ArticleThe American journal of clinical nutrition2015
Validity of the WHO cutoffs for biologically implausible values of weight, height, and BMI in children and adolescents in NHANES from 1999 through 2012.
Article in The American journal of clinical nutrition, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 42 papers.
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42 citing papers in PubMed, 102 citations in OpenAlex.
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- Gender and socio-economic differences in physical activity and fitness among rural Bangladeshi adolescents: a cross-sectional study from the 15-year follow-up of MINIMat cohort.Scientific reports · 2026Article
- The Chinese Eating Disorder Brief Screening Scale (CEDBS): Development and Psychometric Validation in General and Clinical Populations.The International journal of eating disorders · 2026Article
- Extreme Obesity (BMI ≥ 60 kg/mObesity (Silver Spring, Md.) · 2026Article
- Distinct spatial associations of adversity with hippocampal macro- and microstructure in early adolescence.bioRxiv : the preprint server for biology · 2026Article
- Epidemiology of children and adolescents undergoing surgery at Mexican public hospitals: a retrospective registry-based analysis from 2010 to 2022.BMC pediatrics · 2026Article
- Variations in Children's screen time behaviors by weight status among a mostly disadvantaged population.PloS one · 2026Article
- BMI-z score trajectories of Indonesian children and adolescents between 1993 and 2014 and associated risk factors.Public health nutrition · 2025Article
- Weight status of children and adolescents with autism spectrum disorder: A cross-sectional analysis of primary care electronic medical records and linked health administrative datasets in Ontario, Canada.Pediatric obesity · 2025Article
- Childhood BMI trajectories and sociodemographic factors in an Italian pediatric population.Scientific reports · 2025Article
- Using Electronic Medical Records to Estimate the Prevalence of Pediatric Obesity in Mississippi.Journal of public health in the deep South · 2025Article
- Accuracy of the international growth charts to diagnose obesity according to the body composition analysis in US children and adolescents.The British journal of nutrition · 2024Article
- Power and reproducibility in the external validation of brain-phenotype predictions.Nature human behaviour · 2024Article
- A better performing algorithm for identification of implausible growth data from longitudinal pediatric medical records.Scientific reports · 2024Article
- Association Between Early-Life Exposure to Antibiotics and Development of Child Obesity: Population-Based Study in Italy.JMIR public health and surveillance · 2024Article
- Identifying biologically implausible values in big longitudinal data: an example applied to child growth data from the Brazilian food and nutrition surveillance system.BMC medical research methodology · 2024Article
- Did child obesity decline after 2016 food regulations in Chile?Revista panamericana de salud publica = Pan American journal of public health · 2024Article
- The role of social norms, intergroup contact, and ingroup favoritism in weight stigma.PloS one · 2024Article
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Authors and funding
6 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundThe WHO cutoffs to classify biologically implausible values (BIVs) for weight, height, and weight-for-height in children and adolescents are widely used in data cleaning.
objectivesWe assess 1) the prevalence of these BIVs, 2) whether they were consistent with information on waist circumference, arm circumference, and leg lengths, and 3) the effect of their exclusion on the estimated prevalence of obesity in 2- to 19-y-olds in the NHANES, which is a study in which extreme values were verified when recorded.
designWe conducted cross-sectional analyses in 26,480 children and adolescents in the NHANES from 1999-2000 through 2011-2012.
resultsThe overall prevalence for a BIV for any body-size measure was 0.9% (n = 277), and almost all BIVs were due to extremely high, rather than low, values. Of 186 subjects who had a high BIV for weight or body mass index (BMI), all but one subject had both arm and waist circumferences that were greater than the sex- and age-specific 95th percentiles; 75% of subjects had circumferences greater than the 99th percentile. Of 63 subjects with a high height BIV, 75% of them had a leg length that was greater than the 95th percentile. The exclusion of children and adolescents with a BIV reduced the overall prevalence of obesity by ∼0.5 percentage points and by 1.7% in non-Hispanic blacks.
conclusionsMost of the extremely high values of weight, height, and BMI flagged as BIVs in the NHANES are very likely correct. The increase of z score cutoffs or the use of an alternative method to detect possible errors could improve the balance between removing incorrect values and retaining extremely high, but accurate, values in other data sets.
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