Waist-to-height ratio, waist circumference and BMI as indicators of percentage fat mass and cardiometabolic risk factors in children aged 3–7 years

• Published in: Clinical nutrition (Edinburgh, Scotland) Scotland), 2014-04, Vol.33 (2), p.311-315
• Main Authors: Sijtsma, Anna, Bocca, Gianni, L'Abée, Carianne, Liem, Eryn T, Sauer, Pieter J.J, Corpeleijn, Eva
• Format: Article
• Language: English
• Subjects: Adiponectin - blood; Adiposity; Anthropometry; Biological and medical sciences; Blood pressure; Blood Pressure - physiology; Body composition; Body Height; Body Mass Index; Cardiovascular Diseases - epidemiology; Child; Child, Preschool; Cholesterol; Cholesterol, HDL - blood; Cholesterol, LDL - blood; Cross-Sectional Studies; Electric Impedance; Feeding. Feeding behavior; Female; Fundamental and applied biological sciences. Psychology; Gastroenterology and Hepatology; Humans; Insulin; Interleukin-6 - blood; Leptin - blood; Linear Models; Lipid; Male; Overweight - blood; Overweight - complications; Pediatric Obesity - blood; Pediatric Obesity - complications; Risk Assessment; Risk Factors; Triglycerides - blood; Tumor Necrosis Factor-alpha - blood; Vertebrates: anatomy and physiology, studies on body, several organs or systems; Waist Circumference
• ISSN: 0261-5614; 1532-1983
• DOI: 10.1016/j.clnu.2013.05.010

Summary Objective To assess whether waist-to-height-ratio (WHtR) is a better estimate of body fat percentage (BF%) and a better indicator of cardiometabolic risk factors than BMI or waist circumference (WC) in young children. Methods WHtR, WC and BMI were measured by trained staff according to standardized procedures.2 H2 O and2 H218 O isotope dilution were used to assess BF% in 61 children (3–7 years) from the general population, and bioelectrical impedance (Horlick equation) was used to assess BF% in 75 overweight/obese children (3–5 years). Cardiometabolic risk factors, including diastolic and systolic blood pressure, HOMA2-IR, leptin, adiponectin, triglycerides, total cholesterol, HDL- and LDL-cholesterol, TNFα and IL-6 were determined in the overweight/obese children. Results In the children from the general population, after adjustments for age and gender, BMI had the highest explained variance for BF% compared to WC and WHtR ( R2  = 0.32, 0.31 and 0.23, respectively). In the overweight/obese children, BMI and WC had a higher explained variance for BF% compared to WHtR ( R2  = 0.68, 0.70 and 0.50, respectively). In the overweight/obese children, WHtR, WC and BMI were all significantly positively correlated with systolic blood pressure ( r  = 0.23, 0.30, 0.36, respectively), HOMA2-IR ( r  = 0.53, 0.62, 0.63, respectively), leptin ( r  = 0.70, 0.77, 0.78, respectively) and triglycerides ( r  = 0.33, 0.36, 0.24, respectively), but not consistently with other parameters. Conclusion In young children, WHtR is not superior to WC or BMI in estimating BF%, nor is WHtR better correlated with cardiometabolic risk factors than WC or BMI in overweight/obese children. These data do not support the use of WHtR in young children.