Waist circumference and waist-to-height ratio in Norwegian children 4-18 years of age: reference values and cut-off levels

Acta Paediatr. 2011 Dec;100(12):1576-82. doi: 10.1111/j.1651-2227.2011.02370.x. Epub 2011 Jun 16.


Aim: To establish reference values for waist circumference and waist-to-height ratio of Norwegian children.

Material: Data were collected in 2003-2006 as part of a cross-sectional study, including 5725 children 4-18 years of age. Reference curves were fitted with the LMS method; appropriate cut-offs were selected using receiver operating characteristic analysis.

Results: Reference values for waist circumference and waist-to-height ratio are presented. Mean waist circumference increased with age for both genders. Boys had a higher waist circumference at almost all ages. Mean waist-to-height ratio decreased until early adolescence and thereafter increased slightly towards adult age. There was a strong positive correlation between waist circumference and BMI (r = 0.907, p < 0.01) and a moderate positive correlation between waist-to-height ratio and BMI (r = 0.397 p < 0.01). A waist circumference cut-off value of 1.0 SDS (85th percentile) gave a sensitivity of 79% and a specificity of 94% to detect overweight. A cut-off value of 1.6 SDS (95th percentile) gave a sensitivity of 94% and a specificity of 96% to detect obesity.

Conclusion: This study presents the first reference values of waist circumference and waist-to-height ratio for Norwegian children 4-18 years, which also represent the first reference in Scandinavian schoolchildren. The 85th and 95th percentiles of waist circumference are proposed as appropriate cut-offs for central overweight and obesity.

MeSH terms

  • Adolescent
  • Body Height*
  • Body Mass Index*
  • Child
  • Child, Preschool
  • Cross-Sectional Studies
  • Female
  • Humans
  • Male
  • Norway
  • Obesity / diagnosis*
  • ROC Curve
  • Reference Values
  • Sex Factors
  • Waist Circumference*