Waist Circumference Is Not a Better Predictor than BMI for Childhood Diabetes

Measuring a patient's waist circumference is not a better method of identifying an increased risk of developing type 2 diabetes than measuring BMI.

According to a recent study performed by University of Michigan researchers, measuring a patient’s waist circumference is not a better method of identifying children with an increased risk of developing type 2 diabetes than taking a body mass index (BMI) measurement.

The study was led by Joyce M. Lee, MD, a pediatric endocrinologist from University of Michigan’s C.S. Mott Children's Hospital.

Rates of obesity and type 2 diabetes have skyrocketed in the United States in recent years, leading to a search for new ways to identify children at high risk of developing the conditions; generally, children with high insulin levels are most at risk for developing type 2 diabetes.

The American Academy of Pediatrics (AAP) recommends utilizing measuring a child’s BMI in a primary care setting order to predict a child’s risk. Recently, however, researchers have begun investigating whether there are better methods available.

"There is increasing interest in measuring waist circumference in children to assess for chronic disease risk," reported Lee, a member of the Child Health Evaluation and Research (CHEAR) Unit. "Providers may be unsure of whether they should be measuring body mass index, weight circumference or both to determine those risks.”

"Waist circumference measures excess fat around the belly, which is an important risk factor for type 2 diabetes," Lee continued. "It has been suggested that waist circumference should be used instead of BMI for prediction of diabetes risk."

The researchers gathered data from the National Health and Nutrition Examination Survey between the years of 1999 and 2002. They focused on BMI, waist circumference, fasting glucose, and insulin levels in an ethnically diverse sample of 1,571 adolescents.

Of the 1,571 adolescents studied, 12% of them suffered from insulin resistance; the researchers found that in the case of identifying these children, both the BMI and waist circumference measurement methods were equal.

"Waist circumference does not seem to provide a distinct advantage over BMI for identifying high-risk adolescents,” Lee said. “Our findings suggest that further studies are needed before waist circumference is included as part of routine pediatric primary care screening.”

Based on these findings, Lee and colleagues advised primary care doctors to continue using the BMI measurement for now, as is recommended by the AAP.

This study was published online in the Journal of Adolescent Health.