How accurate are self-reported anthropometrics among the Japanese? A scoping review

Abstract

Objectives　Monitoring of obesity and underweight prevalence in general populations is crucial for the implementation of effective public health measures. Self-reported height and weight values are often used to assess the body mass index (BMI) in such epidemiological surveillance. However, it is known that using self-reported height and weight may underestimate the prevalence of obesity (BMI≥25 kg/m²), while its accuracy for underweight (BMI<18.5 kg/m²) prevalence is not well-understood. The aim of this study was to conduct a scoping review on the accuracy of self-reported anthropometrics in the Japanese population, where both obesity and underweight are prevalent.

Methods　Using PubMed and CiNii Research, a literature search was conducted for studies published in English or Japanese by 2022 that were conducted in Japan and compared self-reported and measured height, weight, or/and BMI. The study design and mean reported errors (mean of reported values－mean of measured values) were extracted and tabulated, and differences by BMI categories were also considered.

Results　A total of 17 studies, with 11 being published in English, were included in this review. These studies were conducted in nationwide cohort studies (n=4), local populations (n=4), workplaces (n=3), and educational institutions (n=6), with diverse age ranges (10–91 years) and sample sizes (<100 to >30,000). Although the degree of mean reporting error varied between studies, most of the studies reported that height was overreported, weight was underreported, and BMI was underestimated. In the three studies that reported mean reporting errors by BMI category, the direction of reporting error for height remained consistent across all body size categories, while weight and BMI were overreported and overestimated only among the underweight. Four studies in adults showed that 14.2–37.6% of actually obese individuals and 11.1–32.3% of underweight individuals were misclassified as ‘normal range’ (18.5≤BMI<25 kg/m²) based on self-reporting, while 0.8–5.4% and 1.2–4.1% of individuals actually within the normal range were misclassified as ‘underweight’ and ‘obese’ based on self-report, respectively.

Conclusion　This study suggests that using BMI based on self-reported height and weight can underestimate the prevalence of both obesity and underweight in the Japanese population. These biases should be taken into consideration when using self-reported anthropometrics in epidemiological studies.