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How well do waist circumference and body mass index reflect body composition in pre-pubertal children?



To investigate the quantitative relationship between waist circumference (WC) and height (Ht), and subsequently the association between waist circumference index (WCI), body mass index (BMI) and body composition in pre-pubertal children.


Cross-sectional sample (n=227; boys=127) of pre-pubertal black children (age range 8.8–11.0 years) from the Bone Health sub-study of the Bt20 birth cohort study set in Soweto-Johannesburg, South Africa. Measures of height, weight and WC by anthropometry, total and truncal fat and lean mass by dual-energy X-ray absorptiometry were used in the analysis. Pearson's correlation coefficients were used to examine the associations between BMI, WC and body composition outcomes.


WC was independent of height when height was raised to a power of 0.8. BMI and WCI (WC/Ht) were significantly associated with total and truncal fat and lean mass in both sexes (all P<0.001). BMI showed consistently and significantly higher correlations with body composition than WCI and this association was significantly greater for fat mass than lean mass.


BMI, rather than WCI, would be a better screening tool for total and truncal fat mass in both sexes before puberty.

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The Birth to Twenty birth cohort study receives financial support from the Medical Research Council of South Africa; the Anglo-American Chairman′s Fund; Child, Youth and Family Development of the Human Sciences Research Council of South Africa; and the University of the Witwatersrand. The Bone Health study is financially supported by the Wellcome Trust (United Kingdom) and the South African National Research Foundation.

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Correspondence to N Cameron.

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Contributors: NC was responsible for the study concept and design, interpretation of data and drafting of the paper. LLJ was responsible for data analysis and interpretation, and critical revision of the paper. PLG, SAN and JMP were responsible for interpretation of data and critical revision of the paper.

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Cameron, N., Jones, L., Griffiths, P. et al. How well do waist circumference and body mass index reflect body composition in pre-pubertal children?. Eur J Clin Nutr 63, 1065–1070 (2009).

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