannah G.,
Pan Liping,
Skinner Asheley C.,
Allison David B.,
McGuire Lisa C.,
Blanck Heidi M.
Publication year - 2016
Publication title -
obesity
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.438
H-Index - 199
eISSN - 1930-739X
pISSN - 1930-7381
DOI - 10.1002/oby.21446
Subject(s) - national health and nutrition examination survey , medicine , odds , demography , obesity , cross sectional study , odds ratio , consistency (knowledge bases) , body mass index , physical activity , logistic regression , gerontology , environmental health , mathematics , physical therapy , population , pathology , geometry , sociology
Objective This study assessed the prevalence and consistency of high values of weight, height, and BMI considered to be biologically implausible (BIV) using cut points proposed by WHO among 8.8 million low‐income children (13.7 million observations). Methods Cross‐sectional and longitudinal analyses were performed among 2‐ to 4‐year‐olds who were examined from 2008 through 2011. Results Overall, 2.7% of the body size measurements were classified as BIVs; 95% of these BIVs were very high. Among the subset of children (3.6 million) examined more than once, most of those who initially had a high weight or BMI BIV also had a high BIV at the second examination; odds ratios were >250. Based on several alternative classifications of BIVs, the current cut points likely underestimate the prevalence of obesity by about 1%. Conclusions Many of the extremely high values of body size currently flagged as BIVs are unlikely to be errors. Increasing the z ‐score cut points or using a percentage of the maximum values in the National Health and Nutrition Examination Survey, could improve the balance between removing probable errors and retaining those that are likely correct.