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  • Pediatric Original Article
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Waist circumference-to-height ratio predicts adiposity better than body mass index in children and adolescents

International Journal of Obesity volume 37, pages 943–946 (2013)Cite this article

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Abstract

Objective:

Body mass index (BMI) is the surrogate measure of adiposity most commonly employed in children and adults. Waist circumference (WC) and the waist circumference-to-height ratio (WCHt) have been proposed as markers of adiposity-related morbidity in children. However, no study to date has compared WCHt, WC, BMI and skinfolds thickness for their ability to detect body adiposity.

Aim:

To compare WCHt, WC, BMI and skinfolds for their accuracy in predicting percent body fat (PBF), percent trunk fat (PTF) and fat mass index (FMI) in a large sample of children and adolescents.

Design, setting and participants:

We studied 2339 children and adolescents aged 8–18 years from the US National Health and Nutrition Examination Survey 2003/2004. Body fat was measured using dual-energy X-ray absorptiometry. Multivariable regression splines were used to model the association between PBF, PTF, FMI and the predictors of interest.

Results:

WCHt alone explained 64% of PBF variance as compared with 31% for WC, 32% for BMI and 72% for the sum of triceps and subscapular skinfolds (SF2) (P<0.001 for all). When age and gender were added to the predictors, the explained variance increased to 80% for the WCHt model, 72% for the WC model, 68% for the BMI model and 84% for the SF2 model. There was no practical advantage to add the ethnic group as further predictor. Similar relationships were observed with PTF and FMI.

Conclusions:

WCHt is better than WC and BMI at predicting adiposity in children and adolescents. It can be a useful surrogate of body adiposity when skinfold measurements are not available.

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Author information

Authors and Affiliations

  1. ASL Milano 2, Melegnano, Milano, Italy

    P Brambilla

  2. Clinical Epidemiology Unit, Liver Research Center, Basovizza, Trieste, Italy

    G Bedogni

  3. Albert Einstein College of Medicine, New York, NY, USA

    M Heo

  4. Verona University Medical School, Verona, Italy

    A Pietrobelli

  5. Pennington Biomedical Research Center, Baton Rouge, LA, USA

    A Pietrobelli

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  1. P Brambilla
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  2. G Bedogni
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  3. M Heo
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  4. A Pietrobelli
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Correspondence to P Brambilla.

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Author contributions

PB conceived the study, was responsible for it and drafted the manuscript; GB performed statistical analysis and codrafted the manuscript; MH designed the data collection process and revised the manuscript; AP coconceived the study and codrafted the manuscript; all authors read and approved the manuscript as submitted.

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Brambilla, P., Bedogni, G., Heo, M. et al. Waist circumference-to-height ratio predicts adiposity better than body mass index in children and adolescents. Int J Obes 37, 943–946 (2013). https://doi.org/10.1038/ijo.2013.32

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