Association of BMI measurements to waist circumference and waist-to-height ratio in overweight and obese children

  • Sindy Irenewati Medical Student, Universitas Diponegoro Medical School, Semarang, Central Java
  • Nahwa Arkhaesi Department of Child Heatlh, Universitas Diponegoro Medical School, Semarang, Central Java
  • Wistiani Wistiani Department of Child Heatlh, Universitas Diponegoro Medical School, Semarang, Central Java
Keywords: waist circumference; waist-to-height ratio; obesity; children

Abstract

Background Early monitoring of visceral fat is important to prevent the worsening of obesity in children. In recent years, waist circumference (WC) and waist-to-height ratio (WHtR) measurements have gained attention as an anthropometric indexes for obesity in children. They are an easy-to-use, inexpensive, specific to visceral fat and safe monitoring methods for children. International reference values, however, do not exist for any of the two measures to determine obesity in children.

Objective To compare WC and WHtR to body mass index (BMI) status in overweight and obese children aged 10-12 years.

Methods This cross-sectional study included overweight and obese children aged 10-12 years from four  primary schools in Semarang, Central Java.  Subjects underwent anthropometric measurements including weight, height, and waist circumference. Subjects were classified as obese (>=P95) or overweight (P85<=P<P95) using BMI percentiles according to age and sex. Chi-square test was used to assess for associations between categorical variables and multivariate logistic regression analysis was used to identify a dominant variable.

Results Forty-two obese and 23 overweight children were studied. Children with higher values of WC (PR=1.879) and WHtR (PR=8.352) had a higher prevalence of having higher BMI status (obese). Using multivariate analysis, WHtR was the more dominant variable associated with BMI status, compared to WC.

Conclusion Higher WC (cut off P90) and WHtR (cut off 0.5) have a significant associations with greater obesity children aged 10-12 years. Compared to WC, WHtR is a stronger predictive factor for obesity.

References

1. WHO. Global Health Risks: Mortality and burden of disease attributable to selected major risks. Geneva: WHO; 2009. p.2-3.
2. Rachmi CN, Li M, Alison Baur L. Overweight and obesity in Indonesia: prevalence and risk factors—a literature review. 2017;147:20–9. DOI:10.1016/j.puhe.2017.02.002.
3. Matsuzawa Y. Obesity and metabolic syndrome: the contribution of visceral fat and adiponectin. Diabetes Management. 2014;4:391–401. DOI:10.2217/dmt.14.30.
4. WHO. Obesity and overweight. Available from : https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight [cited Oct 18 2019].
5. Badan Penelitian dan Pengembangan Kementrian Kesehatan RI. Riset Kesehatan Dasar (Riskesdas). Jakarta: Kemenkes RI; 2013. p.397
6. Sherwood L. Fisiologi manusia dari sel ke sistem. 8th ed. Ong HO, Albertus Agung Mahode DR, editors. Jakarta: Penerbit Buku Kedokteran EGC; 2014. p900.
7. Tchernof A, Després J-P. Pathophysiology of human visceral obesity: An update. Physiol Rev. 2013;93:359-404. DOI: 10.1152/physrev.00033.2011.
8. World Health Organization. Waist circumference and waist-hip ratio: Report of a WHO Expert Consultation. Geneva: WHO; 2008. p.1
9. Magalhaes EI, Sant'Ana LF, Priore SE, Franceschini SC. Waist circumference, waist/height ratio, and neck circumference as parameters of central obesity assessment in children. Rev Paul Pediatr. 2014;32:273–81.DOI: 10.1590/0103-0582201432320.
10. Ashwell M, Hsieh SD. Six reasons why the waist-to-height ratio is a rapid and effective global indicator for health risks of obesity and how its use could simplify the international public health message on obesity. Int J Food Sci Nutr. 2005;56:303–7. DOI: 10.1080/09637480500195066.
11. CDC. Growth Charts - Clinical Growth Charts. 2000. Available from: https://www.cdc.gov/growthcharts/clinical_charts.htm. [cited Oct 18 2019].
12. CDC. Anthropometric reference data for children and adults: United States, 2007-2010 - National Center for Health Statistics. Vital Health Stat. 2012;11:2007–10. ISBN 0–8406-0655–9.

