Population-based references for waist and hip circumferences, waist-to-hip and waist-to-height ratios for children and adolescents, and evaluation of their predictive ability

Abstract

Childhood obesity is a public health problem globally as well as in Poland. This paper aimed to provide age- and sex-specific waist circumference, hip circumference, waist-to-height ratio and waist-to-hip ratio normative values for Polish children and adolescents aged 3 − 18 years for more precise monitoring of abdominal fat accumulation. The waist circumference, hip circumference, waist-to-height ratio and waist-to-hip ratio references were constructed with the lambda-mu-sigma (LMS) method using data from two nationally representative health surveys: the OLA study and the OLAF study, the largest available paediatric surveys in Poland which provided measured height, weight, waist, hip and blood pressure for 22,370 children and adolescents aged 3 − 18 years. The predictive ability of newly established references for overweight/obesity as defined by the International Obesity Task Force criteria and elevated blood pressure was tested with receiver operating characteristic. Abdominal obesity cut-offs linked to adult cardiometabolic cut-offs were established. Reference values for waist circumference, hip circumference, waist-to-height ratio and waist-to-hip ratio are presented, as well as waist circumference, waist-to-height ratio and waist-to-hip ratio cut-off values linked to adult’s cut-offs of cardiometabolic risk. The predictive value for overweight and obesity of population-based waist, hip and waist-to-height ratio references was outstanding–area under the receiver operating characteristic curve > 0.95 in both sexes, whereas with regard to the elevated blood pressure predictive ability was low—area under the receiver operating characteristic curve < 0.65. Conclusion: This paper presents the first waist, hip, waist-to-height ratio and waist-to-hip ratio references for Polish children and adolescents aged 3–18 years. The 90th and 95th percentile and cut-offs linked to adult thresholds for cardiometabolic risk are proposed as cut-offs for abdominal obesity. What is Known:• Waist circumference, waist-to-height ratio and waist-to-hip ratio are used to assess abdominal obesity in children and adults.• In Poland, there is no abdominal obesity and hip circumference references for children and adolescents from 3 to 18 years of age. What is New:• Population-based references of central obesity indices and hip references for children and youth aged 3–18 years and cardiometabolic risk thresholds for children and adolescents linked to adult’s cut-offs were established.

Nutrition-Related Knowledge, Diet Quality, Lifestyle, and Body Composition of 7–12-Years-Old Polish Students: Study Protocol of National Educational Project Junior-Edu-Żywienie (JEŻ)

“…Further, body mass index (BMI, kg/m 2 ) and waist circumference to height ratio (WHtR) were calculated. First index is a measure of excessive body weight (and general obesity), while the second serves as a measure of central obesity and is useful in predicting cardiovascular risk factors both in children and adults [ 50 ].…”

“…The BMI and WHtR indices were categorized in accordance with the cut-off values for children and adolescents depending on age and gender based on percentile charts, assuming values between the 10th and 90th percentile as normal [ 50 , 51 ].…”

Impact of Covid-19 lockdowns on the anthropometric development in primary school children in the Rhein-Neckar Region, Germany

“…Eating habits, increased screen time and reduced physical activity were identified as factors connected to disproportional weight gain [ 19 , 29 ]. The definitions of overweight and obesity in children are centered around the standardized Body-Mass-Index (BMI) but additional related variables such as waist and hip circumferences are gaining importance [ 30 ].…”

Comparison of Several Anthropometric Indices Related to Body Fat in Predicting Cardiorespiratory Fitness in School-Aged Children—A Single-Center Cross-Sectional Study

“…Certain somatic measures: body weight (BW), waist circumference (WC), body fat (BF) and anthropometric indices: body mass index (BMI), waist-to-height ratio (WHtR) or waist-hip ratio (WHR) are considered potential predictors of chronic diseases and of an increased risk of all-cause mortality [1][2][3][4][5][6]. The results of studies from all around the world indicate that the assessment of anthropometric indices is of key importance, e.g., in early diagnosis and prevention of metabolic syndrome in children and youth [7], in identifying pediatric patients with cardiometabolic risk [8], in screening for high blood pressure in teenagers [9], in the assessment of central obesity [10], in prediction of early health risks related to central obesity [4] or in identifying cardiovascular disease (CVD) risk factors in an adult population [11].…”

“…The accurate assessment of CRF and BF levels requires specialistic equipment. Hence, CRF is often estimated by means of field-based tests, e.g., the 20 m shuttle run test (20 mSRT) and predictive equations [33,[36][37][38][39][40][41]; on the other hand, for BF distribution, for the estimation of %BF as well as for determining central obesity, WC measurements, anthropometric indices and estimating equations are used [10,17]. In both cases (BF ad CRF), it is much simpler, cheaper and does not require specialistic equipment or laboratory conditions.…”