Determinants of BMI underreporting in adults from families at high risk for type 2 diabetes in Europe: The Feel4Diabetes study

Aim The aim of this study was to investigate the determinants of body mass index (BMI) underreporting in adults from families at high risk for type 2 diabetes in Europe. Subject and methods In total, 3169 adults (65.3% females) from six European countries were included in this cross-sectional analysis using data from the baseline assessment of the Feel4Diabetes study. Anthropometric, sociodemographic, dietary, and behavioral data were assessed, and underreporting of BMI was calculated. Results Underreporting of BMI ranged from 20% to 84%. Women were 1.27 times more likely to underreport their BMI than men ( p = 0.01), while participants from Southeastern Europe were 1.52 times more likely to underreport their BMI than those residing in Central/Northern Europe ( p < 0.001). Furthermore, participants with BMI > 25 kg/m 2 and those with waist circumference (WC) ≥88 cm for women and ≥102 cm for men were 3.4 and 2.6 times more likely to underreport their BMI, respectively ( p < 0.001). Regarding the clinical status of the participants, the existence of (pre)diabetes, hypertension (HTN), and metabolic syndrome (MS) was also associated with underreporting of BMI. More specifically, participants with (pre)diabetes, HTN, and MS were 1.4, 1.6, and 1.8 times more likely to be under-reporters ( p = 0.001, p = 0.003, and p < 0.001, respectively). Conclusion Given the increasing global rates of noncommunicable diseases (NCDs), having a more precise estimation of obesity is crucial in order to develop effective public health policies that promote obesity prevention and contribute to the battle against obesity and NCDs.