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SUPPLEMENT ARTICLES:
Nancy F. Krebs, John H. Himes, Dawn Jacobson, Theresa A. Nicklas, Patricia Guilday, and Dennis Styne
Assessment of Child and Adolescent Overweight and Obesity
Pediatrics 2007; 120: S193-S228 [Abstract] [Full text] [PDF]
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[Read P3R] An Alternative Assessment Method for Overweight
Henry S. Kahn, Giuseppina Imperatore, Yiling J. Cheng   (19 March 2008)

An Alternative Assessment Method for Overweight 19 March 2008
Top
Henry S. Kahn,
physician
National Center for Chronic Disease Prevention and Health Promotion (CDC),
Giuseppina Imperatore, Yiling J. Cheng

Send letter to journal:
Re: An Alternative Assessment Method for Overweight

hkahn{at}cdc.gov Henry S. Kahn, et al.

To the Editor.---

The recent Pediatrics article on “Assessment of Child and Adolescent Overweight and Obesity” (Krebs NF et al. Vol. 120 [Supplement] December 2007, pp. S193-S228) focused on defining obesity by using methods that should be accurate, appropriate, quick, and evidence-based. Although the authors described advantages and problems when using the body mass index, skinfolds, and waist circumference, we were surprised that their review made no mention of the waist/height ratio.

We consider the waist/height ratio to be a practical index that might simplify the clinical and epidemiologic recognition of cardiometabolic risk among young patients.1-4 In addition, since waist circumference5 and visceral abdominal fat6 are inversely related to children’s physical activity, the waist/height ratio might also serve for the simplified and easily comprehensible monitoring of exercise interventions among growing children.

A longitudinal study has recently provided reason to question whether children’s changes in body mass index (SD-score) or sum of skinfolds are adequate to describe their changes in metabolic risk as estimated by insulin resistance or the concentrations of circulating triglycerides, HDL -cholesterol, and adiponectin.7

Henry S. Kahn, MD, Giuseppina Imperatore, MD, PhD, Yiling J. Cheng, MD, PhD

The opinions expressed in this correspondence are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention

Reference List

1. Hara M, Saitou E, Iwata F, Okada T, Harada K. Waist-to-height ratio is the best predictor of cardiovascular disease risk factors in Japanese schoolchildren. J Atheroscler Thromb 2002; 9:127-32.

2. Kahn HS, Imperatore G, Cheng YJ. A population-based comparison of BMI percentiles and waist-to-height ratio for identifying cardiovascular risk in youth. J Pediatr 2005; 146:482-8.

3. McCarthy HD, Ashwell M. A study of central fatness using waist-to -height ratios in UK children and adolescents over two decades supports the simple message - `keep your waist circumference to less than half your height'. Int J Obes 2006; 30:988-92.

4. Freedman DS, Kahn HS, Mei Z et al. Relation of body mass index and waist-to-height ratio to cardiovascular disease risk factors in children and adolescents: the Bogalusa Heart Study. Am J Clin Nutr 2007; 86:33-40.

5. Klein-Platat C, Oujaa M, Wagner A et al. Physical activity is inversely related to waist circumference in 12-y-old French adolescents. Int J Obes 2004; 29:9-14.

6. Saelens BE, Seeley RJ, van Schaick K, Donnelly LF, O'Brien KJ. Visceral abdominal fat is correlated with whole-body fat and physical activity among 8-y-old children at risk of obesity. Am J Clin Nutr 2007; 85:46-53.

7. Jeffery AN, Alba S, Murphy MJ et al. Behavior of insulin resistance and its metabolic correlates in prepubertal children: A longitudinal study (EarlyBird 32). Diabetes Care 2007; 30:2962-4.

Conflict of Interest:

None declared