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(Mis)measurement in the study of food environment: we need better methods to solve the puzzle
  1. Joe Brew
  1. Correspondence to Joe Brew, Department of Epidemiology, University of Florida, Gainesville, FL 32610, USA; joebrew{at}

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Chaparro et al's study of the relationship between early childhood adiposity and nearby food environment represented an important examination of an understudied population. Although their conclusions are certainly thought-provoking, the methods by which they arrived at these conclusions, though common, left me with questions.

First, the authors characterise the advantages of weight-for-height z-score (WHZ) as ‘more appropriate’ than body mass index (BMI) for studying longitudinal adiposity. Although they are right to point out that WHZ has the advantage of being “independent of height at all ages,” they overlook the fact that over-time variability in WHZ is not independent of level of adiposity1 (figure 1). …

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  • Funding University of Florida (Graduate Student Award).

  • Competing interests None.

  • Provenance and peer review Not commissioned; internally peer reviewed.

  • i Figure generated by Joe Brew using R software and the RGL and car libraries. Data is “jittered” Alachua County Public Schools health screening data, as used in the Alachua County Health Department's Community Health Improvement Plan evaluation of youth obesity (2014).2–4

  • ii Figure generated by Joe Brew using R software.4 Base shapefiles provided by Census, 2010. U.S. Census Bureau.

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