Letter to the Editor from Zhang: “International Waist Circumference Percentile Cutoffs for Central Obesity in Children and Adolescents Aged 6 to 18 Years”
Year: 2020
Type: letter
Abstract: The widespread prevalence of obesity in children and adolescents, with its attendant health risks, has become an important public health concern (1). Waist circumference (WC) and related indicators (indicating abdominal fat accumulation) may better predict the risk of cardiovascular disease (2). As of yet, international WC cutoffs to define central obesity in children and adolescents have not been proposed (3); waist-to-height ratio (WHtR), by contrast, has gained increasing interest as a measure of central obesity, independent of sex and age, with the simple public health message: “keep your waist circumference to less than half your height” (4). Fortunately, a set of international age- and sex-specific WC cutoffs, based on data from 8 countries (Bulgaria, China, Iran, Korea, Malaysia, Poland, Seychelles, and Switzerland), have just been established by Xi et al in 2020 (5). Based on a large sample, we examined the profiles of central obesity among children and adolescents by both WC cutoffs and WHtR. Data were obtained from a survey on students’ constitution and health in Shandong, China. A total of 42 296 children and adolescents (21 218 boys and 21 078 girls) aged 7–18 years were included in the analysis (the age- and sex-specific sample size was 1669–1901). Using WC cutoffs, the total prevalence of central obesity was 27.37% (95% confidence interval [CI]: 26.77–27.97%) for boys and 16.80% (95% CI: 16.30–17.30%) for girls. Using WHtR ≥ 0.5, the total prevalence of central obesity was 15.97% (95% CI: 15.48–16.46%) for boys and 7.63% (95% CI: 7.27–7.99%) for girls. A wide disparity in the results of the 2 criteria was observed, and a significant difference was observed in all age groups (P < 0.01). We speculate that the 0.5 threshold of WHtR may be a bit high for children and adolescents. Further research is needed to find which approach (the current WC cutoffs or WHtR ≥ 0.5) should be prioritized as a recommendation in practice.
Author: Ying-Xiu Zhang
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W3090631982