Developing waist-to-height ratio cut-offs to define overweight and obesity in children and adolescents

AbstractObjectiveThe waist-to-height ratio (WHtR) assesses abdominal adiposity and has been proposed to be of greater value in predicting obesity-related cardiovascular health risks in children than BMI. The present study aims to develop WHtR cut-offs for overweight and obesity based on the 85th and 95th percentiles for the percentage body fat (%BF) in a cohort of children and adolescents.DesignWaist circumference (WC), height, triceps and subscapular skinfolds were used to calculate WHtR and %BF. Correlations between WHtR and %BF and WHtR/mid-abdominal skinfold were made. Receiver-operating characteristic (ROC) curve analysis was used to select WHtR cut-offs to define overweight and obesity. Subjects were grouped by WHtR cut-offs, and mean values for anthropometry, blood lipids and blood pressure (BP) variables were compared.SettingAustralian primary and secondary schools.SubjectsA total of 2773 male (M) and female (F) subjects of the 1985 Australian Health and Fitness Survey, aged 8–16 years.ResultsCorrelation coefficients between WHtR and %BF were M:r= 0·73, F:r= 0·60,P< 0·01 and WHtR/mid-abdominal skinfold were M:r= 0·78, F:r= 0·65,P< 0·01. WHtR of 0·46(M) and 0·45(F) best identified subjects with ≥85th percentile for %BF and 0·48(M) and 0·47(F) identified subjects with ≥95th percentile for %BF. When comparing the highest WHtR group to the lowest, both sexes had significantly higher means for weight, WC, %BF, TG (male subjects only), systolic BP (female subjects only) and lower means for HDL cholesterol (P< 0·05).ConclusionsWHtR is useful in clinical and population health as it identifies children with higher %BF at greater risk of developing weight-related CVD at an earlier age.

Download Full-text

Relationship Among Adherence to The Mediterranean Diet and Anthropometric and Metabolic Parameters in Subjects with Obesity

Endocrine Metabolic & Immune Disorders - Drug Targets ◽

10.2174/1871530320999201111161220 ◽

2020 ◽

Vol 20 ◽

Author(s):

Luisa Lampignano ◽

Roberta Zupo ◽

Rossella Donghia ◽

Vito Guerra ◽

Fabio Castellana ◽

...

Keyword(s):

Mediterranean Diet ◽

Hdl Cholesterol ◽

Fat Distribution ◽

Serum Levels ◽

Overweight And Obesity ◽

Height Ratio ◽

Anthropometric Parameters ◽

Cross Sectional ◽

Waist To Height Ratio ◽

The Mediterranean

Background: There is moderate-to-high evidence that the Mediterranean diet prevents increases in body weight and waist circumference in non-obese individuals but less is known about its effects in subjects with overweight and obesity. The present study was focused on exploring the cross-sectional association among the adherence to Mediterranean diet and the most commonly used variables of metabolic and cardiovascular risk factors in a cohort of overweight subjects from a typical Mediterranean region, Apulia, in Southern Italy. Methods:: The study was performed in a cohort of 1214 individuals, all with overweight or obesity but no other clinical condition. We investigated the association among adherence to Mediterranean diet, assessed with the PREDIMED score, and anthropometric parameters [namely body mass index (BMI), WC, waist to height ratio (WHtR) and neck circumference (NC)], fasting serum levels of glucose, insulin, uric acid and lipids (triglycerides, total cholesterol, HDL cholesterol and LDL cholesterol), and blood pressure and insulin resistance, measured by HOMA-IR. Results:: The waist to height ratio was negatively associated to a PREDIMED score ≥7 (p<0.04), whereas HDL cholesterol was positively associated to a PREDIMED score ≥7 (p<0.04) Conclusion: This study suggests that body fat distribution and HDL-cholesterol are the parameters most strongly influenced by MedDiet in Apulian subjects.

Download Full-text

Body composition: population epidemiology and concordance in Australian children aged 11–12 years and their parents

BMJ Open ◽

10.1136/bmjopen-2018-023698 ◽

2019 ◽

Vol 9 (Suppl 3) ◽

pp. 95-105 ◽

Cited By ~ 5

Author(s):

Susan A Clifford ◽

Alanna N Gillespie ◽

Timothy Olds ◽

Anneke C Grobler ◽

Melissa Wake

Keyword(s):

