Waist Circumference Is Associated with Nutritional Risk and Bmi in Preschool Children in Primary Care Practice

Abstract

Background: Waist circumference (WC) is associated with diabetes and cardiovascular disease in adults, and cardiometabolic risk in older children. WC has not been thoroughly explored in healthy preschool children. Objective: To describe waist circumference in a large cohort of preschool children, and to evaluate associations with BMI. Design/Methods: A cross-sectional, prospective observational design was used. Healthy children 2-5 years attending well-child visits were recruited through the TARGet Kids! Network, a Primary Care Research Network including 10 community pediatrician practices and 2 large family medicine group practices, in Toronto, Canada. Questionnaires on demographics, lifestyle factors were administered. Height, weight, and WC of children and their accompanying parent were measured. WC was categorized into categories based on published normative data from the US. Associations between WC and BMI percentiles were measured using regression analysis. Results: 1007 children 2-5 years old were assessed. The mean age was 44 months, and 50% were male. The mean (SD) BMI %ile was 51.3 (30.8). 2.3% were underweight (BMI <5%), 13% were overweight (BMI 85-95%ile), and 5.7% were obese (>95%ile). The mean (SD) WC was 51.6 cm (4.7), and the mean (SD) WC %ile was 56.7 (30). When categorized according to published percentile groups, 6.2, 8.5, 22.4, 28.7, 24.3, and 10% of children were in the <10th, 10-24th, 25-49th, 50-74th, 75-90th, >90th%ile for WC, respectively. Higher WC was strongly associated with higher child BMI, parent BMI, parent WC (p<0.0001), and lower maternal education (p=0.02). Conclusions: WC was measured in a large cohort of healthy preschool children and was associated with child and parent BMI, and parent WC. Longitudinal data on WC in preschool children and associated health outcomes is needed.