Prevalence and Associations of Central Obesity among U.S. Children Ages 6-11: an Analysis of NHANES 2007-2016

Central obesity measures—such as waist circumference (WC) and waist-to-height ratio (WHtR)—were found to have additional predictive power to body mass index (BMI) in assessing cardiometabolic risk. Few studies have assessed how well central obesity measures compared to general obesity as defined by BMI predict vascular health risks among young children. The objective of this dissertation was to estimate the prevalence of central obesity and to assess their associations with dyslipidemia and hypertension among U.S. children ages 6 to 11 years based on the 2007-2016 National Health and Nutrition Examination Survey (NHANES). In 2015-2016, 15.8% of children overall were centrally obese as defined by WC; 29.8% were centrally obese as defined by WHtR; 17.4% were generally obese as defined by BMI. Hispanic American children had a significantly higher prevalence of central and general obesity than non-Hispanic white and black children, and those children living in a high-income family were less centrally obese as defined by WHtR. The study also observed that the prevalence of central obesity as defined by WC was significantly decreased during 2007-2008 through 2015-2016 (from 21.2% to 15.8%). Data suggested that WHtR is a better predictor for dyslipidemia, whereas BMI is a better predictor for hypertension among obesity indexes among U.S. children ages 6 to 11 years. This dissertation provides a foundation for developing childhood obesity-related public health strategies and considerations for pediatric clinicians in screening multi-ethnic groups of children. A more comprehensive investigation of the effectiveness of interventions to reduce WC related to vascular health outcomes can contribute to our understanding of how central fat mass in childhood affects an individual’s long-term health