Should pediatricians be measuring waist circumference?

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We know that BMI is the best clinical measure of overweight and obesity for pediatric patients. Increasingly, pediatricians are calculating BMI and determining that BMI percentile for their patients. In adults, it has been proposed that waist circumference, a measure of central obesity, is a more useful predictor of metabolic problems related to obesity than BMI.

In this issue of The Journal, Lee et al evaluated whether waist circumference was a better predictor of components of the metabolic syndrome than BMI in children and adolescents. They found that obesity-related health issues were best predicted by a combination of BMI and waist circumference. This suggests that the additional information gained by using waist circumference would be useful in the clinic.