Distribution of waist-to-hip ratio, other indices of body fat distributionand obesity and associations with HDL cholesterol in children and young adults aged 4-19 years: The Third National Health and Nutrition Examination Survey

BACKGROUND: Little data has been published on the association of indices of body fat distribution and HDL cholesterol (HDL), a risk factor for cardiov ascular morbidity, in representative samples of total populations of childr en and adolescents including blacks and Hispanics. OBJECTIVE: To describe the distribution of waist-to-hip ratio (WHR) in US c hildren and adolescents and to assess the association with HDL. DESIGN: Cross-sectional survey of a large national sample, the Third Nation al Health and Nutrition Examination Survey. PARTICIPANTS: People aged 4-19y. MEASUREMENTS: Body circumferences, skinfold thickness, body mass index (BMI ), and serum total and HDL cholesterol concentrations. RESULTS: Mean WHR varied consistently with age, gender, and ethnic group. L evels were highest in Mexican Americans. WHR showed significant negative as sociations with HDL cholesterol concentration and positive associations wit h the ratio of total serum cholesterol to HDL in pre- and postpubertal girl s independent of age and BMI. However, associations were often not as stron g as those with BMI. Other indices of body fat distribution were not superi or to WHR. CONCLUSION: Further research is needed on the association of WHR, other ind ices of body fat distribution and HDL measured in childhood with subsequent risk of atherosclerosis.