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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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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DOI: https://doi.org/10.1038/ijo.2013.32
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