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Validity of Body Image Pictogram to Determine Overweight/Obesity in Adults From Less Developed Populations: Results From Pars Cohort Study Publisher Pubmed



Bazdar S1 ; Sharifi MH2 ; Puostchi H3 ; Gandomkar A4 ; Malekzadeh R3 ; Malekzadeh F5 ; Vardanjani HM6
Authors
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Authors Affiliations
  1. 1. MPH Department, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
  2. 2. Research Center for Traditional Medicine and History of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
  3. 3. Liver, Pancreatic, and Biliary Diseases Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
  4. 4. Non-Communicable Disease Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
  5. 5. Digestive Diseases Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
  6. 6. MPH Department, School of Medicine, Research Center for Traditional Medicine and History of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran

Source: Archives of Iranian Medicine Published:2022


Abstract

Background: Despite the evidence for validity of body image pictogram (BIP) to discriminate overweight, obese, and normal individuals, there is little evidence on the probable effect of socio-demographic variables on its validity. To investigate the effects of socioeconomic status (SES), age, ethnicity, and educational level on the validity of BIP to discriminate normal weight, overweight, and obese people. Methods: We used the Pars Cohort Study (PCS) data. Stunkard’s BIP score was used as test measure. Participants were classified as normal (body mass index [BMI]<25), overweight (BMI=25 to 29.9), and obese (BMI≥29.9) based on their BMI (kg/m2). Area under curve (AUC) and its 95% CI were estimated and compared. Optimal cutoff points and their sensitivity, specificity, and likelihood ratio were reported. Results: A total of 9232 participants with a female/male ratio of 1.03 were included. The prevalence of overweight and obesity was 37.4% and 18.2%, respectively. Regardless of socio-demographic levels, the optimal cut-points to discriminate normal BMI from overweight, and overweight from obese participants were BIP score of four and five, respectively. Estimated AUC correlated with ethnicity (P<0.001) for both genders, and with SES for females (P<0.05). Conclusion: Although BIP may be a valid measure to categorize the general adult population into normal, overweight and obese, its validity depends on SES and ethnicity. BIP may be available as a proxy measure for BMI categories in socio-demographically homogeneous populations but not in heterogeneous populations. © 2022 Academy of Medical Sciences of I.R. Iran. All rights reserved.