Body Composition ◽

Waist Circumference ◽

Body Fat ◽

Correlation Coefficients ◽

Home Visits ◽

Overweight And Obesity ◽

Height Ratio ◽

Partial Correlations ◽

Waist To Height Ratio ◽

Parent Child

ObjectivesOverweight and obesity remain at historically high levels, cluster within families and are established risk factors for multiple diseases. We describe the epidemiology and cross-generational concordance of body composition among Australian children aged 11–12 years and their parents.DesignThe population-based cross-sectional Child Health CheckPoint study, nested within the Longitudinal Study of Australian Children (LSAC).SettingAssessment centres in seven major Australian cities and eight regional cities, or home visits; February 2015–March 2016.ParticipantsOf all participating CheckPoint families (n=1874), body composition data were available for 1872 children (49% girls) and 1852 parents (mean age 43.7 years; 88% mothers), including 1830 biological parent-child pairs.MeasuresHeight, weight, body mass index (BMI), waist circumference and waist-to-height ratio for all participants; body fat and fat-free mass by four-limb bioimpedence analysis (BIA) at assessment centres, or body fat percentage by two-limb BIA at home visits. Analysis: parent-child concordance was assessed using (i) Pearson’s correlation coefficients, and (ii) partial correlation coefficients adjusted for age, sex and socioeconomic disadvantage. Survey weights and methods accounted for LSAC’s complex sample design.Results20.7% of children were overweight and 6.2% obese, as were 33.5% and 31.6% of parents. Boys and girls showed similar distributions for all body composition measures but, despite similar BMI and waist-to-height ratio, mothers had higher proportions of total and truncal fat than fathers. Parent-child partial correlations were greatest for height (0.37, 95% CI 0.33 to 0.42). Other anthropometric and fat/lean measures showed strikingly similar partial correlations, ranging from 0.25 (95% CI 0.20 to 0.29) for waist circumference to 0.30 (95% CI 0.25 to 0.34) for fat-free percentage. Whole-sample and sex-specific percentile values are provided for all measures.ConclusionsExcess adiposity remains prevalent in Australian children and parents. Moderate cross-generational concordance across all measures of leanness and adiposity is already evident by late childhood.

Download Full-text

Screening of central obesity among normal-weight children and adolescents in Shandong, China

British Journal Of Nutrition ◽

10.1017/s0007114520004882 ◽

2020 ◽

pp. 1-25

Author(s):

Ying-xiu Zhang ◽

Jian Chen ◽

Xiao-hui Liu

Keyword(s):

Children And Adolescents ◽

Health Risks ◽

Central Obesity ◽

Total Population ◽

Final Analysis ◽

Normal Weight ◽

Overweight And Obesity ◽

Height Ratio ◽

Waist To Height Ratio ◽

Age And Sex

Abstract The prevalence of central obesity in total population has been reported in numerous studies. However, information on the prevalence of central obesity within normal category of body mass index (BMI) is scant. In the present study, we examined the profiles of central obesity among normal-weight children and adolescents. A total of 29 516 (14 226 boys and 15 290 girls) normal-weight children and adolescents (excluding underweight, overweight and obesity) aged 7–18 years were included in the final analysis. Central obesity was defined by the international age- and sex-specific cut-offs of waist circumference (WC) and threshold of waist-to-height ratio (WHtR≥0.5). All subjects were classified into four groups (Q1–Q4) according to the age- and sex-specific quartiles of BMI, those in the upper fourth (Q4) were defined as ‘high-normal BMI’, and those in the lower fourth (Q1) were defined as ‘low-normal BMI’. The prevalence of central obesity as measured by WC was 9.90% (95% CI 9.41–10.39%) for boys and 8.11% (95% CI 7.68–8.54%) for girls; by WHtR was 2.97% (95% CI 2.69–3.25%) for boys and 2.44% (95% CI 2.20–2.68%) for girls. Subjects in the ‘high-normal BMI’ group had a much higher prevalence of central obesity than their counterparts in the ‘low-normal BMI’ group (P<0.01). Central obesity was also evident among normal-weight children and adolescents. Our findings suggest that the health risks of children with normal-weight central obesity may be missed when BMI is used alone as a measure, it is meaningful to include WC in the clinical practice and to include the simple message “Keep your waist to less than half your height”.

Download Full-text

Effectiveness of a Multidisciplinary Lifestyle Intervention to Reduce Obesity among Children and Adolescents

Dhaka Shishu (Children) Hospital Journal ◽

10.3329/dshj.v35i2.49691 ◽

2020 ◽

Vol 35 (2) ◽

pp. 111-118

Author(s):

Md Rizwanul Ahsan ◽

Sabrina Makbul ◽

Probir Kumar Sarkar

Keyword(s):

