Skip to main content

Percentile curves for fat patterning in German adolescents

World Journal of Pediatrics volume 7, pages 16–23 (2011)Cite this article

Abstract

Background

Because the body composition of adolescents varies more than that of adults and anthropometric parameters are regularly used for pediatric body fat measurements, we developed age-, gender-, and ethnicity-specific reference values for waist circumference (WC), hip circumference (HC), waist-to-height ratio (WHtR), waist-to-hip ratio (WHR), and skinfold thickness (SFT) in German adolescents.

Methods

A representative sample of 1633 boys and 1391 girls aged 12–18 years participated in this cross-sectional study. Weight, height, body mass index (BMI), WC, HC, WHR, WHtR, and SFT were measured and smoothed; age-, gender-, and ethnicity-specific reference curves were developed using the LMS method.

Results

Females were significantly heavier than males at 12 years. Beyond age 14 males were significantly heavier and taller than females. The SFT sum increased continuously (+20%) in females and was significantly higher (7.4 mm) than in males. At the 90th percentile, SFTtriceps decreased (−12%) in males but increased (+11%) in females; SFTsubscapular increased in both genders. From 12 to 18 years, WHtR and WHR remained constant, whereas WC and HC increased in both genders. WHtR was the best predictor for abdominal obesity in males (area under the curve [AUC] 0.974 ± 0.004) and females (AUC 0.986 ± 0.003), followed by body fat percentage (AUC 0.937 ± 0.008) in males and WHR (AUC 0.935 ± 0.009) in females.

Conclusion

These age- and gender-specific percentile curves for SFT, WC, HC, WHR, and WHtR, derived from a large national sample of German adolescents, may be useful for developing international reference values for waist circumference and other predictors of adult obesity.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

43,34 €

Price includes VAT (Finland)
Tax calculation will be finalised during checkout.

References

  1. McCarthy HD, Jarrett KV, Emmett PM, Rogers I. Trends in waist circumferences in young British children: a comparative study. Int J Obes (Lond) 2005;29:157–162.

    CAS  Article  Google Scholar 

  2. Moreno LA, Fleta J, Sarría A, Rodríguez G, Gil C, Bueno M. Secular changes in body fat patterning in children and adolescents of Zaragoza (Spain), 1980–1995. Int J Obes Relat Metab Disord 2001;25:1656–1660.

    CAS  Article  PubMed  Google Scholar 

  3. Li C, Ford ES, Mokdad AH, Cook S. Recent trends in waist circumference and waist-to-height ratio among US children and adolescents. Pediatrics 2006;118:e1390–1398.

    Article  PubMed  Google Scholar 

  4. Inokuchi M, Matsuo N, Anzo M, Takayama JI, Hasegawa T. Age-dependent percentile for waist circumference for Japanese children based on the 1992–1994 cross-sectional national survey data. Eur J Pediatr 2007;166:655–661.

    Article  PubMed  Google Scholar 

  5. Belahsen R, Mohamed R, Mohamed M, Mohamed E. Obesity in North Africa. The 5th Asia Oceania Conference on Obesity. Int J Diab Dev Ctries 2008;28Suppl 1:1. (http://www.ijddc.com)

    Google Scholar 

  6. Pandey S, Bhaskaran A, Stringi M, Vaidya R. Childhood and adolescents obesity in affluent school children from Western suburb of Mumbai. The 5th Asia Oceania Conference Obesity. Int J Diab Dev Ctries 2008;28Suppl 1:S7. (http://.ijddc.com)

    Google Scholar 

  7. Kim DM, Ahn CW, Nam SY. Prevalence of obesity in Korea. Obes Rev 2005;6:117–121.

    CAS  Article  PubMed  Google Scholar 

  8. Kelishadi R. Childhood overweight, obesity, and the metabolic syndrome in developing countries. Epidemiol Rev 2007;29:62–76.

    Article  PubMed  Google Scholar 

  9. Eisenmann JC. Waist circumference percentiles for 7- to 15-year-old Australian children. Acta Paediatr 2005;94:1182–1185.

    Article  PubMed  Google Scholar 

  10. Ji CY; Working Group on Obesity in China (WGOC). Report on childhood obesity in China (4) prevalence and trends of overweight and obesity in Chinese urban school-age children and adolescents, 1985–2000. Biomed Environ Sci 2007;20:1–10.

    PubMed  Google Scholar 

  11. Irwin CE, Adams SH, Park J, Newacheck PW. Preventive care for adolescents: few get visits and fewer get services. Pediatrics 2009;123:e565–e572.

    Article  PubMed  Google Scholar 

  12. Alberti KG, Zimmet P, Shaw J; IDF Epidemiology Task Force Consensus Group. The metabolic syndrome—a new worldwide definition. Lancet 2005;366:1059–1062.

    Article  PubMed  Google Scholar 

  13. Zimmet P, Alberti G, Kaufman F, Tajima N, Silink M, Arslanian S, et al. The metabolic syndrome in children and adolescents. Lancet 2007;369:2059–2061.

    Article  PubMed  Google Scholar 

  14. Cole TJ, Bellizzi, Flegal KM, Dietz WH. Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ 2000:320:1240–1243.

    CAS  Article  PubMed  Google Scholar 

  15. National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents. The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics 2004;114:555–576.

