title: Developing waist-to-height ratio cut-offs to define overweight and obesity in children and adolescents.
abstract: OBJECTIVE
  The waist-to-height ratio (WHtR) assesses abdominal adiposity and has been proposed to be of greater value in predicting obesity-related cardiovascular health risks in children than BMI. The present study aims to develop WHtR cut-offs for overweight and obesity based on the 85th and 95th percentiles for the percentage body fat (%BF) in a cohort of children and adolescents.
  
  
  METHODS
  Waist circumference (WC), height, triceps and subscapular skinfolds were used to calculate WHtR and %BF. Correlations between WHtR and %BF and WHtR/mid-abdominal skinfold were made. Receiver-operating characteristic (ROC) curve analysis was used to select WHtR cut-offs to define overweight and obesity. Subjects were grouped by WHtR cut-offs, and mean values for anthropometry, blood lipids and blood pressure (BP) variables were compared.
  
  
  METHODS
  Australian primary and secondary schools.
  
  
  METHODS
  A total of 2773 male (M) and female (F) subjects of the 1985 Australian Health and Fitness Survey, aged 8-16 years.
  
  
  RESULTS
  Correlation coefficients between WHtR and %BF were M: r = 0.73, F: r = 0.60, P < 0.01 and WHtR/mid-abdominal skinfold were M: r = 0.78, F: r = 0.65, P < 0.01. WHtR of 0.46(M) and 0.45(F) best identified subjects with > or = 85th percentile for %BF and 0.48(M) and 0.47(F) identified subjects with > or = 95th percentile for %BF. When comparing the highest WHtR group to the lowest, both sexes had significantly higher means for weight, WC, %BF, TG (male subjects only), systolic BP (female subjects only) and lower means for HDL cholesterol (P < 0.05).
  
  
  CONCLUSIONS
  WHtR is useful in clinical and population health as it identifies children with higher %BF at greater risk of developing weight-related CVD at an earlier age.
authors.affiliation: School of Medicine, Children's Nutrition Research Centre, The University of Queensland, Herston, QLD 4029, Australia. s.nambiar@uq.edu.au
authors.forename: Smita
authors.initials: S
authors.lastname: Nambiar
authors.forename: Ian
authors.initials: I
authors.lastname: Hughes
authors.forename: Peter Sw
authors.initials: PS
authors.lastname: Davies
mesh_terms: D000293:Adolescent; D000704:Analysis of Variance; D001315:Australia / Q000453:epidemiology; D001794:Blood Pressure; D001823:Body Composition; D001827:Body Height; D001835:Body Weight; D002648:Child; D008076:Cholesterol, HDL / Q000097:blood; D005260:Female; D006801:Humans; D008297:Male; D009765:Obesity / Q000175:diagnosis* / Q000453:epidemiology; D050177:Overweight / Q000175:diagnosis* / Q000453:epidemiology; D015995:Prevalence; D012372:ROC Curve; D012016:Reference Values; D012737:Sex Factors; D012885:Skinfold Thickness; D014280:Triglycerides / Q000097:blood; D055105:Waist Circumference
chemical_list: D008076:Cholesterol, HDL; D014280:Triglycerides