Waist-To-Height Ratio as a Screening Tool for Childhood Obesity: A Systematic Literature Review - Abstract
Background: Childhood obesity is growing worldwide and brings concerns that overweight or obese children are more likely to become obese as adults. Early diagnosis is of utmost importance, and for that purpose, WHtR is easy to use and interpret by the primary care physicians.
Objective: To examine the validity of the waist-to-height ratio as a tool for obesity screening in the pediatric population.
Data sources: The search for articles was conducted in the following databases: Medline (via PubMed), Scientific Electronic Library Online (SciELO), CAPES Bank of Theses and Dissertations, and Cochrane Library.
Study selection: The authors independently selected the studies in two steps, first by assessing the title and abstract, and then by reading the full text. Disagreements were resolved through consensus.
Data extraction: The data were summarized in a table covering the study site, year of publication, mean age and standard deviation, total sample size and percentage of boys, cutoff points and gender-related sensitivity and specificity, and risk of bias.
Results: The weighted average cutoff points of the examined studies were 0.459 (± 0.017) for girls and 0.473 (± 0.019) for boys, in the 6–18 year age group.
Limitations: There was one study from a single country responsible for the largest number of samples, which might have affected the results because of ethnic factors.
Conclusions: The WHtR cutoff point for children and adolescents aged 6 to 18 years should be lower than that determined for adults. Studies involving children from several countries are still needed to validate the appropriate cutoff point for childhood obesity diagnosis.