Body Composition ◽

Body Weight ◽

Children And Adolescents ◽

Physical Performance ◽

Cardiometabolic Risk ◽

Dietary Habits ◽

Obese Children ◽

Height Ratio ◽

Waist To Height Ratio ◽

Family Based

Background: Now a days unhealthy lifestyle primarily responsible for the dramatic increase obesity among children and adolescents. Objective: The purpose of the study is to see the effects of a multidisciplinary lifestyle intervention to reduce obese children and adolescents. The main outcome was cardiometabolic risk based on the waist-to-height ratio (WHTR) measurement. Secondary outcomes were (1) changes in body composition; (2) adherence to a Mediterranean diet; and (3) physical performance. Methods: The study involved 64 overweight/obese children or adolescents conducted at Dhaka Shishu Hospital from October 2017 to September 2018. The intervention was multidisciplinary including nutrition, exercise, and psychological aspects based on a family-based approach; it was delivered for six months for children and three months for adolescents. Before and after the intervention, several anthropometric measures height, body weight, body mass index (BMI), waist circumference, and body composition, cardiometabolic risk index waist-to-height ratio (WHTR), and dietary habits of the participants and their families were evaluated. In addition, a set of functional motor fitness tests was performed to evaluate physical performance measures. Results: After the intervention both children and adolescents showed a significant reduction in body weight, BMI, waist circumference, fat mass, and WHTR index and an improvement of fat-free mass, adherence to the Mediterranean diet, and physical fitness performance. Conclusion: A short term family-based multidisciplinary approach is effective in ameliorating the health status, dietary habits, and physical performance in children and adolescents. DS (Child) H J 2019; 35(2) : 111-118

Download Full-text

Waist Circumference and Waist-to-Height Ratio Are More Highly Correlated to Body Mass Index than to Percentage Body Fat in Young Children

Journal of the American Dietetic Association ◽

10.1016/j.jada.2009.06.116 ◽

2009 ◽

Vol 109 (9) ◽

pp. A38

Author(s):

M. Boylan ◽

D. Feng ◽

M. Chyu ◽

Y. Chin ◽

C. Esperat

Keyword(s):

Body Mass Index ◽

Waist Circumference ◽

Young Children ◽

Body Mass ◽

Body Fat ◽

Height Ratio ◽

Percentage Body Fat ◽

Waist To Height Ratio ◽

Highly Correlated

Download Full-text

Waist-to-Height Ratio is an Accurate and Easier Index for Evaluating Obesity in Children and Adolescents*

Obesity ◽

10.1038/oby.2007.601 ◽

2007 ◽

Vol 15 (3) ◽

pp. 748-752 ◽

Cited By ~ 82

Author(s):

Weili Yan ◽

He Bingxian ◽

Yao Hua ◽

Dai Jianghong ◽

Cui Jun ◽

...

Keyword(s):

Children And Adolescents ◽

Height Ratio ◽

Waist To Height Ratio ◽

Obesity In Children

Download Full-text

Waist circumference in 6–12-year-old children: The Health Oriented Pedagogical Project (HOPP)

Scandinavian Journal of Public Health ◽

10.1177/1403494818767790 ◽

2018 ◽

Vol 46 (21_suppl) ◽

pp. 12-20 ◽

Cited By ~ 6

Author(s):

Per Morten Fredriksen ◽

Angelica Skår ◽

Asgeir Mamen

Keyword(s):

Body Mass Index ◽

Socioeconomic Status ◽

Waist Circumference ◽

Central Obesity ◽

Parental Education ◽

Education Level ◽

Overweight And Obesity ◽

Height Ratio ◽

Parental Education Level ◽

Waist To Height Ratio

Aims: With overweight and obesity increasing worldwide, it has become ever more important to monitor the development and distribution of adiposity in children. This study investigated how the measurements of waist circumference (WC) and waist-to-height ratio (WHtR) in children 6–12 years old relate to earlier studies. Methods: In 2015, 2271 children (boys, n = 1150) were measured for height, weight, and WC. Parental education level was used as a measure of socioeconomic status. Results: A significant increase in WC with age was revealed for both sexes ( p < .0001). Boys at 10 and 12 years had a larger WC than girls; otherwise no difference between sexes was found. The WHtR decreased with age for girls ( p < .0001); 14% of the sample displayed a WHtR ≥ 0.50. Comparison with earlier studies showed a higher WC and WHtR despite no change in weight and body mass index. Conclusion: WC and WHtR are recommended as tools for identifying central obesity in children. The results indicate increased WC in 6–12-year-old children compared with earlier findings.

Download Full-text

Physical activity, physical fitness, and cardiovascular health

10.1093/med/9780199232482.003.0025 ◽

2013 ◽

Author(s):

Jos Twisk ◽

Isabel Ferreira

Keyword(s):

Physical Activity ◽

Risk Factors ◽

Physical Fitness ◽

Children And Adolescents ◽

Cardiovascular Health ◽

Density Lipoprotein ◽

Hdl Cholesterol ◽

Cvd Risk Factors ◽

Cvd Risk ◽

Apo B

The incidence of morbidity and mortality related to CVD is rather low in a paediatric population. Studies investigating the relationship between physical activity, physical fitness, and cardiovascular health in children and adolescents are therefore mostly limited to CVD risk factors as outcome measures. For this reason, this chapter will focus on the association of physical activity and physical fitness with CVD risk factors in children and adolescents. These risk factors can be divided into the so-called traditional CVD risk factors; that is, lipoproteins [total cholesterol, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, triglycerides (TG)], blood pressure, body fatness, and diabetes, and ‘new’ CVD risk factors; that is, other lipoproteins [lipoprotein(a) (Lp(a)), apolipoprotein (apo)B, and apoA-1], coagulation and inflammation markers [fibrinogen, C-reactive protein (CRP)], homocysteine, and heart rate variability.

Download Full-text