13. Choi DH, Hur YI, Kang JH, Kim K, Cho YG, Hong SM, et al. Usefulness of the waist circumference-to-height ratio in screening for obesity and metabolic syndrome among Korean children and adolescents: Korea National Health and Nutrition Examination Survey, 2010-2014. Nutrients. 2017;9:e256. DOI:10.3390/nu9030256.
14. Patnaik L, Pattnaik S, Rao EV, Sahu T. Validating neck circumference and waist circumference as anthropometric measures of overweight/obesity in adolescents. Indian Pediatr. 2017;54:377–80. DOI:10.1007/s13312-017-1110-6.
15. Chan DC, Watts GF, Barrett PHR, Burke V. Waist circumference, waist-to-hip ratio and body mass index as predictors of adipose tissue compartments in men. QJM. 2003;96:441–7. DOI:10.1093/qjmed/hcg069.
16. Mukherjee S, Leong HF, Wong XX. Waist circumference percentiles for Singaporean children and adolescents aged 6–17 years. Obes Res Clin Pract. 2016;10:S17–25. DOI: 10.1016/j.orcp.2016.04.004.
17. Mushtaq MU, Gull S, Abdullah HM, Shahid U, Shad MA, Akram J. Waist circumference, waist-hip ratio and waist-height ratio percentiles and central obesity among Pakistani children aged five to twelve years. BMC Pediatr. 2011;11:105. DOI: 10.1186/1471-2431-11-105.
18. Yoo EG. Waist-to-height ratio as a screening tool for obesity and cardiometabolic risk. Korean J Pediatr. 2016;59:425–31. DOI:10.3345/kjp.2016.59.11.425.
19. Cancelier AC, Trevisol D, Schuelter-Trevisol F. Waist-to-height ratio as a screening tool for childhood obesity: A systematic literature review. Ann Pediatr Child Health. 2018;6:1141. ISSN: 2373-9312.
20. Schröder H, Ribas L, Koebnick C, Funtikova A, Gomez SF, Fíto M, et al. Prevalence of abdominal obesity in Spanish children and adolescents. do we need waist circumference measurements in pediatric practice? PLoS One. 2014;9:e87549. DOI : 10.1371/journal.pone.0087549.
21. Vieira SA, Ribeiro AQ, Hermsdorff HHM, Pereira PF, Priore SE, Franceschini S. Waist-to-height ratio index or the prediction of overweight in children. Rev Paul Pediatr. 2018;36:52–8. DOI: 10.1590/1984-0462/;2018;36;1;00002.
22. Ayu R, Sartika D. Faktor risiko obesitas pada anak usia 5-15 tahun. MAKARA. 2011;15:37–43.
23. CDC. Middle Childhood (9-11 years old). Center for Disease Control and Prevention; 2019. Available from: https://www.cdc.gov/ncbddd/childdevelopment/positiveparenting/middle2.html. [cited Oct 18 2019].
24. Brannsether B, Roelants M, Bjerknes R, Júlíusson PB. Waist circumference and waist-to-height ratio in Norwegian children 4 – 18 years of age?: Reference values and cut-off levels. Acta Paediatr. 2011;100:1576–82. DOI: 10.1111/j.1651-2227.2011.02370.x.
25. Karundeng R, Wangko S, Kalangi SJR. Jaringan lemak putih dan jaringan lemak coklat. J Biomedik. 2014;6:8–16.
26. Calara S. Perbandingan pengukuran persentase lemak tubuh dengan skinfold caliper dan bioelectrical impedance analysis (Bia). UNDIP. 2014;1–15.
27. Ibrahim MM. Subcutaneous and visceral adipose tissue?: structural and functional differences. Obes Rev. 2010;11:11-8. DOI: 10.1111/j.1467-789X.2009.00623.x.
28. Zabeen B, Tayyeb S, Naz F, Ahmed F, Rahman M, Nahar J, et al. Prevalence of obesity and central obesity among adolescent girls in a district school in Bangladesh. Vol. 19, Indian J Endocrinol Metab. 2015;19:649-52. DOI: 10.4103/2230-8210.163193.
29. Freedman DS, Thornton JC, Mei Z, Wang J, Dietz WH, Pierson RN, et al. Height and adiposity among children.Obes Res. 2004;12:846–53. DOI:10.1038/oby.2004.102.
30. Mexitalia M, Utari A, Sakundarno M, Yamauchi T, Subagio HW, Soemantri A. Sindroma metabolik pada remaja obesitas (the metabolic syndrome among obese adolescents). Media Med Indones. 2009;43:300–6.
Published
2020-05-12
How to Cite
1.
Irenewati S, Arkhaesi N, Wistiani W. Association of BMI measurements to waist circumference and waist-to-height ratio in overweight and obese children. PI [Internet]. 12May2020 [cited 20Apr.2024];60(3):131-. Available from: https://www.paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/2360
Section
Pediatric Nutrition & Metabolic Disease
Received 2019-12-19
Accepted 2020-05-08
Published 2020-05-12