OBJECTIVE: To examine the validity of self-reported weight and height and t
he resulting body mass index (BMI), and to explore the associations between
demographic, socioeconomic, and health-related factors on the one hand and
bias in self-reported weight and height on the other, in order to determin
e the groups most likely to exhibit bias.
DESIGN: Prospective cohort study.
SUBJECTS: 7350 middle-aged subjects, 5445 men and 1905 women, from the GAZE
L cohort, who have been followed up since 1989 and work at the French natio
nal company Electricite De France-Get De France (EDF-GDF) in various occupa
tions.
MEASUREMENTS: Self-reported weight and height were based on information fro
m yearly mailed questionnaires, and measured weight and height, used here a
s true values, were provided by occupational physicians from 1994 to 1997.
Sex, age, marital status, education, occupation, history of ischemic heart
disease, and treatment for cardiovascular risk factors were obtained from t
he mailed questionnaires or from data provided by the Company's personnel a
nd medical departments.
RESULTS: Strong correlations were found between measured and self-reported
values, but self-reported weight and height displayed significant systemati
c errors. Weight was significantly underestimated for men (0.54 kg) and for
women (0.85 kg), and height overestimated for men (0.38 cm) and women (0.4
0 cm). These biases led to significant underestimations of BMI (0.29 and 0.
44 kg/m(2) for men and women respectively). Consequently, the prevalence of
overweight, defined as BMI > 26.9 kg/m(2) for women and BMI > 27.2 kg/m(2)
for men, was also underestimated, by 13% for men and 17% for women. The fi
ve factors associated with bias in self-reported weight and height were: ov
erweight status, end-digit preference, age, educational level and occupatio
n.
CONCLUSION: These findings suggest that self-reported weight and height sho
uld be treated with caution, because of biases leading to misclassification
for overweight and obesity, especially in certain segments of the populati
on.