Establishing Waist-to-Height Ratio Standards from Criterion-Referenced BMI Using ROC Curves in Low-Income Children
College of Physical Activity and Sport Sciences
The purpose of this study was to establish health-related waist-to-height ratio (WHtR) cut-points associating with FITNESSGRAM’s body mass index (BMI) criterion-referenced standards in low-income children. A secondary aim was to examine the classification agreement between the derived WHtR cut-points and various cardiometabolic blood markers using current recommendations. Participants were 219 children from low-income schools (mean age = 10.5 ± 0.6 years). Waist circumference, height, weight, and cardiometabolic blood markers were collected in a fasting state before school hours. Receiver operating characteristic (ROC) curves were used to determine WHtR cut-points that associated with a child meeting FITNESSGRAM’s age- and sex-specific criterionreferenced standards for BMI. The derived WHtR cut-point was 0.50 (AUC = 0.89, 𝑝 < 0.001; sensitivity = 0.86, specificity = 0.82, and accuracy = 84.3%). Classification agreement using the derived WHtR cut-point with various blood marker standards was statistically significant but considered weak to fair (kappa 0.14–0.34, agreement = 59%–67%, and 𝑝 < 0.01). The WHtR cutpoint of 0.50 can be used with strong accuracy to distinguish low-income children who met FITNESSGRAM’s criterion-referenced standards for body composition; however, the evidence was weaker for its use in distinguishing low-income children meeting specific cardiometabolic blood marker recommendations.
Digital Commons Citation
Burns, Ryan D.; Brusseau, Timothy A.; Fang, Yi; Fu, You; and Hannon, James C., "Establishing Waist-to-Height Ratio Standards from Criterion-Referenced BMI Using ROC Curves in Low-Income Children" (2016). Faculty & Staff Scholarship. 2374.
Burns, R. D., Brusseau, T. A., Fang, Y., Fu, Y., & Hannon, J. C. (2016). Establishing Waist-to-Height Ratio Standards from Criterion-Referenced BMI Using ROC Curves in Low-Income Children. Journal of Obesity, 2016, 1–7. https://doi.org/10.1155/2016/2740538
Copyright © 2016 Ryan D. Burns et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.