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MÁLAGA, Spain – A new study presented at the European Congress on Obesity (ECO) 2025 reveals that a child’s waist-to-height ratio-a simple measure of central obesity-can effectively predict their risk for heart and metabolic diseases as early as age 10.
Key Findings from Danish Cohort
Researchers from Denmark’s Herlev and Gentofte Hospital tracked 736 children from birth to age 10 as part of the COPSAC2010 mother-child cohort. Over 13 years, the children were measured 14 times for waist circumference and height, and underwent comprehensive cardiometabolic risk assessments at age 10.
Lead researcher Dr. David Horner, MD, PhD, explained, “Central obesity in childhood matters, and the waist-to-height ratio offers a simple and effective marker that may help early identification of cardiometabolic and CVD risk.” He emphasized the importance of monitoring central obesity, not just weight, in routine pediatric care.
Three Distinct Trajectories
The study identified three groups based on how children’s waist-to-height ratios changed over time:
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Stable Reference Group (66%): Maintained a consistent ratio.
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High-Falling Group (18%): Started high, peaked at 2.5 years, then declined.
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Slow-Rising Group (15%): Gradually increased over the decade.
Children in the slow-rising group showed significantly higher cardiometabolic risk scores at age 10, including elevated blood pressure, higher triglycerides, increased insulin resistance, and more inflammatory markers. These findings suggest that gradual increases in central obesity during childhood are linked to greater heart and metabolic risks by age 10.
Waist-to-Height Ratio vs. BMI
Dr. Horner argued that waist-to-height ratio may be a more practical and accurate risk assessment tool than the widely used body mass index (BMI), especially for children. Unlike BMI, waist-to-height ratio distinguishes between fat and muscle mass and is consistent across ages and ethnicities.
Session co-moderator Dr. Andrew Agbaje, a pediatric clinical epidemiologist, praised the study: “Waist-to-height ratio has potential to replace BMI because it is cheaply and universally available. This study shows its validity in children, and its predictive value for conditions like fatty liver, diabetes, and heart failure is far better than BMI.”
Practical Implications
Interestingly, the researchers found that a child’s waist-to-height ratio at age 10 was as predictive of heart and metabolic risk as tracking their trajectory over time. “It’s the amount of central fat at the time of assessment that seems to play the biggest role in determining present-day risk,” Dr. Horner noted.
The findings highlight a critical window for early intervention. Monitoring and managing central obesity in children could help prevent future cardiovascular and metabolic diseases.
Disclaimer:
This article summarizes findings presented at a scientific conference and published by Medscape. The results are based on observational data and should not be interpreted as medical advice. Parents and caregivers concerned about their child’s health should consult a qualified healthcare professional for personalized guidance.
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