Original Article
Waist circumference percentiles in nationally representative samples of African-American, European-American, and Mexican-American children and adolescents

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Objective

To describe and provide estimates of the distribution of waist circumference (WC) according to percentiles in African-, European-, and Mexican-American children, and to test for group differences at different percentiles.

Study design

Cross-sectional data from the Third National Health and Nutrition Examination Survey (NHANES III) were examined. The sample evaluated included 9713 nonpregnant persons 2 to 18 years of age with measured values of WCs. Age-, sex-, and ethnicity-specific percentiles were estimated via percentile regression.

Results

WC measurements increased in a monotonic fashion across ages but at nonconstant rates and in a manner that varied across age and sex. At higher percentiles of the distribution, estimates of WC differ between Mexican-American (MA) and European-American (EA) and between African-American (AA) and European-American (EA), and, in some cases, exceeded the adult cutoff value for obesity-related disease risk at as early as 13 years of age.

Conclusion

Age-, sex-, and ethnicity-specific WC percentiles are available for US children and adolescents and can be used as an assessment tool that could impact public health recommendations. Results suggest concern with respect to high WC values among certain ethnic groups.

Section snippets

Subjects

Data from the Third National Health and Nutrition Examination Survey (NHANES III) were used for the study. A total of 9713 persons were included in the analysis: 3414 were African-American (AA), 2746 were European-American (EA), and 3553 were Mexican-American (MA). WC (cm) was measured by trained technicians using a tape measure at just above the uppermost lateral border of the right ilium, at the end of a normal expiration, and was recorded at the nearest millimeter, as described by the

Results

Table I, Table II, Table III show the WC estimated value for percentile regression for EA, AA, and MA children and adolescents according to sex, respectively. Percentile regression values were calculated for every group, even when the statistical tests indicated lack of differences between certain groups. Table IV shows the WC percentile regression values for males and females of all ethnic groups combined.

For the 10th percentile, WC as a function of age in MA girls was significantly different (

Discussion

The results of this investigation clearly demonstrate that the distribution of WC in a representative sample of US children and adolescents differs according to ethnic classification in boys and girls. In general, MA boys and girls have higher WC at the considered percentiles than AA or EA persons. African-American boys have lower WCs when compared with boys of other ethnic groups.

Our results also show that the rates of increase in WC as children become older differ among AA, EA, and MA of both

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Supported in part by NIH grants P30DK056336 and R01DK049779.

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