Abstract Aim To assess the application of current waist‐to‐height ratio (WHtR) and waist circumference (WC) evaluation criteria and identify preferred recommendations for public health practise. Materials and Methods Data were from three waves of the Chinese National Survey on Students Constitution and Health (CNSSCH) conducted in 2010, 2014 and 2019; abdominal obesity was classified using four WHtR and WC standards. Age‐ and sex‐specific WHtR and WC percentile curves were generated using the LMS method. Prevalence of central adiposity by WHtR/WC and general obesity by BMI were compared. Predictive performance of the criteria was validated using an independent dataset with cardiometabolic risk factors. Results WHtR percentile curves showed a relatively flat trend with age in both sexes compared to WC curves. Abdominal obesity prevalence increased significantly from 2010 to 2019 across all criteria: 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%) and international WC cut‐offs (7.95%–11.95%). All abdominal obesity criteria identified substantially more cases than BMI‐based general obesity in 2019 (8.14%). The Chinese WC cut‐offs showed superior predictive performance compared to the other three standards for cardiometabolic outcomes. Conclusions 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.
Zhang et al. (Fri,) studied this question.