Distribution of waist-to-hip ratio, other indices of body fat distribution and obesity and associations with HDL cholesterol in children and young adults aged 4-19 years: The Third National Health and Nutrition Examination Survey

Int J Obes Relat Metab Disord. 1999 Jun;23(6):556-63. doi: 10.1038/sj.ijo.0800866.


Background: Little data has been published on the association of indices of body fat distribution and HDL cholesterol (HDL), a risk factor for cardiovascular morbidity, in representative samples of total populations of children and adolescents including blacks and Hispanics.

Objective: To describe the distribution of waist-to-hip ratio (WHR) in US children and adolescents and to assess the association with HDL.

Design: Cross-sectional survey of a large national sample, the Third National Health and Nutrition Examination Survey.

Participants: People aged 4-19 y.

Measurements: Body circumferences, skinfold thickness, body mass index (BMI), and serum total and HDL cholesterol concentrations.

Results: Mean WHR varied consistently with age, gender, and ethnic group. Levels were highest in Mexican Americans. WHR showed significant negative associations with HDL cholesterol concentration and positive associations with the ratio of total serum cholesterol to HDL in pre- and postpubertal girls independent of age and BMI. However, associations were often not as strong as those with BMI. Other indices of body fat distribution were not superior to WHR.

Conclusion: Further research is needed on the association of WHR, other indices of body fat distribution and HDL measured in childhood with subsequent risk of atherosclerosis.

MeSH terms

  • Adolescent
  • Adult
  • African Americans / statistics & numerical data
  • African Continental Ancestry Group
  • Age Distribution
  • Body Constitution*
  • Body Mass Index
  • Child
  • Child, Preschool
  • Cholesterol / blood
  • Cholesterol, HDL / blood*
  • Cross-Sectional Studies
  • European Continental Ancestry Group / statistics & numerical data
  • Female
  • Health Status Indicators*
  • Health Surveys
  • Hispanic Americans / statistics & numerical data
  • Humans
  • Male
  • Obesity / blood
  • Obesity / diagnosis*
  • Obesity / ethnology*
  • Sex Distribution
  • Triglycerides / blood
  • United States / epidemiology


  • Cholesterol, HDL
  • Triglycerides
  • Cholesterol