Waist Circumference Percentiles in Children and Adolescents

There is a considerable amount of data regarding waist-hip ratios in adults and children as it relates to the development of hyperlipidemia, insulin resistance, hypertension, and diabetes mellitus. It has been speculated that waist circumference alone may be a more useful and more easily obtainable index in both adults and children. Fernández and colleagues utilized the NHANES III data set to determine 10^th, 25^th, 50^th, 75^th, and 90^th percentiles for waist circumference by ethnic background. Data were analyzed from African-American (AA), European-American (EA), Mexican-American (MA) boys and for girls at each age from 2 years through 18 years. The data were gathered by trained technicians using a tape measure just above the uppermost border of the right ilium at the end of normal expiration. The raw data were modeled utilizing an indicator variable and logistic regression. The data set included 4769 boys and 4944 girls.

A number of important findings are observed. In general, MA boys and girls have higher waist circumferences than AA or EA children at each age, while AA boys have lower circumferences than the other ethnic groups. AA boys have a slower rate of increase in waist circumference as they age than do the other boys. MA girls have the fastest rate of increase of all girls. At the 75^th percentile, 16 and 17 year old MA and AA girls exceed the waist circumference cut-off point for obesity related co-morbidities in adult women. See Table for the abdominal circumference data of the entire population studied.

The authors carefully point out that these presentations are not standards of optimal circumference, but rather descriptions of actual findings among the United States childhood population. How the data relate to obesity co-morbidities or whether they have any predictive validity cannot be determined from these variables.

Table Estimated value for percentile regression for all children and adolescents combined, according to sex

The mean values differ among specific populations as compared with the combined population. An example is at the 90th percentile.

Data are differences in cm as compared with the mean combined population in the above table. For complete date of each population across all percentiles the reader is referred to the original article and its additional tables by Fernández et al. J Pediatr 2004;145:439-44.

Editor’s Comment: This manuscript should be an important reference in every pediatrician’s office. Although, as the authors state, the data merely describe observed waist circumference percentiles, they do not establish safe or healthy norms. However, it would certainly be accurate to consider those children whose waist circumferences fall above the 90^th percentile for age, gender, and ethnic background at significant risk for obesity related co-morbidities. Some may ask the rather obvious question, “Why measure and record this variable, when one’s eyes can surely tell that the child is obese?” Clearly, the morbidly obese child is at a high risk regardless of waist circumference. What are not known however, are the cut-off points of central adiposity for serious co-morbidities at different ages for different ethnic backgrounds and gender. Such information could be exceedingly important and only by careful recording and plotting of variables such as waist circumference will we be able to establish these cut-offs. Although the information provided by Fernández and colleagues may initially seem useful only to clinical researchers, it will probably be important to those who care for children.


Home	Search	Current issue	Archive	Site help
Current GGH - Vol. 24 No. 1 View table of contents Download PDF
Click here to subscribe