    Article  Google Scholar 

  16. Schwandt P, Geiss HC, Ritter MM, Ublacker C, Parhofer KG, Otto C, et al. The prevention education program (PEP). A prospective study of the efficacy of family-oriented life style modification in the reduction of cardiovascular risk and disease: design and baseline data. J Clin Epidemiol 1999;52:791–800.

    CAS  Article  PubMed  Google Scholar 

  17. Schwandt P, Bischoff-Ferrari HA, Staehelin HB, Haas GM. Cardiovascular risk screening in school children predicts risk in parents. Atherosclerosis 2009;205:626–631.

    CAS  Article  PubMed  Google Scholar 

  18. World Health Organization. Physical status: the use and interpretation of anthropometry. Technical Report Series 854. Geneva: 1995.

  19. Geiss HC, Parhofer KG, Schwandt P. Parameters of childhood obesity and their relationship to cardiovascular risk factors in healthy prepubescent children. Int J Obes Relat Metab Disord 2001;25:830–837.

    CAS  Article  PubMed  Google Scholar 

  20. Slaughter MH, Lohman TG, Boileau RA, Horswill CA, Stillman RJ, Van Loan MD, et al. Skinfold equations for estimation of body fatness in children and youth. Hum Biol 1988;60:709–723.

    CAS  PubMed  Google Scholar 

  21. Schwandt P, Kelishadi R, Haas GM. First reference curves of waist: circumference for German children: The PEP Family Heart Study. World J Pediatr 2008;4:259–266.

    Article  PubMed  Google Scholar 

  22. Wang J, Thornton, Bari S, Williamson B, Gallagher D, Heymsfield SB, et al. Comparisons of waist circumferences measured at 4 sites. Am J Clin Nutr 2003;77:379–384.

    PubMed  Google Scholar 

  23. Mason C, Katzmarzyk PT. Effect of the site of measurement of waist circumference on the prevalence of the metabolic syndrome. Am J Cardiol 2009;103:1716–1720.

    Article  PubMed  Google Scholar 

  24. Sung RY, So HK, Choi KC, Nelson EAS, Li AM, Yin JA, et al. Waist circumference and waist-to-height ratio of Hong Kong Chinese children. BMC Public Health 2008;8:324.

    Article  PubMed  Google Scholar 

  25. Kelishadi R, Gouya MM, Ardalan G, Hosseini M, Motaghian M, Delavari A, et al. First reference curves of waist and hip circumferences in an Asian population of youths: CASPIAN study. J Trop Pediatr 2007;53:158–164.

    Article  PubMed  Google Scholar 

  26. Kelishadi R, Schwandt P, Haas GM, Hosseini M, Mirmoghtadaee P. Reference curves of anthropometric indices and serum lipid profiles in representative samples of Asian and European children. Arch Med Sci 2008;4:329–335.

    Google Scholar 

  27. Schwandt P, Kelishadi R, Haas GM. Ethnic disparities of the metabolic syndrome in population-based samples of German and Iranian adolescents. Metab Syndr Relat Disord 2010;8:95–98.

    Article  Google Scholar 

  28. Katzmarzyk PT, Srinivasas SR, Chen W, Malina RM, Bouchard C, Berenson GS. Body mass index, waist circumference and clustering of cardiovascular disease risk factors in a Biracial sample of children and adolescents. Pediatrics 2004;114:e198–e205.

    Article  PubMed  Google Scholar 

  29. Steinberger J, Jacobs Jr DR, Raatz S, Moran A, Hong CP, Sinaiko AR. Comparison of body fatness measurements by BMI and skinfolds vs dual energy x-ray absorptiometry and their relation to cardiovascular risk factors in adolescents. Intern J Obesity 2005;29:1346–1352.

    CAS  Article  Google Scholar 

  30. Sardinha LB, Going SB, Teixeira PJ, Lohman T. Receiver operating characteristic analysis of body mass index, triceps skinfold thickness, and arm girth for obesity screening in children and adolescents. Am J Clin Nutr 1999;70:1090–1095.

    CAS  PubMed  Google Scholar 

  31. Zimmermann MB, Gübeli C, Püntener C, Molinari L. Detection of overweight and obesity in a national sample of 6–12-y-old Swiss children: accuracy and validity of reference value for body mass index from US Centers for Disease Control and Prevention and the International Obesity Task Force. Am J Clin Nutr 2004;79:838–843.

    CAS  PubMed  Google Scholar 

  32. Nooyens AC, Koppes LL, Visscher TL, Twisk JW, Kemper HC, Schuit AJ, et al. Adolescent skinfold thickness is a better predictor of high body fatness in adults than is body mass index: the Amsterdam Growth and Health Longitudinal Study. Am J Clin Nutr 2007;85:1533–1539.

    CAS  PubMed  Google Scholar 

Download references

Author information

Affiliations

  1. Arteriosklerose-Praeventions-Institut Muenchen and Nuernberg, Muenchen and Nuernberg, Germany

    Gerda-Maria Haas, Evelyn Liepold & Peter Schwandt

Authors
  1. Gerda-Maria Haas
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Evelyn Liepold
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Peter Schwandt
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Peter Schwandt.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Haas, GM., Liepold, E. & Schwandt, P. Percentile curves for fat patterning in German adolescents. World J Pediatr 7, 16–23 (2011). https://doi.org/10.1007/s12519-011-0241-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12519-011-0241-4

Key words

  • German adolescents
  • skinfold thickness
  • waist circumference
  • waist-to-height ratio
  • waist-to-hip ratio