Evaluating waist-to-height ratio (WHtR) and waist circumference (WC) cut‐offs for abdominal obesity among children and adolescents: Insights from three National Surveys in China
Authors' conclusion
The Chinese WC cut-offs and international cut-off (0.50) are optimal for childhood abdominal obesity screening in China due to their public health applicability. Standardized global criteria are urgently needed to enhance research comparability.
Study context
- Population
- Children and adolescents in the Chinese National Survey on Students Constitution and Health (CNSSCH), 2010, 2014 and 2019
- Exposure
- Four WHtR and WC criteria for abdominal obesity, vs BMI-based general obesity
- Outcome
- Abdominal obesity prevalence, 2010 to 2019
- Follow-up
- 2010–2019
Methodological detailsthree national survey waves (2010, 2014, 2019), LMS percentile curves, validation in independent dataset
- Three national survey waves (2010, 2014, 2019)
- LMS percentile curves
- Validation in independent dataset
Main finding
As reported in the abstract
International cut-off (0.46)
21.26%-27.66%
Chinese WC cut-offs
13.77%-19.64%
International WHtR cut-off (0.50)
9.12%-13.01%
International WC cut-offs
7.95%-11.95%
Observational data: associations, not effects.
Further findings
BMI-based general obesity prevalence · 2019
- BMI-based general obesity
- 8.14%
- All abdominal obesity criteria identified substantially more cases than BMI-based general obesity
Predictive performance for cardiometabolic outcomes
- Chinese WC cut-offs showed superior predictive performance vs the other three standards
- Independent validation dataset
Percentile curves
- WHtR percentile curves relatively flat with age in both sexes vs WC curves
Original publication
Evaluating WHtR and WC cut‐offs for abdominal obesity among children and adolescents: Insights from three National Surveys in China. Diabetes Obes Metab. Published 23 January 2026. doi:10.
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